Family Based Contingency Management for Adolescent Alcohol Abuse

基于家庭的青少年酗酒应急管理

• 批准号: 8451130
• 负责人: CATHERINE STANGER
• 金额: $ 26.99万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-05 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8451130
• 关键词: Family; Based; Contingency; Management; Adolescent

DESCRIPTION (provided by applicant): Based on the 2003-2004 National Survey on Drug Use and Health, 1.5 million youth aged 12-17 years (6.1% of youth in that age range) needed treatment for alcohol abuse, and alcohol is the primary drug reported by 19% of the adolescent treatment population. Recent intervention research on adolescent alcohol abuse has focused primarily on school-based, community, or ER populations. Although new outpatient family-based and contingency-management (CM) interventions for adolescent marijuana abuse have been developed, not one of them specifically targets adolescent primary alcohol users. We could find no published outpatient randomized trial specifically targeting alcohol abuse in adolescents. Thus, little is known about how to most effectively intervene with primary adolescent alcohol abuse and dependence in an outpatient setting. Our goal is to adapt our family-based CM treatment to target primary adolescent alcohol abuse and dependence. Specific Aim 1 is to provide a preliminary demonstration of the efficacy of a familybased CM intervention to treat adolescent alcohol abuse and dependence. CM components include 1) an incentive program to enhance the adolescent's engagement in the treatment process and engender alcohol abstinence by providing positive reinforcement for documented abstinence via breathalyzers administered by parents regularly at home, self and parent report, and clinic-based urine drug testing; and 2) a parent management training program to enhance and maintain the positive effects of the incentive program by teaching parents how to effectively use contingency management in the home environment to motivate their adolescent to achieve abstinence and improve their behavior in other domains. A randomized trial will determine whether the CM intervention enhances outcomes when added to a standard individual cognitive behavioral therapy. Specific Aim 2 is to determine whether and how treatment interventions modify parental and adolescent risk and protective factors using observational and laboratory measures (parenting practices, family functioning, risk taking, delay discounting, and child and parent psychopathology) and to determine whether these factors are associated with outcomes over time. Findings will extend the scientific evidence for CM and support the ability of parents to implement CM at home. Findings that support the CM model's efficacy will make a significant contribution to research on the treatment of adolescent alcohol abuse, which has lagged behind research on adult substance abuse and on adolescent illicit drug use. Future projects will include isolation of active treatment components, dissemination to community clinics, and cost-effectiveness studies.

描述（由申请人提供）：基于2003 - 2004年全国药物使用和健康调查，150万年龄在12-17岁之间（该年龄段的青年占6.1％）需要治疗酒精滥用，而酒精是19％的青少年治疗人群报告的主要药物。最近对青少年酗酒的干预研究主要集中在基于学校，社区或ER人群上。尽管已经开发了针对青少年大麻滥用大麻的新的基于门诊的家庭和应急管理（CM）干预措施，但其中没有一个专门针对青少年主要酒精用户。我们找不到公开的门诊随机试验，专门针对青少年酗酒。因此，关于如何在门诊环境中最有效地干预原发性青少年酒精滥用和依赖性知之甚少。我们的目标是调整我们的基于家庭的CM治疗，以瞄准原发性青少年酒精滥用和依赖性。具体目的1是提供基于家庭的CM干预措施治疗青少年酗酒和依赖性的有效性的初步证明。 CM组件包括1） 激励计划，以增强青少年参与治疗过程的参与并通过为通过父母定期在家中，自我和父母报告和基于诊所的尿液药物测试的呼吸分析提供积极的强化，从而通过呼吸分析提供积极的强化，从而增强青少年参与度的戒酒； 2）通过教父母如何在家庭环境中有效使用意外事件管理以激励其青少年以实现戒酒并改善其在其他领域中的行为，以增强和维持激励计划的积极影响，以增强和维持激励计划的积极影响，以增强和维持激励计划的积极影响，以增强和维持激励计划的积极影响，以增强和维持奖励计划的积极影响。 一项随机试验将确定CM干预措施是否添加到标准个体认知行为疗法中时是否会增强结果。具体目的2是确定治疗干预措施是否以及如何使用观察和实验室措施（育儿习惯，家庭功能，承担，延迟折扣以及子女和父母心理病理学）修改父母和青少年风险以及保护性因素，并确定这些因素是否随着时间的推移与结果相关。调查结果将扩大CM的科学证据，并支持父母在家实施CM的能力。支持CM模型功效的发现将为青少年酗酒的治疗研究做出重大贡献，这落后于对成人药物滥用和青少年非法药物使用的研究。未来的项目将包括隔离积极的治疗成分，向社区诊所传播以及成本效益研究。