MI for Teen Substance Abuse with Psychiatric Comorbidity

患有物质使用障碍的青少年经常患有伴随的精神障碍。 不幸的是，青少年中的物质使用问题提出精神治疗往往不是 尽管这种共病的精神病理学的有害后果，但仍需要充分评估或解决。 这项研究计划的总体目标是开发有效的简短干预方法，以解决 精神障碍共病的高危青少年的物质使用问题，并推进我们的 精神疾病和物质使用障碍之间的关系的知识， 治疗结果研究。 拟议的研究将测试一个量身定制的，基于社会学习的简报的比较功效 动机干预与个性化反馈相比，常规治疗减少物质 在因共病物质使用和精神疾病住院的青少年中使用。我们还将测试 治疗对中间变量的影响，如物质使用问题，精神症状， 改变的动机和住院后的治疗参与，并将研究的机制， 变化 该研究是一项随机（按队列）、两组设计，随时间重复测量， 比较以下两种方法的效果：（a）量身定制的简短动机性访谈干预与个性化访谈干预。 反馈（MI）与（B）常规治疗（TAU）。250名青少年精神病住院患者的样本， 13岁和17岁的人将被招募参加这项研究。受试者将符合一项或多项DSM-IV标准 （非尼古丁）物质使用障碍和一种或多种其他当前轴I障碍， 物质使用障碍受试者将被随访12个月，并自我报告戒断物质 使用将通过呼吸分析和唾液药物测试进行验证。 我们希望这项研究将导致一个专门的，有效的干预发展 针对大量患有药物使用和精神疾病的青少年的方法， 因此将具有重要的临床和公共卫生意义。

Adolescents with substance use disorders frequently suffer from concomitant psychiatric disorders. Unfortunately, substance use problems among adolescents presenting for psychiatric treatment are often not adequately assessed or addressed despite the deleterious consequences of this comorbid psychopathology. The overall objective of this research program is to develop effective brief intervention approaches to address substance use problems in high-risk adolescents with comorbid psychiatric disorders, and to advance our knowledge of the relationship between psychiatric and substance use disorders within the context of a treatment outcome study. The proposed study will test the comparative efficacy of a tailored, social learning-based brief motivational intervention with personalized feedback compared to treatment as usual for reducing substance use in adolescents hospitalized with comorbid substance use and psychiatric disorders. We will also test the effects of treatment on intermediate variables such as substance use problems, psychiatric symptoms, motivation to change and post-hospitalization treatment involvement, and will examine the mechanisms of change. The study is a randomized (by cohort), two group design with repeated measures over time, comparing the efficacy of: (a) a tailored, brief motivational interviewing intervention with personalized feedback (MI) vs. (b) treatment as usual (TAU). A sample of 250 adolescent psychiatric inpatients between the ages of 13 and 17 will be recruited into the study. Subjects will meet criteria for one of more DSM-IV (non-nicotine) substance use disorders and for one or more additional current Axis I disorders, other than a substance use disorder. Subjects will be followed for 12 months, and self-reported abstinence from substance use will be verified using breathanalysis and saliva drug tests. We expect that this study will result in the development of a specialized, efficacious intervention approach for the significant percentage of adolescents with comorbid substance use and psychiatric disorders, and will therefore have important clinical and public health implications.