School-Based Depression Prevention for Adolescents with ADHD

多动症青少年的学校抑郁症预防

• 批准号: 9902950
• 负责人: ANDREA CHRONIS-TUSCANO
• 金额: $ 14.63万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-07 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9902950
• 关键词: Accounting; Address; Adolescence; Adolescent; Adult; Attention deficit hyperactivity disorder; Baltimore; Behavioral; Case Series; Child; Childhood; Cities; Clinic; Clinical; Cognitive; Communities; Community Practice; Comorbidity; Conflict (Psychology); Data; Diagnostic; Disease; Effectiveness; Effectiveness of Interventions; Emotional; Environment; Evidence based intervention; Feedback; Feeling suicidal; Focus Groups; Funding; Future; Goals; Health Personnel; Health Services Accessibility; Healthcare; High School Student; Hospitalization; Hybrids; Impairment; Individual; Inpatients; Intervention; Learning; Link; Low income; Major Depressive Disorder; Manuals; Measures; Mediating; Mental Depression; Mental Health; Mental Health Services; Modeling; Moods; Movement; National Institute of Mental Health; National Institute on Alcohol Abuse and Alcoholism; Nature; Outcome; Parents; Population; Prevention; Prevention approach; Prevention program; Preventive Intervention; Procedures; Protocols documentation; Public Health; Randomized; Randomized Controlled Trials; Research; Research Priority; Rewards; Risk; Schools; Series; Services; Sterile coverings; Structure; Suicide attempt; Supervision; Teenagers; Testing; Time; Training; Universities; Work; Youth; adverse outcome; alcohol related problem; base; child depression; cost; depression prevention; depressive symptoms; design; effectiveness research; effectiveness trial; emotion regulation; evidence base; functional disability; hands-on learning; health care delivery; high school; high school program; improved; in vivo; indicated prevention; inner city; interest; intervention program; motivational enhancement therapy; novel; practice setting; programs; selective prevention; social; suicidal behavior; suicidal risk; suicide rate; teacher; therapy development; treatment as usual; university student; young adult

ABSTRACT/PROJECT SUMMARY Children with ADHD are at elevated risk for depression in adolescence and young adulthood, and this comorbidity is associated with far greater impairment than either disorder alone, including higher rates of inpatient hospitalization and increased risk for suicidal ideation and behavior. Despite these adverse outcomes, existing evidence-based interventions for ADHD have not demonstrated effects in reducing depressive symptoms nor do established depression prevention programs work as well for adolescents with ADHD. Reward responsivity (RR) and emotion regulation (ER) are two key factors demonstrated to mediate the association between ADHD and depression and are thus key targets for prevention. In an effort to address the gap between access and utilization of mental health care, which is especially stark among adolescents with ADHD, we aim to develop and test a modified behavioral activation prevention program [Behaviorally Enhancing Adolescents’ Mood in Schools (BEAM-S)] that incorporates modules to directly target these purported mechanisms. In line with the Deployment-Focused Model of Intervention Development and Testing, we will develop a program that can be easily implemented and sustainable in the high school setting as delivered by school mental health staff that reduces depression and improves overall functioning in adolescents with ADHD, by way of improving RR and ER. As a first step, we will conduct focus groups with community stakeholders (e.g., school mental health providers, school administration, adolescents, parents, teachers) to develop an acceptable and sustainable selected and indicated prevention program for school staff to utilize. We will then initially train school staff to deliver this prevention program via a co- therapy training model to prepare them for their independent implementation of the prevention program in a case series consisting of two groups (one in each of two high schools) to evaluate preliminary feasibility. We will then conduct a stage 1 RCT with a hybrid-type 1 implementation- effectiveness design in which four high schools will be randomized to either the BEAM-S condition (n = 2) or treatment as usual (n = 2). Finally, qualitative and quantitative data from aims 1-3 will be used to prepare final procedures for a future large-scale effectiveness trial R01 (aim 4).

摘要/项目摘要 患有多动症的儿童在青春期和成年早期患抑郁症的风险较高，这 与单独的任何一种疾病相比，合并症所造成的损害要大得多，包括更高的损害 住院率以及自杀意念和行为的风险增加。尽管有这些 不良后果，现有针对多动症的循证干预措施尚未证明对 减少抑郁症状，既定的抑郁症预防计划也不起作用 患有多动症的青少年。奖励反应（RR）和情绪调节（ER）是两个关键因素 被证明可以介导多动症和抑郁症之间的关联，因此是治疗多动症的关键目标 预防。为了努力解决精神卫生保健的获取和利用之间的差距， 这在患有多动症的青少年中尤其明显，我们的目标是开发和测试改良的 行为激活预防计划[行为增强青少年在学校的情绪 (BEAM-S)] 包含直接针对这些所谓机制的模块。符合 以部署为中心的干预开发和测试模型，我们将开发一个程序 可以在高中环境中轻松实施并可持续，如学校心理所提供的 医务人员可以通过以下方式减少患有多动症的青少年的抑郁症并改善其整体功能 提高 RR 和 ER 的方法。第一步，我们将与社区进行焦点小组讨论 利益相关者（例如学校心理健康提供者、学校行政部门、青少年、家长、 教师）制定可接受且可持续的选定和指定的预防计划 学校工作人员利用。然后，我们将首先培训学校工作人员通过共同实施这一预防计划 治疗培训模式，为他们独立实施预防做好准备 案例系列中的计划由两组（两所高中各一组）组成，以进行评估 初步可行性。然后，我们将进行第 1 阶段 RCT，采用混合类型 1 实施 - 有效性设计，其中四所高中将被随机分配到 BEAM-S 条件（n = 2) 或照常治疗 (n = 2)。最后，将使用目标 1-3 的定性和定量数据 为未来大规模有效性试验 R01（目标 4）准备最终程序。