Child Anxiety Prevention Study Long term Extension

儿童焦虑预防研究长期延伸

• 批准号: 8818879
• 负责人: Golda Susan Ginsburg
• 金额: $ 31.93万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8818879
• 关键词: Address; Adolescence; Adult; Age; Alcohol or Other Drugs use; Anxiety; Anxiety Disorders; Behavior Therapy; Biological Markers; Child; Child Rearing; Communities; Cost Savings; Cost-Benefit Analysis; Costs and Benefits; Data; Databases; Development; Dimensions; Disease; Disease remission; Economic Burden; Effectiveness; Emotions; Evaluation; Family; Fright; Funding; Hydrocortisone; Incidence; Individual; Intervention; Interview; Longitudinal Studies; Measures; Mental Health Services; Mental disorders; Methods; Monitor; National Institute of Mental Health; Onset of illness; Outcome; Parents; Pilot Projects; Population; Prevention; Preventive Intervention; Public Health; Relative (related person); Research; Research Domain Criteria; Risk; Salivary; Sampling; Schedule; Severities; Societies; Staging; Symptoms; Target Populations; Time; Translational Research; United States National Institutes of Health; Work; Youth; alpha-amylase; anxiety symptoms; anxiety-related disorders; anxious; base; burden of illness; childhood anxiety; coping; cost; cost effectiveness; depressive symptoms; disability; efficacy trial; executive function; follow-up; health care service utilization; high risk; informant; innovation; intervention effect; intervention program; offspring; prevent; primary outcome; programs; psychologic; public health relevance; response; social; theories; young adult

 DESCRIPTION (provided by applicant): Anxiety disorders in youth are: 1) the most prevalent psychiatric disorders, 2) associated with severe disability, and 3) considered gateway disorders-- as they predict adult psychiatric illnesses. Consequently, these disorders are a public health problem that is costly to afflicted individuals, families, and society. Data on whether these illnesses can be prevented is paramount. Systematic efforts to prevent anxiety disorders in youth appear promising in the short term but data on long-term effectiveness and cost-benefits are lacking. This application proposes an evaluation of the long-term impact and cost-benefits of the Coping and Promoting Strength (CAPS) program (6). CAPS is an intervention aimed at preventing the onset of anxiety disorders in offspring of anxious parents, a population at high risk for developing anxiety and related disorders. Data from the PI's NIMH-funded pilot study and large efficacy trial (K23 MH63427 and R01MH077312) demonstrated promising results at a one year follow-up. This proposed study will continue to evaluate these at risk youth (N = 136) over a four year follow-up period as youth transition into the critical developmental stages of adolescence and young adulthood. This study will be the first long-term follow-up of a preventive intervention for anxiety disorders in high risk offspring, making a major contribution t the field. The study also incorporates several innovative features including 1) a cost-benefit analysis of the intervention, 2) the examination of theory-based mechanisms of intervention effects, and 3) biological markers (e.g., cortisol, alpha amylase, and their coordination) that may help predict illness onset and course. The application was prepared in response to PA- 11-260 and addresses several NIH priorities including: 1) developing and evaluating preventive interventions that reduce the incidence of mental illness, 2) assessing mechanisms of intervention effects across many outcomes (e.g., mental disorders/dimensions, functioning) and 3) incorporating findings from translational science by evaluating salivary biomarkers (i.e., those that reflect HPA axis functioning) to help understand psychiatric illness onset and remission. The study uses rigorous scientific methods including multiple informants and independent evaluators. Findings will inform the field about the intervention impact, mechanisms of intervention effects, costs savings, and predictors (including biomarkers) of illness onset and course. Finally, the study also takes advantage of a rare scientific opportunity by collecting data in this sample that duplicate measures in the PIs follow-up study of clinically anxious youth and healthy controls (R01 MH064089; K24 MH096760) creating a database that will enable comparisons of high risk offspring, clinically anxious, and healthy controls on a number of outcomes including salivary biomarkers and a range of dimensional symptoms outlined the NIMH Research Domain Criteria (e.g., executive functioning, emotion control) that will also be available to the scientific community. Thus, the present study makes efficient use of NIH funds.

 描述（由申请人提供）：青少年中的焦虑症是：1）最常见的精神疾病，2）与严重残疾相关，3）被认为是门户障碍——因为它们预示着成人精神疾病的代价高昂。个人、家庭和社会是否可以预防这些疾病的数据至关重要，短期内预防青少年焦虑症的系统性努力似乎很有希望，但长期有效性和成本效益的数据也很重要。该申请提出了对应对和促进力量 (CAPS) 计划的长期影响和成本效益的评估 (6)，CAPS 是一项旨在预防焦虑父母的后代出现焦虑症的干预措施。来自 PI NIMH 资助的试点研究和大型疗效试验（K23 MH63427 和 R01MH077312）的数据在一年内取得了有希望的结果。这项拟议的研究将在四年的随访期内继续评估这些处于危险中的青少年（N = 136），因为青少年过渡到青春期和成年早期的关键发展阶段。对高危后代焦虑症预防性干预的长期随访，对该领域做出了重大贡献。该研究还纳入了一些创新特征，包括 1) 干预措施的成本效益分析，2) 理论检验。基于干预效果的机制， 3) 可能的生物标志物（例如皮质醇、α淀粉酶及其协调） 该应用程序是根据 PA-11-260 制定的，涉及 NIH 的几个优先事项，包括：1) 制定和评估减少精神疾病发病率的预防性干预措施，2) 评估多种干预措施的效果。结果（例如，精神障碍/维度、功能）和3）通过评估唾液生物标志物（即那些 反映 HPA 轴功能），以帮助了解精神疾病的发病和缓解。该研究采用了包括多名知情者和独立评估者在内的严格科学方法，研究结果将为该领域提供有关干预效果、干预效果机制、成本节省和预测因素的信息。最后，该研究还通过收集数据利用了难得的科学机会。 在此样本中，重复了临床焦虑青少年和健康对照的 PI 后续研究中的测量值（R01 MH064089；K24 MH096760），创建一个数据库，可以对高风险后代、临床焦虑和健康对照的多种结果进行比较包括唾液生物标志物和一系列维度症状，概述了 NIMH 研究领域标准（例如执行功能、情绪控制），科学界也可以使用这些标准。因此，本研究有效利用了 NIH 资金。