School-Based Depression Prevention for Adolescents with ADHD: COVID-Impacted Supplement

多动症青少年的学校抑郁症预防：受新冠肺炎影响的补充品

基本信息

批准号：
10356973
负责人：
ANDREA CHRONIS-TUSCANO
金额：
$ 7.1万
依托单位：
UNIV OF MARYLAND, COLLEGE PARK
依托单位国家：
美国
项目类别：
财政年份：
2018
资助国家：
美国
起止时间：
2018-08-07 至 2022-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10356973
关键词：
Address Adolescent Attention deficit hyperactivity disorder Behavioral Case Series Child Communities Data Disease Effectiveness Evidence based intervention Feedback Feeling suicidal Focus Groups Future Health Personnel Healthcare High School Student Hospitalization Hybrids Impairment Inpatients Mediating Mental Depression Mental Health Modeling Moods Parents Population Prevention Prevention approach Prevention program Procedures Randomized Randomized Controlled Trials Rewards Risk Schools Testing Training Work adverse outcome base child depression comorbidity coronavirus disease depression prevention depressive symptoms effectiveness implementation design effectiveness trial emotion regulation high school high school program improved indicated prevention novel programs selective prevention suicidal behavior suicidal risk teacher therapy development treatment as usual young adult

项目摘要

ABSTRACT/PROJECT SUMMARY Children with ADHD are at elevated risk for depression in adolescence and young adulthood, and this comorbidity is associated with far greater impairment than either disorder alone, including higher rates of inpatient hospitalization and increased risk for suicidal ideation and behavior. Despite these adverse outcomes, existing evidence-based interventions for ADHD have not demonstrated effects in reducing depressive symptoms nor do established depression prevention programs work as well for adolescents with ADHD. Reward responsivity (RR) and emotion regulation (ER) are two key factors demonstrated to mediate the association between ADHD and depression and are thus key targets for prevention. In an effort to address the gap between access and utilization of mental health care, which is especially stark among adolescents with ADHD, we aim to develop and test a modified behavioral activation prevention program [Behaviorally Enhancing Adolescents’ Mood in Schools (BEAM-S)] that incorporates modules to directly target these purported mechanisms. In line with the Deployment-Focused Model of Intervention Development and Testing, we will develop a program that can be easily implemented and sustainable in the high school setting as delivered by school mental health staff that reduces depression and improves overall functioning in adolescents with ADHD, by way of improving RR and ER. As a first step, we will conduct focus groups with community stakeholders (e.g., school mental health providers, school administration, adolescents, parents, teachers) to develop an acceptable and sustainable selected and indicated prevention program for school staff to utilize. We will then initially train school staff to deliver this prevention program via a co- therapy training model to prepare them for their independent implementation of the prevention program in a case series consisting of two groups (one in each of two high schools) to evaluate preliminary feasibility. We will then conduct a stage 1 RCT with a hybrid-type 1 implementation- effectiveness design in adolescents will be randomized to either the BEAM-S condition or treatment as usual. Finally, qualitative and quantitative data from aims 1-3 will be used to prepare final procedures for a future large-scale effectiveness trial R01 (aim 4).

摘要/项目摘要患有多动症的儿童在青春期和成年早期患抑郁症的风险较高，这与单独的任何一种疾病相比，合并症所造成的损害要大得多，包括更高的损害尽管如此，住院率以及自杀意念和行为的风险增加。不良后果，现有的针对多动症的循证干预措施尚未证明对减少抑郁症状，既定的抑郁症预防计划也不起作用奖励反应（RR）和情绪调节（ER）是患有多动症的青少年的两个关键因素。介导多动症和抑郁症之间的关联，因此是治疗的关键目标努力解决精神卫生保健的获取和利用之间的差距，这在患有多动症的青少年中尤其明显，我们的目标是开发和测试改良的行为激活预防计划[行为增强青少年在学校的情绪 (BEAM-S)] 包含直接针对这些所谓机制的模块。以部署为中心的干预开发和测试模型，我们将开发一个程序可以在高中环境中轻松实施并可持续，如学校心理所提供的医务人员可以通过以下方式减少患有多动症的青少年的抑郁症并改善其整体功能改善 RR 和 ER 的方法第一步，我们将与社区进行焦点小组讨论。利益相关者（例如学校心理健康提供者、学校行政部门、青少年、家长、教师）制定可接受且可持续的选定和指定的预防计划然后，我们将首先培训学校工作人员通过共同实施这一预防计划。治疗培训模式，为他们独立实施预防做好准备案例系列中的计划由两组（两所高中各一组）组成，以进行评估然后，我们将进行第 1 阶段 RCT 和混合型 1 实施。青少年的有效性设计将随机分配至 BEAM-S 条件或治疗最后，目标 1-3 的定性和定量数据将用于准备最终结果。未来大规模有效性试验 R01（目标 4）的程序。