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%的患有酒精使用障碍(AUD)的青少年 目前正在接受治疗的患者被诊断为精神疾病。尽管目前最好的治疗方法是 患有酒精使用障碍和共生障碍(AUD+CODS)的青少年只能产生适度的短期疗效 好处，家长参与的治疗会产生最好的结果。与NIAAA改进的战略计划保持一致 对于AUD+Cods的治疗，该应用程序寻求解决一个中心但尚未回答的问题-什么 AUD+CODS患者家长参与治疗过程中的养育行为有助于改善结局？ 育儿是动态的，根据环境、情感和青少年的不同而不同 行为。此外，治疗动机、酒精渴求、酒精和大麻的使用以及内化和 外在症状-核心青少年AUD+CoDS治疗目标-在 跨越了几天。理解治疗过程中的养育行为是改善治疗的原因 结果需要能够捕捉到育儿和核心问题的动态本质的瞬时评估 青春期治疗目标。这项K99/R00研究旨在利用实验医学框架来 研究日常生活中实时捕捉的育儿方式如何影响核心治疗目标(治疗动机、 青少年的酒精渴求、酒精和大麻使用，以及内化和外化症状) 登记了AUD+CoDS的重症门诊患者。K99的具体目标是适应父母 交流、一般育儿做法和针对酒精的育儿措施(目标1)，行为 EMA方案的试点可行性和可接受性研究(N=20个父母-青少年二人；目标2a)，并使用 评估和改进幼儿保育措施和方案的混合方法(目标2b)。塞缪尔博士 Meisel的主要培训目标是(1)提炼独立设计、开发和 执行EMA研究(Robert Miranda博士和Elizabeth McQuaid博士)，(2)巩固指挥专业知识 AUD+Cods青少年的治疗研究(Aaron Hogue和Robert Miranda博士)，(3)适用 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)促进向独立教研员的成功转型。这些培训目标建立在 Meisel博士的F32(AA028414)，这为他提供了扩大研究范围的基础训练 研究青少年酒精使用的开始和升级到青少年酒精使用治疗和 行为改变的机制。R00的具体目标包括检查瞬间育儿-核心治疗 目标关联(N=75个亲子-青少年二元组；目标3a)，并检查 AUD+COD治疗过程中的育儿-治疗目标关联(目标3b)。调查结果将 系统地确定AUD+CODS治疗期间与以下方面最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。