Reducing Risk: A Comprehensive mHealth Sleep Health Intervention for Adolescents at Risk for Depression and Anxiety Disorders

项目摘要 本次申请以患者为导向的导师职业发展奖(K23)旨在支持更多 培训和研究将使候选人能够实现她成为独立人士的职业目标 从事旨在预防青少年精神疾病研究的临床科学家。青春期是一种 紧要期，以抑郁症和焦虑症的发病率急剧上升为特征 称为内在化障碍(ID)。睡眠健康问题是无处不在的、可修改的目标 它先于并预测了入侵检测系统的发展。该项目使用实验设计来(A)改进 睡眠健康(通过睡眠重点治疗)，(B)确定睡眠重点治疗是否有所改善 ID症状，以及已知的ID风险的生物标志物，皮质醇反应和对 应激暴露，以及(C)阐明睡眠健康不良对ID影响的靶向机制 症状和皮质醇测量。本研究将测试一种创新的跨诊断适应 睡眠和昼夜节律干预(TRANS-C)，一种改善睡眠和精神健康的睡眠健康治疗 并有效地治疗青少年中最常见的睡眠健康缺陷，每一种缺陷以前都是 被证明独立地与增加IDs的风险有关。要克服低可用性的挑战 作为获得治疗的障碍，我们采用了Trans-C来提供移动设备(参考 作为mTran S-C)，从而利用青少年使用移动电话的高比率。为了进一步 为了增加机会，我们将在初级保健服务中测试mTranS-C，这是一个经过验证的战略，可以改善获得 行为健康护理。该应用程序建立在候选人在跨诊断机制方面的先前工作基础上 精神疾病、确定干预目标和预防酒精性痴呆以及循证干预 治疗睡眠问题。拟议的培训计划强调候选人的以下培训领域：(1) 发展移动健康技术/科学方面的专门知识，(2)皮质醇的生物学和客观测量，以及 (3)纵向数据集的统计分析方法。一个由导师和 由睡眠干预、移动健康技术/科学、 发展精神病理学、皮质醇测量和统计学方法将共同提供 帮助应聘者实现其培训目标的专业知识。

Project Summary This application for a Mentored Patient-Oriented Career Development Award (K23) aims to support additional training and research that will enable the candidate to achieve her career goal of becoming an independent clinical scientist conducting research aimed at preventing mental illness among adolescents. Adolescence is a critical period characterized by dramatic increases in rates of depression and anxiety disorders, hereafter referred to as internalizing disorders (IDs). Problems with sleep health are ubiquitous and modifiable targets that precede and predict the development of IDs. This project uses an experimental design to (a) improve sleep health (through a sleep focused treatment), (b) determine whether a sleep focused treatment improves ID symptoms, and a known biological marker of risk for IDs, cortisol reactivity and recovery in response to a stress exposure, and (c) elucidate target mechanisms underlying the effect of poor sleep health on ID symptoms, and cortisol measures. The present study will test an innovative adaptation of Transdiagnostic Sleep and Circadian Intervention (TranS-C), a sleep health treatment that improves sleep and mental health and effectively treats the most common sleep health deficits among adolescents, each of which was previously shown to be independently associated with increased risk for IDs. To overcome the challenge of low availability of qualified providers as a barrier to treatment access, we adapted TranS-C for mobile device delivery (referred to as mTranS-C), thereby leveraging the high rates of mobile phone use among adolescents. To further increase access, we will test mTranS-C within primary care services, a proven strategy for improving access to behavioral health care. The application builds on the candidates’ prior work in transdiagnostic mechanisms of mental illness, identifying targets for intervention and the prevention of IDs, and evidence based interventions for sleep problems. The proposed training plan emphasizes the following training areas for the candidate: (1) develop expertise in mHealth technology/science, (2) the biology and objective measurement of cortisol, and (3) statistical methods for analyzing longitudinal data sets. An inter-disciplinary team of mentors and consultants consisting of international leaders in the areas of sleep interventions, mHealth technology/science, developmental psychopathology, cortisol measurement, and statistical methods, collectively will provide the expertise to help the candidate meet her training objectives.