Dynamic Links Between Risk Factors, Substance Use, and Consequences: Ages 18-35

描述（由申请人提供）：物质使用对公共健康有急性和慢性有害影响。然而，在人群、生命过程或出生队列中，使用风险并不相等。关于风险因素在何时以及对谁来说在青年期（YA）的物质使用（烟草，酒精，大麻和其他药物使用）中最重要的问题仍然没有答案，包括YA中物质使用导致成人健康后果的程度，如物质使用障碍（SUD），性风险行为和身心健康缺陷。基于生命历程的角度来看，该项目将朝着检查整个生命历程中的风险因素的显着性的发展变化，并记录长期物质使用后果出现的机制。我们将使用来自38个高中高年级队列（1976年至2013年）的国家面板数据，特别强调20个队列的个体，年龄在18至35岁之间（N~ 24，000）的纵向数据来自监测未来（MTF），以检查有关青少年和YA物质使用行为和成人健康结果的重要未回答问题。应用于MTF数据的前沿统计方法将用于模拟整个YA的风险因素和风险行为之间的动态关联，以及这些行为预测成人健康后果的程度。目标1将研究有关发展变化的流行病学和病因学的物质使用的年龄，队列，社会角色地位，和人口统计学亚组的问题。问题包括认知/态度风险因素与物质使用行为之间的联系随年龄变化的程度。目标2将研究YA物质使用对社会角色地位和健康进入成年的获取和时间的长期影响。例如，我们将研究社会角色在多大程度上介导了YA物质使用对成人健康后果的影响。目标3将侧重于传播新的和先进的方法技术，以检查公共卫生研究人员的风险因素，行为和后果。研究结果将促进我们对具有关键健康影响的物质使用行为的理解，并将为考虑个人行为，风险因素和社会角色的干预措施的制定提供信息，以找到减少青少年吸毒负面后果的策略。

DESCRIPTION (provided by applicant): Substance use has acute and chronic detrimental impacts on public health. However, risk for use is not conferred equally across the population, the life course, or birth cohorts. Central questions about when and for whom risk factors are most important in contributing to substance use (tobacco, alcohol, marijuana, and other drug use) in young adulthood (YA) remain unanswered, including the extent to which substance use in YA leads to adult health consequences such as substance use disorders (SUDs), sexual risk behaviors, and physical/mental health deficits. Based on a life course perspective, this project will move the field toward examining developmental changes in the salience of risk factors across the life course and toward documenting the mechanisms through which long-term substance use consequences emerge. We will use national panel data from 38 high school senior year cohorts (1976 to 2013), with specific emphasis on 20 cohorts of individuals with longitudinal data across ages 18 to 35 (N~24,000) from Monitoring the Future (MTF) to examine significant unanswered questions regarding adolescent and YA substance use behaviors and adult health outcomes. Leading-edge statistical methods applied to MTF data will be used to model the dynamic associations between risk factors and risk behaviors across YA, and the extent to which these behaviors predict adult health consequences. Aim 1 will examine questions regarding developmental changes in the epidemiology and etiology of substance use across ages, cohorts, social role statuses, and demographic subgroups. Questions include the extent to which the links between cognitive/attitudinal risk factors and substance use behaviors change with age. Aim 2 will examine the long-term consequences of YA substance use on the acquisition and timing of social role statuses and health into adulthood. For example, we will examine the extent to which social roles mediate the effect of YA substance use on adult health consequences. Aim 3 will focus on disseminating new and advanced methodological techniques for examining risk factors, behaviors, and consequences to public health researchers. Results will advance our understanding of substance use behaviors with critical health impacts, and will inform the development of interventions that take into account individual behaviors, risk factors, and social roles to find strategies for reducing the negative consequences of drug use in young adulthood.