Kirisci Levent, Tarter Ralph, Mezzich Ada, Ridenour Ty, Reynolds Maureen, Vanyukov Michael
Center for Education and Drug Abuse Research, University of Pittsburgh, School of Pharmacy, Pittsburgh, Pennsylvania 15261, USA.
Am J Addict. 2009 Jan-Feb;18(1):36-47. doi: 10.1080/10550490802408829.
Employing a prospective paradigm, this investigation derived the childhood phenotype and the environtype associated with risk for cannabis use disorder. Two hundred and sixteen boys were evaluated between age 10-12 on a comprehensive protocol using self, mother, and teacher reports and followed-up at ages 19 and 22 to determine the presence of cannabis use disorder. The Transmissible Liability Index (TLI) and Non-Transmissible Liability Index (NTLI) were derived using item response theory. Logistic regression was conducted to evaluate the accuracy of the indexes, singly and in combination, to predict cannabis use disorder. The TLI and NTLI together predicted with 70% and 75% accuracy cannabis use disorder manifest by age 19 and age 22. Sensitivity was 75% at both ages 19 and 22, whereas specificity was respectively 51% and 64%. The findings pertaining to sensitivity indicate that SUD risk for cannabis use disorder can be screened in childhood; however, the specificity scores demonstrate that a low score on the TLI does not inevitably portend a good prognosis up to 10 years later.
本研究采用前瞻性范式,得出了与大麻使用障碍风险相关的儿童期表型和环境类型。对216名10至12岁的男孩进行了综合评估,采用自我报告、母亲报告和教师报告,并在19岁和22岁时进行随访,以确定是否存在大麻使用障碍。使用项目反应理论得出可传递责任指数(TLI)和不可传递责任指数(NTLI)。进行逻辑回归以评估这些指数单独或组合预测大麻使用障碍的准确性。TLI和NTLI共同预测19岁和22岁时出现的大麻使用障碍的准确率分别为70%和75%。19岁和22岁时的敏感性均为75%,而特异性分别为51%和64%。有关敏感性的研究结果表明,大麻使用障碍的物质使用障碍风险可以在儿童期进行筛查;然而,特异性得分表明,TLI得分低并不必然预示着10年后会有良好的预后。