Department of Pharmaceutical Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Twin Res Hum Genet. 2023 Feb;26(1):31-39. doi: 10.1017/thg.2023.8. Epub 2023 Mar 10.
Illicit substance use is dangerous in both acute and chronic forms, frequently resulting in lethal poisoning, addiction, and other negative consequences. Similar to research in other psychiatric conditions, whose ultimate goal is to enable effective prevention and treatment, studies in substance use are focused on factors elevating the risk for the disorder. The rapid growth of the substance use problem despite the effort invested in fighting it, however, suggests the need in changing the research approach. Instead of attempting to identify risk factors, whose neutralization is often infeasible if not impossible, it may be more promising to systematically reverse the perspective to the factors enhancing the aspect of liability to disorder that shares the same dimension but is opposite to risk, that is, resistance to substance use. Resistance factors, which enable the majority of the population to remain unaffected despite the ubiquity of psychoactive substances, may be more amenable to translation. While the resistance aspect of liability is symmetric to risk, the resistance approach requires substantial changes in sampling (high-resistance rather than high-risk) and using quantitative indices of liability. This article provides an overview and a practical approach to research in resistance to substance use/addiction, currently implemented in a NIH-funded project. The project benefits from unique opportunities afforded by the data originating from two longitudinal twin studies, the Virginia Twin Study of Adolescent and Behavioral Development and the Minnesota Twin Family Study. The methodology described is also applicable to other psychiatric disorders.
非法物质的使用无论是在急性还是慢性形式下都是危险的，经常导致致命的中毒、成瘾和其他负面后果。与其他精神疾病的研究类似，其最终目标是实现有效的预防和治疗，物质使用的研究也集中在提高疾病风险的因素上。尽管在对抗物质使用问题上投入了大量努力，但该问题仍在迅速蔓延，这表明需要改变研究方法。与其试图识别风险因素（如果不可行甚至不可能消除这些因素），不如系统地将视角转向增强与风险相同维度但相反的易患障碍的因素，即对物质使用的抵抗力。尽管大多数人都受到精神活性物质的影响，但抵抗因素可以使大多数人不受影响，因此可能更容易转化。虽然责任的抵抗方面与风险对称，但抵抗方法需要在采样（高抵抗而不是高风险）和使用责任的定量指标方面进行重大改变。本文提供了对物质使用/成瘾抵抗研究的概述和实用方法，目前正在 NIH 资助的项目中实施。该项目受益于两个纵向双胞胎研究（弗吉尼亚双胞胎青少年和行为发展研究以及明尼苏达双胞胎家庭研究）的数据提供的独特机会。所描述的方法也适用于其他精神疾病。
