Borderline Adolescent Family Therapy Trial

描述（由申请人提供）： 拟议的I-B阶段研究重点关注符合边缘型人格障碍（BPD）和物质滥用障碍标准的青少年。这些青少年表现出一种自我毁灭的行为模式（自杀企图、自残、暴力反应），加剧和加剧了他们的药物滥用，严重破坏了治疗和家庭关系。这些症状及其严重程度需要专门的干预措施。之前NIDA资助的第一阶段研究导致了综合性边缘青少年家庭治疗（I-BAFT）模型的发展，该模型整合了1）Linehan专门针对边缘成年人的技能培训工作，2）基于结构家庭治疗的家庭治疗对药物滥用青少年有效，3）适合这种特定类型药物滥用者的个人水平干预。本申请建议进行“药物滥用障碍行为和心理社会疗法的I-B期研究”，在小型随机试验中测试新开发的I-BAFT，并对其疗效进行更实质性的测试，以获得II期试验所需的必要指标。除了关注药物和BPD结局外，该研究还将获得对假设介质（例如，家庭功能和情绪调节）。我们将招募40名符合DSM-IV BPD标准的药物滥用青少年（20名男性和20名女性，14-17岁）及其家人。参与者将从迈阿密大学/杰克逊纪念医院的青少年成瘾接收设施（JARF）和青少年评估中心（JAC）招募。青少年及其家人将被随机分配到（1）I-BAFT条件或（2）个体药物咨询（IDC）条件。这两种治疗条件都是手动的，并有可用的依从性检查表。I-BAFT和IDC都将作为为期七个月的干预措施实施，每周两次。将在基线、治疗中期（4个月）、治疗后（8个月）和随访（12个月）时进行评估。纵向数据分析（生长曲线建模）和临床显著性将用于检验研究假设。

DESCRIPTION (provided by applicant): The proposed Stage I-B study focuses on adolescents who meet criteria for both Borderline Personality Disorder (BPD) and Substance Abuse Disorder. These adolescents display a pattern of self-destructive behaviors (suicide attempts, self-mutilization, violent reactions) that intensify and exacerbate their drug abuse, and severely disrupt treatment and family relations. This constellation of symptoms and their severity require specialized interventions. A previous NIDA funded Stage I study led to the development of the Integrative Borderline Adolescent Family Therapy (I-BAFT) model that integrated 1) Linehan's work on skills training specifically for Borderline adults with 2) family treatment based on Structural Family Therapy shown efficacious with substance abusing adolescents and 3) individual level interventions adapted for this specific subtype of drug abuser. This application proposes to conduct a "Stage I-B study of behavioral and psychosocial therapies for substance abuse disorder" testing the newly developed I-BAFT in a small randomized trial and providing a more substantial test of its efficacy, to obtain the necessary indicators needed for a Stage II trial. In addition to focusing on drug and BPD outcomes, the study will also obtain preliminary indicators of impact on hypothesized mediators (e .g. family functioning and emotion regulation). We will recruit 40 drug-abusing adolescents (20 male and 20 female, 14-17 years of age) who meet DSM-IV criteria for BPD, and their families. Participants will be recruited from the Juvenile Addictions Receiving Facility (JARF) at the University of Miami/Jackson Memorial Hospital and the Juvenile Assessment Center (JAC). The adolescents and their families will be randomly assigned to either the (1) I-BAFT condition, or (2) the Individual Drug Counseling (IDC) condition. Both treatment conditions are manualized and have adherence checklists available. Both I-BAFT and IDC will be implemented as seven-month interventions with two sessions per week. Assessments will be conducted at baseline, mid-treatment (4 months), post-treatment (8 months), and follow-up (12 months). Longitudinal data analysis (growth curve modeling) and Clinical Significance v/ill be used to test study hypotheses.