Development of a Family-Based Treatment for Adolescent Methamphetamine Abuse

开发针对青少年甲基苯丙胺滥用的家庭治疗方法

• 批准号: 7643215
• 负责人: Holly Barrett Waldron
• 金额: $ 66.23万
• 依托单位: OREGON RESEARCH INSTITUTE
• 依托单位国家: 美国
• 财政年份: 2007
• 资助国家: 美国
• 起止时间: 2007-09-01 至 2011-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7643215
• 关键词: Adherence; Adolescent; Adult; Affect; Amygdaloid structure; Anterior; Area; Behavior; Brain; Brain imaging; Characteristics; Chronic; Clinical; Clinical Trials; Cognitive; Decision Making; Dependence; Development; Drug usage; Effectiveness; Elements; Ensure; Epidemic; Family; Family Relationship; Family psychotherapy; Feedback; Foundations; Functional Magnetic Resonance Imaging; Goals; Holly; Imaging Techniques; Imaging technology; Impulsivity; Individual; Individual Differences; Intervention; Investigation; Laboratories; Lead; Link; Manuals; Measures; Mediating; Mediator of activation protein; Methamphetamine; Modeling; Nucleus Accumbens; Outcome; Participant; Pathway interactions; Play; Population; Procedures; Randomized; Relapse; Relative (related person); Research; Research Personnel; Rewards; Risk; Risk-Taking; Role; Sampling; Solid; Staging; Structure; Substance Use Disorder; System; Testing; Training; Treatment Effectiveness; Treatment Efficacy; Treatment Protocols; Treatment outcome; United States National Institutes of Health; United States Substance Abuse and Mental Health Services Administration; Youth; adolescent substance abuse; adolescent substance use; base; clinically significant; cognitive function; comparative; coping; depression; design; effective therapy; indexing; interdisciplinary approach; intervention effect; methamphetamine abuse; neural circuit; neuroimaging; neurotoxicity; non-drug; nondrug therapy; novel; peer; programs; psychologic; putamen; relating to nervous system; response; social neuroscience; therapy development; treatment adherence; treatment effect; treatment program; treatment response

DESCRIPTION (provided by applicant): Methamphetamine (meth) abuse in the U.S. has reached epidemic proportions, especially in the Western States and has been linked to a host of physical and psychological problems. Even more troubling, meth use during the adolescent period may interfere with normal brain development. These findings suggest that the endemic use of meth will require the development and testing of effective treatments aimed at adolescent abusers to forestall potentially deleterious outcomes. Moreover, combining clinical and neuroscientific approaches in an interdisciplinary model should lead to more prescriptive and efficacious treatments. In the current study, therefore, we merge the development of meth-specific interventions with a more detailed examination of how meth use affects neural systems and how alterations in specific brain areas influence treatment response. The proposed study represents a Stage IA/IB treatment development project, utilizing an interdisciplinary approach, consistent with the NIH Roadmap and designed to develop, refine, and pilot test a theoretically grounded intervention for adolescent meth abuse or dependence. The meth-specific intervention (AMT) will integrate family therapy with core elements of effective adult meth treatment programs, adapted to be developmentally appropriate for adolescents. This will be compared to a stand-alone family therapy intervention (FFT), an efficacious and effective treatment for adolescent substance use disorders. Further, in an effort to inform our treatment approach, a laboratory task will be developed to measure decision-making (i.e., risk-taking and impulsivity) and combined with functional brain imaging procedures (fMRI) to assess the effect of meth and other drug use on the neural circuits underlying these cognitive functions. Our Stage 1A research aim is to develop and test the meth-specific manualized treatment protocol. As well, we will examine the validity of our fMRI procedures in assessing the function of reward-related pathways in the brain known to be affected by meth in a subset of 32 adolescents referred for meth treatment and 16 nondrug-using controls to determine if the brain structures underlying decision-making in the two groups differ significantly. Stage 1B aims following will pilot test the manualized AMT procedure to establish its feasibility and validate its discriminability from FFT, verify the acceptability of the treatment by examining rates of engagement and retention, determine significant clinical outcomes relative to FFT alone, and examine predicted mediators and moderators to determine the core mechanisms of treatment efficacy. fMRI measures will be viewed relative to informing treatment engagement and retention as well as both short-term and long-term treatment outcomes. Stage 1B research will involve 60 adolescent meth abusers randomly assigned to either AMT or FFT who will be assessed at pretreatment, and at 3- months and 6-months following treatment initiation. The ultimate purpose of the research is to evaluate the potential promise of the AMT intervention, as informed by fMRI technology, for further investigation in a formal Stage 2 clinical trial.

描述（由申请人提供）：美国甲基苯丙胺（甲基苯丙胺（甲基苯丙胺）滥用已经达到了流行病，尤其是在西方国家，并且与许多身体和心理问题有关。更令人不安的是，在青少年时期使用甲基苯丙胺可能会干扰正常的大脑发育。这些发现表明，对甲基苯丙胺的特有用途将需要开发和测试旨在阻止青少年虐待者的有效治疗方法，以阻止潜在的有害结果。此外，在跨学科模型中结合临床和神经科学方法应导致更具规定性和有效的治疗方法。因此，在当前的研究中，我们将甲基苯丙胺特异性干预措施的开发与对甲基苯丙胺使用的使用方式的更详细检查相结合，从而影响神经系统以及特定大脑区域的变化如何影响治疗反应。拟议的研究代表了IA/IB阶段的治疗开发项目，采用跨学科方法，与NIH路线图一致，并旨在开发，完善和试点测试一种理论上扎根于青少年甲基苯丙胺滥用或依赖性的干预措施。甲基苯丙胺的干预措施（AMT）将将家庭疗法与有效的成人甲基甲基苯丙胺治疗计划的核心元素相结合，该计划在发展上适合于青少年。这将与独立的家庭疗法干预（FFT）进行比较，这是对青少年物质使用障碍的有效和有效治疗。此外，为了告知我们的治疗方法，将开发一项实验室任务，以衡量决策（即冒险和冲动性），并与功能性大脑成像程序（fMRI）相结合，以评估甲基苯丙胺和其他药物使用对这些认知功能的神经回路的影响。我们的第1A阶段研究目的是开发和测试METH特定的手动治疗方案。同样，我们还将研究fMRI程序在评估已知在32名参考甲基甲基苯酚治疗的青少年中已知的奖励相关途径的功能的有效性，该途径受到了甲基苯酚的影响，并确定16种非降低对照组以确定两组在两组中的大脑结构是否存在很大不同。第1阶段的目的以下将试行测试手动AMT程序，以确定其可行性并验证其与FFT的可区分性，通过检查参与率和保留率来验证治疗的可接受性，确定与单独使用FFT相对于FFT的重大临床结果，并检查预测的介体和主持人，以确定治疗效率的核心机制。将FMRI措施相对于告知治疗参与和保留率以及短期和长期治疗结果的措施。 1B阶段的研究将涉及60名青少年滥用者随机分配给AMT或FFT，后者将在预处理时进行评估，并在治疗开始后的3个月和6个月。该研究的最终目的是评估FMRI技术所示的AMT干预的潜在希望，以在正式的2阶段临床试验中进行进一步研究。