Resilience through the High School Years

描述（由申请人提供）：这个重新提交的竞争性延续旨在扩展一个非常成功的纵向，诊断研究的345部落登记的Ojibwe儿童（年龄10-12岁，在第1波）和465他们的照顾者通过青春期和高中。延续将支持14岁以上的另外四波数据 16岁到17岁 19年了这项研究和它的同伴研究401 Ojibwe儿童和511他们的照顾者（一年前启动）构成了对这些年龄段的美国印第安儿童的唯一当代纵向诊断研究。这一延续的总体目标是调查前四波报告的早发性情绪/行为问题和精神障碍对适应，精神障碍，和精神卫生服务利用模式在关键的高中几年。该研究将使用前瞻性数据1）调查Ojibwe文化中存在的特定文化保护因素，这些因素可能会预防，延迟或减少早发性情绪和行为问题以及精神障碍的后果; 2）调查与Ojibwe儿童在高中期间的个人特征以及历史和社会背景相关的风险因素。我们的基线数据表明，在10-12岁和13-15岁之间，单一精神障碍的患病率从26.2%增加到44.8%，两种或两种以上精神障碍的患病率[从10.4%增加到26.6%]（DISC 4.0儿童和女性看护人报告）。保留地/保留地的历史和社会背景为美洲印第安人和加拿大第一民族青少年提供了独特的发展背景。这项前瞻性研究是理想的位置，以调查重要的文化差异的发展途径：1）它纳入了文化适应的关键结构的风险和保护因素; 2）它提供了创新的新的文化具体措施的风险和保护因素，创造了在研究的开始;和3）它将提供有关早期情绪发作的影响的信息/行为问题和精神障碍对青少年在高中阶段的关键转变和调整的影响。调查人员正在与部落政府密切合作，将这些调查结果转化为基于药物的预防措施，旨在减少Ojibwe儿童的早期情绪，行为和药物滥用问题。公共卫生相关性：这是目前唯一一项从10-12岁开始并持续到高中阶段的土著青少年纵向诊断研究。该研究已经记录了保留地和保留地的心理健康/药物使用危机，大约四分之一的青少年在13岁时达到行为障碍或药物滥用障碍的终身标准 15年终生单一精神障碍的患病率为44.8%，与全国科摩罗研究复制中的成年人的患病率相当。这些结果将在干预措施的最佳年龄、性别特有的风险和保护因素以及文化特有的风险和保护因素方面指导预防研究。

DESCRIPTION (provided by applicant): This resubmitted competitive continuation seeks to extend a highly successful longitudinal, diagnostic study of 345 tribally enrolled Ojibwe children (aged 10-12 years at wave 1) and 465 of their caretakers through adolescence and the high school years. The continuation would support four additional waves of data from ages 14 16 years through ages 17 19 years. This study and its companion study of 401 Ojibwe children and 511 of their caretakers (launched one year earlier) make up the only contemporary longitudinal diagnostic study of American Indian children at these ages.The overall goal of this continuation is to investigate the effects of early onset emotional/behavioral problems and mental disorders reported in the first four waves on adjustment, mental disorder, and mental health services utilization patterns during the critical high school years. The study will use prospective data to 1) investigate culturally specific protective factors that exist within the Ojibwe culture that may prevent, delay, or reduce the consequences of early onset emotional and behavioral problems and mental disorders; and 2) investigate risk factors that are associated with indiviudal characteristics and the historical and social contexts of Ojibwe children during their high school years. Our baseline data indicate the prevalence rate for a single mental disorder increased from 26.2 percent to 44.8 percent between the ages of 10-12 years and 13-15 years and that the prevalence of two or more mental disorders [more than doubled from 10.4 percent to 26.6 percent] (combined DISC 4.0 child and female caretaker reports). The historical and social contexts of reservations/reserve present a unique developmental context for American Indian and Canadian First Nations adolescents. This prospective study is ideally situated to investigate important cultural variation in developmental pathways: 1) it incorporates culturally adapted key constructs of risk and protective factors; 2) it provides innovative new culturally specific measures of risk and protective factors that were created at the study's onset; and 3) it will provide information regarding the influence of early onset of emotional/behavioral problems and mental disorders on critical transitions and adjustment as the adolescents move through their high school years. The investigators are working closely with the tribal governments to translate these findings into empirically-based preventions aimed at reducing early onset emotional, behavioral and substance abuse problems among Ojibwe children. PUBLIC HEALTH RELEVANCE: This is the only current longitudinal diagnostic study of Indigenous adolescents beginning at ages 10-12 years and continuing through the high school years. The study has already documented a mental health/substance use crisis on the reservations and reserves with approximately one-fourth of the youth meeting lifetime criteria for conduct disorder or a substance abuse disorder at ages 13 15 years. The prevalence of lifetime single mental disorders is 44.8 percent, a rate comparable to that of adults in the National Comorbidity Study Replication. These results will guide prevention research in terms of optimal ages for interventions, gender specific risk and protective factors, and culturally specific risk and protective factors.