Decreasing Stress and Anxiety in Adolescents from High-Conflict Homes: Testing a Mindfulness Group + Ecological Momentary Intervention

摘要 这份K01申请的候选人是一名助理教授，他有一个完善的、富有成效的项目 基础社会科学研究，研究家庭关系，特别是婚姻冲突对 青春期健康。她的长期目标是在这项研究计划的基础上发展和测试心身 改善来自高冲突家庭的青少年的压力和焦虑的干预。要这样做，申请人 需要在以下方面进行额外的培训：a)进行正念干预的随机对照试验 B)通过发展密集纵向数据分析的技能，评估随机对照试验随时间的影响。 拟议的培训计划是为了通过讲习班在这些关键领域提供额外的培训， 授课课程、面对面指导和主要研究活动。研究项目的总体目标 是支持开发和测试干预模式，以直接针对高风险和 服务不足的青少年群体：那些来自高冲突家庭的人，因此可能会表现出 压力生理失调、压力增加和焦虑增加的问题。过去的努力，减少 冲突对后代的负面影响侧重于针对家庭冲突，而不是直接关注 加强对高危青少年的监管。正念干预是一种很有希望的方法 直接针对来自高冲突家庭的青少年，以建立监管能力。然而，他们并没有 生态瞬时干预(EMI)也不是这些干预措施的补充 已经被开发出来了。将EMI纳入传统治疗方法通常会提高治疗效果，而且 特别适合青少年。具体目标是：1)开发EMI补充(干预 在两次会议之间通过手机传送的内容)到基于证据的 为青少年提供正念计划，并通过 混合方法研究；2)评估L2B Plus(L2B Plus)在青少年中的可行性和可接受性 以及，3)检查正念在多大程度上减少生理压力 来自高冲突家庭的青少年的调节失调、感觉到的压力和焦虑，两者都是通过实验得出的 将L2B与对照、健康教育计划和b)在现有数据集中进行观察性比较。在这两个地方 研究表明，正念、压力和焦虑之间的联系将在人与人之间以及人与人之间的关系中得到检验。排队 由于NCCIH的重点是研究身心练习如何改善压力和焦虑，目前的项目 将促进对提高正念如何支持来自冲突家庭的青少年的理解； 该项目预计将产生一种灵活的干预模式，该模式易于实施，并受到 家庭和青少年，可以进行修改，以广泛服务于因慢性疾病而处于危险之中的青少年 压力。这项研究还有望产生支持L2B Plus更大规模RCT的关键试点数据。

Abstract The candidate for this K01 application is an Assistant Professor with a well-established, productive program of basic social science research investigating the effects of family relationships, particularly marital conflict, on adolescent health. Her long-term goal is to build upon this research program to develop and test mind-body interventions to improve stress and anxiety in adolescents from high-conflict homes. To do so, the applicant needs additional training in: a) conducting randomized controlled trials (RCTs) of mindfulness interventions and b) assessing the effects of RCTs over time by developing skills in the analysis of intensive longitudinal data. The proposed training plan was developed to provide additional training in these key areas through workshops, didactic courses, in-person mentoring, and primary research activities. The overall goal of the research project is to support the development and testing of an intervention model to directly target a high-risk and underserved adolescent group: those who are from high-conflict homes and are therefore likely to display problems with dysregulated stress physiology, increased stress, and increased anxiety. Past efforts to reduce negative effects of conflict on offspring have focused on targeting family conflict rather than directly focusing on improving regulation in adolescents who are at-risk. Mindfulness interventions represent a promising approach to directly target adolescents from high-conflict homes to build regulatory capabilities. However, they have not been used in this way, nor have ecological momentary intervention (EMI) supplements to these interventions been developed. Incorporating EMI into traditional treatments often increases treatment efficacy, and is particularly appropriate for adolescents. The specific aims are to: 1) develop an EMI supplement (intervention content delivered via cell phone between sessions) to Learning to Breathe (L2B), an evidence-based mindfulness program for adolescents, and to determine the best delivery plan for this EMI supplement via a mixed methods study; 2) evaluate the feasibility and acceptability of L2B Plus (L2B plus EMI) for adolescents from high-conflict homes, and, 3) examine the extent to which mindfulness reduces physiological stress dysregulation, perceived stress, and anxiety in adolescents from high-conflict homes, both a) experimentally by comparing L2B to a control, health education program and b) observationally in an existing dataset. In both studies, links between mindfulness, stress, and anxiety will be examined between- and within-person. In line with NCCIH’s focus on investigating how mind-body practices improve stress and anxiety, the current project will advance understanding of how increasing mindfulness can support adolescents from high-conflict homes; this project is expected to result in a flexible intervention model that is feasible to implement and well-liked by families and adolescents, and that can be modified to broadly serve adolescents at-risk because of chronic stress. This study is also expected to result in the key pilot data supporting a larger-scale RCT of L2B Plus.