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標題: | 利用社會網絡探討精神作用性物質使用之心理社會與行為因子 Using Social Networks to Explore Psychosocial and Behavioral Determinants of Psychoactive Substance Use |
作者: | Te-Tien Ting 丁德天 |
指導教授: | 陳為堅(Wei J. Chen) |
關鍵字: | 酒精期待,飲酒行為,青春期,同儕,酒精代謝基因ADH1B,酒精代謝基因ALDH2,社會網絡,受訪者引介抽樣法,非法藥物使用,電腦輔助式自我訪談工具, Alcohol expectancies,alcohol use,adolescence,peers,puberty,ADH1B,ALDH2,social network,Respondent-Driven Sampling (RDS),illegal drug use,computer-assisted self-interview, |
出版年 : | 2014 |
學位: | 博士 |
摘要: | 本論文欲探討社會網絡對於精神作用性物質使用的影響與應用,共包含三部分,即:探索青少年社會網絡對其1) 酒精期待,2) 飲酒行為的影響,以及3)如何運用社會網絡之理論,設計適當的抽樣與加權方式來估計年輕成人之非法藥物使用情形。第一部分探討青少年前期之同儕行為與社會網絡位置對於其酒精期待的影響,此研究透過大台北的分層抽樣、學校調查,共訪視779位六年級學童,收集三波追蹤資料,評估其飲酒行為、酒精期待,與其他控制變項。運用複雜抽樣下迴歸模式(complex survey regression analyses),依據個案六年級飲酒經驗分層,並分析這些個案於六年級時期的同儕網絡與七年級時期的同儕行為對於個案七年級時正、負向酒精期待的影響。研究結果顯示:六年級尚無飲酒經驗之青少年,同儕飲酒與其酒精期待有顯著相關,且隨著個案處在不同階段的青春期而有不同的相關模式(例如青春期晚期是正相關swt=0.55、而青春期早期是負相關swt=-0.40);對於有飲酒經驗的青少年,如位於同儕網絡中的橋樑位置,則會有較多的負向期待,但同儕飲酒與青春期發育卻與酒精期待無顯著相關(swt=0.25)。不論其六年級之前是否曾喝過酒,近期的飲酒經驗與期待喝酒能增進社交互動有顯著的正相關。此研究提供了證據顯示:對於尚無飲酒經驗之早期青少年,同儕飲酒行為與青春期發育對於酒精期待的影響有交互作用。第二部分探討青春期早期之青少年,酒精代謝基因之遺傳變異與社會網絡對持續飲酒的影響、以及青春期發育的修飾作用。此研究乃透過498位10~12歲曾喝過酒的台灣學童進行四波調查,分析其酒精代謝基因型與社會網絡對於後續飲酒行為的影響。根據他們的後續飲酒行為,分為三大類主要依變項:1.後續不再碰酒,2.零星飲酒,3.持續多次飲酒,並以多元邏輯斯回歸模型加以分析。結果顯示:青春期發育會修飾基因的影響:在青春期尚未發育者當中,酒精代謝基因(ADH1B與ALDH2)具有顯著的保護作用;在控制其他共變項之後,此保護作用依然顯著。在同儕網絡中具有橋梁位置者,則較多會繼續零星喝酒(aOR=3.30)、或是持續多次喝酒(aOR=3.35)。本研究結果顯示,雖然酒精代謝基因對後續飲酒行為的保護作用會因青春期發育而降低,但社會網絡對後續飲酒的影響亦有著獨立的貢獻。第三部分嘗試運用受訪者引介抽樣法來網羅有菸酒使用習慣的族群,並估計此抽樣模式的實際應用模式,也期望獲得較具代表性的盛行率估計值。此研究藉由18-50歲有抽菸習慣且居住在大台北區域的個案,請他們引介五位有類似行為模式的親友或同事,以電腦輔助式自我訪談工具來收集個案之藥物使用行為,並以RDSAT來進行分析。田野執行告一段落後,進行平衡檢定,結果顯示研究參與者網羅朋友的波數到達三波到五波後,粗估值與加權後之估計值相差不到0.02,可快速達到平衡。從加權後的數值可知,在有抽菸喝酒習慣之族群中,每五人就有一人曾使用過非法藥物;有使用過非法藥物者中,則有超過六成的人是多重藥物使用者。若進一步將其分為十八歲之前抽菸與十八歲以後才開始抽菸之次族群,可以看到十八歲之前就開始抽菸之次族群,非法藥物使用的盛行率是另一個次族群的兩到三倍以上。我們的研究結果提供實際的田野經驗,驗證RDS的理論基礎,並獲得較少偏差、較具有代表性的估計值。 This dissertation is motivated by a puzzling function of social network on psychoactive substance use and aims to evaluate the influence of social network on adolescent alcohol expectancies and use and the application of social network on adult illegal drug use. Study I aimed to examine the influence of peers on alcohol expectancies in early adolescence. Alcohol-related information and other covariates of 779 6th graders were assessed in a three-wave longitudinal study of in northern Taiwan. Complex survey regression analyses, stratified by drinking experience at 6th grade, were performed to identify the association of positive and negative alcohol expectancies with peer influence at 7th grade. The results showed that, for alcohol-naive adolescents, recent exposure to peer drinking was significantly associated with positive and negative alcohol expectancies at grade 7, which was moderated by pubertal development (e.g., ESBlate puberty: swt=0.55; ESBearly puberty: swt=-0.40). For alcohol-experienced adolescents, occupying a bridge position was slightly link with negative expectancy (swt=0.25), but peer drinking and pubertal development did not show any significant links with alcohol expectancies. Current drinking is a strong predictor for the expectancy of enhanced social behaviors for both groups. This study provided evidence for the effect of interplay between peer factors and pubertal development on alcohol expectancies in early adolescence. Study II aimed to (1) evaluate the effects of genetic variants of ADH1B and ALDH2, (2) explore possible moderating effects of pubertal development, and (3) assess the potential influence of social network on continued alcohol use in early adolescence. Information pertaining to drinking experience, alcohol-metabolizing genes (i.e., ADH1B and ALDH2), social network and other covariates was collected among 498 Taiwanese children who had initiated drinking before the ages of 10–12 in a four-wave longitudinal study. Follow-up alcohol involvement was categorized into ex-, sporadic, and continued drinkers. Multinomial logistic regression analyses were used to assess the effects of genes, pubertal development, and social network on continued alcohol use. Pubertal development modified genetic effects on subsequent drinking. Only for individuals in early pubertal stage, both genes exhibited significant protective effects on subsequent alcohol use after adjusting for other covariates. Meanwhile, children having the bridge position in their peer network were more likely to be sporadic drinkers (aOR=3.30) and continued drinkers (aOR=3.30). Our results demonstrated the moderating effect of pubertal development on the protective influence of alcohol-metabolizing genes on subsequent alcohol use among alcohol-experienced children as well as the independent contribution of early life’s social network to their alcohol involvement. Study III aimed to evaluate the applicability of respondent-driven sampling (RDS) and obtained its bias-reduced estimates among regular tobacco and alcohol users in Taipei, Taiwan. This study was implemented to recruit seed individuals who aged between 18 and 50, were regular tobacco and alcohol users, and were current residence in Taipei. Each respondent was asked to refer up to five friends known to be regular tobacco smokers and alcohol drinkers to participate in the present study. Information pertaining to drug use was collected by the audio computer-assisted self-interview instrument. Software built for RDS analyses was used for data analyses. The prevalence estimates of illegal drug using behaviors attained equilibrium after 3 to 5 recruitment waves. About one-fifth of legal substance users had ever used illegal drugs, among which over 60% were polydrug users. The RDS-adjusted prevalences of illegal drug using behaviors among early-onset smokers were all twice or three times higher than those among late-onset smokers. Our results provided an empirical basis for the applicability of RDS to obtain bias-reduced prevalence estimates of illegal drugs in the subpopulation of legal substance users. |
URI: | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/55647 |
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