Targeting maladaptive responding to negative affect in adolescent cannabis users

项目摘要 该项目旨在开发和评估针对青少年大麻使用障碍的行为干预 强调对消极情感症状(如抑郁、焦虑)的适应性反应。适应不良 对负面情绪的认知、行为和情绪反应与物质使用和 物质使用问题(包括大麻)。青春期和青春期代表着一种发展 仍在发展对负面情绪的调节的时期，以及使用大麻的时期 大麻使用障碍的流行和发病。因此，开发和评估大麻使用障碍 强调改善对负面情绪的反应的干预措施对 这个发育期。 首先，我们将开发一种干预措施，将适应应对的技能和策略编织在一起 负面影响，特别是与渴望和使用大麻的高危时期有关的负面影响，转化为以证据为基础的 对青春期晚期和成年期早期个体的物质使用障碍干预。在开发了 最初的协议，并将其交付给一小部分参与者，我们将收集反馈以指导改进 干预行动。在完善干预措施后，我们计划进行12次个别治疗，我们将 进行试点随机临床试验。参与者(N=80)，年龄18-25岁，患有大麻使用障碍和 代表不良适应反应的结构对负面情绪的提升(即，高焦虑敏感度，低 痛苦耐受，或情绪失调的几个方面，包括高情绪压抑和低认知 (A)青少年的标准认知行为疗法 物质使用障碍(SUD-CBT)或(B)我们开发的新干预措施，情感管理培训 大麻使用障碍(CUD-AMT)。参与者将在基线、治疗后和6个月后接受评估 对目标机制的自我报告和行为指数以及实质内容的后续评估 使用结果(特定于大麻的物质和更广泛定义的物质)。参与者子集(n=50) 还将接受治疗前后的功能磁共振成像评估，以评估神经情绪指数 与SUD-CBT相比，CUD-AMT的监管得到了更大程度的改善。 大麻使用障碍是青少年中最普遍的物质使用障碍。 成人，并经常导致使用其他物质。与高性激素相关的负面情绪和障碍 消极情绪(即焦虑和单相情绪障碍)非常普遍，并与显著的 物质使用障碍共病。目标是在青春期后期和年轻时仍然具有延展性的过程 成年期与物质使用障碍的维持有关的疾病有可能减少 在这一人群中，物质使用障碍的负担，从而对公共卫生造成重大影响。

Project Summary This project aims to develop and evaluate a behavioral intervention for adolescent cannabis use disorder that emphasizes adaptive responding to negative affective symptoms (e.g., depression, anxiety). Maladaptive cognitive, behavioral, and emotional reactions to negative affect are associated with substance use and substance use problems (including cannabis). Adolescence and young adulthood represents a developmental period in which the regulation of negative emotions is still being developed, as well as a time when cannabis use is prevalent and cannabis use disorders onset. Thus, developing and evaluating cannabis use disorder interventions that emphasize the improvement of responding to negative affect may be particularly important for this developmental period. First, we will develop an intervention that weaves skills and strategies for responding adaptively to negative affect, particularly as it relates to high-risk times for cannabis craving and use, into an evidence-based substance use disorder intervention for individuals in late adolescence and early adulthood. After developing the initial protocol and delivering it to a small sample of participants, we will gather feedback to guide refinements to the intervention. After refining the intervention, which we plan to be a 12-session individual treatment, we will conduct the pilot randomized clinical trial. Participants (N = 80) aged 18-25 with cannabis use disorder and elevations in constructs representing maladaptive reactivity to negative affect (i.e., high anxiety sensitivity, low distress tolerance, or facets of emotion dysregulation including high emotional suppression and low cognitive reappraisal ability) will be randomized to receive either: (a) standard cognitive behavioral therapy for adolescent substance use disorders (SUD-CBT) or (b) the novel intervention we develop, affective management training for cannabis use disorders (CUD-AMT). Participants will be assessed at baseline, post-treatment, and a 6-month follow-up assessment on self-report and behavioral indices of the targeted mechanisms, as well as on substance use outcomes (both cannabis-specific and substances more broadly defined). A sub-set of participants (n = 50) will also undergo pre- and post-treatment fMRI assessment to evaluate whether neural indices of emotion regulation are improved to a greater extent in CUD-AMT compared to SUD-CBT. Cannabis use disorder is the most prevalent substance use disorder among adolescents and young adults, and often leads to the use of other substances. Negative affect and disorders associated with high negative affect (i.e., anxiety and unipolar mood disorders) are highly prevalent and associated with significant substance use disorder comorbidity. Targeting a process that is still malleable in late adolescence and young adulthood and that is associated with the maintenance of substance use disorders has the potential to reduce the burden of substance use disorders in this population, thus making a significant public health impact.