School-Based Depression Prevention for Adolescents with ADHD: COVID-Impacted Supplement

多动症青少年的学校抑郁症预防：受新冠肺炎影响的补充品

• 批准号: 10356973
• 负责人: ANDREA CHRONIS-TUSCANO
• 金额: $ 7.1万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-07 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10356973
• 关键词: Address; Adolescent; Attention deficit hyperactivity disorder; Behavioral; Case Series; Child; Communities; Data; Disease; Effectiveness; Evidence based intervention; Feedback; Feeling suicidal; Focus Groups; Future; Health Personnel; Healthcare; High School Student; Hospitalization; Hybrids; Impairment; Inpatients; Mediating; Mental Depression; Mental Health; Modeling; Moods; Parents; Population; Prevention; Prevention approach; Prevention program; Procedures; Randomized; Randomized Controlled Trials; Rewards; Risk; Schools; Testing; Training; Work; adverse outcome; base; child depression; comorbidity; coronavirus disease; depression prevention; depressive symptoms; effectiveness implementation design; effectiveness trial; emotion regulation; high school; high school program; improved; indicated prevention; novel; programs; selective prevention; suicidal behavior; suicidal risk; teacher; therapy development; treatment as usual; young adult

ABSTRACT/PROJECT SUMMARY Children with ADHD are at elevated risk for depression in adolescence and young adulthood, and this comorbidity is associated with far greater impairment than either disorder alone, including higher rates of inpatient hospitalization and increased risk for suicidal ideation and behavior. Despite these adverse outcomes, existing evidence-based interventions for ADHD have not demonstrated effects in reducing depressive symptoms nor do established depression prevention programs work as well for adolescents with ADHD. Reward responsivity (RR) and emotion regulation (ER) are two key factors demonstrated to mediate the association between ADHD and depression and are thus key targets for prevention. In an effort to address the gap between access and utilization of mental health care, which is especially stark among adolescents with ADHD, we aim to develop and test a modified behavioral activation prevention program [Behaviorally Enhancing Adolescents’ Mood in Schools (BEAM-S)] that incorporates modules to directly target these purported mechanisms. In line with the Deployment-Focused Model of Intervention Development and Testing, we will develop a program that can be easily implemented and sustainable in the high school setting as delivered by school mental health staff that reduces depression and improves overall functioning in adolescents with ADHD, by way of improving RR and ER. As a first step, we will conduct focus groups with community stakeholders (e.g., school mental health providers, school administration, adolescents, parents, teachers) to develop an acceptable and sustainable selected and indicated prevention program for school staff to utilize. We will then initially train school staff to deliver this prevention program via a co- therapy training model to prepare them for their independent implementation of the prevention program in a case series consisting of two groups (one in each of two high schools) to evaluate preliminary feasibility. We will then conduct a stage 1 RCT with a hybrid-type 1 implementation- effectiveness design in adolescents will be randomized to either the BEAM-S condition or treatment as usual. Finally, qualitative and quantitative data from aims 1-3 will be used to prepare final procedures for a future large-scale effectiveness trial R01 (aim 4).

摘要/项目摘要 患有ADHD的儿童在青春期和青春期患抑郁症的风险增加，这一点 与任何一种疾病相比，共病与更大的损害有关，包括更高的 住院率和自杀意念和行为风险增加。尽管如此 不良结果，现有的基于证据的ADHD干预措施在 减少抑郁症状也不是既定的抑郁症预防计划对 患有多动症的青少年。奖励响应性(RR)和情绪调节(ER)是两个关键因素 证实了ADHD和抑郁症之间的联系，因此是治疗的关键目标 预防。为了解决获得和利用精神卫生保健之间的差距， 这在患有ADHD的青少年中尤为明显，我们的目标是开发和测试一种改进的 行为激活预防计划[在学校提高青少年的行为情绪 (BEAM-S)]它包含了直接针对这些据称的机制的模块。符合 以部署为中心的干预开发和测试模式，我们将开发一个计划， 可以在高中环境中轻松实施并可持续，由学校心理传授 卫生工作人员，通过以下方式减少抑郁并改善患有ADHD的青少年的整体功能 提高RR和ER的方法。作为第一步，我们将与社区一起开展焦点小组 利益相关者(例如，学校心理健康提供者、学校行政部门、青少年、家长、 教师)制定可接受的、可持续的、有选择和有指示的预防计划 学校教职员工可以利用。然后，我们将首先培训学校工作人员，通过联合- 治疗培训模式，为他们独立实施预防做好准备 由两个小组(两所高中各一组)组成的案例系列项目进行评估 初步可行性。然后，我们将使用混合类型1实施进行阶段1 RCT- 青少年的有效性设计将随机分为BEAM-S条件或治疗 像往常一样。最后，将使用目标1-3的定性和定量数据来准备期末考试 未来大规模有效性试验R01的程序(目标4)。

项目成果

Understanding ADHD in Black Adolescents in Urban Schools: A Qualitative Examination of Factors that Influence ADHD Presentation, Coping Strategies, and Access to Care.

• DOI: 10.1080/23794925.2021.2013140
• 发表时间: 2022
• 期刊: Evidence-based practice in child and adolescent mental health