School-Based Depression Prevention for Adolescents with ADHD

多动症青少年的学校抑郁症预防

• 批准号: 9902950
• 负责人: ANDREA CHRONIS-TUSCANO
• 金额: $ 14.63万
• 依托单位: UNIV OF MARYLAND, COLLEGE PARK
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-08-07 至 2021-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9902950
• 关键词: Accounting; Address; Adolescence; Adolescent; Adult; Attention deficit hyperactivity disorder; Baltimore; Behavioral; Case Series; Child; Childhood; Cities; Clinic; Clinical; Cognitive; Communities; Community Practice; Comorbidity; Conflict (Psychology); Data; Diagnostic; Disease; Effectiveness; Effectiveness of Interventions; Emotional; Environment; Evidence based intervention; Feedback; Feeling suicidal; Focus Groups; Funding; Future; Goals; Health Personnel; Health Services Accessibility; Healthcare; High School Student; Hospitalization; Hybrids; Impairment; Individual; Inpatients; Intervention; Learning; Link; Low income; Major Depressive Disorder; Manuals; Measures; Mediating; Mental Depression; Mental Health; Mental Health Services; Modeling; Moods; Movement; National Institute of Mental Health; National Institute on Alcohol Abuse and Alcoholism; Nature; Outcome; Parents; Population; Prevention; Prevention approach; Prevention program; Preventive Intervention; Procedures; Protocols documentation; Public Health; Randomized; Randomized Controlled Trials; Research; Research Priority; Rewards; Risk; Schools; Series; Services; Sterile coverings; Structure; Suicide attempt; Supervision; Teenagers; Testing; Time; Training; Universities; Work; Youth; adverse outcome; alcohol related problem; base; child depression; cost; depression prevention; depressive symptoms; design; effectiveness research; effectiveness trial; emotion regulation; evidence base; functional disability; hands-on learning; health care delivery; high school; high school program; improved; in vivo; indicated prevention; inner city; interest; intervention program; motivational enhancement therapy; novel; practice setting; programs; selective prevention; social; suicidal behavior; suicidal risk; suicide rate; teacher; therapy development; treatment as usual; university student; young adult

ABSTRACT/PROJECT SUMMARY Children with ADHD are at elevated risk for depression in adolescence and young adulthood, and this comorbidity is associated with far greater impairment than either disorder alone, including higher rates of inpatient hospitalization and increased risk for suicidal ideation and behavior. Despite these adverse outcomes, existing evidence-based interventions for ADHD have not demonstrated effects in reducing depressive symptoms nor do established depression prevention programs work as well for adolescents with ADHD. Reward responsivity (RR) and emotion regulation (ER) are two key factors demonstrated to mediate the association between ADHD and depression and are thus key targets for prevention. In an effort to address the gap between access and utilization of mental health care, which is especially stark among adolescents with ADHD, we aim to develop and test a modified behavioral activation prevention program [Behaviorally Enhancing Adolescents’ Mood in Schools (BEAM-S)] that incorporates modules to directly target these purported mechanisms. In line with the Deployment-Focused Model of Intervention Development and Testing, we will develop a program that can be easily implemented and sustainable in the high school setting as delivered by school mental health staff that reduces depression and improves overall functioning in adolescents with ADHD, by way of improving RR and ER. As a first step, we will conduct focus groups with community stakeholders (e.g., school mental health providers, school administration, adolescents, parents, teachers) to develop an acceptable and sustainable selected and indicated prevention program for school staff to utilize. We will then initially train school staff to deliver this prevention program via a co- therapy training model to prepare them for their independent implementation of the prevention program in a case series consisting of two groups (one in each of two high schools) to evaluate preliminary feasibility. We will then conduct a stage 1 RCT with a hybrid-type 1 implementation- effectiveness design in which four high schools will be randomized to either the BEAM-S condition (n = 2) or treatment as usual (n = 2). Finally, qualitative and quantitative data from aims 1-3 will be used to prepare final procedures for a future large-scale effectiveness trial R01 (aim 4).

摘要/项目摘要 患有多动症的儿童在青少年和成年中患抑郁症的风险较高，这 合并症与单独的任何一种疾病相比，合并症的障碍远大得多，包括更高 住院住院和自杀念头和行为的风险增加。尽管如此 不利的结果，现有的基于证据的多动症干预措施尚未证明 减轻抑郁症状，建立的抑郁症预防计划也不得不适合 患有多动症的青少年。奖励响应（RR）和情绪调节（ER）是两个关键因素 证明可以调解多动症与抑郁症之间的关联，因此是 预防。为了解决精神卫生保健的访问和利用之间的差距， 在患有多动症的青少年中，这尤其鲜明，我们旨在开发和测试经过修改的 行为激活预防计划[行为增强了学校的心情 （Beam-s），该模块直接针对这些所谓的机制。与 以部署为中心的干预开发和测试模型，我们将开发一个计划 可以在学校心理上提供的高中环境中轻松实施和可持续 减少抑郁症并改善多动症青少年的整体功能的卫生人员，由 改善RR和ER的方法。第一步，我们将与社区进行焦点小组 利益相关者（例如，学校心理健康提供者，学校管理，青少年，父母， 教师）制定可接受且可持续的选择和指示的预防计划 学校工作人员要利用。然后，我们最初将培训学校工作人员，通过共同 治疗培训模型，为他们独立实施预防做好准备 在一个案例系列中，由两组组成的案例系列（两所高中中的一组）来评估 初步可行性。然后，我们将使用混合型1实施进行1阶段RCT- 有效性设计，其中四所高中将被随机分配到Beam-S条件（n = 2）或像往常一样治疗（n = 2）。最后，将使用AIM 1-3的定性和定量数据 为将来的大规模有效性试验R01准备最终程序（AIM 4）。