Efficacy and Neurobiological Mechanisms of a Parenting-Focused Mindfullness Intervention to Prevent Adolescent Substance Use

项目摘要/摘要 物质使用障碍(SODS)是一个重大的公共卫生问题。人们对小说的需求 青少年药物使用预防战略，特别是了解发展的干预措施 植根于基础科学发现。重要的基础研究表明，父母压力是患高血压的风险因素 青少年药物使用。另一项单独的研究发现，正念干预可以减少 成年人。总而言之，正念干预可能会减轻父母的压力，防止父母压力的增加 青春期的物质使用。然而，很少有随机对照试验(RCT)评估正念。 对父母的干预，没有一项对神经生物学机制进行了测试。通过我们由NIDA资助的R34 (试点和可行性)奖，我们开发并实施了一项以育儿为中心的专注的试点RCT 对100名压力较大的青少年父母进行干预，即专心育儿(PM)干预。我们 发现PM减少了父母的压力，增加了适应性和专注性的父母行为，减少了父母 我们实验室亲子互动任务(PAIT)中的情绪和皮质醇应激反应，以及 预防青少年药物使用和精神病理症状增加到1年随访，如 与家长教育(PE)对照相比。在20名母亲的子样本中，PM也减少了母亲的 前岛反应性和杏仁核到背外侧前额叶皮质的连接性增加，这预示着 更具适应性的育儿方式。拟议的研究将采取下一步，进行大规模的PM随机对照试验 通过更长时间的随访和更严格的PE控制，以及充分测试神经生物学机制。 300名压力较大的早期青少年(12-14岁)的父母将被随机分配到 PM或PE干预。在干预前、干预期间和干预后，以及在6个月、1年和2年随访时- UPS(进入青春期中期)，我们将收集问卷、临床访谈和生物学测量 父母压力、父母教养、青少年药物使用和药物使用问题，以及青少年(和父母) SUD和精神病理症状。在干预前和干预后，观察适应性和有意识的育儿方式 行为、父母情绪和皮质醇应激反应将在Pait任务中进行测量。150位母亲 将在检查情绪相关神经生物学机制的前后完成功能磁共振成像课程。 我们将检查：1.PM在预防青少年药物使用和症状增加方面的有效性； 2.父母压力和父母教养方式对青少年物质使用的影响 功能性核磁共振反应和连接性作为PM的神经生物学机制这将是第一个RCT展台- 针对青少年父母的单独正念干预，并首次测试神经生物学机制。这个 这项研究将提供有效的干预措施，既减轻父母的压力，又防止青少年使用药物和 将确定神经生物学机制，以针对和加强PM和其他育儿干预。

Project Summary/Abstract Substance use disorders (SUDs) are a significant public health problem. There is a need for novel substance use prevention strategies for adolescents, particularly developmentally-informed interventions rooted in basic science findings. Significant basic research indicates parent stress as a risk factor for adolescent substance use. A separate body of research finds that mindfulness interventions reduce stress in adults. Taken together, mindfulness interventions may reduce parent stress and prevent increases in substance use in adolescence. However, few randomized controlled trials (RCTs) have evaluated mindfulness interventions for parents and none have tested neurobiological mechanisms. Through our NIDA-funded R34 (Pilot and Feasibility) award, we developed and conducted a pilot RCT of a parenting-focused mindfulness intervention, the Parenting Mindfully (PM) intervention, in 100 highly-stressed parents of adolescents. We found that PM reduced parent stress, increased adaptive and mindful parenting behavior, decreased parent emotional and cortisol stress reactivity in our laboratory parent-adolescent interaction task (PAIT), and prevented increases in adolescent substance use and psychopathology symptoms to 1 year follow-up, as compared to a Parent Education (PE) control. In a sub-sample of 20 mothers, PM also decreased mothers’ anterior insula reactivity and increased amygdala to dorsolateral prefrontal cortex connectivity, which predicted more adaptive parenting. The proposed study will take the next step by conducting a large RCT of PM with a longer follow-up and more rigorous PE control and by fully testing neurobiological mechanisms. 300 highly-stressed parents of early adolescents (age 12-14) will be randomly assigned to receive the PM or PE intervention. Before, during, and after the interventions, and at 6 month, 1 year, and 2 year follow- ups (into middle adolescence), we will collect questionnaire, clinical interview, and biological measures of parent stress, parenting, adolescent substance use and substance use problems, and adolescent (and parent) SUD and psychopathology symptoms. At pre- and post-intervention, observed adaptive and mindful parenting behaviors and parent emotional and cortisol stress reactivity will be measured in the PAIT task. 150 mothers will complete fMRI sessions at pre- and post- examining emotion-related neurobiological mechanisms. We will examine: 1. Efficacy of PM in preventing increases in adolescent substance use and symptoms; 2. Parent stress and parenting as mechanisms of PM on adolescent substance use; 3. Parent emotion-related fMRI responses and connectivity as neurobiological mechanisms of PM. This will be the first RCT of a stand- alone mindfulness intervention for parents of adolescents and the first to test neurobiological mechanisms. The study will provide an effective intervention to both reduce parent stress and prevent youth substance use and will identify neurobiological mechanisms to target and strengthen PM and other parenting interventions.