Differential Sensitivity Markers in Youth Drug Abuse Prevention

 描述（由申请人提供）：拟议的R34试点研究将进行可行性和探索性干预结果研究，从而为早期青少年吸毒者制定个性化干预框架。该研究将探讨代表两个理论上不同的框架的假定主持人，并确定他们是否是后续R 01研究的合适候选人。一个适度框架是基于风险严重性（RS），这反映在延迟折扣（DD）的个体差异上，这是一种冲动决策的形式，与更严重的滥用和成瘾水平呈正相关。第二个更具探索性的框架是基于微分灵敏度（DS）理论。DS框架规定，由于特定的敏感性因素，个人对环境影响（如干预措施提供的影响）的反应各不相同。本研究将探讨与奖赏动机系统相关的DS标记物，包括多巴胺能基因、耳后生理反射和高感觉加工敏感性特征。一个学校-机构-大学伙伴关系将合作为120名青少年（13-16岁）提供服务，这些青少年因最近的酒精和/或大麻事件而被转介到社区咨询中心。招募将选择轻度/中度吸毒者。参与者将被随机分配到两种基于证据的药物滥用干预措施之一。这两种干预提供相同的递送剂量，但在它们的治疗变化机制方面不同（即，环境影响程度）。青少年干预计划（TI; Winters和Leitten，2007）是一项以青少年为重点的干预措施，使用动机访谈，目标设定和技能培训来促进负责任决策的内部发展，目标是选择更健康的态度和行为来替代药物使用行为。日常育儿计划（EP; Dishion等人，二○ ○三年; 2010年）是一项以家庭为重点的干预措施，与父母合作，提供必要的环境支架，帮助青少年逐步内化决策技能，加强和促进健康的生活方式，以替代吸毒。从风险严重程度的角度来看，我们预计DD的个体差异将解释干预反应的适度差异，青年评分为陡峭的折扣，需要更全面的EP来显示治疗收益。我们预计，在一个或所有DS因素中具有高敏感性值的个体将显示出积极的干预效果，无论是随机分配到TI还是EP，因为假设TI和EP都为高DS青年提供了足够的干预影响。相比之下，在敏感性因素中得分较低的年轻人将需要更环保的EP来显示类似的益处。该R34的目的是（1）评估招募、评估和随访参与干预试验的青年的可行性，（2）评估工作人员忠实实施TI和EP的能力，以及（3）获得有希望的数据 在随后的R 01研究中，这将有助于回答“哪种干预措施最适合哪种青少年”的问题。

 DESCRIPTION (provided by applicant): The proposed R34 pilot study will conduct feasibility and exploratory intervention outcome research that will lead to the development of a personalized intervention framework for early stage adolescent drug users. The study will explore putative moderators representing two theoretically distinct frameworks and determine whether they are suitable candidates for a subsequent R01 study. One moderation framework is based on risk severity (RS) as reflected by individual differences in delay discounting (DD), a form of impulsive decision making that is positively associated with escalation to more serious levels of abuse and addiction. A second more exploratory framework is based on differential sensitivity (DS) theory. The DS framework stipulates that individuals, due to specific sensitivity factors, vary in their responsiveness to environmental influence such as the influence provided by an intervention. The study will explore DS markers associated with the reward motivational system, including dopaminergic genes, the post-auricular physiological reflex and a high sensory- processing sensitivity trait. A school-agency-university partnership will collaborate in providing services to 120 adolescents (ages 13-16) who were referred to a community counseling center because of a recent alcohol and/or marijuana incident. Recruitment will select mild/moderate drug users. Participants will be randomized to one of two evidence-based drug abuse interventions. The two interventions offer the same delivery dosage but differ in terms of their mechanism of therapeutic change (i.e., degree of environmental influence). The Teen Intervene program (TI; Winters and Leitten, 2007) is a youth-focused intervention that uses motivational interviewing, goal setting, and skills training to foster the internal development of responsible decision-making with the goal of choosing attitudes and behaviors that are healthier alternatives to drug use behaviors. The Everyday Parenting program (EP; Dishion et al., 2003; 2010) is a family focused-intervention that works with parents to provide environmental scaffolding necessary to help teens gradually internalize decision-making skills that reinforce and promote healthy lifestyle alternatives to drug use. From a risk severity perspective, we anticipate individual differences in DD will account for a moderate amount of variance in intervention response with youth scoring as steep discounters requiring the more comprehensive EP to show treatment gains. We anticipate that individuals with high sensitivity values in one or all DS factors will show positive intervention effects whether randomized to either TI or EP, owing to the assumption that both TI and EP provide sufficient intervention impact for high DS youth. In contrast, youth scoring low in sensitivity factors will require the more environmentally enriched EP to show similar benefits. The aims of this R34 are to (1) assess feasibility of recruiting, assessing, and following-up enrolled youth in an intervention tril, (2) assess the ability of staff to implement TI and EP with fidelity, and (3) obtain promising data on moderator and outcome variables that will help answer the question of "what intervention works best for which youth" in a subsequent R01 study.