Prevalence, onset and progression of substance use in adolescents and young adults with Autism Spectrum Disorders

项目摘要 青少年和青壮年自闭症的酒精使用和酒精使用障碍(AUD) 谱系障碍(ASD)被精神健康专业人员认为是罕见的。这 结论主要基于临床经验，作为有关酒精的经验性文献 和其他药物(AOD)在美国几乎不存在。斯堪的纳维亚健康登记研究 提示与普通公众相比，ASD人群中使用AOD的总体水平较低。临床 研究还表明，与正常人相比，被诊断为ASD的人的AOD发生率更低 被诊断出患有其他精神疾病。尽管如此，AOD使用率高达30% 在ASD人群中也有报道。此外，似乎还有一些亚群患有 自闭症，如与注意力缺陷多动障碍(ADHD)共发生的患者， AOD使用率和AUDS的显著比率不仅与其他精神病患者竞争 疾病，但也表明需要适当的识别和必要时的治疗。 重要的是，ASD的患病率估计在过去的10-20年里有所增加，而且有很大的 这一增长的比例包括认知和语言功能较高的个人。 自闭症人群的这一子集更有可能被纳入并暴露于标准型 教育和社会背景，增加了使用AOD的风险。文献有力地支持了 需要关于AOD患病率的详细和可靠的信息 美国患有自闭症的青少年和年轻人的样本。在本申请中，我们建议 评估一个大的、特征良好的、以人群为基础的ASD样本(罗德岛联合会 自闭症研究和治疗(RI-CART)，将使我们能够提供，到目前为止，在- 美国ASD人群中AOD使用和AUD患病率的深度特征，AS 以及有关AOD的发病和进展到更严重的使用和AUDS的速度的数据。 同样重要的是，需要核实或驳斥AOD的风险和保护因素 人口。我们将检查共病情况，特别关注ADHD和焦虑。 精神错乱。我们还将确定导致在关键路口使用AOD风险的因素 青少年和患有自闭症的年轻人，如向独立生活的过渡，这是 通常与更多的同龄人接触和较少的结构和社会控制有关。我们建议 研究12-24岁的RI-CART参与者(N=410)的子样本，他们要么有智商≥ 85或智商≥75，在一项4波纵向队列序列研究中，口语流利。我们 将研究AOD的使用与年龄的关系，以及与关键的发育转变的关系 (例如，进入高中或离开高中，进入有监督的生活或独立生活/大学)。

Project Summary Alcohol use and alcohol use disorders (AUD) in adolescents and young adults with autism spectrum disorders (ASD) have been considered rare by mental health professionals. This conclusion has primarily been based on clinical experience as the empirical literature on alcohol and other drug (AOD) use in the US is virtually nonexistent. Scandinavian health registry studies suggest AOD use is lower in the ASD population overall compared to the general public. Clinical studies also indicate lower rates of AOD in persons diagnosed with ASD compared to persons diagnosed with other psychiatric disorders. Nonetheless, rates of AOD use as high as 30% have been reported in the ASD population. In addition, there appear to be subgroups of persons with ASD, such as those with co-occurring Attention Deficit Hyperactivity Disorder (ADHD), with substantial rates of AOD use and AUDs that not only rival persons with other psychiatric disorders, but also indicate a need for proper identification and, when indicated, treatment. Importantly, prevalence estimates for ASD have increased in the past 10-20 years and a large proportion of that increase includes individuals with higher cognitive and language functioning. This subset of the ASD population is more likely to be included in and exposed to normative educational and social contexts, increasing risk for AOD use. The literature strongly supports the need for detailed and reliable information on the prevalence of AOD in a representative sample of adolescents and young adults with ASD in the US. In this application, we propose to assess a large, well-characterized, population-based ASD sample (Rhode Island Consortium for Autism Research and Treatment- RI-CART) that will enable us to provide, by far, the most in- depth characterization of AOD use and AUD prevalence in the ASD population in the US, as well as data regarding AOD onset and rate of progression to more severe use and AUDs. Equally important is the need to verify, or refute, risk and protective factors for AOD in this population. We will examine comorbid conditions, with specific focus on ADHD and anxiety disorders. We will also characterize the factors inducing risk of AOD use at critical junctions for adolescents and young adults with ASD, such as the transition to independent living, which is often associated with greater peer contact and less structure and social control. We propose to study a subsample of RI-CART participants (N=410) age 12-24 years, who either have an IQ ≥ 85 or an IQ ≥ 75 and are verbally fluent, in a 4-wave longitudinal, cohort-sequential study. We will examine AOD use in relation to age, as well as in relation to key developmental transitions (e.g., into and from high school, into supervised living or independent living/college).