Ecological Momentary Assessment of Mechanisms of Change during a Mindfulness-based Intervention for At-risk Adolescents

项目摘要/摘要 青少年的心理健康问题，如焦虑和抑郁，在过去急剧增加 对个人和社会造成重大损失的十年。众所周知，心理健康问题会直接导致 以及与长期压力相关的身体健康问题。不幸的是，暴露在慢性应激源下的青少年 可能由于情绪调节障碍而出现心理健康问题的风险增加， 青春期应对压力源所必需的自我调节任务。基于正念的干预 (Mbi)已被提议通过改善 正念和情绪调节困难。然而，大多数关于青少年MBI机制的研究 变化仅在受试者之间的水平上进行，横截面数据受低值影响 生态有效性。此外，关于mbi如何帮助青少年保持正念和健康，我们知之甚少。 压力时刻的情绪调节。使用生态瞬时评估(EMA)可以帮助填补 通过提供关于瞬时的、州一级的过程的信息，这些文献中的空白。目的 该项目是利用环境管理指数来了解MBI在多大程度上促进了青少年对 压力时刻的正念和健康的情绪调节。具体的目标是(1)描述、优先 对于干预，生活应激源、状态正念和状态之间的实时、动态关系 高危青少年的情绪调节困难和(2)调查在多大程度上参与 与控制条件相比，MBI改变了这些实时、动态的关系。这些目标将受到考验 在一项更大规模的父母随机对照试验的背景下，旨在研究MBI的可行性和 改善高危青少年不良饮食行为的可接受性及其有效性 (11-18y)提到了一个以社区为基础的指导计划，因为它“面临着没有充分发挥其潜力的风险”。 目前的建议是这项试验的新扩展，增加了正念、情绪的EMA测量 调节困难和生活应激源到样本子集(N=160)中的80个。多层结构方程 将使用建模来调查目标。这项提议旨在推动候选人的长期 目标是成为一名独立的科学家，拥有先进的方法和统计知识，可以 应用于使mbi和冥想实践的有效性最大化，用于慢性阻塞性肺病社区 压力暴露。培训目标是a)发展进行和分析环境影响评估的必要技能，b)获得 关于在高压力环境下对青少年进行MBI临床试验的知识，以及c)进一步了解 与应激相关的mbi变化的生理机制。本建议书产生的知识将提供 关于MBI对理论化的变化机制和培训的影响程度的基本信息 将使应聘者成为一名创新、熟练的研究人员，能够利用先进的统计数据 对高压力环境下青少年的互补和综合实践进行严格的研究。

Project Summary/Abstract Adolescent mental health problems, such as anxiety and depression, have drastically increased over the past decade with major costs to individuals and society. Mental health problems are known to contribute to immediate and long-term stress-related physical health problems. Unfortunately, adolescents exposed to chronic stressors are at an increased risk for developing mental health problems likely due to impairments in emotion regulation, a self-regulatory task of adolescence necessary for coping with stressors. Mindfulness-based interventions (MBIs) have been proposed to ameliorate mental and physical health problems through improvements in mindfulness and emotion regulation difficulties. However, most research on adolescent MBI mechanisms of change has only been conducted at the between-subjects level with cross-sectional data that are subject to low ecological validity. Further, little is known about how MBIs help adolescents to maintain mindfulness and healthy emotion regulation in moments of stress. The use of ecological momentary assessment (EMA) can help to fill these gaps in the literature by providing information about momentary, state-level processes. The purpose of this project is to utilize EMA to understand the extent to which an MBI promotes adolescents’ maintenance of mindfulness and healthy emotion regulation in moments of stress. The specific aims are to (1) characterize, prior to an intervention, the real-time, dynamic relationships between life stressors, state mindfulness, and state emotion regulation difficulties in at-risk adolescents and (2) to investigate the extent to which participation in an MBI compared to a control condition changes these real-time, dynamic relationships. These aims will be tested within the context of a larger, parent randomized controlled trial designed to study an MBI’s feasibility and acceptability as well as its effectiveness for improving maladaptive eating behaviors among at-risk adolescents (11-18y) referred to a community-based mentoring program for being “at-risk for not reaching their full potential.” The current proposal is a novel extension of this trial by adding EMA measurements of mindfulness, emotion regulation difficulties, and life stressors to a sample subset (n=80 of N=160). Multilevel structural equation modeling will be used to investigate the aims. This proposal is designed to advance the candidate’s long-term goal of becoming an independent scientist with advanced methodological and statistical knowledge that can be applied to maximizing the effectiveness of MBIs and contemplative practices for use in communities with chronic stress exposure. The training objectives are to a) develop necessary skills to conduct and analyze EMA, b) gain knowledge about MBI clinical trials with adolescents in high-stress contexts, and c) further understanding of stress-related physiological mechanisms of change in MBIs. Knowledge generated from this proposal will provide essential information about the extent to which an MBI impacts theorized mechanisms of change and the training will enable the candidate to become an innovative, skilled researcher capable of utilizing advanced statistics to conduct rigorous research on complementary and integrative practices for adolescents in high-stress contexts.