Assessing Parenting at the Momentary Level to Understand Parenting Behaviors that Contribute to Improved Treatment Outcomes for Youth with Co-Occurring Disorders

评估瞬时水平的养育方式，以了解有助于改善患有并发疾病的青少年的治疗结果的养育行为

• 批准号: 10693819
• 负责人: Samuel Noah Meisel
• 金额: $ 18.25万
• 依托单位: EMMA PENDLETON BRADLEY HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10693819
• 关键词: Address; Admission activity; Adolescent; Adolescent Behavior; Affect; Alcohol consumption; Alcohols; Behavioral Mechanisms; Child Rearing; Communication; Data; Development; Diagnosis; Ecological momentary assessment; Enrollment; Exhibits; Faculty; Feedback; Future; Goals; Grant; Intervention; Length; Life; Measures; Medicine; Mental Health; Methods; Monitor; Motivation; National Institute on Alcohol Abuse and Alcoholism; Nature; Outcome; Outpatients; Parents; Phase; Pilot Projects; Prediction of Response to Therapy; Protocols documentation; Psychiatric Diagnosis; Reporting; Research; Research Personnel; Risk; Sampling; Site; Strategic Planning; Symptoms; Testing; Time; Training; Treatment outcome; Youth; acceptability and feasibility; adolescent alcohol treatment; adolescent substance use; adolescents with alcohol use disorders; alcohol abuse therapy; alcohol availability; alcohol craving; alcohol use disorder; associated symptom; behavior change; design; dual diagnosis; evidence base; improved; improved outcome; marijuana use; outcome prediction; outpatient programs; pilot test; protocol development; recruit; research study; skills; substance use treatment; teenage parents; treatment program; treatment research; underage drinking; virtual

PROJECT SUMMARY/ABSTRACT. Over 80% of adolescents with an alcohol use disorder (AUD) who present to treatment have a co-occurring psychiatric diagnosis. Although the best available treatments for adolescents with alcohol use disorders and co-occurring disorders (AUD+CODs) yield only modest short-term benefits, parent-involved treatments result in the best outcomes. In line with NIAAA’s strategic plan to improve treatments for AUD+CODs, this application seeks to address a central, yet unanswered question – what parenting behaviors during parent-involved treatment for AUD+CODs contribute to improved outcomes? Parenting is dynamic and varies from moment to moment depending on context, affect, and adolescent behavior. Moreover, treatment motivation, alcohol craving, alcohol and cannabis use, and internalizing and externalizing symptoms — core adolescent AUD+CODs treatment targets — vary considerably within and across days. Understanding the parenting behaviors during treatment that account for improved treatment outcomes requires momentary assessments that can capture the dynamic nature of parenting and core adolescent treatment targets. This K99/R00 study intends to leverage an experimental medicine framework to study how parenting, captured in real time in daily life, impacts core treatment targets (treatment motivation, alcohol craving, alcohol, and cannabis use, and internalizing and externalizing symptoms) among adolescents enrolled in an intensive outpatient for AUD+CODs. The specific aims for the K99 are to adapt parental communication, general parenting practices, and alcohol-specific parenting measures to EMA (Aim 1), conduct a pilot feasibility and acceptability study of the EMA protocol (N=20 parent-adolescent dyads; Aim 2a), and use mixed methods to evaluate and refine the EMA parenting measures and protocol (Aim 2b). Dr. Samuel Meisel’s overarching training goals are to (1) refine skills in independently designing, developing, and executing EMA research (Drs. Robert Miranda and Elizabeth McQuaid), (2) solidify expertise in conducting treatment research with adolescents with AUD+CODs (Drs. Aaron Hogue and Robert Miranda), (3) apply experimental medicine methods to adolescent AUD+COD treatment mechanisms research (Dr. John Kelly), and (4) promote a successful transition to independent faculty researcher. These training objectives build on Dr. Meisel’s F32 (AA028414), which provided him with the foundational training to broaden his research from studying the initiation and escalation of adolescent alcohol use to adolescent alcohol use treatment and mechanisms of behavior change. R00 specific aims include examining momentary parenting-core treatment target associations (N=75 parent-adolescent dyads; Aim 3a) and examining changes in the strength of parenting-treatment target associations over the course of AUD+COD treatment (Aim 3b). Findings will systematically identify the specific parenting practices during AUD+CODs treatment that most strongly relate to core treatment targets and will serve as preliminary data for future R01 and R34 applications.

项目总结/摘要。超过80%的酒精使用障碍（AUD）青少年， 目前的治疗有一个共同出现的精神病诊断。尽管目前最好的治疗方法 患有酒精使用障碍和共病（AUD+ COD）的青少年仅产生适度的短期 父母参与的治疗会带来最好的结果。根据NIAAA的战略计划， AUD+ COD的治疗，本申请旨在解决一个核心但尚未回答的问题- 父母参与治疗AUD+ COD期间的养育行为有助于改善结局？ 养育子女是动态的，根据环境、情感和青少年的不同而随时变化。 行为此外，治疗动机，酒精渴望，酒精和大麻的使用，以及内化和 外化症状-核心青少年AUD+ COD治疗目标-在内部和 跨越几天。了解治疗期间的养育行为，以改善治疗 结果需要瞬间的评估，可以捕捉养育的动态性质和核心 青少年治疗目标。这项K99/R 00研究旨在利用实验医学框架， 研究如何养育，在日常生活中的真实的时间捕获，影响核心治疗目标（治疗动机， 酒精渴望，酒精和大麻的使用，以及内在和外在症状） 因AUD+ COD入组重症门诊。K99的具体目标是适应父母 沟通，一般的育儿实践，和酒精特定的育儿措施，以EMA（目标1），进行 EMA方案的初步可行性和可接受性研究（N=20对父母-青少年;目标2a），以及使用 混合方法来评估和完善EMA养育措施和协议（目标2b）。塞缪尔博士 Meisel的总体培训目标是（1）完善独立设计，开发和 执行EMA研究（Robert米兰达博士和Elizabeth McQuaid博士），（2）巩固开展 青少年AUD+ COD治疗研究（Aaron Hogue和Robert米兰达博士），（3）应用 实验医学方法对青少年AUD+COD治疗机制的研究（约翰·凯利博士）， （4）促进向独立研究型教师的成功过渡。这些培训目标建立在 博士Meisel的F32（AA 028414），这为他提供了基础训练，以扩大他的研究， 研究青少年酒精使用的开始和升级到青少年酒精使用治疗， 行为改变的机制。R 00的具体目标包括检查瞬时亲核治疗 目标协会（N=75父母-青少年二对;目标3a）和检查的强度变化， 在AUD+COD治疗过程中的亲药-治疗靶点关联（目标3b）。发现将 系统地确定AUD+ COD治疗期间与以下因素关系最密切的具体育儿实践： 核心处理目标，并将作为未来R 01和R34应用的初步数据。