Integrated Family-Based Treatment of Co-Occurring Adolescent SUD and ADHD

描述(由申请人提供)：对于患有SUD和ADHD的青少年，迫切需要结合行为和药物干预的综合治疗模式，以实现这两种疾病的持久临床收益。霍格博士在青少年肥皂泡的家庭治疗方面的专业知识使他成为这一领域富有成效的研究人员的极佳人选。修改后的K02申请的目的是在三个核心领域为Hogue博士提供培训和合作研究经验：(1)行为干预核心：针对青少年ADHD的发展精神病理学和行为治疗培训，包括针对学校和学习问题的治疗计划；(2)精神药理学核心：针对青少年ADHD和其他共生疾病的药物干预和遵从性问题以及针对青少年障碍的药物试验进行培训；(3)神经发育核心：关于与ASU和ADHD相关的神经发育风险因素的培训，以及用于研究患有SUD/ADHD青少年的脑过程和治疗反应的神经成像(FMRI)技术方面的培训。在这些核心领域的培训将导致开发一种新的治疗ASU/ADHD的方法，即功能性家庭治疗-综合模型(FFT-IM)，这是ASU基于经验的模型的改编版本，其中包括神经心理学评估和ADHD的循证精神刺激药物治疗方案。培训活动将在FFT-IM的第一阶段试点研究中达到高潮，涉及N=20名患有SUD/ADHD的青少年。FFT-IM的这一阶段的试点研究旨在产生关于可行性和可接受性、治疗保真度以及对行为、发育和家庭结果的影响大小估计的概念验证数据。准实验设计将比较20例FFT-IM病例和20例来自相同地理区域、在社区诊所接受常规服务的TAU匹配对照病例的服务利用效果和治疗后结果。将为新开发的FFT-IM组件开发观测保真度工具，并用于评估试点案例中的遵守情况和能力。如果前景看好，研究结果将为FFT-IM的随机疗效试验奠定基础。 公共卫生相关性：ADHD是ASU常见的共生疾病，对成功的ASU治疗和维持治疗成果提出了重大挑战。这份K02申请中描述的职业发展目标将导致开发针对ASU/ADHD的综合行为/药物治疗，并使首席研究员为专注于开发和测试青春期各种共生障碍的综合模型的独立研究生涯做好准备。

DESCRIPTION (provided by applicant): For adolescents with comorbid SUD and ADHD, integrated treatment models that combine behavioral and pharmacological interventions are urgently needed to achieve lasting clinical gains for both conditions. Dr. Hogue's expertise in family-based treatment for adolescent SUDs makes him an excellent candidate to become a productive investigator in this area. The objective of this amended K02 application is to provide Dr. Hogue with training and collaborative research experiences in three core areas: (1) Behavioral Intervention Core: training in developmental psychopathology and behavioral treatment for adolescent ADHD that includes treatment planning for school and learning problems; (2) Psychopharmacology Core: training in medication intervention and compliance issues for adolescent ADHD and other co-occurring disorders, and in the conduct of medication trials for adolescent disorders; (3) Neurodevelopment Core: training in neurodevelopmental risk factors associated with ASU and ADHD and in neuroimaging (fMRI) techniques for investigating brain processes and treatment response in adolescents with SUD/ADHD. Training in these core areas will lead to development of a new treatment for ASU/ADHD, Functional Family Therapy - Integrated Model (FFT-IM), an adapted version of an empirically based model for ASU that incorporates neuropsychological assessment and an evidence-based psychostimulant medication protocol for ADHD. Training activities will culminate in a Stage I pilot study of FFT-IM involving N = 20 adolescents with SUD/ADHD. This Stage Ia pilot study of FFT-IM is designed to yield proof-of-concept data with regard to feasibility and acceptability, treatment fidelity, and effect size estimates for behavioral, developmental, and family outcomes. The quasi-experimental design will compare service utilization effects and posttreatment outcomes in 20 FFT-IM cases versus 20 TAU matched comparison cases drawn from the same geographic area who receive routine services in community clinics. Observational fidelity tools will be developed for newly developed FFT-IM components and used to evaluate adherence and competence in the pilot cases. If promising, study results would set the foundation for a randomized efficacy trial of FFT-IM. PUBLIC HEALTH RELEVANCE: ADHD is common co-occurring condition for ASU that presents a significant challenge to successful ASU treatment and maintenance of treatment gains. The career development goals described in this K02 application will lead to development of an integrated behavioral/pharmacological treatment for ASU/ADHD and prepare the Principal Investigator for an independent research career focused on developing and testing integrated models for a variety of co-occurring disorders in adolescence.