Heathy Bodies, Healthy Minds: Helping Adolescents with PCOS

描述(由申请者提供)：这项以患者为导向的研究职业发展奖(K23)将使Dana Rofey博士能够对患有行为(肥胖、睡眠)、情绪(抑郁)和身体(胰岛素、葡萄糖、Ghrelin、瘦素、IL-6和CRP)障碍的青少年进行跨学科的纵向干预研究。该应用程序将调查患有多囊卵巢综合征(PCOS)的青少年，该综合征将作为一种典型的身体疾病，包括高肥胖率、抑郁症和睡眠障碍。应聘者是一名有执照的临床心理学家，专门研究肥胖症，曾接受过以下方面的培训：a)抑郁症的病因、评估和治疗；b)治疗结果研究(例如，手动开发、试点测试、评估)的实施经验；c)多元统计学的基本技术；d)对儿童肥胖症的跨学科方面的理解；以及e)临床试验的设计和实施。罗菲博士的短期目标是继续开展与多囊卵巢综合征相关的神经生物学因素方面的培训，重点是将睡眠作为大脑活动的标志；肥胖的内分泌和代谢方面；以及用于纵向治疗结果分析的统计建模。培训将通过以下方式完成：(A)与罗纳德·达尔医学博士和席尔瓦·阿尔斯兰尼亚医学博士导师以及一个咨询专家团队进行会议和指导阅读；(B)正式课程；(C)出席会议、期刊俱乐部和研究会议；以及(D)在监督下的数据收集和分析实践经验。匹兹堡大学医学院将是这次培训的主要地点，提供儿科学、精神病学、内分泌学和生物统计学方面的卓越结合。在多囊卵巢综合征中心和青少年医学诊所的基础设施内，拟议的研究将包括126名患有多囊卵巢综合征的11-21岁青少年。这项研究旨在调查增强型认知行为疗法对身体(体重、睡眠)和情绪(情绪)障碍的影响，并探索症状的补救与潜在的生理变化(如胰岛素、炎症)之间的关系。拟议的计划结合了一种创新的方法，利用生态瞬时评估(EMA)将客观的实验室体重、情绪和睡眠测量与青少年现实世界环境中更具生态有效性的测量相结合。对患有复杂慢性病以及身体和情绪障碍的青少年进行有效干预的见解将使申请者在为肥胖青少年进行翻译研究方面处于有利地位。 公共卫生相关性：肥胖青少年的复杂和相互关联的过程使有效的干预具有挑战性。这种增强的认知行为疗法产生了跨领域(体重、情绪和睡眠)的协同效应，在青春期变得越来越突出。这项研究将为未来针对重要的身体、情感和行为方面的干预奠定基础。

DESCRIPTION (provided by applicant): This Mentored Patient-Oriented Research Career Development Award (K23) will enable Dr. Dana Rofey to conduct interdisciplinary, longitudinal intervention research in adolescents with behavioral (obesity, sleep), emotional (depression), and physical (insulin, glucose, ghrelin, leptin, IL-6, and CRP) disturbances. This application will investigate adolescents with Polycystic Ovary Syndrome (PCOS) which will serve as a model physical illness consisting of high rates of obesity, depression, and sleep disturbances. The candidate is a licensed clinical psychologist, specialized in obesity, who also has prior training in a) the etiology, assessment, and treatment of depression; b) experience in the conduct of treatment-outcome research (i.e., manual development, pilot testing, evaluation); c) basic techniques in multivariate statistics; d) an understanding of the interdisciplinary aspects of childhood obesity; and e) clinical trial design and implementation. Dr. Rofey's short-term goals are to pursue training in neurobiological factors related to PCOS with a focus on sleep as a marker of brain activity; endocrine and metabolic aspects of obesity, and statistical modeling for the analysis of longitudinal treatment outcomes. Training will be accomplished via (a) meetings and guided readings with mentors Ronald Dahl MD and Silva Arslanian MD, and an expert team of consultants; (b) formal coursework; (c) attendance at conferences, journal clubs, and research meetings; and (d) supervised hands-on experiences in the collection and analysis of data. The University Of Pittsburgh School Of Medicine will be the primary site of this training, offering a combination of excellence in pediatrics, psychiatry, endocrinology, and biostatistics. Within the infrastructure of the Polycystic Ovary Syndrome Center and The Adolescent Medicine Clinic, the proposed research will include 126, 11-21.-year-old adolescents with PCOS. The study aims to investigate the effects of an enhanced cognitive behavioral therapy on physical (weight, sleep) and emotional (mood) disturbances, as well as to explore the relationship between remediation of symptoms and underlying physiological changes (e.g., insulin, inflammation). The proposed plan incorporates an innovative methodology that bridges objective laboratory measures of weight, emotion, and sleep and more ecologically valid measurements within the adolescents' real-world environment utilizing ecological momentary assessment (EMA). Insights into efficacious interventions for adolescents with complex chronic illness alongside of physical and emotional disturbances will place the applicant in a strong position to conduct translational research for adolescents with obesity. PUBLIC HEALTH RELEVANCE: Complex and interrelated processes in adolescents with obesity make efficacious interventions challenging. This enhanced cognitive behavioral therapy creates a synergistic effect across domains (weight, mood, and sleep) in ways that become increasingly salient during adolescence. This research will lay the groundwork for future interventions targeting important physical, emotional, and behavioral facets.