Test of an Adolescent Anxiety Sensitivity Amelioration Program for At-Risk Youth

描述（由申请人提供）：首席研究员（PI）的目标是成为一名以研究为导向的学术环境中的科学家，其研究项目侧重于预防青少年的焦虑精神病理学。因此，我们制定了一个全面的培训计划，以系统地提高PI的能力：1)关于与焦虑精神病理学相关的基础广泛的风险因素的概念模型的专业知识；2)焦虑相关脆弱性和病理复杂评估的方法熟练程度；3)了解针对青少年的预防项目的发展、评估、实施、分析和传播。重要的是，拟议的研究旨在通过帮助PI完善相关研究技能来补充培训计划，同时完成青少年风险因素减少计划的初步测试。拟议的样本将包括88名焦虑敏感性（AS）水平升高的青少年（10至14岁），这是一种反映对焦虑后果恐惧的认知脆弱性变量。成人研究支持针对AS的有效性，特别是在预防恐慌和焦虑精神病理学方面。因此，AS是一种“基础广泛”的风险因素，有可能影响多种疾病。风险因素研究表明，在青少年中，AS的改变对恐慌和广泛性焦虑障碍有影响。然而，很少有研究评估在青少年中减少AS的影响，这是不幸的，因为青少年是焦虑障碍发病的“核心风险”时期。此外，尽管有证据表明父母可能在促进预防规划方面发挥关键作用，但没有研究考虑到此类规划对gad相关结果的影响，也没有研究包括家庭层面的干预因素。为了解决文献中这些显著的空白，本项目的主要目的是通过实验测试青少年焦虑敏感性改善计划（AASAP）的效果。高AS青少年和一名家长将被随机分配到AASAP，其中包括一个50分钟的心理教育和实验者主导的内感受性暴露，或者是一个一般的健康信息控制条件。将评估AASAP的即时、两周和四周效果，包括对自我报告的AS、惊恐发作症状和广泛性焦虑症状的影响。此外，该计划预计将影响使用复杂挑战程序索引的恐慌和gad相关漏洞。该项目与美国国立卫生研究院（National Institutes of health）的公共卫生使命相一致，也与最近多次呼吁培训老练的预防科学家相一致。具体来说，考虑到与焦虑精神病理学相关的巨大人类痛苦和经济成本，为有发展此类问题风险的青少年构建量身定制的干预方案至关重要。我们期望，作为这个项目的结果，我们将为青少年制定一个明确的社会心理干预计划，以经验支持的与多种焦虑相关的过程为目标。

DESCRIPTION (provided by applicant): Principal Investigator's (PI) goal is to be a scientist in a research-oriented academic setting with a research program focused on preventing anxiety psychopathology among adolescents. A comprehensive training plan was therefore constructed to systematically advance the PI's: 1) expertise regarding conceptual models of broad-based risk factors pertinent to anxiety psychopathology; 2) methodological proficiency related to the sophisticated assessment of anxiety-related vulnerability and pathology; and 3) understanding of the development, evaluation, implementation, analysis, and dissemination of prevention programs targeting youth. Importantly, the proposed study is designed to complement the training program by helping the PI to refine relevant research skills while completing an initial test of an adolescent risk factor reduction program. The proposed sample will consist of 88 adolescents (10 to 14 years) with elevated levels of anxiety sensitivity (AS), a cognitive vulnerability variable reflecting fear of the consequences of anxiety. Adult research supports the effectiveness of targeting AS in terms of preventing panic specifically, and anxiety psychopathology generally. AS is thus a "broad-based" risk factor with the potential to impact multiple disorders. Risk factor research suggests AS modification among youth has implications for panic as well as generalized anxiety disorder. However, very little work has evaluated the impact of AS reduction among youth, which is unfortunate given adolescence is a period of "core risk" in terms of anxiety disorder onset. Further, no work has considered the effect of such a program on GAD-relevant outcomes, nor has any work included family-level intervention factors, despite evidence suggesting parents likely play a critical role in promoting prevention programming. To address these notable gaps in the literature, the primary aim of this project is to experimentally test the effects of an Adolescent Anxiety Sensitivity Amelioration Program (AASAP). High AS youth and a parent will be randomly assigned to either the AASAP, which consists of a single 50min session of psychoeducation and experimenter-led interoceptive exposure, or a general health information control condition. Immediate, two-week, and four-week effects of the AASAP will be evaluated, including effects on self-reported AS, panic attack symptoms, and symptoms of generalized anxiety. Further, the program is expected to impact panic- and GAD-relevant vulnerability indexed using sophisticated challenge procedures. This project aligns with the public health mission of the National Institutes of Health, along with multiple recent calls to train sophisticated prevention scientists. Specifically, given the considerable human suffering and economic costs associated with anxiety psychopathology, it is critically important to construct tailored intervention programs for adolescents at risk for developing such problems. We expect that as a result of this project we will have developed a well-specified psychosocial intervention program for adolescents that targets empirically supported processes with relevance to multiple anxiety-relevant conditions.