Treatment of Emotional Disorders in Adolescence

描述(由申请人提供)：本申请是为了向NIMH申请一项有指导的以患者为导向的研究职业发展奖(K23)，以促进申请人Jill T.Ehrenreich博士的学术生涯发展。申请人将与她的主要导师David Barlow博士、她的共同导师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，以发展进行临床研究的专业知识，以建立针对青少年情绪障碍的创新且有效的干预措施。在一份跨越五年的职业发展计划中，申请者勾勒出了短期和长期目标，为她以患者为导向的研究生涯做好准备。短期目标包括在几个“核心”领域获得教学培训和指导，这些领域已经被选中，以加深她现有的技能，并将她的技能扩展到新的领域。申请者的长期目标是开发一系列方案研究，专注于开发儿童和青少年焦虑障碍及其最常见的共病疾病的创新治疗方法，并开始作为一名临床科学家的高生产率职业生涯。一项正式的研究计划被提出，以调查青春期的情绪障碍，特别是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和心理脆弱性，彼此之间表现出高度的共病，并有证据表明可能对发育产生慢性影响，但很少有治疗研究调查单一方案的有效性，并适用于治疗青春期的这种疾病。拟议研究计划的主要目标是开发和应用一种新的治疗青少年情绪障碍的方法，其基础是对青少年焦虑和抑郁的有效治疗，以及针对成年人的现有干预措施，该干预措施将适合干预的基本治疗成分与广泛的情绪障碍相结合。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协议治疗(Adapt)；(2)使用Adapt对15名有焦虑和/或单相情绪障碍的青少年进行一项小型开放试验；以及(3)在对60名患有焦虑和/或单相情绪障碍的青少年进行的初步研究中，确定Adapt计划的初始效果大小，并评估治疗后3个月和6个月变化的维持情况。由此产生的治疗可能会产生深远的影响，通过传播到社区提供者，治疗患有焦虑和抑郁的青少年，凭借其形式上的相对一致性，以及其应用的广泛性。

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.