Reducing stress with parenting-focused mindfulness to prevent youth substance use

通过以养育为中心的正念来减轻压力，以防止青少年滥用药物

• 批准号: 8634088
• 负责人: Tara M Chaplin
• 金额: $ 21.67万
• 依托单位: GEORGE MASON UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-04-01 至 2016-02-29
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8634088
• 关键词: 14 year old; Adolescence; Adolescent; Adult; Alcohol or Other Drugs use; Alcohols; Animals; Arousal; Basic Science; Behavioral; Behavioral Mechanisms; Biological; Child; Child Guidance Clinics; Chronic; Cigarette; Clinic; Clinical; Communities; Conflict (Psychology); Control Groups; Data; Development; Drug usage; Emotional; Environment; Expectancy; Face; Family; Goals; HIV; HIV risk; Human; Illicit Drugs; Intervention; Interview; Laboratories; Linear Models; Link; Low income; Measures; Mediating; Mental Depression; Modeling; National Institute of Drug Abuse; Outcome; Parent-Child Relations; Parenting behavior; Parents; Physiological; Plant Roots; Prevention strategy; Psychopathology; Public Health; Questionnaires; Randomized; Recruitment Activity; Relative (related person); Reporting; Research Personnel; Risk; Risk Behaviors; Risk Factors; Sex Behavior; Stress; Substance Use Disorder; Substance abuse problem; Surveys; Symptoms; Testing; Time; Uncontrolled Study; Unsafe Sex; Violence; Youth; adolescent substance abuse; adolescent substance use; base; biological adaptation to stress; career; cost effective; critical period; drug abuse prevention; early adolescence; eighth grade; emotion regulation; experience; follow-up; impaired driving performance; improved; intervention effect; maternal stress; mindfulness; mindfulness-based stress reduction; novel; offspring; peer; post intervention; prevent; public health relevance; response; sex; sex risk; stress related disorder; stressor; substance use prevention; tenth grade; transmission process; twelfth grade

DESCRIPTION (provided by applicant): Adolescence is a critical period for the development of substance use disorders. There is a clear need for novel substance use preventions for youth, particularly developmentally-informed interventions rooted in basic science findings (NIDA, 2010). Significant basic research indicates parent stress as a risk factor for adolescent substance use and HIV risk behaviors. This risk may be exacerbated in low-income families who face multiple chronic stressors. Mindfulness-based stress reduction (MBSR) is an empirically-supported treatment that reduces stress in adults. However, the potentially powerful effects of MBSR on parenting stress and adolescent outcomes have not been tested. The goal of the proposed study is to develop and test a parenting-focused version of MBSR to reduce parent stress and prevent adolescent substance use and HIV risk behaviors in low-income urban families. We hypothesize that parenting-focused MBSR (P-MBSR) will decrease parent stress, improve parenting behavior and the parent-child relationship, decrease youth bio-behavioral arousal, and prevent risk for substance use and HIV risk behaviors. In this early-career investigator initiated project, 120 parents of 12-14 year olds reporting high parenting stress will be recruited at a child guidance clinic serving a low-income urban community. Parents will be randomly assigned to receive either an 8 week P-MBSR intervention at the clinic (based on the MBSR intervention implemented at the Yale Stress Center by Dr. Sinha, co-I) or to a parenting advice control group. At pre- and post-intervention, adaptive and mindful parenting behaviors and parent and youth bio-behavioral stress responses will be measured using a cutting-edge laboratory paradigm that models parent-adolescent interactions and youth emotional and physiological responses to interactions (developed by Dr. Chaplin, PI; Chaplin et al., 2012). Before, after, and at 6 months and 1 year post-intervention, we will collect questionnaire, clinical interview, and biological measures of parent stress, stress-related disorders, parenting, parent-child closeness, and adolescent intentions and expectancies for and engagement in substance use and HIV risk behaviors (e.g., unprotected sex). We will test intervention effects with HLM analyses. Based on our pilot finding that MBSR decreased stress in adults, we expect that P-MBSR will reduce parent stress, increase adaptive and mindful parenting and close parent-adolescent relationships, decrease adolescent physiological and emotional responses to parent interactions and prevent youth substance use and risky sex. If hypotheses are supported, the study will provide: 1. Initial feasibility and efficacy data for P-MBSR, 2. Pilot effect size data for a R01 application to conduct a longer-term RCT of P-MBSR, 3. Evidence of relevance and acceptability of P- MBSR in a real-world setting, and 4. Longitudinal data on substance use in at-risk youth. P-MBSR could be a cost-effective strategy to reduce stress and stress-related disorders in at-risk adults and at the same time prevent drug use and risk behavior in their children.

描述（由申请人提供）：青春期是物质使用障碍发生的关键时期。青少年显然需要新型物质使用预防措施，特别是基于基础科学发现的发展干预措施（NIDA，2010）。重要的基础研究表明，父母的压力是青少年药物滥用和艾滋病毒危险行为的一个危险因素。在面临多种慢性压力源的低收入家庭中，这种风险可能会加剧。基于正念的减压（MBSR）是一种基于经验的治疗方法，可减轻成年人的压力。然而，MBSR 对养育压力和青少年结局的潜在强大影响尚未得到测试。拟议研究的目标是开发和测试以育儿为中心的 MBSR 版本，以减轻父母的压力并防止低收入城市家庭的青少年药物使用和艾滋病毒危险行为。我们假设以养育为中心的MBSR（P-MBSR）将减轻父母压力，改善养育行为和亲子关系，减少青少年生物行为唤醒，并预防物质使用和艾滋病毒危险行为的风险。 在这个早期职业调查员发起的项目中，将在为低收入城市社区提供服务的儿童指导诊所招募 120 名报告养育压力较高的 12-14 岁儿童的家长。家长将被随机分配到诊所接受为期 8 周的 P-MBSR 干预（基于 Sinha 博士在耶鲁压力中心实施的 MBSR 干预），或分配到育儿建议对照组。在干预前后，将使用尖端实验室范式来测量适应性和正念养育行为以及父母和青少年的生物行为压力反应，该范式模拟父母与青少年的互动以及青少年对互动的情感和生理反应（由博士开发）卓别林，PI；卓别林等，2012）。干预前、干预后、干预后 6 个月和 1 年，我们将收集父母压力、压力相关疾病、养育方式、亲子亲密程度以及青少年的意图和期望和参与的问卷、临床访谈和生物学测量。物质使用和艾滋病毒危险行为（例如无保护的性行为）。我们将通过 HLM 分析来测试干预效果。基于我们的试点发现，MBSR 可以减轻成年人的压力，我们预计 P-MBSR 将减轻父母的压力，增强适应性和正念养育，以及密切父母与青少年的关系，减少青少年对父母互动的生理和情绪反应，并防止青少年物质使用和有风险的性行为。如果假设得到支持，该研究将提供： 1. P-MBSR 的初始可行性和有效性数据， 2. R01 应用进行 P-MBSR 长期随机对照试验的试点效应大小数据， 3. 相关性和有效性的证据P-MBSR 在现实环境中的可接受性，以及 4. 高危青少年物质使用的纵向数据。 P-MBSR 可能是一种经济有效的策略，可以减少高危成年人的压力和压力相关疾病，同时防止儿童吸毒和危险行为。