Family Based Contingency Management for Adolescent Alcohol Abuse

基于家庭的青少年酗酒应急管理

• 批准号: 7900587
• 负责人: CATHERINE STANGER
• 金额: $ 47.1万
• 依托单位: UNIV OF ARKANSAS FOR MED SCIS
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-05 至 2012-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7900587
• 关键词: Abstinence; Accounting; Adolescent; Adult; Aftercare; Age; Alcohol abuse; Alcohol consumption; Alcohol or Other Drugs use; Alcohols; Behavior; Behavioral; Behavioral Mechanisms; Child; Clinic; Cognitive Therapy; Communities; Contracts; Data; Dependence; Drug abuse; Drug usage; Educational process of instructing; Family; Family Practice; Future; Goals; Health; Home environment; Illicit Drugs; Incentives; Individual; Intervention; Intervention Studies; Laboratories; Learning; Link; Maintenance; Marijuana Abuse; Measures; Modeling; Monitor; Outcome; Outpatients; Parenting behavior; Parents; Patient Self-Report; Pharmaceutical Preparations; Population; Positive Reinforcements; Preventive Intervention; Procedures; Process; Psychopathology; Publishing; Randomized Clinical Trials; Relapse; Reporting; Research; Research Personnel; Risk; Risk Factors; Risk-Taking; Schools; Staging; Substance abuse problem; Surveys; Symptoms; Testing; Time; Training; Training Programs; Treatment outcome; Urine; Work; Youth; active method; adolescent alcohol abuse; aged; alcohol abstinence; alcohol abuse therapy; alcohol and other drug; base; contingency management; cost effectiveness; discount; discounting; drug testing; improved; motivational enhancement therapy; novel; peer; programs; randomized trial; therapy development; treatment duration; underage drinking

DESCRIPTION (provided by applicant): Based on the 2003-2004 National Survey on Drug Use and Health, 1.5 million youth aged 12-17 years (6.1% of youth in that age range) needed treatment for alcohol abuse, and alcohol is the primary drug reported by 19% of the adolescent treatment population. Recent intervention research on adolescent alcohol abuse has focused primarily on school-based, community, or ER populations. Although new outpatient family-based and contingency-management (CM) interventions for adolescent marijuana abuse have been developed, not one of them specifically targets adolescent primary alcohol users. We could find no published outpatient randomized trial specifically targeting alcohol abuse in adolescents. Thus, little is known about how to most effectively intervene with primary adolescent alcohol abuse and dependence in an outpatient setting. Our goal is to adapt our family-based CM treatment to target primary adolescent alcohol abuse and dependence. Specific Aim 1 is to provide a preliminary demonstration of the efficacy of a familybased CM intervention to treat adolescent alcohol abuse and dependence. CM components include 1) an incentive program to enhance the adolescent's engagement in the treatment process and engender alcohol abstinence by providing positive reinforcement for documented abstinence via breathalyzers administered by parents regularly at home, self and parent report, and clinic-based urine drug testing; and 2) a parent management training program to enhance and maintain the positive effects of the incentive program by teaching parents how to effectively use contingency management in the home environment to motivate their adolescent to achieve abstinence and improve their behavior in other domains. A randomized trial will determine whether the CM intervention enhances outcomes when added to a standard individual cognitive behavioral therapy. Specific Aim 2 is to determine whether and how treatment interventions modify parental and adolescent risk and protective factors using observational and laboratory measures (parenting practices, family functioning, risk taking, delay discounting, and child and parent psychopathology) and to determine whether these factors are associated with outcomes over time. Findings will extend the scientific evidence for CM and support the ability of parents to implement CM at home. Findings that support the CM model's efficacy will make a significant contribution to research on the treatment of adolescent alcohol abuse, which has lagged behind research on adult substance abuse and on adolescent illicit drug use. Future projects will include isolation of active treatment components, dissemination to community clinics, and cost-effectiveness studies.

说明(申请人提供)：根据2003-2004年全国毒品使用与健康调查，150万12-17岁青年(占该年龄段青年的6.1%)因酗酒而需要治疗，酒精是青少年治疗人群中19%报告的主要药物。最近对青少年酗酒的干预研究主要集中在学校、社区或急诊室人群。尽管针对青少年滥用大麻制定了新的以家庭为基础的门诊和应急管理(CM)干预措施，但其中没有一个专门针对青少年初级酒精使用者。我们找不到专门针对青少年酗酒的公开发表的门诊随机试验。因此，关于如何在门诊环境中最有效地干预青少年的初级酒精滥用和依赖，人们知之甚少。我们的目标是调整我们的以家庭为基础的CM治疗，以针对青少年的原发酒精滥用和依赖。具体目标1是初步演示以家庭为基础的CM干预治疗青少年酗酒和依赖的有效性。CM组件包括1)和 一项激励计划，旨在通过父母定期在家中进行的呼气测试、自我和父母报告以及临床尿液药物测试，为有记录的戒酒提供积极的强化，从而加强青少年在治疗过程中的参与度，并促使青少年戒酒；以及2)父母管理培训计划，通过教父母如何有效地在家庭环境中使用应急管理来激励青少年实现戒酒并改善他们在其他领域的行为，来增强和保持激励计划的积极效果。 一项随机试验将确定在标准的个体认知行为疗法的基础上，CM干预是否会改善结果。具体目标2是确定治疗干预措施是否以及如何使用观察性和实验室措施(育儿做法、家庭功能、冒险行为、延迟折扣以及儿童和父母的精神病理学)改变父母和青少年的风险和保护因素，并确定这些因素是否与随着时间的推移而产生的结果有关。这些发现将扩大CM的科学证据，并支持父母在家中实施CM的能力。支持CM模型有效性的研究结果将对青少年酒精滥用的治疗研究做出重大贡献，青少年酒精滥用的治疗研究落后于成人药物滥用和青少年非法药物使用的研究。未来的项目将包括分离有效的治疗成分，传播到社区诊所，以及成本效益研究。