Differential Response to Evidenced-Based Treatment

对循证治疗的不同反应

• 批准号: 7384390
• 负责人: PHILLIPPE Belton CUNNINGHAM
• 金额: $ 49万
• 依托单位: MEDICAL UNIVERSITY OF SOUTH CAROLINA
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-01 至 2010-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7384390
• 关键词: Address; Adherence; Adolescent; Attention; Basic Science; Behavior; Behavioral; Behavioral Sciences; Biological; Biological Sciences; Caregivers; Caring; Characteristics; Child; Child Mental Health; Clinical Services; Communities; Data Analyses; Development; Emotional; Environment; Environmental Risk Factor; Evidence based treatment; Family; Family Characteristics; Family Practice; Goals; Health Services Research; Hydrocortisone; Individual; Intervention; Investigation; Lighting; Link; Longitudinal Studies; Mediating; Mediator of activation protein; Mental Health; Methods; Modeling; Parenting behavior; Parents; Participant; Persons; Prevention; Procedures; Process; Psychopathology; Recommendation; Research; Role; Services; Source; Surgeon; Testing; Therapeutic; Time; Translational Research; Treatment outcome; United States Public Health Service; Youth; anti social; base; behavioral/social science; caN protocol; effectiveness research; environmental stressor; follow-up; indexing; next generation; programs; response; social; symposium; therapy design

DESCRIPTION (provided by applicant): The central goal of this study is to identify factors associated with children's differential response to an empirically validated treatment designed to reduce serious youth antisocial behavior and delivered in community-based settings. Specifically, this longitudinal study will examine a transactional model of treatment response and non-response that focuses on the interaction of child (biological), family, environment and treatment adherence variables that are likely to influence treatment outcome in community mental health care settings. A total of 185 families receiving an evidence-based treatment (Multisystemic therapy; MST) in community settings will be assessed 5 times (pre treatment, twice midtreatment, post treatment, follow-up) using a multi source, multi method assessment battery. Components of the transactional model guiding this investigation will be tested by linking child factors that have been identified in basic science (child emotional responsiveness, indexed by cortisol levels) and treatment outcome research (parent psychopathology, therapist adherence, parenting practices, environmental stressors) as potential mediators and moderators of treatment outcome among antisocial youth. The general aims of this single group longitudinal study are to: Aim 1: Examine individual, family, and environmental factors that may contribute directly and/or indirectly to treatment adherence to evidence-based treatment procedures and to treatment outcome. Aim 2: Evaluate the role of therapist adherence in predicting changes in caregiver behavior; and determine whether interactions among pretreatment individual and family characteristics and environmental stressors during treatment moderate the association between adherence and changes in family practices. Aim 3: Determine whether changes in parenting practices during treatment mediate the relationship between therapist adherence and changes in youth antisocial behavior. Aim 4: Examine basic science questions regarding treatment related changes in youth emotional reactivity in the context of evidence-based treatment.

描述（由申请人提供）：本研究的中心目标是确定与儿童对经过经验验证的治疗的差异反应相关的因素，该治疗旨在减少严重的青少年反社会行为并在社区环境中提供。具体来说，这项纵向研究将检查治疗反应和无反应的交易模型，重点关注儿童（生物）、家庭、环境和治疗依从性变量之间的相互作用，这些变量可能会影响社区精神卫生保健机构的治疗结果。将使用多来源、多方法评估组对在社区环境中接受循证治疗（多系统治疗；MST）的总共 185 个家庭进行 5 次评估（治疗前、治疗中期两次、治疗后、随访）。指导这项调查的交易模型的组成部分将通过将基础科学（儿童情绪反应，以皮质醇水平为索引）和治疗结果研究（父母精神病理学、治疗师依从性、养育方式、环境压力源）中确定的儿童因素联系起来进行测试反社会青年中治疗结果的潜在中介者和调节者。这项单组纵向研究的总体目标是： 目标 1：检查可能直接和/或间接影响循证治疗程序和治疗结果的治疗依从性的个人、家庭和环境因素。目标 2：评估治疗师依从性在预测护理者行为变化中的作用；并确定治疗前的个人和家庭特征以及治疗期间的环境压力源之间的相互作用是否会调节依从性和家庭实践改变之间的关联。目标 3：确定治疗期间养育方式的变化是否会调节治疗师依从性与青少年反社会行为变化之间的关系。目标 4：在循证治疗的背景下，研究有关青少年情绪反应的治疗相关变化的基本科学问题。