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

描述（由申请人提供）：对于青少年同时患有SUD和ADHD，迫切需要结合行为和药物干预的综合治疗模式，以实现两种情况的持久临床收益。Hogue博士在以家庭为基础的青少年sud治疗方面的专业知识使他成为该领域富有成效的研究者的优秀候选人。本次修订的K02申请的目的是为Hogue博士提供三个核心领域的培训和合作研究经验：(1)行为干预核心：青少年多动症的发展精神病理学和行为治疗培训，包括学校和学习问题的治疗计划；(2)精神药理学核心：培训青少年ADHD及其他共患障碍的药物干预和依从性问题，并开展青少年障碍的药物试验；(3)神经发育核心：训练与ASU和ADHD相关的神经发育危险因素，以及神经成像（fMRI）技术用于研究青少年SUD/ADHD的脑过程和治疗反应。在这些核心领域的培训将导致ASU/ADHD的新治疗方法的发展，功能家庭治疗-综合模型（FFT-IM），一个基于经验的ASU模型的改编版本，结合了神经心理学评估和基于证据的ADHD精神兴奋剂药物治疗方案。培训活动将在FFT-IM的第一阶段试点研究中达到高潮，该研究涉及N = 20名患有SUD/ADHD的青少年。FFT-IM的第一阶段试点研究旨在产生关于可行性和可接受性、治疗保真度以及行为、发育和家庭结果的效应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TAU匹配的对照病例的服务利用效果和治疗后结果，这些病例来自同一地理区域，在社区诊所接受常规服务。将为新开发的FFT-IM组件开发观察保真度工具，并用于评估试点案例中的依从性和能力。如果有希望，研究结果将为FFT-IM的随机疗效试验奠定基础。

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.