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Incredible Years - Parent Training

难以置信的岁月 - 家长培训

基本信息

批准号：
10674630
负责人：
Arielle Hope Sheftall
金额：
$ 26.32万
依托单位：
RESEARCH INST NATIONWIDE CHILDREN'S HOSP
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-01 至 2027-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10674630
关键词：
11 year old 18 year old 9 year old Acceleration Address Adult Age Age of Onset Awareness Behavior Behavior Therapy Buffers Cause of Death Child Child Behavior Child Rearing Child of Impaired Parents Childhood Clinic Communication impairment Diagnostic Discipline Educational process of instructing Effectiveness Emergency department visit Emotional Emotions Empathy Environment Family Feeling suicidal Future Genetic Goals Heritability Hostility Intervention Interview Measures Mediator Methods Monitor National Institute of Mental Health Outcome Parents Participant Patient Self-Report Perception Physiological Population Practical Robust Implementation and Sustainability Model Prevention program Public Health Qualitative Methods Race Randomized Recording of previous events Reporting Research Research Priority Risk Risk Assessment Risk Factors Risk Reduction Schools Self-Injurious Behavior Services Stressful Event Suicide Suicide attempt Suicide prevention Testing Time Training Training Programs Visit Vulnerable Populations Youth acceptability and feasibility behavior observation boys cohesion coping mechanism depressive symptoms early onset effective intervention effectiveness testing effectiveness/implementation hybrid efficacious intervention emotion dysregulation emotion regulation externalizing behavior follow-up girls high risk high risk population implementation framework improved intervention effect maltreatment model design non-suicidal self injury offspring parent-child communication parental monitoring peer permissiveness post intervention prevent primary outcome programs reducing suicide resilience secondary outcome skills social skills statistics suicidal adolescent suicidal behavior suicidal risk suicide rate transmission process treatment as usual trend virtual

项目摘要

Project Summary/Abstract Suicide is the eighth leading cause of death among U.S. children ages 5-11 years. From 2012-2017, youth suicides increased at an alarming 14.7% annually. During this time, ER visits increased 92% among 5- to 18- year-olds—to 1.12 million. Almost half of these visits involved a 5- to 11-year-old child. To date, however, limited research on child suicide and suicidal behavior (SB) exists, and there are no empirically supported prevention programs despite recognition by NIMH that youth suicide prevention should be a national priority. One especially vulnerable group is children with a parental history of suicide attempts (PH+). PH+ children are 4-6x more likely to engage in SB than their peers and show especially early age of onset—often before age 10. In this proposal, we target specific parent- and child-level vulnerabilities/risk factors for SB among these families. Although suicide risk is heritable, existing research shows (1) effects of shared family environment on SB and suicide, over-and-above genetic influences; and (2) specific family environment mechanisms that contribute to SB and suicide. Such mechanisms include harsh, invalidating, and low-warmth parenting, as well as impaired parent-child communication and poor parental monitoring of children’s behavior. These parenting practices reinforce emotional lability and emotion dysregulation, which are common to both parents and children in at-risk families. In our previous study (R21MH116206), PH+ children, ages 6-9 years, reported less family cohesion, and PH+ parents reported more permissive parenting, which co-occurs with harshness, hostility, and emotion dysregulation. Effective interventions that target these parenting practices and improve parent and child emotion regulation (ER) may reduce risk for youth SB but have not been tested in PH+ families. We will compare a virtual version of Incredible Years® parent training (IY-PT) to Enhanced Usual Care (EUC). IY-PT decreases parents’ emotional reactivity and teaches them to effectively “coach” their children on successful ER. IY-PT is effective in increasing positive parenting and improving ER skills of both parents and children, with large effect sizes that maintain at 1- and 2-year follow-ups. We will (1) test acceptability and feasibility of virtual IY-PT for this population from both parent and clinician perspectives; (2) determine whether IY-PT is effective in decreasing suicide risk among PH+ youth; and (3) explore acceptability and feasibility as potential moderators between PH+ status and parent and child outcome. ER and parenting are primary outcomes and NSSI, SI, and depressive symptoms are secondary outcomes. Measures include interviews, direct observations, and self-reports. Participants include 100 PH+ families who will complete a baseline, be randomized to virtual IY-PT or EUC, and complete 1-,3-, and 6-month reassessments post-intervention. This effectiveness-implementation hybrid model design I, guided by PRISM Implementation Science Framework, could have major implications for preventing an imminent public health concern among at-risk youth.

项目概要/摘要自杀是美国 5-11 岁儿童的第八大死因。 2012-2017年青年自杀率每年以惊人的 14.7% 的速度增加。在此期间，5 岁至 18 岁儿童的急诊就诊次数增加了 92% 岁儿童——112万。其中几乎一半的访问涉及 5 至 11 岁的儿童。然而，迄今为止，关于儿童自杀和自杀行为（SB）的研究有限，并且没有经验支持尽管 NIMH 认识到预防青少年自杀应成为国家优先事项，但仍制定了预防计划。一个特别脆弱的群体是父母有自杀未遂史的儿童（PH+）。 PH+ 儿童是发生 SB 的可能性是同龄人的 4-6 倍，而且发病年龄特别早——通常在 10 岁之前。在本提案中，我们针对 SB 的特定父级和子级漏洞/风险因素家庭。尽管自杀风险具有遗传性，但现有研究表明（1）共同家庭环境对自杀风险的影响 SB 和自杀，超越遗传影响； (2)具体的家庭环境机制导致 SB 和自杀。这些机制包括严厉的、无效的和冷漠的养育方式，以及亲子沟通受损以及父母对孩子行为的监控不力。这些育儿做法会加剧情绪不稳定和情绪失调，这对于父母和孩子来说都很常见。高危家庭的儿童。在我们之前的研究 (R21MH116206) 中，6-9 岁的 PH+ 儿童报告较少家庭凝聚力，PH+ 父母报告说，他们的养育方式更加宽容，但同时也存在严厉的态度，敌意和情绪失调。针对这些育儿实践并改善的有效干预措施父母和孩子的情绪调节 (ER) 可能会降低青少年 SB 的风险，但尚未在 PH+ 中进行测试家庭。我们将比较虚拟版本的 Incredible Years® 家长培训 (IY-PT) 与增强型日常护理（欧盟委员会）。 IY-PT 降低父母的情绪反应，并教会他们有效地“指导”孩子成功的急诊室。 IY-PT 可以有效地增加积极的养育方式并提高父母双方的 ER 技能儿童，具有较大的效应量，可维持 1 年和 2 年的随访。我们将 (1) 测试可接受性和从家长和临床医生的角度来看，虚拟 IY-PT 对该人群的可行性； (2)判断是否 IY-PT 可有效降低 PH+ 青少年的自杀风险； (3) 探讨可接受性和可行性 PH+ 状态与父母和孩子结果之间的潜在调节因素。急诊室和养育子女是首要的 NSSI、SI 和抑郁症状是次要结果。措施包括访谈、直接观察和自我报告。参与者包括 100 个 PH+ 家庭，他们将完成基线，成为随机分配至虚拟 IY-PT 或 EUC，并完成干预后 1、3 和 6 个月的重新评估。这有效性-实施混合模型设计 I，以 PRISM 实施科学框架为指导，可能对预防高危青少年面临迫在眉睫的公共卫生问题产生重大影响。