Incredible Years - Parent Training

难以置信的岁月 - 家长培训

基本信息

批准号：
10436047
负责人：
Arielle Hope Sheftall
金额：
$ 28.71万
依托单位：
RESEARCH INST NATIONWIDE CHILDREN'S HOSP
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-08-01 至 2027-07-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10436047
关键词：
11 year old 18 year old 9 year old Address Adult Age Age of Onset Awareness Behavior Behavior Therapy Buffers Cause of Death Child Child Behavior Child Rearing Childhood Clinic Communication impairment Discipline Effectiveness Emergency department visit Emotional Emotions Empathy Environment Family Feeling suicidal Future Genetic Goals Heritability Hostility Impairment Intervention Interview Measures Mediator of activation protein Methods Monitor National Institute of Mental Health Outcome Parents Participant Patient Self-Report Perception Physiological Population Practical Robust Implementation and Sustainability Model Prevention program Public Health Qualitative Methods Race Randomized Recording of previous events Reporting Research Research Priority Risk Risk Assessment Risk Factors Schools Self-Injurious Behavior Services Stressful Event Suicide Suicide attempt Suicide prevention Testing Time Training Training Programs Visit Vulnerable Populations Youth acceptability and feasibility behavior observation boys cohesion coping mechanism depressive symptoms early onset effective intervention effectiveness implementation study effectiveness testing efficacious intervention emotion dysregulation emotion regulation externalizing behavior follow-up girls high risk high risk population implementation framework improved intervention effect maltreatment model design non-suicidal self injury offspring parent-child communication parental monitoring peer post intervention prevent primary outcome programs reducing suicide resilience secondary outcome skills social skills statistics suicidal adolescent suicidal behavior suicidal risk transmission process treatment as usual trend virtual

项目摘要

Project Summary/Abstract Suicide is the eighth leading cause of death among U.S. children ages 5-11 years. From 2012-2017, youth suicides increased at an alarming 14.7% annually. During this time, ER visits increased 92% among 5- to 18- year-olds—to 1.12 million. Almost half of these visits involved a 5- to 11-year-old child. To date, however, limited research on child suicide and suicidal behavior (SB) exists, and there are no empirically supported prevention programs despite recognition by NIMH that youth suicide prevention should be a national priority. One especially vulnerable group is children with a parental history of suicide attempts (PH+). PH+ children are 4-6x more likely to engage in SB than their peers and show especially early age of onset—often before age 10. In this proposal, we target specific parent- and child-level vulnerabilities/risk factors for SB among these families. Although suicide risk is heritable, existing research shows (1) effects of shared family environment on SB and suicide, over-and-above genetic influences; and (2) specific family environment mechanisms that contribute to SB and suicide. Such mechanisms include harsh, invalidating, and low-warmth parenting, as well as impaired parent-child communication and poor parental monitoring of children’s behavior. These parenting practices reinforce emotional lability and emotion dysregulation, which are common to both parents and children in at-risk families. In our previous study (R21MH116206), PH+ children, ages 6-9 years, reported less family cohesion, and PH+ parents reported more permissive parenting, which co-occurs with harshness, hostility, and emotion dysregulation. Effective interventions that target these parenting practices and improve parent and child emotion regulation (ER) may reduce risk for youth SB but have not been tested in PH+ families. We will compare a virtual version of Incredible Years® parent training (IY-PT) to Enhanced Usual Care (EUC). IY-PT decreases parents’ emotional reactivity and teaches them to effectively “coach” their children on successful ER. IY-PT is effective in increasing positive parenting and improving ER skills of both parents and children, with large effect sizes that maintain at 1- and 2-year follow-ups. We will (1) test acceptability and feasibility of virtual IY-PT for this population from both parent and clinician perspectives; (2) determine whether IY-PT is effective in decreasing suicide risk among PH+ youth; and (3) explore acceptability and feasibility as potential moderators between PH+ status and parent and child outcome. ER and parenting are primary outcomes and NSSI, SI, and depressive symptoms are secondary outcomes. Measures include interviews, direct observations, and self-reports. Participants include 100 PH+ families who will complete a baseline, be randomized to virtual IY-PT or EUC, and complete 1-,3-, and 6-month reassessments post-intervention. This effectiveness-implementation hybrid model design I, guided by PRISM Implementation Science Framework, could have major implications for preventing an imminent public health concern among at-risk youth.

项目摘要/摘要自杀是5-11岁的美国儿童中第八大死亡原因。从2012年至2017年，青年自杀每年增加14.7％。在此期间，急诊室的访问在5至18-中增长了92％一岁的孩子，达112万。这些访问中几乎一半涉及一个5至11岁的孩子。但是，迄今为止对儿童自杀和自杀行为（SB）的研究有限，并且没有经验支持 NIMH的预防计划目的地认可青年自杀预防应该是国家优先事项。一个特别脆弱的群体是有自杀企图历史的儿童（PH+）。 pH+儿童是与同龄人相比，参与SB的可能性高4-6倍，特别是在10岁之前出现的发病年龄。在此提案中，我们针对特定的父母和子女级漏洞/SB的风险因素家庭。尽管自杀风险是可遗传的，但现有研究表明（1）共享家庭环境对 SB和自杀，遗传影响；（2）特定的家庭环境机制有助于SB和自杀。这种机制还包括危害，无效和低温育儿由于父母的沟通受损和对儿童行为的父母监测不佳。这些育儿实践加强了情感劳动和情绪失调，这对父母都是共同的，处于危险家庭的孩子。在我们先前的研究（R21MH116206）中，pH+儿童（6-9岁）报告较少家庭凝聚力和pH+父母报告了更多宽松的育儿，这与危害同时发生，敌意和情绪失调。针对这些育儿实践并改善的有效干预措施父母和儿童情绪调节（ER）可能会降低青年SB的风险，但尚未在pH+中进行测试家庭。我们将比较一个虚拟版本的不可思议的年龄®父母培训（IY-PT）来增强常规护理（EUC）。 IY-PT降低了父母的情感反应性，并教会他们有效地“指导”他们的孩子成功的ER。 IY-PT可有效地提高积极的育儿和提高父母的ER技能和儿童，其效果大小较大，可维持1年和2年的随访。我们将（1）测试可接受性和从父母和临床角度，虚拟IY-PT的可行性；（2）确定是否 IY-PT可有效降低pH+青年的自杀风险；（3）探索可接受性和可行性 pH+状态与父母和子女结局之间的潜在主持人。 ER和育儿是主要的结果和NSSI，SI和抑郁症状是次要结果。措施包括访谈，直接观察和自我报告。参与者包括100个pH+家庭，他们将完成基线，干预后，随机分配至虚拟IY-PT或EUC，并完成1-，3-和6个月的重新评估。这有效性实施混合模型设计I，在Prism实施科学框架的指导下，可能对防止处于危险中的年轻人迫在眉睫的公共卫生关注有重大影响。