Assessing Parenting at the Momentary Level to Understand Parenting Behaviors that Contribute to Improved Treatment Outcomes for Youth with Co-Occurring Disorders

评估瞬时水平的养育方式，以了解有助于改善患有并发疾病的青少年的治疗结果的养育行为

• 批准号: 10424874
• 负责人: Samuel Noah Meisel
• 金额: $ 18.25万
• 依托单位: EMMA PENDLETON BRADLEY HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10424874
• 关键词: Address; Adolescent; Adolescent Behavior; Affect; Alcohol consumption; Alcohols; Behavioral Mechanisms; Cannabis; Child Rearing; Communication; Data; Development; Ecological momentary assessment; Enrollment; Exhibits; Faculty; Feedback; Foundations; Future; Goals; Grant; Intervention; Length; Life; Measures; Medicine; Mental Health; Methods; Monitor; Motivation; National Institute on Alcohol Abuse and Alcoholism; Nature; Outcome; Outpatients; Parents; Phase; Pilot Projects; Plant Roots; Protocols documentation; Psychiatric Diagnosis; Reporting; Research; Research Personnel; Risk; Sampling; Strategic Planning; Symptoms; Testing; Time; Training; Treatment outcome; Youth; acceptability and feasibility; adolescent alcohol treatment; adolescent substance use; adolescents with alcohol use disorders; alcohol abuse therapy; alcohol availability; alcohol craving; alcohol use disorder; associated symptom; behavior change; design; dual diagnosis; evidence base; improved; improved outcome; marijuana use; outcome prediction; outpatient programs; pilot test; protocol development; recruit; research study; skills; substance use treatment; teenage parents; treatment program; treatment research; underage drinking; virtual

PROJECT SUMMARY/ABSTRACT. Over 80% of adolescents with an alcohol use disorder (AUD) who present to treatment have a co-occurring psychiatric diagnosis. Although the best available treatments for adolescents with alcohol use disorders and co-occurring disorders (AUD+CODs) yield only modest short-term benefits, parent-involved treatments result in the best outcomes. In line with NIAAA’s strategic plan to improve treatments for AUD+CODs, this application seeks to address a central, yet unanswered question – what parenting behaviors during parent-involved treatment for AUD+CODs contribute to improved outcomes? Parenting is dynamic and varies from moment to moment depending on context, affect, and adolescent behavior. Moreover, treatment motivation, alcohol craving, alcohol and cannabis use, and internalizing and externalizing symptoms — core adolescent AUD+CODs treatment targets — vary considerably within and across days. Understanding the parenting behaviors during treatment that account for improved treatment outcomes requires momentary assessments that can capture the dynamic nature of parenting and core adolescent treatment targets. This K99/R00 study intends to leverage an experimental medicine framework to study how parenting, captured in real time in daily life, impacts core treatment targets (treatment motivation, alcohol craving, alcohol, and cannabis use, and internalizing and externalizing symptoms) among adolescents enrolled in an intensive outpatient for AUD+CODs. The specific aims for the K99 are to adapt parental communication, general parenting practices, and alcohol-specific parenting measures to EMA (Aim 1), conduct a pilot feasibility and acceptability study of the EMA protocol (N=20 parent-adolescent dyads; Aim 2a), and use mixed methods to evaluate and refine the EMA parenting measures and protocol (Aim 2b). Dr. Samuel Meisel’s overarching training goals are to (1) refine skills in independently designing, developing, and executing EMA research (Drs. Robert Miranda and Elizabeth McQuaid), (2) solidify expertise in conducting treatment research with adolescents with AUD+CODs (Drs. Aaron Hogue and Robert Miranda), (3) apply experimental medicine methods to adolescent AUD+COD treatment mechanisms research (Dr. John Kelly), and (4) promote a successful transition to independent faculty researcher. These training objectives build on Dr. Meisel’s F32 (AA028414), which provided him with the foundational training to broaden his research from studying the initiation and escalation of adolescent alcohol use to adolescent alcohol use treatment and mechanisms of behavior change. R00 specific aims include examining momentary parenting-core treatment target associations (N=75 parent-adolescent dyads; Aim 3a) and examining changes in the strength of parenting-treatment target associations over the course of AUD+COD treatment (Aim 3b). Findings will systematically identify the specific parenting practices during AUD+CODs treatment that most strongly relate to core treatment targets and will serve as preliminary data for future R01 and R34 applications.

项目摘要/摘要。超过 80% 患有酒精使用障碍 (AUD) 的青少年 正在接受治疗的人同时患有精神病学诊断。尽管现有的最佳治疗方法 患有酒精使用障碍和并发疾病 (AUD+COD) 的青少年仅产生适度的短期效果 好处，父母参与的治疗会带来最好的结果。符合 NIAAA 改善的战略计划 对于 AUD+COD 的治疗，该应用程序旨在解决一个核心但尚未解答的问题 – 什么 父母参与的 AUD+COD 治疗期间的养育行为有助于改善结果吗？ 养育子女是动态的，并且根据环境、情感和青少年的不同而随时变化 行为。此外，治疗动机、酒精渴望、酒精和大麻的使用以及内化和 外化症状——核心青少年 AUD+COD 治疗目标——内部和外部差异很大 跨越数日。了解治疗期间改善治疗的养育行为 结果需要即时评估，以捕捉养育和核心的动态本质 青少年治疗目标。这项 K99/R00 研究旨在利用实验医学框架 研究日常生活中实时捕捉到的养育方式如何影响核心治疗目标（治疗动机、 青少年对酒精的渴望、酒精和大麻的使用以及内化和外化症状） 参加了 AUD+COD 的重症门诊。 K99 的具体目标是适应家长的需求 与 EMA 进行沟通、一般育儿实践和针对酒精的育儿措施（目标 1）、 EMA 方案的试点可行性和可接受性研究（N=20 父母-青少年二人组；目标 2a），并使用 评估和完善 EMA 育儿措施和协议的混合方法（目标 2b）。塞缪尔博士 Meisel 的总体培训目标是 (1) 提高独立设计、开发和开发的技能 执行 EMA 研究（Robert Miranda 博士和 Elizabeth McQuaid 博士），(2) 巩固开展 EMA 研究的专业知识 针对患有 AUD+COD 的青少年的治疗研究（Aaron Hogue 博士和 Robert Miranda），(3) 申请 实验医学方法对青少年AUD+COD治疗机制的研究（约翰·凯利博士）， (4) 促进向独立教职研究员的成功过渡。这些培训目标建立在 Meisel 博士的 F32 (AA028414) 为他提供了基础培训，以扩大他的研究范围 研究青少年饮酒的开始和升级到青少年饮酒治疗 行为改变的机制。 R00的具体目标包括检查暂时的养育核心治疗 目标关联（N=75 父母-青少年二元组；目标 3a）并检查关联强度的变化 AUD+COD 治疗过程中的养育-治疗目标关联（目标 3b）。调查结果将 系统地确定 AUD+COD 治疗期间与以下因素最密切相关的具体育儿实践： 核心治疗目标，并将作为未来R01和R34应用的初步数据。