Targeting maladaptive responding to negative affect in adolescent cannabis users

项目摘要 该项目旨在开发和评估青少年大麻使用障碍的行为干预， 强调对消极情感症状的适应性反应（例如，抑郁、焦虑）。适应不良 对负面情绪的认知、行为和情绪反应与物质使用有关， 药物使用问题（包括大麻）。青春期和青年期代表着一种发展性的 在这一时期，负面情绪的调节仍在发展，以及大麻使用的时间 是普遍的，大麻使用障碍发作。因此，开发和评估大麻使用障碍 强调改善对负面影响的反应的干预措施可能特别重要， 这个发展时期。 首先，我们将制定一项干预措施，为适应性地应对 负面影响，特别是因为它涉及大麻渴望和使用的高风险时期， 对青少年后期和成年早期个体的物质使用障碍干预。在开发了 初始协议并将其交付给一小部分参与者，我们将收集反馈以指导改进， 干预。在完善干预措施后，我们计划将其作为12个疗程的个体治疗，我们将 进行初步随机临床试验。参与者（N = 80）年龄在18-25岁之间，患有大麻使用障碍， 代表对负面影响的适应不良反应性的结构中的升高（即，焦虑敏感度高， 痛苦容忍，或情绪失调的方面，包括高情绪抑制和低认知 重新评价能力）将随机接受：（a）青少年标准认知行为治疗 物质使用障碍（SUD-CBT）或（B）我们开发的新干预，情感管理培训， 大麻使用障碍（CUD-AMT）。将在基线、治疗后和6个月时对受试者进行评估 对目标机制的自我报告和行为指数以及实质性问题进行后续评估 使用结果（大麻特有的和更广泛定义的物质）。参与者子集（n = 50） 还将接受治疗前和治疗后的功能磁共振成像评估，以评估情绪的神经指标是否 与SUD-CBT相比，CUD-AMT在更大程度上改善了调节。 大麻使用障碍是青少年和年轻人中最普遍的物质使用障碍 成年人，并往往导致使用其他物质。与高血压相关的负面情绪和疾病 负面影响（即，焦虑和单极情绪障碍）是非常普遍的，并与显著的 物质使用障碍合并症目标是在青春期后期和年轻时仍然具有可塑性的过程 成年期，并与物质使用障碍的维持有关，有可能减少 这一人群中药物使用障碍的负担，从而对公共卫生产生重大影响。

Project Summary This project aims to develop and evaluate a behavioral intervention for adolescent cannabis use disorder that emphasizes adaptive responding to negative affective symptoms (e.g., depression, anxiety). Maladaptive cognitive, behavioral, and emotional reactions to negative affect are associated with substance use and substance use problems (including cannabis). Adolescence and young adulthood represents a developmental period in which the regulation of negative emotions is still being developed, as well as a time when cannabis use is prevalent and cannabis use disorders onset. Thus, developing and evaluating cannabis use disorder interventions that emphasize the improvement of responding to negative affect may be particularly important for this developmental period. First, we will develop an intervention that weaves skills and strategies for responding adaptively to negative affect, particularly as it relates to high-risk times for cannabis craving and use, into an evidence-based substance use disorder intervention for individuals in late adolescence and early adulthood. After developing the initial protocol and delivering it to a small sample of participants, we will gather feedback to guide refinements to the intervention. After refining the intervention, which we plan to be a 12-session individual treatment, we will conduct the pilot randomized clinical trial. Participants (N = 80) aged 18-25 with cannabis use disorder and elevations in constructs representing maladaptive reactivity to negative affect (i.e., high anxiety sensitivity, low distress tolerance, or facets of emotion dysregulation including high emotional suppression and low cognitive reappraisal ability) will be randomized to receive either: (a) standard cognitive behavioral therapy for adolescent substance use disorders (SUD-CBT) or (b) the novel intervention we develop, affective management training for cannabis use disorders (CUD-AMT). Participants will be assessed at baseline, post-treatment, and a 6-month follow-up assessment on self-report and behavioral indices of the targeted mechanisms, as well as on substance use outcomes (both cannabis-specific and substances more broadly defined). A sub-set of participants (n = 50) will also undergo pre- and post-treatment fMRI assessment to evaluate whether neural indices of emotion regulation are improved to a greater extent in CUD-AMT compared to SUD-CBT. Cannabis use disorder is the most prevalent substance use disorder among adolescents and young adults, and often leads to the use of other substances. Negative affect and disorders associated with high negative affect (i.e., anxiety and unipolar mood disorders) are highly prevalent and associated with significant substance use disorder comorbidity. Targeting a process that is still malleable in late adolescence and young adulthood and that is associated with the maintenance of substance use disorders has the potential to reduce the burden of substance use disorders in this population, thus making a significant public health impact.