Integrated Family-Based Treatment of Co-Occurring Adolescent SUD and ADHD

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DESCRIPTION (provided by applicant): For adolescents with comorbid SUD and ADHD, integrated treatment models that combine behavioral and pharmacological interventions are urgently needed to achieve lasting clinical gains for both conditions. Dr. Hogue's expertise in family-based treatment for adolescent SUDs makes him an excellent candidate to become a productive investigator in this area. The objective of this amended K02 application is to provide Dr. Hogue with training and collaborative research experiences in three core areas: (1) Behavioral Intervention Core: training in developmental psychopathology and behavioral treatment for adolescent ADHD that includes treatment planning for school and learning problems; (2) Psychopharmacology Core: training in medication intervention and compliance issues for adolescent ADHD and other co-occurring disorders, and in the conduct of medication trials for adolescent disorders; (3) Neurodevelopment Core: training in neurodevelopmental risk factors associated with ASU and ADHD and in neuroimaging (fMRI) techniques for investigating brain processes and treatment response in adolescents with SUD/ADHD. Training in these core areas will lead to development of a new treatment for ASU/ADHD, Functional Family Therapy - Integrated Model (FFT-IM), an adapted version of an empirically based model for ASU that incorporates neuropsychological assessment and an evidence-based psychostimulant medication protocol for ADHD. Training activities will culminate in a Stage I pilot study of FFT-IM involving N = 20 adolescents with SUD/ADHD. This Stage Ia pilot study of FFT-IM is designed to yield proof-of-concept data with regard to feasibility and acceptability, treatment fidelity, and effect size estimates for behavioral, developmental, and family outcomes. The quasi-experimental design will compare service utilization effects and posttreatment outcomes in 20 FFT-IM cases versus 20 TAU matched comparison cases drawn from the same geographic area who receive routine services in community clinics. Observational fidelity tools will be developed for newly developed FFT-IM components and used to evaluate adherence and competence in the pilot cases. If promising, study results would set the foundation for a randomized efficacy trial of FFT-IM. PUBLIC HEALTH RELEVANCE: ADHD is common co-occurring condition for ASU that presents a significant challenge to successful ASU treatment and maintenance of treatment gains. The career development goals described in this K02 application will lead to development of an integrated behavioral/pharmacological treatment for ASU/ADHD and prepare the Principal Investigator for an independent research career focused on developing and testing integrated models for a variety of co-occurring disorders in adolescence.