Largely as a consequence of the aging of the population, rates of physical disability have risen significantly over the decade of the 90's and substantial additional increases are projected. As of 1992 more than 10 percent of Americans 18-64, and more than 23 percent of those 65 and older were experiencing significant activity limitations. Despite this, very little is known about the significance of physical disability with respect to substance use or mental health problems. This application builds upon an ongoing study addressed to the prevalence of substance and psychiatric disorders as they vary by the presence and severity of physical disability, and to the identification of potentially modifiable risk and protective factors associated with these outcomes. An additional and central objective is to understand ethnic/racial differences in the substance/mental health risk associated with physical disability and in factors associated with variations in degree of risk. The original application proposed a two-wave panel study to address these objectives and was reviewed in February 1999. Unfortunately, under budgeting on our part, in combination with a significant cut imposed by NIDA, resulted in funding that was only sufficient to cover the extensive preparations that were required and the first of the planned two waves of interviews. This application requests funding to support the previously approved second wave of interviews and the addition of interviews with spouse/partners (or other significant person) of both disabled and comparison participants. Among other important opportunities, the 'significant other' interviews will allow assessment of the impact of their substance use, abuse and dependence and/or mental health problems for risk of negative mental health and substance outcomes among participants, and to specify variations in such effects across gender, age, ethnicity and disability status.
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