Smartphone-based meditation training to reduce adolescent depression

项目总结/摘要 尽管有强有力的证据表明（a）抑郁症在青春期急剧上升，（B）青春期的心理健康状况 青春期预测终身轨迹，（c）基于冥想的干预（MBIs）减少抑郁 青少年人群中MBI的症状、获取和研究都很有限。移动的健康 MBI的交付提供了可访问性、可负担性和个性化的承诺。关于mHealth的研究 成人MBIs表明这些项目在减少抑郁症方面是可行的，可接受的，安全的，有效的 症状再加上行为和心理生理学动态评估的进展（即，个人 通过可穿戴设备，mHealth和个人传感数据代表了一个新的前沿领域， 干预研究和心理保健。尽管移动健康技术在当今的 青少年，几乎没有关于青少年mHealth MBIs的研究，也没有研究整合 mHealth MBI交付与个人传感数据.拟议的职业发展奖开始， 通过培养候选人进行临床研究的技能来解决这一知识差距 青少年样本，个人感知数据和先进的调解方法，以确定机制， 变化这项新的训练将被用来研究，在150名青少年的样本中， 症状，mHealth MBI的影响，具有强大的初步疗效证据。参与者将被 随机分配到mHealth MBI或等待列表控制条件。目标1将评估可行性， 在抑郁青少年中进行为期8周的mHealth MBI的可接受性和安全性。目标2将初步评估 减少抑郁症状的有效性。目标3将表征心理学（即，固着 思维、认知距离、孤独），行为（即，通过地理位置数据进行社交隔离），以及 心理生理学的（即，通过可穿戴设备测量睡眠质量和心率）对抑郁症 症状使用先进的结构方程建模方法。这些方法将提供初步的 干预有效性的证据，同时可能确定多个层面的变化机制， 分析，为规划未来的大规模随机对照试验提供关键数据。所有的目标都将是 通过临床研究基础的教学，体验和指导培训， NIH资助的临床和转化研究所（ICTR）和健康心理中心。目标3 将通过个人传感数据和先进调解方法的新培训， 在这些领域拥有广泛专业知识的导师团队。结合本课题的研究目的和培养目标， 该项目旨在促进开发可获得的，可接受的，安全的，有效的移动健康MBIs， 治疗并最终预防青少年抑郁症。该奖项将使候选人能够进行 未来的干预和机制研究旨在减轻青少年抑郁负担。

Project Summary / Abstract Despite robust evidence that (a) depression rises precipitously during adolescence, (b) mental health during adolescence predicts lifelong trajectories, and (c) meditation-based interventions (MBIs) reduce depressive symptoms, access to and research on MBIs in adolescent populations is limited. Mobile health (mHealth) delivery of MBIs offers the promise of accessibility, affordability, and personalization. Research on mHealth MBIs in adults indicates these programs are feasible, acceptable, safe, and effective in reducing depressive symptoms. Coupled with advances in ambulatory assessment of behavior and psychophysiology (i.e., personal sensing data) through wearable devices, mHealth and personal sensing data represent a new frontier in intervention research and mental health care. Although mHealth technologies are ubiquitous for today’s adolescents, there is virtually no research on mHealth MBIs in adolescents and no research integrating mHealth MBI delivery with personal sensing data. The proposed Career Development Award begins to address this knowledge gap by developing the candidate’s skills to conduct research involving clinical adolescent samples, personal sensing data, and advanced mediation methods to identify mechanisms of change. This new training will be leveraged to study, in a sample of 150 adolescents with elevated depressive symptoms, the impact of a mHealth MBI that has strong preliminary evidence of efficacy. Participants will be randomly assigned to the mHealth MBI or to a wait-list control condition. Aim 1 will assess the feasibility, acceptability, and safety of the 8-week mHealth MBI in depressed adolescents. Aim 2 will preliminarily assess program efficacy in reducing depressive symptoms. Aim 3 will characterize psychological (i.e., perseverative thinking, cognitive distancing, loneliness), behavioral (i.e., social isolation via geolocation data), and psychophysiological (i.e., sleep quality and heart rate metrics via wearable) mediator effects on depressive symptoms using advanced structural equation modeling methods. These methods will provide preliminary evidence of intervention efficacy while potentially identifying mechanisms of change at multiple levels of analysis, providing critical data for planning future, large-scale randomized controlled trials. All aims will be supported by didactic, experiential, and mentored training in the fundamentals of clinical research through the NIH-funded Institute for Clinical and Translational Research (ICTR) and the Center for Healthy Minds. Aim 3 will be facilitated by new training in personal sensing data and advanced mediation methods, supported by a mentor team with extensive expertise in these domains. Combined, the research aims and training goals of this project seek to promote the development of accessible, acceptable, safe, and effective mHealth MBIs for the treatment and ultimately prevention of adolescent depression. This award will enable the candidate to conduct future intervention and mechanism research aimed at reducing the burden of depression in adolescents.