Family Based Contingency Management for Adolescent Alcohol Abuse

基于家庭的青少年酗酒应急管理

• 批准号: 8451130
• 负责人: CATHERINE STANGER
• 金额: $ 26.99万
• 依托单位: DARTMOUTH COLLEGE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-08-05 至 2014-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8451130
• 关键词: Family; Based; Contingency; Management; Adolescent

DESCRIPTION (provided by applicant): Based on the 2003-2004 National Survey on Drug Use and Health, 1.5 million youth aged 12-17 years (6.1% of youth in that age range) needed treatment for alcohol abuse, and alcohol is the primary drug reported by 19% of the adolescent treatment population. Recent intervention research on adolescent alcohol abuse has focused primarily on school-based, community, or ER populations. Although new outpatient family-based and contingency-management (CM) interventions for adolescent marijuana abuse have been developed, not one of them specifically targets adolescent primary alcohol users. We could find no published outpatient randomized trial specifically targeting alcohol abuse in adolescents. Thus, little is known about how to most effectively intervene with primary adolescent alcohol abuse and dependence in an outpatient setting. Our goal is to adapt our family-based CM treatment to target primary adolescent alcohol abuse and dependence. Specific Aim 1 is to provide a preliminary demonstration of the efficacy of a familybased CM intervention to treat adolescent alcohol abuse and dependence. CM components include 1) an incentive program to enhance the adolescent's engagement in the treatment process and engender alcohol abstinence by providing positive reinforcement for documented abstinence via breathalyzers administered by parents regularly at home, self and parent report, and clinic-based urine drug testing; and 2) a parent management training program to enhance and maintain the positive effects of the incentive program by teaching parents how to effectively use contingency management in the home environment to motivate their adolescent to achieve abstinence and improve their behavior in other domains. A randomized trial will determine whether the CM intervention enhances outcomes when added to a standard individual cognitive behavioral therapy. Specific Aim 2 is to determine whether and how treatment interventions modify parental and adolescent risk and protective factors using observational and laboratory measures (parenting practices, family functioning, risk taking, delay discounting, and child and parent psychopathology) and to determine whether these factors are associated with outcomes over time. Findings will extend the scientific evidence for CM and support the ability of parents to implement CM at home. Findings that support the CM model's efficacy will make a significant contribution to research on the treatment of adolescent alcohol abuse, which has lagged behind research on adult substance abuse and on adolescent illicit drug use. Future projects will include isolation of active treatment components, dissemination to community clinics, and cost-effectiveness studies.

描述（申请人提供）：根据 2003-2004 年全国吸毒与健康调查，150 万 12-17 岁青少年（占该年龄段青少年的 6.1%）需要治疗酗酒，而酒精是首要治疗手段19% 的青少年治疗人群报告使用该药物。最近针对青少年酗酒的干预研究主要集中在学校、社区或急诊室人群。尽管已经针对青少年大麻滥用制定了新的基于家庭的门诊和应急管理 (CM) 干预措施，但没有一项专门针对青少年主要酒精使用者。我们找不到专门针对青少年酗酒的已发表的门诊随机试验。因此，对于如何在门诊环境中最有效地干预原发性青少年酒精滥用和依赖，人们知之甚少。我们的目标是调整我们以家庭为基础的 CM 治疗，以针对主要的青少年酒精滥用和依赖。具体目标 1 是初步证明以家庭为基础的 CM 干预治疗青少年酒精滥用和酒精依赖的有效性。 CM 组件包括 1) 一个 激励计划，通过父母定期在家中进行的呼气分析仪、自我报告和家长报告以及基于诊所的尿液药物检测，对有记录的戒酒行为提供积极强化，以增强青少年对治疗过程的参与并促使他们戒酒； 2) 家长管理培训计划，通过教导家长如何有效地利用家庭环境中的应急管理来激励青少年实现节欲并改善其在其他领域的行为，从而增强和维持激励计划的积极效果。 一项随机试验将确定将 CM 干预添加到标准个人认知行为疗法中后是否会增强治疗效果。具体目标 2 是使用观察和实验室措施（养育方式、家庭功能、冒险、延迟贴现以及儿童和父母精神病理学）确定治疗干预措施是否以及如何改变父母和青少年的风险和保护因素，并确定这些因素是否是与一段时间内的结果相关。研究结果将扩展 CM 的科学证据，并支持父母在家中实施 CM 的能力。支持 CM 模型功效的研究结果将为青少年酗酒治疗的研究做出重大贡献，该研究一直落后于成人药物滥用和青少年非法药物使用的研究。未来的项目将包括隔离活性治疗成分、向社区诊所传播以及成本效益研究。