Reducing Risk: A Comprehensive mHealth Sleep Health Intervention for Adolescents at Risk for Depression and Anxiety Disorders

项目摘要 本次申请以患者为导向的导师职业发展奖(K23)旨在支持更多 培训和研究将使候选人能够实现她成为独立人士的职业目标 从事旨在预防青少年精神疾病研究的临床科学家。青春期是一种 紧要期，以抑郁症和焦虑症的发病率急剧上升为特征 称为内在化障碍(ID)。睡眠健康问题是无处不在的、可修改的目标 它先于并预测了入侵检测系统的发展。该项目使用实验设计来(A)改进 睡眠健康(通过睡眠重点治疗)，(B)确定改善睡眠是否会产生积极影响 与IDs的发展有关的风险的行为和生物学基础和(C)阐明目标 睡眠健康不良对ID风险的行为和生物基础的影响的潜在机制。这个 本研究将测试跨诊断睡眠和昼夜干预(TRANS-C)的创新适应， 一种睡眠健康疗法，可改善睡眠和心理健康，并有效治疗最常见的睡眠 青少年中的健康缺陷，以前证明每一种缺陷都与 增加身份证的风险。要克服合格供应商供应不足的挑战，这是 治疗接入，我们将tran-C适应于移动设备交付(称为mTranS-C)，因此 利用青少年使用手机的高比率。为了进一步增加访问权限，我们将测试 初级保健服务中的mTRANS-C，这是一种改善获得行为保健的成熟战略。这个 应用程序建立在候选人先前在精神疾病跨诊断机制方面的工作基础上，识别 干预和预防睡眠障碍的目标，以及针对睡眠问题的循证干预。这个 拟议的培训计划强调应聘者的以下新培训领域：(1)治疗 发展和评估，特别是与移动健康平台有关的；(2)生物学和目标 测量HPA轴(风险的生物底物)，以及(3)分析的统计方法 纵向数据集。由国际领导人组成的跨学科导师和顾问团队 在睡眠干预、发展精神病理学、移动健康技术和统计学领域 方法，将提供专业知识，帮助应聘者达到她的培训目标。

Project Summary This application for a Mentored Patient-Oriented Career Development Award (K23) aims to support additional training and research that will enable the candidate to achieve her career goal of becoming an independent clinical scientist conducting research aimed at preventing mental illness among adolescents. Adolescence is a critical period characterized by dramatic increases in rates of depression and anxiety disorders, hereafter referred to as internalizing disorders (IDs). Problems with sleep health are ubiquitous and modifiable targets that precede and predict the development of IDs. This project uses an experimental design to (a) improve sleep health (through a sleep focused treatment), (b) determine whether improving sleep positively impacts behavioral and biological substrates of risk associated with the development of IDs and (c) elucidate target mechanisms underlying the effect of poor sleep health on behavioral and biological substrates of ID risk. The present study will test an innovative adaptation of Transdiagnostic Sleep and Circadian Intervention (TranS-C), a sleep health treatment that improves sleep and mental health and effectively treats the most common sleep health deficits among adolescents, each of which was previously shown to be independently associated with increased risk for IDs. To overcome the challenge of low availability of qualified providers as a barrier to treatment access, we adapted TranS-C for mobile device delivery (referred to as mTranS-C), thereby leveraging the high rates of mobile phone use among adolescents. To further increase access, we will test mTranS-C within primary care services, a proven strategy for improving access to behavioral health care. The application builds on the candidates’ prior work in transdiagnostic mechanisms of mental illness, identifying targets for intervention and the prevention of ID’s, and evidence based interventions for sleep problems. The proposed training plan emphasizes the following new training areas for the candidate: (1) treatment development and assessment, specifically as it pertains to mHealth platforms, (2) the biology and objective measurement of the HPA axis (a biological substrate of risk), and (3) statistical methods for analyzing longitudinal data sets. An inter-disciplinary team of mentors and consultants consisting of international leaders in the areas of sleep interventions, developmental psychopathology, mHealth technologies, and statistical methods, will provide the expertise to help the candidate meet her training objectives.