Assessing Parenting at the Momentary Level to Understand Parenting Behaviors that Contribute to Improved Treatment Outcomes for Youth with Co-Occurring Disorders

评估瞬时水平的养育方式，以了解有助于改善患有并发疾病的青少年的治疗结果的养育行为

• 批准号: 10424874
• 负责人: Samuel Noah Meisel
• 金额: $ 18.25万
• 依托单位: EMMA PENDLETON BRADLEY HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2024-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10424874
• 关键词: Address; Adolescent; Adolescent Behavior; Affect; Alcohol consumption; Alcohols; Behavioral Mechanisms; Cannabis; Child Rearing; Communication; Data; Development; Ecological momentary assessment; Enrollment; Exhibits; Faculty; Feedback; Foundations; Future; Goals; Grant; Intervention; Length; Life; Measures; Medicine; Mental Health; Methods; Monitor; Motivation; National Institute on Alcohol Abuse and Alcoholism; Nature; Outcome; Outpatients; Parents; Phase; Pilot Projects; Plant Roots; Protocols documentation; Psychiatric Diagnosis; Reporting; Research; Research Personnel; Risk; Sampling; Strategic Planning; Symptoms; Testing; Time; Training; Treatment outcome; Youth; acceptability and feasibility; adolescent alcohol treatment; adolescent substance use; adolescents with alcohol use disorders; alcohol abuse therapy; alcohol availability; alcohol craving; alcohol use disorder; associated symptom; behavior change; design; dual diagnosis; evidence base; improved; improved outcome; marijuana use; outcome prediction; outpatient programs; pilot test; protocol development; recruit; research study; skills; substance use treatment; teenage parents; treatment program; treatment research; underage drinking; virtual

PROJECT SUMMARY/ABSTRACT. Over 80% of adolescents with an alcohol use disorder (AUD) who present to treatment have a co-occurring psychiatric diagnosis. Although the best available treatments for adolescents with alcohol use disorders and co-occurring disorders (AUD+CODs) yield only modest short-term benefits, parent-involved treatments result in the best outcomes. In line with NIAAA’s strategic plan to improve treatments for AUD+CODs, this application seeks to address a central, yet unanswered question – what parenting behaviors during parent-involved treatment for AUD+CODs contribute to improved outcomes? Parenting is dynamic and varies from moment to moment depending on context, affect, and adolescent behavior. Moreover, treatment motivation, alcohol craving, alcohol and cannabis use, and internalizing and externalizing symptoms — core adolescent AUD+CODs treatment targets — vary considerably within and across days. Understanding the parenting behaviors during treatment that account for improved treatment outcomes requires momentary assessments that can capture the dynamic nature of parenting and core adolescent treatment targets. This K99/R00 study intends to leverage an experimental medicine framework to study how parenting, captured in real time in daily life, impacts core treatment targets (treatment motivation, alcohol craving, alcohol, and cannabis use, and internalizing and externalizing symptoms) among adolescents enrolled in an intensive outpatient for AUD+CODs. The specific aims for the K99 are to adapt parental communication, general parenting practices, and alcohol-specific parenting measures to EMA (Aim 1), conduct a pilot feasibility and acceptability study of the EMA protocol (N=20 parent-adolescent dyads; Aim 2a), and use mixed methods to evaluate and refine the EMA parenting measures and protocol (Aim 2b). Dr. Samuel Meisel’s overarching training goals are to (1) refine skills in independently designing, developing, and executing EMA research (Drs. Robert Miranda and Elizabeth McQuaid), (2) solidify expertise in conducting treatment research with adolescents with AUD+CODs (Drs. Aaron Hogue and Robert Miranda), (3) apply experimental medicine methods to adolescent AUD+COD treatment mechanisms research (Dr. John Kelly), and (4) promote a successful transition to independent faculty researcher. These training objectives build on Dr. Meisel’s F32 (AA028414), which provided him with the foundational training to broaden his research from studying the initiation and escalation of adolescent alcohol use to adolescent alcohol use treatment and mechanisms of behavior change. R00 specific aims include examining momentary parenting-core treatment target associations (N=75 parent-adolescent dyads; Aim 3a) and examining changes in the strength of parenting-treatment target associations over the course of AUD+COD treatment (Aim 3b). Findings will systematically identify the specific parenting practices during AUD+CODs treatment that most strongly relate to core treatment targets and will serve as preliminary data for future R01 and R34 applications.

项目摘要/摘要。超过80％的饮酒障碍青少年（AUD） 治疗目前的精神病诊断。虽然是最好的治疗方法 酒精使用障碍和同时发生疾病（AUD+COD）的青少年仅产生适度的短期 益处，父母涉及的治疗可带来最佳结果。符合NIAAA的战略计划 AUD+COD的治疗方法，本应用程序旨在解决一个中心但未解决的问题 - 什么 AUD+COD的父母治疗期间的育儿行为有助于改善结果？ 育儿是动态的，并且根据上下文，情感和青少年的不同而有所不同 行为。此外，治疗动机，渴望，酒精和大麻的使用以及内在化和 外部化症状 - 核心青少年AUD+CODS治疗目标 - 在内部仔细变化和 跨几天。了解治疗过程中的育儿行为，以改善治疗 结果需要瞬间评估，以捕获育儿和核心的动态性质 青少年治疗目标。这项K99/R00研究打算利用实验医学框架 研究如何在日常生活中实时捕获的育儿如何影响核心治疗目标（治疗动机， 青少年的酒精渴望，酒精和大麻的使用以及内在化和外在化符号） 参加AUD+COD的密集门诊病人。 K99的具体目的是适应父母 沟通，一般的育儿实践和针对EMA的酒精特定育儿措施（AIM 1），进行 EMA方案的可行性和可接受性研究（n = 20个父型二元组； AIM 2A），并使用 评估和完善EMA育儿度量和方案的混合方法（AIM 2B）。塞缪尔博士 Meisel的总体培训目标是（1）完善独立设计，开发和 执行EMA研究（罗伯特·米兰达（Robert Miranda）和伊丽莎白·麦奎德（Elizabeth McQuaid）博士），（2）巩固进行专业知识 使用Aud+Cods的青少年（Aaron Hogue和Robert Miranda博士）的治疗研究，（3）适用 青少年AUD+COD治疗机制研究（John Kelly博士）的实验医学方法， （4）促进成功过渡到独立教师研究员。这些训练对象建立在基础上 Meisel博士的F32（AA028414），为他提供了基础培训，以扩大他的研究 研究青少年酒精使用的倡议和升级，以便青少年酒精使用治疗和 行为改变的机制。 R00具体目的包括检查瞬时育儿核心治疗 目标关联（n = 75个父母 - 青少年二元组； AIM 3A），并检查了强度的变化 在AUD+COD治疗过程中，育儿与治疗目标关联（AIM 3B）。调查结果会 系统地确定在AUD+CODS治疗过程中的特定育儿惯例 核心治疗目标，并将作为未来R01和R34应用程序的初步数据。