Stage II Research on Outpatient Treatment for Adolescents with Comorbidity

青少年合并症门诊治疗的第二阶段研究

• 批准号: 8845343
• 负责人: ASHLI J SHEIDOW
• 金额: $ 53.68万
• 依托单位: OREGON SOCIAL LEARNING CENTER, INC.
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-06-01 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8845343
• 关键词: Stage; II; Research; Outpatient; Treatment

PROJECT SUMMARY/ABSTRACT Adolescent substance abuse results in significant negative outcomes and extraordinary costs for youths, their families, communities, and society. Moreover, rates of psychiatric comorbidity among substance abusing youth range from 25% up to 82%, and youths with a dual diagnosis are more than twice as costly to treat compared to those with no comorbidity. Community-based treatment for these youth most often is disjointed, with youth and families having to navigate separate treatment systems for the disorders or only receiving treatment for a single disorder. Notably, multiple studies have shown that youth with co-occurring problems have worse outcomes and return to pre-treatment levels of substance use more often and more rapidly than those without a psychiatric diagnosis. The applicant principal investigator, a new investigator, recently completed a NIDA-funded Stage I project focused on developing and piloting a psychosocial treatment specifically for youth presenting for outpatient treatment with co-occurring substance use and internalizing (i.e., mood and/or anxiety) problems. Results were promising with the experimental group exhibiting significantly less substance use and more rapid reductions in anxiety and depressive symptoms compared to the control group. In addition, extensive treatment and therapist training manuals were generated. The proposed research is a Stage II randomized clinical trial (RCT) to compare the experimental treatment (OutPatient Treatment for Adolescents; OPT-A) to an "active placebo" on key clinical indices from pre-treatment through 18 months. The proposed RCT (n = 160) employs the treatment manual, quality assurance protocol, and therapist training protocol developed and successfully piloted in the Stage I study, to evaluate the efficacy of OPT-A for youth referred to outpatient treatment of co- occurring substance use and internalizing problems. The following outcomes will be evaluated: drug use; mental health; behavioral, school, peer, and family functioning; and consumer satisfaction. In addition to providing a strong test of treatment efficacy, the proposed project will leverage the data collection of the RCT to provide a preliminary evaluation of putative mechanisms of action. In summary, this study will advance a promising treatment developed through the Stage I behavioral therapies development program to a Stage II controlled trial. It builds on the treatment manual, therapist training materials, and quality assurance system already developed. The intervention addresses one of the more prevalent and most challenging, costly, and understudied presenting problems among adolescent outpatients. If successful, this research could provide a considerable contribution in the treatment field for youth with co-occurring substance use and internalizing disorders.

项目摘要/摘要 青少年滥用药物滥用导致年轻人的显着负面结果和非凡的成本， 他们的家庭，社区和社会。此外，物质之间的精神病率 虐待青年的25％至82％不等，双重诊断的年轻人的成本是两倍以上 与没有合并症的人相比。这些年轻人经常以社区为基础的治疗是 脱节，青年和家人不得不为疾病或仅导航单独的治疗系统 接受单个疾病的治疗。值得注意的是，多项研究表明，与 问题的结果较差，并恢复了频率更高的物质使用水平 比没有精神诊断的人快。申请人首席研究员，新研究员， 最近完成了一个由NIDA资助的阶段I项目，专注于开发和试行一个社会心理 专门针对青年进行的治疗，用于通过同时发生的物质使用和 内在化（即情绪和/或焦虑）问题。实验组有希望的结果 焦虑和抑郁症状的吸毒物质的使用量明显较少 与对照组相比。此外，广泛的治疗和治疗师培训手册是 生成。拟议的研究是II期随机临床试验（RCT），以比较 实验治疗（青少年的门诊治疗； opt-a）在钥匙上的“活跃安慰剂” 从预处理到18个月的临床指数。拟议的RCT（n = 160）采用治疗 手动，质量保证协议和治疗师培训方案制定并成功试行 我研究的阶段，以评估OPT-A对青年的功效 发生的物质使用和内部化问题。将评估以下结果：吸毒； 心理健康；行为，学校，同伴和家庭功能；和消费者满意度。此外 提供对治疗功效的强烈考验，该项目将利用数据收集 RCT提供了推定的作用机理的初步评估。总而言之，这项研究将 通过I阶段I行为疗法发展计划开发出了有希望的待遇 进入II期对照试验。它以治疗手册，治疗师培训材料和质量为基础 保证系统已经开发。该干预措施解决了最普遍，大多数 具有挑战性，昂贵且研究不足的人在青少年门诊患者中出现问题。如果成功， 这项研究可以在治疗领域为同时发生的年轻人提供相当大的贡献 物质使用和内在疾病。