Sexual differences in long-term health implications of adolescent risk behavior

描述(由申请人提供)：关于青少年冒险行为(物质使用和性风险)与抑郁症之间潜在因果关系的研究结果喜忧参半。一些研究表明，危险行为会导致抑郁，而另一些研究则表明，抑郁会增加危险行为。1-5压力模型表明，危险行为会刺激身体的压力反应，这是对新奇事物的内分泌反应，从而增加炎症和抑郁症状的风险。6-10另一种自我用药模型表明，抑郁的青少年可能会使用药物或进行性行为来自我治疗抑郁。1在后一种模型中，抑郁减少了冲动控制，并改变了心理社会功能(例如，减少动力)。5、11生物性行为使这些问题更加复杂；女性不太可能从事危险行为，但抑郁症的发生率较高，而男性承担更多风险，但抑郁率较低。1、2、12、13然而，尚不清楚将危险行为与抑郁症联系起来的发育过程是否或如何因性别而异。除了青春期的健康风险，这些关联可能对健康有长期的影响，包括物质依赖和疾病前通路的建立，因为抑郁和压力都会增加炎症，当慢性时，损害免疫功能。14-17本项目将使用国家青少年健康纵向研究(Add Health)的数据来解决两个研究目标：1)分别检查男性和女性的冒险行为(物质使用/性风险)和抑郁症状之间的滞后关系，以评估方向性；2)确定青春期和成年初期的冒险/抑郁症状特征，并将具有类似特征的青少年分为潜伏期；3)利用自我报告和生物标志物数据，审查潜在类别成员(即随时间变化的风险模式)对年轻人健康的潜在影响(例如，药物滥用/依赖、性传播感染(STI)、疾病前途径)。Add Health数据允许在一个大的、种族多样化的全国样本中对这些关联从青春期到年轻成年期的性别差异进行前瞻性检查。分析方法将包括重复测量和混合回归模型，以研究抑郁症状和风险接管之间的联系，潜在班级增长模型，按类型对个人的冒险行为和抑郁症状轨迹进行分组，以及适当的回归方法，将班级成员资格与青年时期的健康结果联系起来。研究结果将加强我们对青少年冒险模式的直接和长期健康影响的理解，并为干预工作提供信息。

DESCRIPTION (provided by applicant): Research findings on the potential causal association between adolescent risk taking (substance use and sexual risk) and depression are mixed. Some studies suggest risk behavior leads to depression while others suggest depression increases risk behavior.1-5 A Stress Model suggests risk behavior leads to depression by inciting the body's stress response, an endocrine reaction to novelty exposure, which subsequently increases inflammation and risk of depressive symptoms.6-10 An alternative Self-Medication Model suggests depressed adolescents may use substances or engage in sexual risk taking to self-medicate their depression.1 In the latter model, depression decreases impulse control and modifies psychosocial functioning (e.g., reduces motivation).5,11 Biological sex further complicates these issues; females are less likely to engage in risk behavior but have higher rates of depression, whereas males take more risks but have lower rates of depression.1,2,12,13 It is not clear whether or how the developmental processes linking risk behavior and depression vary by sex, however. In addition to health risk during adolescence, these associations may have long-term implications for health, including substance dependency and establishment of pre-disease pathways, as both depression and stress can increase inflammation, and when chronic, harm immune function.14-17 This project will use data from the National Longitudinal Study of Adolescent Health (Add Health) to address two research aims: 1) examine, separately for males and females, time lagged associations between risk taking (substance use/sexual risk) and depressive symptoms to assess directionality; 2) identify risk taking/depressive symptom profiles across adolescence and emerging adulthood, and group adolescents with similar profiles into latent classes; 3) examine the potential young adult health implications (e.g., substance abuse/dependency, sexually transmitted infections (STIs), pre-disease pathways) of latent class membership (i.e., patterns of risk over time) using both self-report and biomarker data. Add Health data allow for prospective examination of sex differences in these associations from adolescence into young adulthood in a large, racially diverse, national sample. Analytical methods will include repeated measures and mixed regression models to look at associations between depressive symptoms and risk taking over time, Latent Class Growth Models to group individuals' risk taking and depressive symptom trajectories by type, and appropriate regression methods to link class membership to health outcomes in young adulthood. Findings will enhance our understanding of the immediate and long-term health implications of patterns of adolescent risk taking, and inform intervention efforts.