Dowling Gayathri J, Hoffman Elizabeth A, Cole Katherine M, Wargo Eric M, Volkow Nora
Division of Extramural Research, National Institute on Drug Abuse, National Institutes of Health, Bethesda, Maryland.
Focus (Am Psychiatr Publ). 2024 Oct;22(4):449-457. doi: 10.1176/appi.focus.20240016. Epub 2024 Oct 15.
Increasing rates of overdose among U.S. adolescents and young adults, along with rising rates of emotional distress in these groups, are renewing the urgency for developmentally targeted and personalized substance use and other mental health prevention interventions. Most prevention programs recognize the unique vulnerability of childhood and adolescence and target parents and youths, addressing modifiable environmental risk and protective factors that affect behavior during periods when the brain is most susceptible to change. Until recently, a scarcity of comprehensive studies has limited a full understanding of the complexity of factors that may affect neurodevelopment, including substance exposure in pregnancy and/or subsequent substance use in adolescence, alongside their dynamic interactions with environmental factors and genetics. Two large longitudinal cohort studies funded by National Institutes of Health-the Adolescent Brain Cognitive Development (ABCD) Study and the HEALthy Brain and Child Development (HBCD) Study-are collecting data on neurodevelopment and a wide range of environmental and biological factors across the first two decades of life to build databases that will allow researchers to study how individual neurodevelopmental trajectories are influenced by drugs, adverse childhood experiences, and genetics, among other factors. These studies are already deepening the understanding of risk and resilience factors that prevention programs could target and will identify critical windows where interventions can have the most impact on an individual's neurodevelopmental trajectory. This article describes what is being learned from ABCD and expected from HBCD and how these studies might inform prevention as these children grow and more data are gathered.
美国青少年和青年成年人中药物过量率不断上升,同时这些群体的情绪困扰率也在上升,这再次凸显了制定针对不同发育阶段且个性化的药物使用及其他心理健康预防干预措施的紧迫性。大多数预防项目都认识到儿童期和青少年期的独特易感性,并以父母和青少年为目标,应对可改变的环境风险和保护因素,这些因素会在大脑最易发生变化的时期影响行为。直到最近,由于缺乏全面的研究,人们对可能影响神经发育的因素的复杂性,包括孕期药物暴露和/或青少年期随后的药物使用,以及它们与环境因素和基因的动态相互作用,还缺乏全面的了解。美国国立卫生研究院资助的两项大型纵向队列研究——青少年大脑认知发展(ABCD)研究和健康大脑与儿童发展(HBCD)研究——正在收集生命最初二十年中神经发育以及广泛的环境和生物因素的数据,以建立数据库,使研究人员能够研究个体神经发育轨迹如何受到药物、童年不良经历和基因等因素的影响。这些研究已经加深了对预防项目可以针对的风险和复原力因素的理解,并将确定干预措施对个体神经发育轨迹影响最大的关键窗口期。本文描述了从ABCD研究中学到的内容以及对HBCD研究的期望,以及随着这些孩子成长并收集到更多数据,这些研究可能如何为预防工作提供信息。