Differential Sensitivity Markers in Youth Drug Abuse Prevention

青少年药物滥用预防中的差异敏感性标记

• 批准号: 9279098
• 负责人: GERALD J AUGUST
• 金额: $ 22.01万
• 依托单位: UNIVERSITY OF MINNESOTA
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-07-15 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9279098
• 关键词: Adolescent; Adult; Age; Alcohol consumption; Alcohols; Attitude; Behavior; Child Rearing; Chronic; Client; Cognition; Communication; Communities; Counseling; Data; Decision Making; Dependency; Development; Drug abuse; Drug usage; Drug user; Effect Modifiers (Epidemiology); Elements; Enrollment; Environment; Family; Fostering; Future; Genes; Goals; Growth; Impulsivity; Individual; Individual Differences; Intervention; Marijuana; Measures; Modeling; Motivation; Outcome; Outcomes Research; Parents; Participant; Patient Self-Report; Pattern; Physiological; Pilot Projects; Prevention; Preventive Intervention; Problem Solving; Professional counselor; Randomized; Recruitment Activity; Reflex action; Research; Rewards; Risk; Risk Marker; Sarin; Schools; Sensory; Services; Severities; Subgroup; System; Teenagers; Testing; Therapeutic; Tobacco; Treatment outcome; Universities; Variant; Work; Youth; addiction; adolescent drug abuse; adolescent drug use; base; cost; discount; discounting; dosage; environmental enrichment for laboratory animals; evidence base; group intervention; healthy lifestyle; interest; intervention effect; marijuana use; marijuana user; motivational enhancement therapy; personalized care; personalized intervention; preempt; programs; public health relevance; response; scaffold; skills; skills training; social stigma; theories; tool; trait; trend; Adolescent; Adult; Age; Alcohol consumption; Alcohols; Attitude; Behavior; Child Rearing; Chronic; Client; Cognition; Communication; Communities; Counseling; Data; Decision Making; Dependency; Development; Drug abuse; Drug usage; Drug user; Effect Modifiers (Epidemiology); Elements; Enrollment; Environment; Family; Fostering; Future; Genes; Goals; Growth; Impulsivity; Individual; Individual Differences; Intervention; Marijuana; Measures; Modeling; Motivation; Outcome; Outcomes Research; Parents; Participant; Patient Self-Report; Pattern; Physiological; Pilot Projects; Prevention; Preventive Intervention; Problem Solving; Professional counselor; Randomized; Recruitment Activity; Reflex action; Research; Rewards; Risk; Risk Marker; Sarin; Schools; Sensory; Services; Severities; Subgroup; System; Teenagers; Testing; Therapeutic; Tobacco; Treatment outcome; Universities; Variant; Work; Youth; addiction; adolescent drug abuse; adolescent drug use; base; cost; discount; discounting; dosage; environmental enrichment for laboratory animals; evidence base; group intervention; healthy lifestyle; interest; intervention effect; marijuana use; marijuana user; motivational enhancement therapy; personalized care; personalized intervention; preempt; programs; public health relevance; response; scaffold; skills; skills training; social stigma; theories; tool; trait; trend

 DESCRIPTION (provided by applicant): The proposed R34 pilot study will conduct feasibility and exploratory intervention outcome research that will lead to the development of a personalized intervention framework for early stage adolescent drug users. The study will explore putative moderators representing two theoretically distinct frameworks and determine whether they are suitable candidates for a subsequent R01 study. One moderation framework is based on risk severity (RS) as reflected by individual differences in delay discounting (DD), a form of impulsive decision making that is positively associated with escalation to more serious levels of abuse and addiction. A second more exploratory framework is based on differential sensitivity (DS) theory. The DS framework stipulates that individuals, due to specific sensitivity factors, vary in their responsiveness to environmental influence such as the influence provided by an intervention. The study will explore DS markers associated with the reward motivational system, including dopaminergic genes, the post-auricular physiological reflex and a high sensory- processing sensitivity trait. A school-agency-university partnership will collaborate in providing services to 120 adolescents (ages 13-16) who were referred to a community counseling center because of a recent alcohol and/or marijuana incident. Recruitment will select mild/moderate drug users. Participants will be randomized to one of two evidence-based drug abuse interventions. The two interventions offer the same delivery dosage but differ in terms of their mechanism of therapeutic change (i.e., degree of environmental influence). The Teen Intervene program (TI; Winters and Leitten, 2007) is a youth-focused intervention that uses motivational interviewing, goal setting, and skills training to foster the internal development of responsible decision-making with the goal of choosing attitudes and behaviors that are healthier alternatives to drug use behaviors. The Everyday Parenting program (EP; Dishion et al., 2003; 2010) is a family focused-intervention that works with parents to provide environmental scaffolding necessary to help teens gradually internalize decision-making skills that reinforce and promote healthy lifestyle alternatives to drug use. From a risk severity perspective, we anticipate individual differences in DD will account for a moderate amount of variance in intervention response with youth scoring as steep discounters requiring the more comprehensive EP to show treatment gains. We anticipate that individuals with high sensitivity values in one or all DS factors will show positive intervention effects whether randomized to either TI or EP, owing to the assumption that both TI and EP provide sufficient intervention impact for high DS youth. In contrast, youth scoring low in sensitivity factors will require the more environmentally enriched EP to show similar benefits. The aims of this R34 are to (1) assess feasibility of recruiting, assessing, and following-up enrolled youth in an intervention tril, (2) assess the ability of staff to implement TI and EP with fidelity, and (3) obtain promising data on moderator and outcome variables that will help answer the question of "what intervention works best for which youth" in a subsequent R01 study.

 描述（由适用提供）：拟议的R34试点研究将进行可行性和探索性干预结果研究，这将导致为早期青少年吸毒者提供个性化干预框架。该研究将探索代表两个理论上不同框架的推定主持人，并确定它们是否是随后的R01研究的合适候选者。一个节制框架是基于风险严重性（RS），这反映在延迟折现（DD）的个体差异中，这种冲动决策的一种形式与升级到更严重的虐待和成瘾水平呈正相关。第二个探索性框架是基于差异灵敏度（DS）理论。 DS框架定义了由于特定的敏感性因素，个人对环境影响的反应（例如干预所提供的影响）有所不同。该研究将探索与奖励动机系统相关的DS标记，包括多巴胺能基因，后声学后的生理反射和高感觉化学敏感性特征。由于最近的酒精和/或大麻事件，学校机构 - 大学的合作伙伴关系将合作为120名青少年（13-16岁）提供服务，他们被转介给社区咨询中心。招聘将选择温和/适度的吸毒者。参与者将被随机分为两种基于证据的药物滥用干预措施之一。这两种干预措施提供了相同的递送剂量，但在其理论机理（即环境影响程度）方面有所不同。青少年干预计划（TI； Winters and Leitten，2007年）是一种以青年为中心的干预措施，它使用动机访谈，目标设定和技能培训来促进负责任决策的内部发展，以选择选择与药物使用行为更健康的参与者和行为。日常育儿计划（Ep; Dishion等，2003; 2010）是一种专注于家庭的干预，与父母一起提供必要的环境脚手架，以帮助青少年逐渐内化决策技巧，从而增强和促进健康的生活方式替代药物的替代品。从风险严重程度的角度来看，我们预计DD的个体差异将在干预反应方面有适度的差异，而青年评分是钢折叠术，需要更全面的EP才能显示出治疗的收益。我们预计，一个或所有DS因素中具有高灵敏度值的个体将显示出积极的干预效果，无论是随机与Ti还是EP，TI和EP都对高DS青年产生了足够的干预影响。相比之下，敏感性因素的年轻人得分较低将需要更加环保的EP表现出类似的好处。该R34的目的是（1）评估招聘，评估和后续招募和后续年轻人的可行性，以干预三核，（2）评估员工以忠诚实施TI和EP的能力，以及（3）获得有前途的数据 关于主持人和结果变量，将有助于回答以后的R01研究中“哪种干预效果最适合哪个青年”的问题。