Capacity Enhancement Core

能力增强核心部分的介绍

Introduction to the Capacity Enhancement Core Section This is the first revision of a NIDA P30 proposal for a Center for Drug Abuse Prevention in the Child Welfare System (CDAP-CWS). The reviewers noted many strengths, as well as some limitations, of this Core in the original proposal. Strengths included creative strategies for incorporating the proposed focus areas into current and future studies, appropriate conceptual and operational approaches for the focus areas selected, and the high potential public health significance of the focus areas. The experience and past productivity of the research team and the record of mentoring early career scientists were also seen as strengths. Concerns identified by one or more reviewer involved the following: a question about the value to CWS policy and practice of pubertal development as a focus area, a question about the innovativeness of the costing focus area, concerns about synergy across the three focus areas, questions about the adequacy of the existing data/measures for conducting proposed analyses and generalizability due to truncated samples, concerns about the lack of specification of mechanisms to support the development of new innovative projects, and budget questions about the size of the subcontracts and the allocation of PI time. We are grateful to the reviewers for their careful review and helpful comments. In addressing the concerns, we have made modifications to the Capacity Enhancement Core that we believe have resulted in a stronger, more relevant plan for building a program of CWS drug abuse prevention research that has the potential to be informative and relevant to CWS researchers, practitioners, and policy leaders. Please note that, because substantial changes were made in this section of the revised application, we have not marked changed text in any way. 1. Selection of Focus Areas for the Capacity Enhancement Core. Reviewer 3 noted that the focus on pubertal development, although scientifically interesting, was narrow and lacked direct relevance to the CWS, especially in terms of implications for Type 2 translation of science into practice. Although this concern was not shared by the other two reviewers, upon consideration we determined that it would be advantageous to replace the pubertal development work with a more broad focus on stress neurobiology and genetics as predictors, mediators, and moderators of drug abuse and related problems. As is described in this focus area, emerging work in this more general area of research has direct relevance within the CWS for services and policy and will inform the next generation of randomized intervention trials. Moreover, it is an area in which we already have expertise within our research group. For example, Fisher's work on the HPA axis has shown alterations among children in foster care, with atypical diurnal cortisol levels being prevalent among children who experienced caregiver neglect. However, participation in the Multidimensional Treatment Foster Care for Preschoolers intervention resulted in increased regulation of the HPA axis relative to children in regular foster care (Fisher et al., 2007). Fisher and colleagues have also begun to examine prefrontal cortex activity in foster children because of the link between particular executive functions that are known to emanate from the prefrontal cortex (e.g., inhibitory control, attention, and working memory) and to relate to drug abuse and disruptive behavior disorders (Fisher, Gunnar, et al., 2006). In Pilot 2, proposed by Center early career investigator Saldana in collaboration with Fisher, we extend this work to examine executive attention via the Attention Network Task in mothers who abuse drugs. We hypothesize that deficits in executive attention will predict low responsiveness to treatments designed improve parenting and deter drug abuse. New work on gene variants also holds promise for CWS drug abuse prevention research. Center Co-l Leve is at the forefront of this work. Her prospective adoption study (359 sets of adoptive parents, their adopted child, and the child's birth parents) has the potential to inform CWS practice and policy in two ways: by detailing specific environmental processes that could be brought to bear in early childhood that can help offset genetic risk and lead to resilient adjustment in children and by detailing specific genetically influenced characteristics (e.g., sociability and persistence) that can increase child resilience even in the face of early adversity (Leve et al., 2007). Our work in this area will benefit from the rapid advances in knowledge that are occurring in the field of molecular genetics. For example, Bradley and colleagues (2008) recently found that child abuse and trauma were less likely to result in adult depressive symptoms in the presence of genetic polymorphisms within the corticotropin-releasing hormone type 1 receptor (CRHR1) gene. This finding suggests that Gene x Environment interaction is important for the expression of depressive symptoms in adults with CRHR1 risk or protective alleles who have a history of child abuse. Thus, in place of the more narrow focus on puberty in the prior proposal, we now plan to build on the knowledge that exists within our center and infuse our collective program of current and future CWS drug abuse prevention research with methods and measures of neurobiological and genetic mechanisms of risk and resilience. This will be accomplished through training of our Center scientists and sharing state-of-the-art work in this focus area with CWS practitioners and policy leaders.