Reducing Risk: A Comprehensive mHealth Sleep Health Intervention for Adolescents at Risk for Depression and Anxiety Disorders

项目摘要 本申请的指导病人为导向的职业发展奖（K23）旨在支持额外的 培训和研究，这将使候选人实现她的职业目标，成为一个独立的 从事预防青少年精神疾病研究的临床科学家。青春期是一个 以抑郁症和焦虑症发病率急剧上升为特征的关键时期，此后 称为内化障碍（ID）。睡眠健康问题是普遍存在且可修改的目标 它先于并预测了ID的发展。该项目使用实验设计来（a）改善 睡眠健康（通过睡眠集中治疗），（B）确定睡眠集中治疗是否改善 ID症状，以及ID风险的已知生物标志物，皮质醇反应性和响应于 压力暴露，以及（c）阐明睡眠健康不良对ID影响的目标机制 症状和皮质醇测量。本研究将测试一个创新的适应transdiagnosis 睡眠和昼夜节律干预（TransS-C），一种改善睡眠和心理健康的睡眠健康治疗方法 并有效地治疗青少年中最常见的睡眠健康缺陷，其中每一个都是以前 显示与ID风险增加独立相关。克服低可用性的挑战 合格的提供者作为治疗访问的障碍，我们将TransS-C用于移动终端输送（参考 到mTransS-C），从而利用青少年使用移动的电话的高比率。进一步 为了增加可及性，我们将在初级保健服务中测试mTranS-C，这是一项经过验证的改善可及性的战略， 行为医疗保健。该应用程序建立在候选人先前在转诊断机制方面的工作基础上， 精神疾病，确定干预目标和预防ID，以及循证干预 治疗睡眠问题建议的培训计划强调候选人的以下培训领域：（1） 发展移动健康技术/科学的专业知识，（2）皮质醇的生物学和客观测量，以及 (3)分析纵向数据集的统计方法。一个跨学科的导师团队， 由睡眠干预、移动健康技术/科学领域的国际领导者组成的顾问， 发展精神病理学，皮质醇测量和统计方法，共同将提供 专业知识，以帮助候选人达到她的培训目标。

Project Summary This application for a Mentored Patient-Oriented Career Development Award (K23) aims to support additional training and research that will enable the candidate to achieve her career goal of becoming an independent clinical scientist conducting research aimed at preventing mental illness among adolescents. Adolescence is a critical period characterized by dramatic increases in rates of depression and anxiety disorders, hereafter referred to as internalizing disorders (IDs). Problems with sleep health are ubiquitous and modifiable targets that precede and predict the development of IDs. This project uses an experimental design to (a) improve sleep health (through a sleep focused treatment), (b) determine whether a sleep focused treatment improves ID symptoms, and a known biological marker of risk for IDs, cortisol reactivity and recovery in response to a stress exposure, and (c) elucidate target mechanisms underlying the effect of poor sleep health on ID symptoms, and cortisol measures. The present study will test an innovative adaptation of Transdiagnostic Sleep and Circadian Intervention (TranS-C), a sleep health treatment that improves sleep and mental health and effectively treats the most common sleep health deficits among adolescents, each of which was previously shown to be independently associated with increased risk for IDs. To overcome the challenge of low availability of qualified providers as a barrier to treatment access, we adapted TranS-C for mobile device delivery (referred to as mTranS-C), thereby leveraging the high rates of mobile phone use among adolescents. To further increase access, we will test mTranS-C within primary care services, a proven strategy for improving access to behavioral health care. The application builds on the candidates’ prior work in transdiagnostic mechanisms of mental illness, identifying targets for intervention and the prevention of IDs, and evidence based interventions for sleep problems. The proposed training plan emphasizes the following training areas for the candidate: (1) develop expertise in mHealth technology/science, (2) the biology and objective measurement of cortisol, and (3) statistical methods for analyzing longitudinal data sets. An inter-disciplinary team of mentors and consultants consisting of international leaders in the areas of sleep interventions, mHealth technology/science, developmental psychopathology, cortisol measurement, and statistical methods, collectively will provide the expertise to help the candidate meet her training objectives.