Ecological Momentary Assessment of Mechanisms of Change during a Mindfulness-based Intervention for At-risk Adolescents

项目总结/摘要 青少年心理健康问题，如焦虑和抑郁，在过去急剧增加 十年来，个人和社会付出了巨大的代价。众所周知，心理健康问题会导致 和长期压力相关的身体健康问题。不幸的是，长期处于压力下的青少年 由于情绪调节障碍， 青少年应对压力所必需的自我调节任务。正念干预 （MBIs）已被提议通过改善以下方面来改善精神和身体健康问题： 正念和情绪调节困难。然而，大多数关于青少年MBI机制的研究， 仅在受试者间水平进行了变更，横截面数据受低风险影响。 生态有效性此外，人们对MBIs如何帮助青少年保持正念和健康知之甚少。 在压力下的情绪调节使用生态瞬时评估（EMA）可以帮助填补 通过提供有关瞬时状态级过程的信息来填补文献中的这些空白。的目的 本项目是利用EMA来了解MBI在多大程度上促进了青少年对 压力时刻的正念和健康的情绪调节。具体目标是（1）表征，优先 干预，生活压力源，状态正念和状态之间的实时，动态关系 情绪调节困难在高危青少年和（2）调查的程度，参与一个 MBI与控制条件相比改变了这些实时、动态的关系。这些目标将受到考验 在一个更大的背景下，父母随机对照试验，旨在研究MBI的可行性， 可接受性及其对改善高危青少年适应不良饮食行为的有效性 （11- 18 y）提到了一个基于社区的辅导方案，因为“有可能无法充分发挥其潜力”。 目前的建议是一个新的扩展，通过增加EMA测量正念，情绪， 调节困难和生活压力源的样本子集（N=80/N=160）。多层结构方程 模型将被用来调查的目的。这项提案旨在推动候选人的长期 目标是成为一名独立的科学家，拥有先进的方法学和统计学知识， 应用于最大限度地提高MBIs和预防性实践在慢性病社区的有效性， 压力暴露培训目标是：a）培养进行和分析EMA的必要技能，B）获得 了解在高压力环境下对青少年进行MBI临床试验的情况，以及c）进一步了解 MBIs变化的应激相关生理机制。从本提案中获得的知识将提供 关于MBI影响理论化的变革机制和培训的程度的基本信息 将使候选人成为一个创新的，熟练的研究人员能够利用先进的统计， 对在高压环境中为青少年提供的补充和综合做法进行严格研究。

Project Summary/Abstract Adolescent mental health problems, such as anxiety and depression, have drastically increased over the past decade with major costs to individuals and society. Mental health problems are known to contribute to immediate and long-term stress-related physical health problems. Unfortunately, adolescents exposed to chronic stressors are at an increased risk for developing mental health problems likely due to impairments in emotion regulation, a self-regulatory task of adolescence necessary for coping with stressors. Mindfulness-based interventions (MBIs) have been proposed to ameliorate mental and physical health problems through improvements in mindfulness and emotion regulation difficulties. However, most research on adolescent MBI mechanisms of change has only been conducted at the between-subjects level with cross-sectional data that are subject to low ecological validity. Further, little is known about how MBIs help adolescents to maintain mindfulness and healthy emotion regulation in moments of stress. The use of ecological momentary assessment (EMA) can help to fill these gaps in the literature by providing information about momentary, state-level processes. The purpose of this project is to utilize EMA to understand the extent to which an MBI promotes adolescents’ maintenance of mindfulness and healthy emotion regulation in moments of stress. The specific aims are to (1) characterize, prior to an intervention, the real-time, dynamic relationships between life stressors, state mindfulness, and state emotion regulation difficulties in at-risk adolescents and (2) to investigate the extent to which participation in an MBI compared to a control condition changes these real-time, dynamic relationships. These aims will be tested within the context of a larger, parent randomized controlled trial designed to study an MBI’s feasibility and acceptability as well as its effectiveness for improving maladaptive eating behaviors among at-risk adolescents (11-18y) referred to a community-based mentoring program for being “at-risk for not reaching their full potential.” The current proposal is a novel extension of this trial by adding EMA measurements of mindfulness, emotion regulation difficulties, and life stressors to a sample subset (n=80 of N=160). Multilevel structural equation modeling will be used to investigate the aims. This proposal is designed to advance the candidate’s long-term goal of becoming an independent scientist with advanced methodological and statistical knowledge that can be applied to maximizing the effectiveness of MBIs and contemplative practices for use in communities with chronic stress exposure. The training objectives are to a) develop necessary skills to conduct and analyze EMA, b) gain knowledge about MBI clinical trials with adolescents in high-stress contexts, and c) further understanding of stress-related physiological mechanisms of change in MBIs. Knowledge generated from this proposal will provide essential information about the extent to which an MBI impacts theorized mechanisms of change and the training will enable the candidate to become an innovative, skilled researcher capable of utilizing advanced statistics to conduct rigorous research on complementary and integrative practices for adolescents in high-stress contexts.