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: 9110930
• 负责人: GERALD J AUGUST
• 金额: $ 22.07万
• 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 2018-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9110930
• 关键词: Accounting; Adolescent; Adult; Age; 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; Health; Individual; Individual Differences; Intervention; Lead; Marijuana; Measures; Modeling; Outcome; Outcomes Research; Parents; Participant; Patient Self-Report; Pattern; Physiological; Pilot Projects; Preventive Intervention; Problem Solving; Professional counselor; Randomized; Recruitment Activity; Reflex action; Research; Rewards; Risk; Risk Marker; Schools; Sensory Process; Services; Severities; Staging; Subgroup; System; Teenagers; Testing; Therapeutic; Tobacco; Treatment outcome; Universities; Variant; Work; Youth; addiction; adolescent drug abuse; adolescent drug use; base; cost; discounting; dosage; drug abuse prevention; evidence base; group intervention; healthy lifestyle; interest; intervention effect; marijuana use; marijuana user; motivational enhancement therapy; personalized care; personalized intervention; preempt; programs; 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（由申请人提供）：拟议的 R34 试点研究将进行可行性和探索性干预结果研究，从而为早期青少年吸毒者开发个性化干预框架。该研究将探索代表两个理论上不同的框架和假定的调节因素。确定他们是否是后续 R01 研究的合适候选者，一个调节框架基于延迟贴现 (DD) 的个体差异所反映的风险严重性 (RS)，这是一种与正相关的冲动决策形式。第二个更具探索性的框架基于差异敏感性（DS）理论，DS 框架规定，由于特定的敏感性因素，个体对环境影响（例如所提供的影响）的反应有所不同。该研究将探索与奖励激励系统相关的 DS 标记，包括多巴胺能基因、耳后生理反射和高感觉处理敏感性特征，学校、机构和大学将合作提供。为 120 名因最近酗酒和/或大麻事件而被转介至社区咨询中心的青少年提供服务。 招募将选择轻度/中度吸毒者，参与者将被随机分配到两种基于证据的药物中的一种。这两种干预措施提供相同的给药剂量，但其治疗改变的机制（即环境影响的程度）不同。以青少年为中心的干预措施，利用动机访谈、目标设定和技能培训来促进负责任决策的内部发展，目标是选择比吸毒行为更健康的态度和行为（EP；Dishion）。 et al., 2003; 2010）是一项以家庭为中心的干预措施，与父母合作提供必要的环境支架，帮助青少年逐渐内化决策技能，从而加强和促进健康的生活方式替代吸毒。预料DD 的个体差异将导致青年评分的干预反应出现适度的差异，因为需要更全面的 EP 来显示治疗效果，我们预计在一个或所有 DS 因素中具有高敏感度值的个体将表现出积极的结果。无论是随机分配到 TI 还是 EP，因为假设 TI 和 EP 都为高 DS 青年提供了足够的干预影响，相反，敏感因素得分较低的青年将需要环境更丰富的 EP 才能显示出类似的益处。 R34 的目标是 (1) 评估招募、评估和跟踪参加干预试验的青年的可行性，(2) 评估工作人员忠实实施 TI 和 EP 的能力，以及 (3) 获得有希望的数据 调节变量和结果变量将有助于回答后续 R01 研究中“哪种干预措施最适合哪些青少年”的问题。