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.

描述（由申请人提供）：根据2003-2004年全国药物使用和健康调查，150万12-17岁的青少年（该年龄段青少年的6.1%）需要接受酒精滥用治疗，酒精是19%的青少年治疗人群报告的主要药物。最近对青少年酒精滥用的干预研究主要集中在学校，社区或急诊室人群。虽然新的门诊以家庭为基础的和应急管理（CM）的青少年大麻滥用的干预措施已经开发出来，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酒精滥用的已发表的门诊随机试验。因此，很少有人知道如何最有效地干预初级青少年酒精滥用和依赖门诊设置。我们的目标是调整我们以家庭为基础的CM治疗，以针对主要的青少年酒精滥用和依赖。具体目标1是提供一个初步的示范效果的家庭为基础的CM干预治疗青少年酒精滥用和依赖。CM组件包括1） 鼓励青少年参与治疗过程，并通过父母定期在家进行的酒精测醉、自我和父母报告以及诊所尿液药物检测，对记录在案的戒酒情况给予积极的强化，从而促使青少年戒酒;和2）一个家长管理培训计划，通过教导家长如何有效地使用应急措施，加强和保持激励计划的积极效果在家庭环境中进行管理，以激励青少年实现禁欲，并改善他们在其他领域的行为。 一项随机试验将确定当将CM干预添加到标准的个体认知行为治疗中时，CM干预是否会增强结果。具体目标2是确定治疗干预是否以及如何使用观察和实验室测量（育儿实践，家庭功能，风险承担，延迟折扣，儿童和父母精神病理学）来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时间推移的结果相关。研究结果将扩展CM的科学证据，并支持父母在家中实施CM的能力。支持CM模型的功效的研究结果将对青少年酗酒治疗的研究做出重大贡献，这已经落后于成人药物滥用和青少年非法药物使用的研究。未来的项目将包括隔离积极的治疗成分，向社区诊所传播，以及成本效益研究。