Time for a paradigm shift: The adolescent brain in addiction treatment.
Time for a paradigm shift: The adolescent brain in addiction treatment.
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DOI：
10.1016/j.nicl.2022.102960
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发表时间：
2022
期刊：
影响因子：
--
通讯作者：
Feldstein Ewing SW
中科院分区：
文献类型：
--
作者：
Mackiewicz Seghete KL;Filbey FM;Hudson KA;Hyun B;Feldstein Ewing SW
本研究将fMRI与青年行为随机对照试验相结合。我们的fMRI范式评估青少年大脑对治疗师语言的反应。在12个月时，MI青年表现出比BAM青年显著更好的治疗结果。青年表现出对复杂反射与正念和复杂反射与对抗的大脑变化（例如，楔前叶;中央后回）。青少年大脑对治疗师语言的改变与结果有关。改善青少年成瘾治疗结果的一种途径是使用转化方法来帮助确定支持积极治疗成分和促进青少年行为改变的发展神经科学机制。该样本包括163名青少年（15-19岁），随机接受动机访谈（MI）和短暂的青少年正念（BAM）。青少年完成了一个功能磁共振成像范例，评估青少年大脑对治疗师语言的反应（复杂反射与意识;复杂反射与对抗;意识与对抗）在治疗前（完成全面干预之前）和治疗后（3个月随访）以及3，6和12个月的行为测量。两个治疗组的青年在3个月和6个月时都表现出明显的问题饮酒减少，但MI青年在12个月时的治疗结果明显优于BAM青年。我们观察到对治疗师语言的神经反应存在几个显著的治疗组差异（MI > BAM），包括在治疗前检查复杂反射与正念，以及复杂反射与对抗（例如，上级颞回，舌回）;以及在治疗后当检查注意与对抗时（例如，辅助运动区;额中回）。当在治疗组（MI + BAM）之间崩溃时，我们观察到时间上的显著差异，青年显示出对复杂反射与正念以及复杂反射与对抗的大脑变化模式（例如，楔前叶;中央后回）。没有证据表明存在显著的组×时间相互作用。然而，额中回等区域对治疗师语言（复杂反射与对抗）的大脑反应变化与12个月时问题饮酒的减少有关。然而，几乎没有观察到治疗组差异。这些数据强调了更好地理解治疗师语言及其对发育中大脑的影响的必要性，以便为青少年未来的治疗开发提供信息和汇总成瘾治疗中最具影响力的元素。
This study integrates fMRI with a behavioral randomized controlled trial with youth. Our fMRI paradigm assessed adolescent brain response to therapist language. MI youth demonstrated significantly better treatment outcomes than BAM youth at 12 months Youth showed brain change in response to complex reflection vs. mindful and complex reflection vs. confront (e.g., precuneus; postcentral gyrus). Youth brain change to therapist language was associated with outcomes. One route to improve adolescent addiction treatment outcomes is to use translational approaches to help identify developmental neuroscience mechanisms that undergird active treatment ingredients and advance adolescent behavior change. This sample included 163 adolescents (ages 15–19) randomized to motivational interviewing (MI) vs. brief adolescent mindfulness (BAM). Youth completed an fMRI paradigm assessing adolescent brain response to therapist language (complex reflection vs. mindful; complex reflection vs. confront; mindful vs. confront) at pre- (prior to the completion of the full intervention) and post-treatment (at 3-month follow-up) and behavioral measures at 3, 6 and 12 months. Youth in both treatment groups showed significant problem drinking reductions at 3 and 6 months, but MI youth demonstrated significantly better treatment outcomes than BAM youth at 12 months. We observed several significant treatment group differences (MI > BAM) in neural response to therapist language, including at pre-treatment when examining complex reflection vs. mindful, and complex reflection vs. confront (e.g., superior temporal gyrus, lingual gyrus); and at post-treatment when examining mindful vs. confront (e.g., supplementary motor area; middle frontal gyrus). When collapsed across treatment groups (MI + BAM), we observed significant differences by time, with youth showing a pattern of brain change in response to complex reflection vs. mindful, and complex reflection vs. confront (e.g., precuneus; postcentral gyrus). There was no evidence of a significant group × time interaction. However, brain change in response to therapist language (complex reflection vs. confront) in regions such as middle frontal gyrus, was associated with reductions in problem drinking at 12 months. Yet, few treatment group differences were observed. These data underscore the need to better understand therapist language and it's impact on the developing brain, in order to inform and aggregate the most impactful elements of addiction treatment for future treatment development for adolescents.
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影响因子：
4.3
作者：
Chen G;Saad ZS;Adleman NE;Leibenluft E;Cox RW
通讯作者：
Cox RW
DOI：
10.3109/00952990.2015.1049701
发表时间：
2015
期刊：
The American journal of drug and alcohol abuse
影响因子：
--
作者：
DeWitt SJ;Ketcherside A;McQueeny TM;Dunlop JP;Filbey FM
通讯作者：
Filbey FM
DOI：
10.1016/j.pnpbp.2020.110037
发表时间：
2021-01-10
影响因子：
5.6
作者：
Cao, Ruixiang;Yang, Xiangyun;Li, Zhanjiang
通讯作者：
Li, Zhanjiang
影响因子：
1.9
作者：
Bauer, Clemens C. C.;Caballero, Camila;Gabrieli, John D. E.
通讯作者：
Gabrieli, John D. E.
影响因子：
4.7
作者：
Davey, Christopher G.;Fornito, Alex D.;Harrison, Ben J.
通讯作者：
Harrison, Ben J.