Bates M E, Labouvie E W
Center of Alcohol Studies, Rutgers University, Piscataway, New Jersey 08855-0969, USA.
Alcohol Clin Exp Res. 1997 Aug;21(5):944-50.
Adolescence is a time of heightened risk for relatively intensive alcohol and other drug use behaviors. However, heavy use is often "adolescence-limited," giving way to moderation or cessation in adulthood. We examined individual differences in risk factors at age 18 that were predictive of alternative alcohol and drug use trajectories from adolescence to adulthood. Data were collected prospectively on four occasions from participants in the Rutgers Health and Human Development Project. Subsets of individuals representing three prototypical trajectories of (1) consistently low alcohol and drug use during adolescence and early adulthood; (2) heavier alcohol or drug use during adolescence, but not during adulthood; and (3) persistent heavier alcohol or drug use from adolescence into adulthood were found to differ significantly on a number of intrapersonal, behavioral, and environmental risk factors, with the adolescence-limited group consistently scoring between the other two groups. Based on these results, a composite risk index was constructed. In the total sample, however, when the effect of alcohol and drug use behaviors at age 18 was controlled, the composite risk index was unrelated to adult (age 28 to 31) levels of alcohol and drug use and consequences. Thus, in this community sample, well-documented risk factors assessed in adolescence did not exhibit any direct, longterm effects on use intensity and problems in adulthood. It is concluded that the assessed risk factors (disinhibition, cognitive structure, play, deviant coping, friends' deviance, and stressful life events) are not immutable, but subject to individual and normative changes during the transition from adolescence to adulthood. More research is needed to determine the long-term stability of risk factors, and how changes in risk factors over time, discontinuities in what constitutes risk in adolescence versus adulthood, and proximal adult protective factors that compensate for early risk contribute to developmental patterns of use.
青春期是酒精和其他药物使用行为相对频繁的高风险时期。然而,大量使用往往是“青春期受限的”,到成年期会趋于适度或停止。我们研究了18岁时风险因素的个体差异,这些差异可预测从青春期到成年期不同的酒精和药物使用轨迹。从罗格斯健康与人类发展项目的参与者那里前瞻性地收集了四次数据。代表三种典型轨迹的个体子集分别为:(1)青春期和成年早期酒精和药物使用一直较低;(2)青春期酒精或药物使用较多,但成年期没有;(3)从青春期到成年期持续大量使用酒精或药物。结果发现,这三组在一些个人、行为和环境风险因素上存在显著差异,青春期受限组的得分始终介于另外两组之间。基于这些结果,构建了一个综合风险指数。然而,在总样本中,当控制了18岁时酒精和药物使用行为的影响后,综合风险指数与成人(28至31岁)的酒精和药物使用水平及后果无关。因此,在这个社区样本中,青春期评估的有充分记录的风险因素对成年期的使用强度和问题没有任何直接的长期影响。研究得出结论,所评估的风险因素(抑制解除、认知结构、玩耍、异常应对、朋友的偏差行为和压力性生活事件)并非一成不变,而是在从青春期到成年期的过渡过程中会受到个体和规范变化的影响。需要更多的研究来确定风险因素的长期稳定性,以及随着时间推移风险因素的变化、青春期与成年期风险构成的不连续性,以及补偿早期风险的近端成人保护因素如何促成使用的发展模式。