Early Adolescents Polysubstance Use Patterns: Longitudinal Changes and Bidirectional Relations with Externalizing Behaviors

项目摘要 青春期早期的物质使用与各种不良后果有关。早期青少年 通常开始使用一种以上的物质（即，多物质使用），这增加了他们的风险， 结果，包括成人物质使用障碍、精神健康障碍以及社会和法律的问题。 然而，很少有研究确定了早期青少年使用多种物质的模式。有一个 在青少年早期使用多种物质的发展以及风险和保护性知识方面存在重大差距 多物质使用的因素。有明确的证据表明，早期青少年的物质使用与 外化行为，包括身体攻击和犯罪行为。不太清楚的是 参与外化行为预测随后的物质使用变化，或者 物质使用预测外化行为的变化。此外，很少有研究证明理论 可以解释这些关系的机制。拟议研究的目标是解决先前的局限性 通过确定代表早期青少年多种物质使用模式的亚组， 他们的过渡随着时间的推移，并检查他们的共同和纵向的双向关系，与物理 侵略和犯罪。拟议的研究还将探讨同伴和照顾者因素作为潜在的 这些关系的调解人。这些目标与NIDA的目标一致，即确定 以及解决物质使用的现实世界复杂性的优先重点（主题3），包括 多种药物的使用和共同发生的健康状况。这些目标将通过分析4波 每3个月从2，755名早期青少年的主要非洲裔美国人样本中收集数据 生活在贫困和暴力发生率高的城市社区。潜跃迁分析和纵向 将使用交叉滞后结构方程模型来研究随时间的变化。具体目标是： 1)检查所有三所中学内部和之间的多物质使用模式的纵向变化 2）评估身体攻击和身体攻击之间的并行和纵向双向关系， 青少年犯罪和多种物质使用模式，以及3）探索同龄人青少年犯罪和护理人员知识， 中介或预测青少年的外化和物质使用行为随着时间的推移。差异 将对每个目标的性别和年级进行审查。研究结果将通过改进我们的 了解早期使用多种药物的风险，可能强调最佳干预时期，以及 确定可能的干预目标。此外，NRSA F31中概述的研究和培训， 博士奖学金申请将装备申请人的技能和指导需要追求一个 独立研究生涯，包括了解影响青少年药物使用的因素， 先进的纵向统计方法的能力，以及与科学写作相关的专业技能 和传播。

PROJECT SUMMARY Substance use during early adolescence is associated with a variety of adverse outcomes. Early adolescents often initiate use of more than one substance (i.e., polysubstance use), which increases their risk for negative outcomes, including adult substance use disorders, mental health disorders, and social and legal problems. However, few studies have identified patterns of polysubstance use among early adolescents. There is a critical gap in knowledge of how polysubstance use develops during early adolescence and risk and protective factors for polysubstance use. There is clear evidence that early adolescents’ substance use co-occurs with externalizing behaviors, including physical aggression and delinquent behavior. What is less clear is the extent to which engaging in externalizing behaviors predicts subsequent changes in substance use, or whether substance use predicts changes in externalizing behaviors. Moreover, few studies have tested theoretical mechanisms that may explain these relations. The goal of the proposed study is to address limitations of prior research by identifying subgroups representing patterns of early adolescents’ polysubstance use, establishing their transitions over time, and examining their concurrent and longitudinal bidirectional relations with physical aggression and delinquency. The proposed study will also explore peer and caregiver factors as potential mediators of these relations. These goals align with NIDA’s goal of identifying causes and consequences of substance use, and priority focus (Theme 3) of addressing real-world complexities of substance use, including polydrug use and co-occurring health conditions. The aims will be addressed through analysis of 4 waves of data that were collected every 3 months from a primarily African American sample of 2,755 early adolescents living in urban communities with high rates of poverty and violence. Latent transition analysis and longitudinal cross-lagged structural equation models will be used to examine changes over time. The specific aims are to: 1) Examine longitudinal changes in polysubstance use patterns within and across all three middle school grades, 2) Evaluate concurrent and longitudinal bidirectional relations between physical aggression and delinquency and polysubstance use patterns, and 3) Explore peer delinquency and caregiver knowledge as mediators or predictors of adolescents’ externalizing and substance use behaviors over time. Differences across sex and grade will be examined for each aim. The findings will inform prevention efforts by refining our understanding of risk for early polysubstance use, potentially highlighting optimal intervention periods, and identifying possible intervention targets. Moreover, the research and training outlined in this NRSA F31 pre- doctoral fellowship application will equip the applicant with skills and mentoring needed to pursue an independent research career, including knowledge of factors that impact adolescents’ substance use, competences in advanced longitudinal statistical methods, and professional skills related to scientific writing and dissemination.