Targeting maladaptive responding to negative affect in adolescent cannabis users

针对青少年大麻使用者的负面影响的适应不良反应

• 批准号: 9371970
• 负责人: Kate Basia Wolitzky-Taylor
• 金额: $ 14.87万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-09-15 至 2020-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9371970
• 关键词: Adolescence; Adolescent; Adolescent and Young Adult; Affect; Affective; Affective Symptoms; Aftercare; Alcohol or Other Drugs use; Alcohols; Amygdaloid structure; Anxiety; Behavior Therapy; Behavioral; Biological Markers; Brain; Brain imaging; Cannabis; Cognitive; Cognitive Therapy; Comorbidity; Development; Disease; Drug usage; Educational process of instructing; Emotional; Emotional disorder; Emotions; Exposure to; Feedback; Focus Groups; Fright; Functional Magnetic Resonance Imaging; General Population; Goals; Individual; Intervention; Lead; Link; Maintenance; Measurement; Measures; Medial; Mediating; Mediator of activation protein; Mental Depression; Mood Disorders; Onset of illness; Outcome; Participant; Pathologic; Patient Self-Report; Patients; Population; Process; Protocols documentation; Public Health; Randomized; Randomized Clinical Trials; Reaction; Recruitment Activity; Regulation; Research; Risk; Sampling; Substance Addiction; Substance Use Disorder; Testing; Time; Tobacco; Training; Treatment outcome; Work; adolescent substance use; aged; alcohol and other drug; anxiety sensitivity; arm; behavioral construct; bodily sensation; cognitive reappraisal; craving; design; distress tolerance; emerging adult; emotion dysregulation; emotion regulation; emotional reaction; emotional symptom; evidence base; follow up assessment; follow-up; high risk; improved; indexing; individualized medicine; marijuana use; marijuana use disorder; marijuana user; mindfulness; negative affect; novel; relating to nervous system; response; satisfaction; screening; skills; standard care; therapy outcome; young adult

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.

项目摘要 该项目旨在开发和评估针对青少年大麻使用障碍的行为干预措施 强调适应性反应负面情感症状（例如抑郁症，焦虑）。适应不良 认知，行为和对负面影响的情绪反应与物质使用和 药物使用问题（包括大麻）。青春期和年轻成年代表了发展 调节负面情绪的调节时期以及大麻使用的时间 普遍存在，大麻使用障碍发作。因此，发展和评估大麻使用障碍 强调改善负面影响的干预措施对 这个发展时期。 首先，我们将开发一种干预措施，编织技能和策略以适应 负面影响，特别是与大麻渴望和使用的高风险时代有关的影响， 在青春期和成年初期对个体的物质使用障碍干预。开发 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到 干预。在完善干预措施之后，我们计划成为12条课程的个人待遇，我们将 进行飞行员随机临床试验。参与者（n = 80），年龄18-25岁，患有大麻使用障碍和 代表对负面影响不良反应性不良反应性的构建体的升高（即高焦虑敏感性，低 遇险宽容或情绪失调的方面，包括高情绪抑制和低认知能力 重新评估能力）将被随机接收：（a）青少年的标准认知行为疗法 药物使用障碍（SUD-CBT）或（b）我们开发的新颖干预措施，情感管理培训 大麻使用障碍（CUD-AMT）。参与者将在基线，治疗后和6个月进行评估 对目标机制的自我报告和行为指数的后续评估以及物质的后续评估 使用结果（大麻特异性和物质更广泛地定义）。参与者的子集（n = 50） 还将接受治疗前和治疗后的fMRI评估，以评估情感的神经指标是否 与SUD-CBT相比，在CUD-AMT中，调节的改进程度更大。 大麻使用障碍是青少年和年轻人中最普遍的药物使用障碍 成年人，并且经常导致其他物质使用。与高有关的负面影响和疾病 负面影响（即焦虑和单极情绪障碍）高度普遍，并且与显着相关 药物使用障碍合并症。针对一个在青春期和YOUNG的过程中仍然可延展的过程 成年，这与维持物质使用障碍有关，有可能减少 该人群中物质使用障碍的负担，从而产生了重大的公共卫生影响。