Dialectical Behavior Therapy for Bipolar Adolescents

描述(由申请人提供)：尽管青春期双相情感障碍的发病率和死亡率很高，但到目前为止还没有针对这一人群的经经验验证的心理社会干预措施。这项以患者为导向的指导研究职业发展奖的目的是使候选人能够制定一项研究计划，将临床、发展和神经生物学方法整合在一起，评估和治疗患有双相情感障碍的青少年的情感调节障碍。拟议的研究计划侧重于双相情感障碍青少年的家庭心理社会干预的治疗开发和初步调查。干预措施将包括年龄和 辩证行为疗法(DBT)的疾病相关修改，这是一种针对成年人的循证治疗，重点是增强情绪调节技能。以家庭为基础的DBT的可行性和有效性将在拟议的开放试点试验中进行审查。这项研究将在西方精神病学研究所和诊所的儿童和青少年躁郁症服务诊所进行。60名患有双相情感障碍的青少年(12-18岁)将接受以家庭为基础的DBT。假设DBT将是可行的，并为这些人群所接受，并将与影响调节、情绪的改善有关 症状学和一年随访的心理社会功能。探索性分析将检验治疗反应的预测因素。培训内容包括：1)青少年发展，2)情感调节的神经生物学，3)儿童双相情感障碍的药理学管理，以及4)分析纵向治疗结果数据的统计方法。这样的培训活动将通过提高候选人开发、交付和评估干预结果的能力来支持研究计划，该干预包含了情绪调节的多学科方法。培训和研究计划共同支持候选人的长期目标，即建立一个多学科的创新治疗研究计划，以双相情感障碍青少年为目标。这一领域的进一步研究具有重大的公共卫生意义，因为它有可能减少与早发性双相情感障碍相关的不良结局，包括成年期的恶化过程、慢性心理社会损害、治疗抵抗和自杀。

DESCRIPTION (provided by applicant): Despite the substantial morbidity and mortality associated with bipolar disorder in adolescence, there are no empirically validated psychosocial interventions for this population to date. The purpose of this Mentored Patient-Oriented Research Career Development Award is to enable the candidate to develop a program of research that integrates clinical, developmental, and neurobiological approaches to the assessment and treatment of affective dysregulation for adolescents with bipolar disorder. The proposed research plan focuses on treatment development and preliminary investigation of a family-based psychosocial intervention targeting affective dysregulation for adolescents with bipolar disorder. The intervention will include age- and illness-related modifications to Dialectical Behavior Therapy (DBT), an evidence-based treatment for adults focused on enhancing emotion regulation skills. Feasibility and efficacy of Family-Based DBT will be examined in the proposed open pilot trial. The study will be conducted at the Child and Adolescent Bipolar Services clinic at Western Psychiatric Institute and Clinic. Sixty adolescents (age 12-18) with bipolar disorder will receive Family-Based DBT. It is hypothesized that DBT will be feasible to deliver and acceptable to this population, and will be associated with improvements in affect regulation, mood symptomatology, and psychosocial functioning over one-year follow-up. Exploratory analyses will examine predictors of treatment response. Training will be sought in: 1) adolescent development, 2) the neurobiology of affect regulation, 3) pharmacological management of pediatric bipolar disorder, and 4) statistical methods for analyzing longitudinal treatment-outcome data. Such training activities will support the research plan by enhancing the candidate's ability to develop, deliver, and assess outcomes for the intervention that incorporate a multidisciplinary approach to emotion regulation. Together, the training and research plans support the candidate's long-term goal of establishing a multidisciplinary program of innovative treatment research targeting affective dysregulation among adolescents with bipolar disorder. Further research in this area is of significant public health importance, as it has the potential to decrease poor outcomes associated with early-onset bipolar disorder, including a deteriorative course into adulthood, chronic psychosocial impairment, treatment resistance, and suicidality.