Mechanisms of Risk and Resilience in Adolescent Drug Treatment and Recovery

项目总结/摘要 青少年物质使用障碍（SUD）是一个重大的公共卫生问题。 青少年在SUD治疗后复发率很高，甚至高于成年人。 虽然我们对青少年发展的风险和复原力途径了解很多， SUDs，关于成功与不成功的预测因子和机制知之甚少 青少年SUD治疗。有一种机制在预测贫困方面显示出了希望， 成人的治疗结果是高度的痛苦不耐受（DI）：无法或感知无法 来承受痛苦的情绪拟议的研究集中在DI的基线水平， 以及现有住院和重症门诊期间和之后的DI变化 青少年的治疗方案。大约134名青少年将完成一项 DI的综合评估，包括自我报告、生理测量和DI 基线任务，治疗期间3次，6个月随访期间3次。 青少年和家长还将完成对已知风险因素的评估， SUD的发展和维持，包括青少年和家庭物质使用史， 同伴物质使用，父母监控，社会支持，创伤症状， 内部化/外部化问题。在治疗和随访期间，青少年将报告他们的 物质渴望和物质使用复发的水平。根据参与者的基线DI和 DI随时间的变化，结合其他测量的风险因素， 研究将用于预测渴望程度和未来复发。具体而言，结果将 提供有DI复发风险的青少年的受试者内和受试者间特征。 此外，由于受试者内的多重评估，建议的 研究可以通过展示基于DI的干预何时可能 是最需要的或者最有益的。最后，根据区域的主要目标， R15计划，学生将获得宝贵的经验，在严格和深入的研究， 成瘾，改变机制和恢复的领域。学生将参加 实施研究方案、数据分析、手稿准备和研究 在会议上的演讲，加强学生的未来职业前景，以及 改善大学的研究环境。

PROJECT SUMMARY/ABSTRACT Adolescent substance use disorders (SUDs) present a significant public health concern. Adolescents have high rates of relapse following SUD treatment, higher even than adults. Although much is known about risk and resilience pathways for the development of adolescent SUDs, much less is known about predictors and mechanisms of successful versus unsuccessful SUD treatment in adolescents. One mechanism that has shown promise in predicting poor treatment outcomes for adults is high distress intolerance (DI): the inability or perceived inability to withstand distressing emotions. The proposed research focuses on baseline levels of DI, as well as change in DI during and following an existing residential and intensive outpatient treatment program for adolescents. Approximately 134 adolescents will complete a comprehensive assessment of DI, including self-reports, physiological measurements, and DI tasks at baseline, 3 times during treatment, and 3 times during the 6-month follow-up period. Adolescents and parents will also complete assessments of known risk factors for the development and maintenance of SUDs, including adolescent and family substance use history, peer substance use, parental monitoring, social support, trauma symptoms, and internalizing/externalizing problems. During treatment and follow-up, adolescents will report their level of substance craving and substance use relapses. Based on participants' baseline DI and DI change over time, in combination with other measured risk factors, results of the proposed research will be used to predict levels of craving and future relapse. Specifically, results will provide within- and between-subjects profiles of adolescents at risk for a DI-based relapse. Further, because of the multiple assessments within subjects, the results of the proposed research can inform future interventions by demonstrating when a DI-based intervention might be the most needed or beneficial. Finally, in accordance with the key objectives of the AREA R15 program, students will gain invaluable experience in rigorous and intensive research in the areas of addictions, change mechanisms, and recovery. Students will participate in the implementation of research protocols, data analysis, manuscript preparation, and research presentations at conferences, strengthening the students' future career prospects, as well as enhancing the university's research environment.