在青春期,创伤事件和药物使用是否同时发生? 测试三个因果病因学假设
Herry Patel1, Susan F Tapert1, Sandra A Brown1,2
1Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
概括
潜在的创伤性事件 (PTE) 可以导致青少年的物质使用 (SU),但不是相反. 这项研究在一大批青少年样本中严格测试了PTE和SU之间的因果关系,发现了PTE在SU之前的证据.
科学领域:
- 青少年心理学 青少年心理学
- 成的神经科学成的神经科学
- 公共卫生 公共卫生
背景情况:
- 潜在的创伤性事件 (PTE) 和物质使用 (SU) 在青少年中经常同时发生.
- 现有的这种并发症的因果假设,来自于成年人对创伤后应激障碍 (PTSD) 和物质使用障碍 (SUD) 的研究,在青少年群体中缺乏严格的测试.
- 建立因果关系需要考虑诸如遗传学和社会经济地位等常常被忽视的混因素.
研究的目的:
- 在全国青少年样本中严格测试PTE和SU之间的因果关系.
- 确定PTE是否先于SU,SU是否先于PTE,或者它们是否同时发生.
- 为了考虑可能影响观察到的关联的混变量.
主要方法:
- 利用了来自青少年大脑和认知发展研究 (N=11,468) 的全国数据.
- 每年评估PTE和SU (酒精,大麻,尼古丁).
- 用人内部的变化,并根据时间变化的混因素 (例如年龄,内化/外化症状,同行物质使用) 进行调整,以减轻偏见.
主要成果:
- 在控制混之前,PTE和SU显示出显著的竞争和潜在的关联,PTE预测更多的SU.
- 在严格对混进行调整后,PTE与酒精和尼古丁使用保持了显著的并发关联,但不是大麻.
- 预期的PTE预测了酒精和尼古丁的增加的SU,但相反的情况 (SU预测PTE) 没有得到支持.
结论:
- 这些发现支持一个单向因果模型,其中PTE先于并影响青少年SU.
- 这项研究没有发现青少年的SU是导致或导致PTE的证据.
- 解释成年人PTSD和SUD并发症的理论模型可能需要在适用于青少年群体之前进行调整.
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