Behavioral Interventions for the Dually Diagnosed

描述(由申请人提供)： 此K02应用程序寻求精神病学家研究人员的支持，以实施一项研究计划，将行为原则转化为药物滥用障碍患者的临床干预措施，以及伴随的精神病学或医学诊断。这位候选人具有临床阿片类药物药理学背景，最近将他的研究重点转向行为疗法干预措施，以解决两个临床问题：(1)改善双重诊断患者的资金管理，使残疾检查不用于购买药物；(2)提高对艾滋病毒等伴随疾病处方药物的依从性。这位候选人已经将创新的行为方法应用于这些问题，现在他寻求扩大这项工作，使其更广泛地适用于临床实践。他将在以下方面进一步发展自己的技能：(A)治疗传播战略；(B)成本效益和成本效益的确定；(C)延迟折扣理论在病人预算编制和治疗依从性方面的应用；(D)了解社会保障管理局和退伍军人福利管理局在确定患有药物滥用障碍的残疾人的受款人需求和做法时遵循的程序；以及(E)更高级的统计分析。在支持期间，他的研究将包括三种类型的研究：(A)针对资金管理和用药依从性的行为干预的临床试验；(B)评估“资金管理需求”替代诊断标准的可靠性和有效性的诊断性研究，旨在开发一种结构化的诊断访谈，以诊断资金管理需求；以及(C)在描述“真实世界”环境中收款人分配和实践的大型数据集中，对收款人分配对药物滥用和成本结果的影响进行二次分析。计划中的研究研究与职业发展活动交织在一起：(A)临床试验将包括收集时间偏好数据--节省和花费的资金，决定用即时奖励换取更大的延迟奖励，以及对立即奖励和延迟奖励和损失的偏好的纸笔衡量(如延迟贴现功能)；(B)诊断性研究将利用参与受款人分配的社会保障管理局官员的投入进行；(C)统计和费用培训将是临床试验和二级数据集分析的一部分。

DESCRIPTION (provided by applicant): This K02 application seeks support for a psychiatrist researcher to conduct a program of research that translates behavioral principles into clinical interventions for patients with substance abuse disorders and concomitant psychiatric or medical diagnoses. The candidate has a background in clinical opioid pharmacology, and has recently shifted his research focus to behavioral therapy interventions addressing two clinical problems: (1) improving management of funds by dually diagnosed patients so that disability checks are not used to purchase drugs and (2) improving adherence to medication prescribed for concomitant disorders such as HIV. The candidate has applied innovative behavioral approaches to these problems, and he now seeks to expand this work to make it more broadly applicable to clinical practice. He will further develop his skills in (a) treatment dissemination strategies, (b) determination of cost-effectiveness and cost benefit, (c) the application of delayed discounting theory to patient budgeting and treatment adherence (d) understanding the procedures followed by the Social Security Administration and Veterans Benefits Administration in determining payee need and practice among disabled persons with substance abuse disorders and (e) more advanced statistical analyses. During the period of support, his research will include studies of three types: (a) clinical trials of behavioral interventions targeted to money management and medication adherence (b) a diagnostic study evaluating the reliability and validity of alternative diagnostic criteria for "need for money management" and aimed at development of a structured diagnostic interview to diagnose the need for money management and (c) a secondary analysis of the effects of payee assignment on substance abuse and cost outcomes in a large data set that describes payee-ship assignment and practice in "real world" settings. The planned research studies are intertwined with career development activities: (a) the clinical trials will include the collection of time preference data - funds saved and spent, decisions to trade immediate prizes for larger delayed prizes, and paper-and-pencil measures of preferences for immediate vs. delayed rewards and losses (e.g. delayed discounting functions); (b) the diagnostic study will be carried out with input from the Social Security Administration officials involved in payee assignment;(c) statistical and cost training will be part of the clinical trials and secondary dataset analysis.