Treatment of Emotional Disorders in Adolescence

描述（由申请人提供）：本申请是向 NIMH 申请以患者为导向的研究职业发展奖 (K23)，以促进申请人 Jill T. Ehrenreich 博士的学术职业发展。申请人将与其主要导师 David Barlow 博士、共同导师 Wendy Silverman 博士以及专家顾问 Laura Mufson 博士、John Weisz 博士、James Gross 博士、Richard Lerner 博士和 Timothy Brown 博士合作，发展临床研究方面的专业知识，为患有情绪障碍的青少年建立创新且有效的干预措施。在为期五年的职业发展计划中，申请人制定了短期和长期目标，为她从事以患者为导向的研究职业做好准备。短期目标包括在几个“核心”领域获得教学培训和指导，这些领域被选择来深化她现有的技能并将她的技能扩展到新领域。申请人的长期目标是开发一系列计划性研究，重点开发针对儿童和青春期焦虑症及其最常见合并症的创新疗法，并开启作为临床科学家的高产职业生涯。提出了一项正式的研究计划来调查青春期的情绪障碍，特别关注焦虑症和单相情绪障碍。尽管理论和研究表明这些疾病可能具有共同的生物学和心理弱点，彼此之间表现出较高的合并症，并有证据表明对发育有潜在的长期影响，但很少有治疗研究调查单一方案的有效性以及是否适用于治疗青春期的这一系列疾病。拟议研究计划的主要目标是基于对青少年焦虑和抑郁的有效治疗以及现有的成人干预措施，将适合干预广泛情绪障碍的基本治疗成分结合起来，开发和应用一种针对青少年情绪障碍的新型治疗方法。该项目的主要目标是：（1）为表现出一系列情绪障碍的青少年创建一种新的治疗方法，名为青少年抑郁和焦虑方案治疗（ADAPT）； (2) 使用 ADAPT 对 15 名表现出焦虑和/或单相情绪障碍的青少年进行小型开放试验； (3) 在一项对 60 名患有焦虑和/或单相情感障碍的青少年进行的试点研究中确定 ADAPT 计划的初始效果大小，并评估治疗后 3 个月和 6 个月的变化维持情况。由此产生的治疗方法可能会通过向治疗青少年焦虑和抑郁症的社区提供者传播而产生深远的影响，因为其形式上的相对一致性以及应用的广泛性。

DESCRIPTION (provided by applicant): This application is a request for a Mentored Patient-Oriented Research Career Development Award (K23) from the NIMH to foster the academic career development of the applicant, Jill T. Ehrenreich, Ph.D. The applicant will work with her primary mentor, Dr. David Barlow, her co-mentor, Dr. Wendy Silverman, and expert consultants, Dr. Laura Mufson, Dr. John Weisz, Dr. James Gross, Dr. Richard Lerner, and Dr. Timothy Brown, to develop expertise in conducting clinical research to establish innovative and efficacious interventions for adolescents with emotional disorders. In a career development plan spanning five years, the applicant has delineated short-term and long-term goals to prepare her for a patient-oriented research career. Short-term goals include obtaining didactic training and mentoring in several "core" areas that have been chosen to deepen her existing skills and to expand her skills into new areas. The applicant's long-term goals are to develop a programmatic line of research that is focused on developing innovative treatments for anxiety disorders in childhood and adolescence, and their most commonly comorbid conditions, as well as to launch a highly productive career as a clinical scientist. A formal research plan is proposed to investigate emotional disorders in adolescence, focusing specifically on anxiety disorders and unipolar mood disorders. Despite theory and research that suggests these disorders may share common biological and psychological vulnerabilities, demonstrate high comorbidity with one another, and evidence a potentially chronic impact on development, there have been few treatment studies investigating the efficacy of a single protocol with the applicability to treat this array of conditions in adolescence. The primary goal of the proposed research plan is to develop and apply a novel treatment for adolescents with emotional disorders, based on efficacious treatments for anxiety and depression in youth and an existent intervention for adults that unites fundamental treatment components appropriate for intervention with wide range of emotional disorders. The main goals of this project are: (1) to create a new treatment, entitled Adolescent Depression and Anxiety Protocol Treatment (ADAPT), for adolescents exhibiting a range of emotional disorders; (2) to conduct a small open trial using ADAPT with 15 adolescents evidencing anxiety and/or unipolar mood disorders; and, (3) to establish an initial effect size for the ADAPT program in a pilot study with 60 adolescents with anxiety and/or unipolar mood disorders and to assess maintenance of change at 3 and 6 months following treatment. The resulting treatment may have a far-reaching impact via dissemination to community providers treating adolescents with anxiety and depression by virtue of its relative consistency in format, combined with its breadth of application.