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

项目总结/摘要 物质使用障碍（SUD）是一个重要的公共卫生问题。需要新颖 青少年药物使用预防战略，特别是了解发展情况的干预措施 根植于基础科学发现。重要的基础研究表明，父母的压力是一个危险因素， 青少年药物使用一项独立的研究发现，正念干预可以减少压力， 成年人了总的来说，正念干预可以减少父母的压力，防止父母的压力增加。 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，没有一个测试过神经生物学机制。通过NIDA资助的R34 （试点和可行性）奖，我们开发并进行了一项以父母为中心的正念的试点RCT 在100名高度紧张的青少年父母中进行了一项名为“用心养育”（PM）的干预。我们 研究发现，PM减少了父母的压力，增加了适应性和有意识的养育行为，减少了父母的压力。 情绪和皮质醇应激反应在我们的实验室父母-青少年互动任务（PAIT），和 预防青少年物质使用和精神病理学症状增加至1年随访， 与父母教育（PE）对照相比。在20名母亲的子样本中，PM也降低了母亲的 前额叶反应性和杏仁核到背外侧前额叶皮层连接性增加，这预测了 适应性更强的父母拟议的研究将通过进行PM的大型RCT采取下一步 通过更长的随访和更严格的PE控制以及充分测试神经生物学机制。 300名青少年（12-14岁）的高度紧张父母将被随机分配接受 PM或PE干预。在干预之前、期间和之后，以及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，临床访谈和生物测量， 父母压力，养育，青少年物质使用和物质使用问题，以及青少年（和父母） SUD和精神病理学症状。在干预前和干预后，观察到的适应性和细心的父母 行为和父母情绪和皮质醇应激反应将在PAIT任务中测量。150母亲 将完成功能磁共振成像会议在前和后检查情绪相关的神经生物学机制。 我们将研究：1. PM在预防青少年药物使用和症状增加方面的功效; 2.父母压力和教养方式是PM影响青少年物质使用的机制;父母情感相关 fMRI反应和连接作为PM的神经生物学机制。这将是第一个随机对照试验的立场- 这是对青少年父母的单独正念干预，也是第一次测试神经生物学机制。的 这项研究将提供有效干预措施，以减轻父母的压力，防止青少年使用药物， 将确定神经生物学机制，以针对和加强PM和其他育儿干预措施。

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.