Treatment of Youth Alcohol Abuse and Suicidality

青少年酗酒和自杀的治疗

• 批准号: 7047900
• 负责人: CHRISTIANNE L. ESPOSITO-SMYTHERS
• 金额: $ 31.49万
• 依托单位: BROWN UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-04-15 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7047900
• 关键词: adolescence (12-20); alcoholism /alcohol abuse; alcoholism /alcohol abuse therapy; behavioral /social science research tag; clinical research; clinical trial phase I; cognitive behavior therapy; comorbidity; coping; group therapy; human subject; human therapy evaluation; marijuana abuse; patient oriented research; suicide

DESCRIPTION (provided by applicant): This application is being submitted in response to NIAAA PA-02-067 "Treatment of Alcohol Abuse/Dependent Patients With Psychiatric Comorbidity". Adolescent alcohol abuse/dependence is a serious public health problem associated with life threatening outcomes. Among adolescents in alcohol/substance treatment, up to 67% exhibit suicidal ideation and 30% suicidal behavior. Integrated interventions that incorporate treatment of these co-occurring problems have not been tested with adolescents. The primary purpose of this proposal is to conduct a randomized Stage I trial to evaluate a manualized cognitive behavioral treatment protocol for adolescents with alcohol use disorder and co-occurring suicidality. Our long term objective is to yield a more effective and feasible outpatient treatment approach for adolescents with these co-occurring conditions. There are three primary aims in this project: 1) pilot and refine the manualized cognitive behavioral treatment protocol for adolescents with alcohol use disorders and co-occurring suicidality; 2) test this intervention in a small randomized trial to calculate an effect size for a future Stage II clinical trial; and 3) demonstrate feasibility and acceptability of this intervention relative to non-integrated treatment. To accomplish these aims, a two step sequence of treatment development is proposed. In Phase I therapists will be trained, cases will be piloted, and manual revisions will be made. Phase II will include a small randomized trial. Adolescents discharged from a psychiatric inpatient unit will be randomly assigned to the integrated cognitive behavioral treatment or the non-integrated treatment for their outpatient care, both provided by project staff. The integrated treatment will include 20 sessions of cognitive behavioral therapy, provided by one therapist, which integrates treatment of alcohol use and suicidality. The non-integrated treatment will include 12 sessions of cognitive behavioral therapy targeting suicidality and 8 sessions of psycho-educational group therapy targeting alcohol use, each provided by different therapists. Outcome will be assessed at the end of treatment and 6 months post-treatment. The proposed treatment is designed to address objectives18-10 and 18-2 of Healthy People 2010 to "increase the proportion of persons with co-occurring substance abuse and mental disorders who receive treatment of both disorders" and "reduce the rate of suicide attempts by adolescents".

描述（由申请人提供）：本申请是为了响应 NIAAA PA-02-067“酒精滥用/患有精神共病的受抚养患者的治疗”而提交的。青少年酒精滥用/依赖是一个严重的公共卫生问题，可能会危及生命。在接受酒精/药物治疗的青少年中，高达 67% 的人表现出自杀意念，30% 的人表现出自杀行为。治疗这些同时发生的问题的综合干预措施尚未在青少年中进行过测试。该提案的主要目的是进行一项随机第一阶段试验，以评估针对患有酒精使用障碍和并发自杀倾向的青少年的手动认知行为治疗方案。我们的长期目标是为患有这些并发疾病的青少年提供更有效、更可行的门诊治疗方法。该项目有三个主要目标：1）针对患有酒精使用障碍和并发自杀倾向的青少年试点和完善手动认知行为治疗方案； 2) 在一项小型随机试验中测试这种干预措施，以计算未来 II 期临床试验的效果大小； 3) 证明这种干预相对于非综合治疗的可行性和可接受性。为了实现这些目标，提出了治疗开发的两步顺序。在第一阶段，将对治疗师进行培训，对病例进行试点，并进行手动修改。第二阶段将包括一项小型随机试验。从精神科住院部出院的青少年将被随机分配接受综合认知行为治疗或非综合治疗进行门诊护理，这两种治疗均由项目工作人员提供。综合治疗将包括由一名治疗师提供的 20 次认知行为治疗，其中结合了酗酒和自杀的治疗。非综合治疗将包括 12 次针对自杀的认知行为治疗和 8 次针对饮酒的心理教育团体治疗，每次由不同的治疗师提供。将在治疗结束时和治疗后 6 个月评估结果。拟议的治疗旨在实现《2010 年健康人口》的目标 18-10 和 18-2，即“增加同时患有药物滥用和精神障碍的人接受这两种疾病治疗的比例”和“通过以下方式降低自杀企图率”青少年”。