Capacity Enhancement Core

《能力提升核心部分》简介 这是NIDA关于儿童药物滥用预防中心的P30提案的第一次修订 福利制度(CDAP-CWS)。评审者注意到了这个核心的许多优点，以及一些局限性 在最初的提案中。优势包括创造性地将拟议的重点领域纳入 当前和未来的研究，所选重点领域的适当概念和操作方法， 以及重点地区潜在的高公共卫生意义。的经验和过去的生产力 研究团队和指导早期职业科学家的记录也被视为优势。 一个或多个审阅者确定的问题涉及以下内容：关于CWS价值的问题 青春期发展的政策和实践作为重点领域，一个关于青春期发展的创新问题 成本计算重点领域，对三个重点领域的协同作用的关注，关于 现有数据/措施，用于执行拟议的分析和由于样本截断而产生的概括性； 对缺乏支持新的创新项目开发的具体机制表示关切， 以及关于分包合同大小和PI时间分配的预算问题。我们非常感谢 感谢审查员的仔细审查和有益的评论。在回应这些关注时，我们已作出以下努力 对能力增强核心的修改，我们认为这些修改导致了更强大、更相关的 建立CWS药物滥用预防研究计划的计划，该计划有可能提供信息 并与CWS研究人员、从业者和政策领导者相关。请注意，因为大量的 修改后的申请表中的这一部分已做了更改，我们没有以任何方式标记更改的文本。 1.能力增强核心重点领域的选择。审查者3注意到，重点放在 青春期发育虽然在科学上很有趣，但范围很窄，与CWS缺乏直接相关性， 尤其是在将科学转化为实践的类型2的含义方面。尽管这种担忧并不是 其他两位评审员都同意，经过考虑，我们决定更换 青春期发育更广泛地关注应激神经生物学和遗传学作为预测因素， 毒品滥用和相关问题的调解人和调解人。正如本重点领域所描述的，新兴的 在这一更一般的研究领域的工作与CWS内的服务和政策直接相关，并将 通知下一代随机干预试验。此外，这是我们已经拥有的一个领域 我们研究小组中的专业知识。例如，费舍尔在HPA轴上的工作表明， 寄养儿童，非典型的昼夜皮质醇水平在经历了 照顾者的疏忽。然而，参与多维治疗对学龄前儿童的寄养关怀 干预导致相对于正常寄养儿童的HPA轴的调节增加(Fisher et 等人，2007年)。费舍尔和他的同事也开始研究寄养儿童的前额叶皮质活动。 因为已知从前额叶发出的特定执行功能之间的联系 大脑皮质(如抑制控制、注意力和工作记忆)，并与药物滥用和破坏性有关 行为障碍(Fisher，Gunnar等人，2006年)。在试点2中，由中心早期职业调查员提出 Saldana与Fisher合作，我们将这项工作扩展到通过注意力来考察高管注意力 滥用药物的母亲的网络任务。我们假设，高管注意力的不足将预示着低 对旨在改善育儿能力和阻止药物滥用的治疗的反应性。 基因变异的新工作也为CWS药物滥用预防研究带来了希望。中心联席-L列夫 站在了这项工作的前列。她的预期收养研究(359对养父母，他们的领养 儿童和儿童的亲生父母)有可能通过两种方式为儿童福利服务的做法和政策提供信息： 详细说明了可以在儿童早期实施的具体环境过程，这些过程可以帮助抵消 遗传风险和导致儿童的弹性调整，并通过详细说明特定的遗传影响 特征(如社交能力和坚持性)，即使在早年也能提高儿童的韧性 逆境(Leve等人，2007年)。我们在这方面的工作将受益于知识的快速进步，这些知识是 发生在分子遗传学领域的。例如，Bradley和他的同事(2008)最近发现 儿童虐待和创伤不太可能导致存在遗传因素的成人抑郁症状 促肾上腺皮质激素释放激素1型受体(CRHR1)基因的多态性。这一发现 提示x基因与环境的交互作用对成人抑郁症状的表达具有重要意义 有虐待儿童史的CRHR1风险或保护性等位基因。因此，取代了更窄的 关注青春期在之前的提案中，我们现在计划建立在我们中心现有的知识和 将我们当前和未来CWS药物滥用预防研究的集体计划注入方法和 风险和复原力的神经生物学和遗传机制的测量。这将通过以下方式实现 培训我们中心的科学家，并与CWS从业者和 政策领导者。

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.