Stage II Research on Outpatient Treatment for Adolescents with Comorbidity

项目总结/摘要 青少年药物滥用会给青年带来严重的负面后果和巨大的代价， 他们的家庭、社区和社会。此外，药物治疗中精神共病的发生率 虐待青少年的比例从25%到82%不等，患有双重诊断的青少年的成本是前者的两倍多。 与没有合并症的人相比。对这些青少年的社区治疗通常是 脱节，年轻人和家庭不得不为这些疾病导航单独的治疗系统， 接受单一疾病的治疗值得注意的是，多项研究表明，青年与共同发生的 问题有更糟糕的结果，并返回到治疗前的物质使用水平更频繁， 比那些没有精神病诊断的人更快。申请人主要研究者，新研究者， 最近完成了一个NIDA资助的第一阶段项目，重点是开发和试点一个心理社会学 专门针对因同时使用药物而门诊治疗的青少年的治疗， 内化（即，情绪和/或焦虑）问题。实验组的结果很有希望 表现出明显更少的物质使用和更快的减少焦虑和抑郁症状 与对照组相比。此外，广泛的治疗和治疗师培训手册， 生成的.拟议的研究是一项II期随机临床试验（RCT）， 实验性治疗（青少年门诊治疗; OPT-A）到“活性安慰剂”的关键 治疗前至18个月的临床指标。拟定的RCT（n = 160）采用了 制定了手册、质量保证规程和治疗师培训规程，并在 第一阶段研究，评估OPT-A对门诊治疗的青少年的疗效， 出现物质使用和内化问题。将评价以下结果：药物使用; 心理健康;行为、学校、同伴和家庭功能;以及消费者满意度。除了 为测试治疗效果，拟议项目将利用 RCT旨在提供对假定作用机制的初步评价。总之，这项研究将 推进通过第一阶段行为疗法开发计划开发的有前途的治疗方法 进行第二阶段的对照试验它建立在治疗手册、治疗师培训材料和质量的基础上。 保障体系已经形成。干预措施解决了一个更普遍和最 具有挑战性的，昂贵的，研究不足的问题，青少年门诊病人。如果成功， 这项研究可以为青少年并发症的治疗领域做出相当大的贡献。 物质使用和内化障碍。

PROJECT SUMMARY/ABSTRACT Adolescent substance abuse results in significant negative outcomes and extraordinary costs for youths, their families, communities, and society. Moreover, rates of psychiatric comorbidity among substance abusing youth range from 25% up to 82%, and youths with a dual diagnosis are more than twice as costly to treat compared to those with no comorbidity. Community-based treatment for these youth most often is disjointed, with youth and families having to navigate separate treatment systems for the disorders or only receiving treatment for a single disorder. Notably, multiple studies have shown that youth with co-occurring problems have worse outcomes and return to pre-treatment levels of substance use more often and more rapidly than those without a psychiatric diagnosis. The applicant principal investigator, a new investigator, recently completed a NIDA-funded Stage I project focused on developing and piloting a psychosocial treatment specifically for youth presenting for outpatient treatment with co-occurring substance use and internalizing (i.e., mood and/or anxiety) problems. Results were promising with the experimental group exhibiting significantly less substance use and more rapid reductions in anxiety and depressive symptoms compared to the control group. In addition, extensive treatment and therapist training manuals were generated. The proposed research is a Stage II randomized clinical trial (RCT) to compare the experimental treatment (OutPatient Treatment for Adolescents; OPT-A) to an "active placebo" on key clinical indices from pre-treatment through 18 months. The proposed RCT (n = 160) employs the treatment manual, quality assurance protocol, and therapist training protocol developed and successfully piloted in the Stage I study, to evaluate the efficacy of OPT-A for youth referred to outpatient treatment of co- occurring substance use and internalizing problems. The following outcomes will be evaluated: drug use; mental health; behavioral, school, peer, and family functioning; and consumer satisfaction. In addition to providing a strong test of treatment efficacy, the proposed project will leverage the data collection of the RCT to provide a preliminary evaluation of putative mechanisms of action. In summary, this study will advance a promising treatment developed through the Stage I behavioral therapies development program to a Stage II controlled trial. It builds on the treatment manual, therapist training materials, and quality assurance system already developed. The intervention addresses one of the more prevalent and most challenging, costly, and understudied presenting problems among adolescent outpatients. If successful, this research could provide a considerable contribution in the treatment field for youth with co-occurring substance use and internalizing disorders.