Reducing Risk: A Comprehensive mHealth Sleep Health Intervention for Adolescents at Risk for Depression and Anxiety Disorders

项目摘要 本申请的指导病人为导向的职业发展奖（K23）旨在支持额外的 培训和研究，这将使候选人实现她的职业目标，成为一个独立的 从事预防青少年精神疾病研究的临床科学家。青春期是一个 以抑郁症和焦虑症发病率急剧上升为特征的关键时期，此后 称为内化障碍（ID）。睡眠健康问题是普遍存在且可修改的目标 它先于并预测了ID的发展。该项目使用实验设计来（a）改善 睡眠健康（通过睡眠集中治疗），（B）确定改善睡眠是否积极影响 与ID发展相关的风险的行为和生物学基质;（c）阐明目标 睡眠不佳对ID风险的行为和生物基质的影响的潜在机制。的 本研究将测试跨诊断睡眠和昼夜节律干预（transdiagnosis Sleep and Circadian Intervention，transS-C）的创新适应， 睡眠健康治疗，改善睡眠和心理健康，有效治疗最常见的睡眠 青少年的健康缺陷，其中每一个以前被证明是独立相关的， 增加了ID风险。为了克服合格的医疗服务提供者少这一障碍， 治疗接入，我们将TransS-C用于移动终端输送（称为mTransS-C），从而 利用青少年使用移动的电话的高比率。为了进一步增加访问，我们将测试 初级保健服务中的mTranS-C，是改善行为健康护理可及性的成熟策略。的 申请建立在候选人先前在精神疾病的transdiagnosis机制方面的工作， 干预和预防ID的目标，以及基于证据的睡眠问题干预措施。的 拟议的培训计划强调以下新的培训领域的候选人：（1）治疗 开发和评估，特别是因为它涉及到mHealth平台，（2）生物学和目标 HPA轴（风险的生物学基质）的测量，以及（3）用于分析的统计方法 纵向数据集。由国际领导人组成的跨学科导师和顾问团队 在睡眠干预，发展心理病理学，移动健康技术和统计领域， 方法，将提供专业知识，以帮助候选人达到她的培训目标。

Project Summary This application for a Mentored Patient-Oriented Career Development Award (K23) aims to support additional training and research that will enable the candidate to achieve her career goal of becoming an independent clinical scientist conducting research aimed at preventing mental illness among adolescents. Adolescence is a critical period characterized by dramatic increases in rates of depression and anxiety disorders, hereafter referred to as internalizing disorders (IDs). Problems with sleep health are ubiquitous and modifiable targets that precede and predict the development of IDs. This project uses an experimental design to (a) improve sleep health (through a sleep focused treatment), (b) determine whether improving sleep positively impacts behavioral and biological substrates of risk associated with the development of IDs and (c) elucidate target mechanisms underlying the effect of poor sleep health on behavioral and biological substrates of ID risk. The present study will test an innovative adaptation of Transdiagnostic Sleep and Circadian Intervention (TranS-C), a sleep health treatment that improves sleep and mental health and effectively treats the most common sleep health deficits among adolescents, each of which was previously shown to be independently associated with increased risk for IDs. To overcome the challenge of low availability of qualified providers as a barrier to treatment access, we adapted TranS-C for mobile device delivery (referred to as mTranS-C), thereby leveraging the high rates of mobile phone use among adolescents. To further increase access, we will test mTranS-C within primary care services, a proven strategy for improving access to behavioral health care. The application builds on the candidates’ prior work in transdiagnostic mechanisms of mental illness, identifying targets for intervention and the prevention of ID’s, and evidence based interventions for sleep problems. The proposed training plan emphasizes the following new training areas for the candidate: (1) treatment development and assessment, specifically as it pertains to mHealth platforms, (2) the biology and objective measurement of the HPA axis (a biological substrate of risk), and (3) statistical methods for analyzing longitudinal data sets. An inter-disciplinary team of mentors and consultants consisting of international leaders in the areas of sleep interventions, developmental psychopathology, mHealth technologies, and statistical methods, will provide the expertise to help the candidate meet her training objectives.