Behavioral Treatment Development for Co-occurring Opioid Dependence and Anxiety

针对同时发生的阿片类药物依赖和焦虑的行为治疗开发

• 批准号: 9254531
• 负责人: Rebecca Kathryn McHugh
• 金额: $ 19.02万
• 依托单位: MCLEAN HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-04-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9254531
• 关键词: Address; Aftercare; Alcohol or Other Drugs use; Anxiety; Anxiety Disorders; Area; Behavior Therapy; Behavioral; Center for Translational Science Activities; Chronic; Clinical; Clinical Research; Clinical Sciences; Clinical Trials; Cognitive Therapy; Complement; Data; Data Analyses; Data Analytics; Development; Disease; Distress; Drug usage; Environment; Evaluation; Family; Feedback; Goals; High Prevalence; Hospitals; Individual; International; Interviewer; K-Series Research Career Programs; Learning; Link; Maintenance; Manuals; Measures; Mental disorders; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methodology; Nature; Opiate Addiction; Opioid; Outcome; Participant; Patient Self-Report; Patients; Population; Process; Psychologist; Psychophysiology; Public Health; Recruitment Activity; Reporting; Research; Research Personnel; Resources; Risk; Risk Factors; Role; Sampling; Scientist; Severities; Societies; Stress; Substance Addiction; Symptoms; Target Populations; Techniques; Testing; Training; Training Activity; Treatment Protocols; Treatment outcome; Writing; addiction; anxiety symptoms; career; career development; design; disorder risk; dual diagnosis; efficacy testing; experience; functional outcomes; implementation research; medical schools; novel; opioid use; patient oriented research; predictive of treatment response; prognostic; programs; public health relevance; randomized trial; research study; satisfaction; skills; standard care; stress reactivity; therapy development; treatment of anxiety disorders; treatment response; treatment strategy

DESCRIPTION (provided by applicant): Anxiety is a risk factor for the use of opioids and anxiety disorders are highly prevalent among individuals with opioid dependence. Moreover, individuals with co-occurring opioid dependence and anxiety disorders often experience poorer drug use, anxiety, and functional outcomes following treatment. Despite the links between opioid dependence and anxiety disorders and the risk associated with their co-occurrence, very little is known about this common dual diagnosis, and efficacious treatment options have yet to be established. Dr. Rebecca Kathryn McHugh's career goal is to conduct patient-oriented research focused on the co-occurrence of substance dependence and anxiety disorders. The integrated training and research plans proposed in this application will provide Dr. McHugh with advanced training in several critical areas needed to enhance her program of research toward this career goal. Under the mentorship of internationally renowned leaders in the field of substance dependence, training is targeted to the following domains: (1) clinical research in co- occurring disorders (Dr. Roger Weiss), (2) the nature and treatment of opioid dependence (Dr. Weiss), (3) behavioral treatment development and testing (Dr. Shelly Greenfield), (4) the role of stress in substance dependence (Dr. Rajita Sinha), and (5) longitudinal data analytic techniques (Dr. Garrett Fitzmaurice). These training objectives will be achieved through a combination of didactic and applied activities and through the application of these skills in a Stage 1 behavioral treatment development trial involving the development and pilot testing of a novel integrated cognitive behavioral treatment for co-occurring opioid dependence and anxiety (I-CBT). Target areas for learning in each training domain are directly linked to the specific aims of this researc study, which include (1) the development of an integrated cognitive behavioral treatment manual for opioid dependence and anxiety disorders (I-CBT), (2) pilot testing the efficacy of I-CBT for reducing opioid use and anxiety symptoms compared to standard CBT for opioid dependence, (3a) the examination of the association between pre-treatment reactivity to stress and opioid use outcomes following treatment, and (3b) the examination of changes in stress reactivity following treatment. McLean Hospital and Harvard Medical School provide an ideal environment for the attainment of these training and research objectives, including clinical units supportive o patient-oriented research, seminars and courses in designating training areas, and a highly active Clinical and Translational Science Center with a wide array of resources for career development and training. This K23 Award would provide Dr. McHugh with a repertoire of advanced skills designed to complement her prior training and to provide an essential bridge between her prior experience and her career goal to conduct an active program of patient-oriented research as an independent scientist, toward the ultimate goal of reducing the public health burden of substance dependence and anxiety disorders.

描述(申请人提供)：焦虑是使用阿片类药物的一个危险因素，焦虑症在阿片类药物依赖者中非常普遍。此外，同时患有阿片依赖和焦虑障碍的患者在治疗后往往会经历较差的药物使用、焦虑和功能结果。尽管阿片依赖和焦虑症之间存在联系，以及它们共同出现的风险，但人们对这种常见的双重诊断知之甚少，而且还没有建立有效的治疗选择。丽贝卡·凯瑟琳·麦克休博士的职业目标是进行以患者为导向的研究，重点是物质依赖和焦虑症的共存问题。这份申请中提出的综合培训和研究计划将为麦克休博士提供几个关键领域的高级培训，以加强她的研究计划，实现这一职业目标。在物质依赖领域国际知名领导者的指导下，培训针对以下领域：(1)共生疾病的临床研究(Roger Weiss博士)，(2)阿片依赖的性质和治疗(Weiss博士)，(3)行为治疗开发和测试(Shelly Greenfield博士)，(4)压力在物质依赖中的作用(Rajita Sinha博士)，以及(5)纵向数据分析技术(Garrett Fitzmaurice博士)。这些培训目标将通过教学和应用活动的结合以及在阶段1行为中应用这些技能来实现 治疗开发试验，包括开发和试点测试一种治疗阿片类药物依赖和焦虑共存的新型综合认知行为疗法(I-CBT)。每个培训领域的学习目标领域与本研究的具体目标直接相关，其中包括：(1)编制阿片依赖和焦虑症综合认知行为治疗手册(I-CBT)，(2)与阿片依赖标准CBT相比，初步测试I-CBT在减少阿片类药物使用和焦虑症状方面的有效性，(3a)研究治疗前对应激的反应性与治疗后阿片类药物使用结果之间的关联，以及(3b)研究治疗后应激反应的变化。麦克莱恩医院和哈佛医学院为实现这些培训和研究目标提供了理想的环境，包括支持以患者为中心的研究的临床单位，指定培训领域的研讨会和课程，以及高度活跃的临床和转化科学中心，拥有广泛的职业发展和培训资源。这一K23奖项将为麦克休博士提供一系列高级技能，旨在补充她之前的培训，并在她以前的经验和她的职业目标之间提供一座重要的桥梁，即作为一名独立科学家开展以患者为导向的积极研究计划，朝着减少物质依赖和焦虑症的公共卫生负担的最终目标迈进。