Improving Emotion Dysregulation and Interpersonal Conflict Among Families of Adolescents with ADHD

Project Summary/Abstract The proposal presents a four-year research career development program focused on the evaluation of the RELAX (Regulating Emotions Like An eXpert) intervention for families of adolescents with attention- deficit/hyperactivity disorder (ADHD), and the development of ecological momentary intervention (EMI) procedures a cutting-edge approach to support skill rehearsal in real life via smartphone apps. The candidate is currently an Assistant Professor of Psychology at Virginia Tech. The outline proposal builds on her previous research and clinical experience working with families of adolescents with ADHD by providing training and mentorship that will facilitate her growth in four areas: (1) Developing proficiency in managing and responsibly conducting clinical trials research; (2) Acquiring skills in the development and implementation of EMI; (3) Gaining skills in data management and conducting longitudinal, multilevel analytic methods and clinical trial analyses; and (4) Building community partnerships to ensure successful disseminating, implementing, and sustainability of evidence-based interventions. The proposed clinical trial and didactic work will position the candidate with a unique set of cutting-edge skills and statistical abilities that will enable her to transition to independence as a clinical scientist conducting clinical trials research with families. Adolescents with ADHD experience a host of negative outcomes, including risk for substance abuse, suicidality, and mood disorders, partly due to the high levels of emotion dysregulation (ED) they experience. Despite this, no evidence-based intervention exists for adolescents with ADHD that directly targets ED. As such, the proposed research is both significant and innovative. Specifically, RELAX targets ED among families of adolescents with ADHD in a brief, group-based intervention. In-person and telehealth pilot studies of RELAX provide promising findings; however, the effectiveness of RELAX delivered through real world clinical settings is needed. Families also indicated the desire for more opportunities to practice skills learned during RELAX in focus groups following the pilot study; EMI could address this need. Despite EMI being used in other clinical populations, EMI has not been explored among youth with ADHD, nor by simultaneously utilizing it with parents and adolescents. This K01 will implement a small clinical trial to assess the acceptability, feasibility, and preliminary efficacy of RELAX delivered by community clinicians relative to control. Additionally, it will iteratively develop the EMI procedures to use in the future for skill rehearsal during and following RELAX. The aims of this research are: (1) Quantify the acceptability, feasibility, and efficacy of RELAX relative to control at post-intervention and short- and long-term follow-ups; (2) Identify the extent to which changes in RELAX main outcomes during RELAX are associated with improvements in social-emotional and behavioral functioning at follow-up; and (3) Identify stakeholder feedback on the EMI procedures. This study has potential to support future independent research, and holds promise for transforming treatments for adolescents with ADHD.