Integrated Family-Based Treatment of Co-Occurring Adolescent SUD and ADHD

描述（由申请人提供）：对于合并SUD和ADHD的青少年，迫切需要联合收割机结合行为和药物干预的综合治疗模式，以实现两种疾病的持久临床收益。霍格博士在青少年SUD的家庭治疗方面的专业知识使他成为这一领域富有成效的研究者的优秀候选人。Hogue博士在三个核心领域的培训和合作研究经验：（1）行为干预核心：青少年ADHD的发展精神病理学和行为治疗培训，包括学校和学习问题的治疗计划;（2）精神药理学核心：在青少年多动症和其他并发症的药物干预和依从性问题方面以及在青少年疾病的药物试验方面进行培训;（3）神经发育核心：培训与ASU和ADHD相关的神经发育风险因素，以及神经成像（fMRI）技术，用于调查SUD/ADHD青少年的大脑过程和治疗反应。在这些核心领域的培训将导致开发一种新的治疗ASU/ADHD，功能性家庭治疗-综合模型（FFT-IM），一个改编版本的经验为基础的模型ASU，结合神经心理学评估和循证精神兴奋剂药物治疗方案ADHD。培训活动将在涉及N = 20名SUD/ADHD青少年的FFT-IM第I阶段试点研究中达到高潮。本项FFT-IM的Ia期初步研究旨在产生关于可行性和可接受性、治疗保真度以及行为、发育和家庭结局的效应量估计的概念验证数据。准实验设计将比较20例FFT-IM病例与20例TAU匹配对照病例的服务利用效果和治疗后结局，这些病例来自同一地理区域，在社区诊所接受常规服务。将为新开发的FFT-IM组件开发观察保真度工具，并用于评价试点病例的依从性和能力。如果有希望，研究结果将为FFT-IM的随机疗效试验奠定基础。 公共卫生相关性：ADHD是ASU的常见并发症，对成功的ASU治疗和维持治疗收益提出了重大挑战。本K 02申请中描述的职业发展目标将导致开发ASU/ADHD的综合行为/药理学治疗，并为主要研究者准备独立的研究生涯，专注于开发和测试青春期各种并发症的综合模型。

DESCRIPTION (provided by applicant): For adolescents with comorbid SUD and ADHD, integrated treatment models that combine behavioral and pharmacological interventions are urgently needed to achieve lasting clinical gains for both conditions. Dr. Hogue's expertise in family-based treatment for adolescent SUDs makes him an excellent candidate to become a productive investigator in this area. The objective of this amended K02 application is to provide Dr. Hogue with training and collaborative research experiences in three core areas: (1) Behavioral Intervention Core: training in developmental psychopathology and behavioral treatment for adolescent ADHD that includes treatment planning for school and learning problems; (2) Psychopharmacology Core: training in medication intervention and compliance issues for adolescent ADHD and other co-occurring disorders, and in the conduct of medication trials for adolescent disorders; (3) Neurodevelopment Core: training in neurodevelopmental risk factors associated with ASU and ADHD and in neuroimaging (fMRI) techniques for investigating brain processes and treatment response in adolescents with SUD/ADHD. Training in these core areas will lead to development of a new treatment for ASU/ADHD, Functional Family Therapy - Integrated Model (FFT-IM), an adapted version of an empirically based model for ASU that incorporates neuropsychological assessment and an evidence-based psychostimulant medication protocol for ADHD. Training activities will culminate in a Stage I pilot study of FFT-IM involving N = 20 adolescents with SUD/ADHD. This Stage Ia pilot study of FFT-IM is designed to yield proof-of-concept data with regard to feasibility and acceptability, treatment fidelity, and effect size estimates for behavioral, developmental, and family outcomes. The quasi-experimental design will compare service utilization effects and posttreatment outcomes in 20 FFT-IM cases versus 20 TAU matched comparison cases drawn from the same geographic area who receive routine services in community clinics. Observational fidelity tools will be developed for newly developed FFT-IM components and used to evaluate adherence and competence in the pilot cases. If promising, study results would set the foundation for a randomized efficacy trial of FFT-IM. PUBLIC HEALTH RELEVANCE: ADHD is common co-occurring condition for ASU that presents a significant challenge to successful ASU treatment and maintenance of treatment gains. The career development goals described in this K02 application will lead to development of an integrated behavioral/pharmacological treatment for ASU/ADHD and prepare the Principal Investigator for an independent research career focused on developing and testing integrated models for a variety of co-occurring disorders in adolescence.