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

描述(由申请人提供)：首席调查员(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，研究项目重点是预防青少年中的焦虑心理病理。因此，构建了一项全面的培训计划，以系统地提高PI的以下方面：1)与焦虑精神病理学有关的基础广泛的风险因素概念模型的专业知识；2)与焦虑相关脆弱性和病理学的复杂评估相关的方法熟练程度；以及3)了解针对青年的预防方案的制定、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名青少年(10至14岁)，他们的焦虑敏感度(AS)水平升高，这是一种反映对焦虑后果的恐惧的认知脆弱性变量。成人研究支持针对AS的有效性，特别是在预防恐慌方面，而焦虑精神病理学一般支持这种有效性。因此，这是一个“广泛的”风险因素，有可能影响多种疾病。风险因素研究表明，青少年中的变态行为不仅会导致广泛性焦虑症，还会引发恐慌。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，因为青春期是焦虑症发病的“核心风险”时期。此外，没有任何工作考虑到这种计划对与GAD相关的结果的影响，也没有任何工作包括家庭层面的干预因素，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。为了解决这些文献中的显著差距，本项目的主要目的是通过实验测试青少年焦虑敏感度改善计划(AASAP)的效果。HIGH AS青年和一名父母将被随机分配到AASAP，其中包括一次50分钟的心理教育和实验者引导的内部感觉暴露，或一般健康信息控制条件。将评估AASAP的即时、两周和四周的效果，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，预计该计划将影响使用复杂的挑战程序编制的恐慌和GAD相关漏洞索引。该项目与国家卫生研究院的公共卫生使命相一致，以及最近多次呼吁培训复杂的预防科学家。具体地说，考虑到与焦虑精神病相关的相当大的人类痛苦和经济成本，为有可能出现此类问题的青少年制定量身定做的干预计划至关重要。我们期望，作为这个项目的结果，我们将为青少年开发一个明确的心理社会干预计划，目标是与多种与焦虑相关的疾病相关的经验支持的过程。

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.