Approach Bias Modification for Co-Occurring Cannabis and Alcohol Use among Treatment-Seeking Adolescents

项目摘要/摘要 酒精和大麻是青少年最常用的第一和第二种物质。 青春期是一个相当发展的时期，这使得青少年的大脑特别容易受到 酒精和大麻使用的负面影响。开发和测试针对酒精和 在青春期使用大麻对于减少代价高昂的后果至关重要。认知加工中的偏差 与药物有关的刺激在发展和维持有问题的物质使用方面发挥着重要作用。 接近回避任务(AAT)是一个计算机化的程序，可以有效地评估内隐的接近偏见 对于酒精和大麻，参与者按下或拉出操纵杆以回应无关的特征 在计算机屏幕上显示的图像(例如，在纵向时按下，在横向时按拉)。经过修改的A AAT的版本(MAAT)也用作认知偏差修正(CBM)干预，以进行再培训 受试者通过主要呈现目标刺激而对刺激产生的内隐偏向或背离 格式化(例如，推或拉)。尽管研究表明MAAT干预措施有效地减少了 有问题的酒精和大麻的使用，缺乏研究这种干预在 青少年。拟议的研究将测试一项综合MAAT的试点随机对照试验 针对寻求治疗的青少年(N=52)中同时存在的酒精和大麻的使用进行干预。 具体目标包括测试干预对大麻/酒精刺激方法偏差(AIM)的影响 1)和干预后1个月和3个月的大麻/酒精使用(目标2)，并检查意图的作用 渴望在治疗条件和使用之间的关系中起中介作用。研究环境， 墨尔本南加州大学的设施和资源非常适合在成瘾研究中指导职业发展。K23 培训目标是：1)增加关于大麻使用的病因和治疗机制的知识；2) 在寻求治疗的人中获得跨临床试验研究阶段的基本知识和经验 有药物使用问题的青少年，包括采用EMA方法；3)发展CBM方面的专门知识； 4)获得结合脑电的经验，以确定物质使用干预措施中的变化机制；以及5) 增强科学交流和整体学术生产力。来自Carla博士的结构化指导 克梅特·丹尼尔森、林赛·斯奎格里亚、丽莎·麦克蒂格和小罗伯特·米兰达。将确保达到培训目标。 候选人的长期职业目标是指导研究组合：1)开发和测试创新能力 针对青少年和初出茅庐的成年人的药物使用问题的干预方法；2)提供这些 现有现实世界环境中的创新干预措施；以及3)确定干预措施中的变化机制 使用多个分析单元。在此建议的培训旨在培养这些领域的专业知识 与以前的培训相比，这是一个明显的进步，如果没有K23，这是不可能的。

PROJECT SUMMARY/ABSTRACT Alcohol and cannabis are the first and second most commonly used substances among adolescents. Adolescence is a period of considerable development, making the adolescent brain particularly vulnerable to negative effects of alcohol and cannabis use. Developing and testing interventions that target both alcohol and cannabis use during adolescence are vital to decreasing costly consequences. Biases in cognitive processing of drug-related stimuli play an important role in the development and maintenance of problematic substance use. The Approach-Avoidance Task (AAT) is a computerized program, effective in assessing implicit approach biases for both alcohol and cannabis, in which participants push or pull a joystick in response to an irrelevant feature of an image presented on a computer screen (e.g., push when in portrait, pull when in landscape). A modified version of the AAT (mAAT) is also used as a Cognitive Bias Modification (CBM) intervention, to retrain participants’ implicit biases toward or away from stimuli by presenting the target stimuli predominantly in one format (e.g., push or pull). Despite research demonstrating the effectiveness of mAAT interventions to reduce problematic alcohol and cannabis use, there is a dearth of research examining this intervention among adolescents. The proposed research will test a pilot randomized controlled trial of an integrated mAAT intervention to target co-occurring alcohol and cannabis use among treatment-seeking adolescents (N=52). Specific aims include to test the effect of the intervention on approach biases for cannabis/alcohol stimuli (Aim 1) and cannabis/alcohol use at 1- and 3-months post-intervention (Aim 2), and to examine the role of intentions and cravings as mediators in the relationship between treatment condition and use. The research environment, facilities, and resources at MUSC are ideally suited for mentored career development in addiction research. K23 training objectives are to: 1) increase knowledge of etiological and treatment mechanisms for cannabis use; 2) acquire essential knowledge and experience across the stages of clinical trial research among treatment-seeking adolescents with substance use problems, including incorporating EMA methods; 3) develop expertise in CBM; 4) gain experience incorporating EEG to identify change mechanisms in substance use interventions; and 5) enhance scientific communication and overall academic productivity. Structured mentorship from Drs. Carla Kmett Danielson, Lindsay Squeglia, Lisa McTeague, and Robert Miranda Jr. will ensure training goals are met. The candidate’s long-term career goal Is to direct a research portfolio that: 1) develops and tests innovative intervention approaches for substance use problems among adolescents and emerging adults; 2) delivers these innovative interventions in existing real-world settings; and 3) identifies change mechanisms within interventions using multiple units of analysis. The training proposed herein is designed to develop expertise across these areas, represents a clear progression from prior training and would not be possible without this K23.