Adolescent Response to Psychotherapy: The Role of Neuronal Networks

描述（由申请人提供）：大麻是青少年司法人群中滥用最严重的物质，几乎一半（45%）涉及司法的青少年符合大麻使用障碍的终身标准。然而，估计只有26%的人在心理社会干预后实现了戒断。生物风险因素是可能影响社会心理干预效果的一个尚未得到充分研究的因素。这一概念验证提案寻求使用功能磁共振成像（fMRI）应用转化神经生物学模型来评估在对大麻使用障碍青少年进行广泛传播的社会心理干预期间和之后开始和维持行为改变的神经和遗传基础。具体来说，第一个目的是确定在心理社会干预后，活性成分是否标志着行为改变（例如减少大麻使用）背后的神经认知转变。第二个目的是探索遗传因素（多巴胺受体变异）是否可以预测接受心理社会干预后大脑的不同激活。为了实现这些目标，64名大麻滥用青少年（14-17岁）将在基线和6周完成遗传、神经认知和行为评估，并接受经验支持的大麻使用障碍简短干预。拟议的研究预计将提供关键的基础数据，以促进研究社会心理干预如何以及对谁起作用的转化研究的发展。

DESCRIPTION (provided by applicant): Cannabis is the most abused substance among juvenile justice populations, with almost half (45%) of justice-involved adolescents meeting lifetime criteria for cannabis use disorders. However, only an estimated 26% achieve abstinence following psychosocial interventions. Biological risk factors are one understudied component that may influence the efficacy of psychosocial interventions. This proof of concept proposal seeks to apply a translational neurobiological model using functional MRI (fMRI) to evaluate the neural and genetic underpinnings of the initiation and maintenance of behavior change during and following a widely disseminated psychosocial intervention for adolescents with cannabis use disorders. Specifically, the first aim is to determine whether active ingredients signal a neurocognitive shift that underlies behavioral change (e.g., reduced cannabis use) following a psychosocial intervention. The second aim will explore whether genetic factors (dopamine receptor variants) may predict differential brain activation following receipt of a psychosocial intervention. To accomplish these aims, 64 marijuana-abusing adolescents (ages 14-17) will complete genetic, neurocognitive, and behavioral assessments at baseline and 6 weeks, and receive an empirically supported brief intervention for cannabis use disorders. The proposed research is expected to provide critical foundational data that will facilitate the development of translational studies investigating how and for whom psychosocial interventions work. PUBLIC HEALTH RELEVANCE: Cannabis is the most abused substance among juvenile justice populations, with almost half (45%) of justice-involved adolescents meeting lifetime criteria for cannabis use disorders. Unfortunately, only an estimated 26% of individuals achieve abstinence following psychosocial cannabis interventions. This proof of concept proposal seeks to innovatively integrate biological and behavioral approaches using functional MRI (fMRI) to evaluate the neural and genetic underpinnings of the initiation and maintenance of behavior change (reduced cannabis use) during and following a widely disseminated psychosocial intervention for adolescents with cannabis use disorders. To our knowledge, no one has explored whether functional brain differences mediate the impact of psychosocial addictions interventions. Integrating our understanding of brain activation and treatment response is likely to take a major step towards improving our understanding of patient response to psychosocial cannabis interventions.