Decreasing Stress and Anxiety in Adolescents from High-Conflict Homes: Testing a Mindfulness Group + Ecological Momentary Intervention

摘要 该K 01申请的候选人是一名助理教授，拥有完善的，富有成效的计划， 基础社会科学研究，调查家庭关系，特别是婚姻冲突， 青少年健康她的长期目标是在这个研究项目的基础上开发和测试身心 干预措施，以改善来自高冲突家庭的青少年的压力和焦虑。为此，申请人 需要额外的培训：a）进行正念干预的随机对照试验（RCT）， B）通过培养分析密集纵向数据的技能，评估随机对照试验随时间推移的效果。 拟订拟议培训计划是为了通过讲习班在这些关键领域提供额外培训， 教学课程、亲自指导和主要研究活动。研究项目的总体目标 支持开发和测试一种干预模式，直接针对高风险和 服务不足的青少年群体：那些来自高冲突家庭，因此可能表现出 压力生理失调、压力增加和焦虑增加的问题。过去为减少 冲突对后代的负面影响集中在针对家庭冲突，而不是直接关注 改善对高危青少年的监管。正念干预是一种很有前途的方法 直接针对来自高冲突家庭的青少年，以建立监管能力。然而，他们没有 以这种方式使用，也没有生态瞬时干预（EMI）补充这些干预 开发了将EMI纳入传统治疗通常会提高治疗效果， 尤其适合青少年。具体目标是：1）开发EMI补充剂（干预 内容通过手机传递会话之间）学习呼吸（L2 B），一个基于证据的 青少年的正念计划，并通过一个 混合方法研究; 2）评估L2 B Plus（L2 B plus EMI）用于青少年的可行性和可接受性 从高冲突的家庭，和，3）检查在何种程度上正念减少生理压力 来自高冲突家庭的青少年的失调，感知压力和焦虑，a）实验性地， 将L2 B与对照、健康教育程序进行比较，以及B）在现有数据集中进行观察。无论是 研究中，正念，压力和焦虑之间的联系将在人与人之间进行检查。一致 NCCIH的重点是调查身心练习如何改善压力和焦虑，目前的项目 将进一步了解如何增加正念可以支持青少年从高冲突的家庭; 预计该项目将产生一个灵活的干预模式，该模式实施起来可行，并受到 家庭和青少年，可以修改，以广泛服务于青少年的风险，因为慢性 应力该研究还有望获得支持L2 B Plus更大规模RCT的关键试点数据。

Abstract The candidate for this K01 application is an Assistant Professor with a well-established, productive program of basic social science research investigating the effects of family relationships, particularly marital conflict, on adolescent health. Her long-term goal is to build upon this research program to develop and test mind-body interventions to improve stress and anxiety in adolescents from high-conflict homes. To do so, the applicant needs additional training in: a) conducting randomized controlled trials (RCTs) of mindfulness interventions and b) assessing the effects of RCTs over time by developing skills in the analysis of intensive longitudinal data. The proposed training plan was developed to provide additional training in these key areas through workshops, didactic courses, in-person mentoring, and primary research activities. The overall goal of the research project is to support the development and testing of an intervention model to directly target a high-risk and underserved adolescent group: those who are from high-conflict homes and are therefore likely to display problems with dysregulated stress physiology, increased stress, and increased anxiety. Past efforts to reduce negative effects of conflict on offspring have focused on targeting family conflict rather than directly focusing on improving regulation in adolescents who are at-risk. Mindfulness interventions represent a promising approach to directly target adolescents from high-conflict homes to build regulatory capabilities. However, they have not been used in this way, nor have ecological momentary intervention (EMI) supplements to these interventions been developed. Incorporating EMI into traditional treatments often increases treatment efficacy, and is particularly appropriate for adolescents. The specific aims are to: 1) develop an EMI supplement (intervention content delivered via cell phone between sessions) to Learning to Breathe (L2B), an evidence-based mindfulness program for adolescents, and to determine the best delivery plan for this EMI supplement via a mixed methods study; 2) evaluate the feasibility and acceptability of L2B Plus (L2B plus EMI) for adolescents from high-conflict homes, and, 3) examine the extent to which mindfulness reduces physiological stress dysregulation, perceived stress, and anxiety in adolescents from high-conflict homes, both a) experimentally by comparing L2B to a control, health education program and b) observationally in an existing dataset. In both studies, links between mindfulness, stress, and anxiety will be examined between- and within-person. In line with NCCIH’s focus on investigating how mind-body practices improve stress and anxiety, the current project will advance understanding of how increasing mindfulness can support adolescents from high-conflict homes; this project is expected to result in a flexible intervention model that is feasible to implement and well-liked by families and adolescents, and that can be modified to broadly serve adolescents at-risk because of chronic stress. This study is also expected to result in the key pilot data supporting a larger-scale RCT of L2B Plus.