Examination of emotion regulation strategy use in an outpatient treatment program for adolescents with co-occurring disorders

PROJECT SUMMARY/ABSTRACT Most adolescents (61-88%) who present to treatment with alcohol use disorder (AUD) have a co-occurring psychiatric diagnosis. Youth with AUD and a co-occurring diagnosis exhibit poorer general functioning and worse treatment outcomes compared to those with AUD alone. Unfortunately, treatments for adolescent AUD lag behind those for adults and show small effect sizes. To improve interventions for this population, there is a need to understand how and why adolescent AUD treatments work and to identify transdiagnostic treatment mechanisms that can target symptoms of multiple disorders simultaneously. Emotion regulation skill use is one such mechanism. This proposal leverages ecological momentary assessment (EMA) to study the change in emotion regulation skill use within a treatment context as well as examine its influence on relevant AUD and co-occurring disorder treatment outcomes. The proposed research will examine these processes within a community sample of adolescents (aged 13-18) undergoing an intensive outpatient program for AUD and co- occurring disorders. Given the cost and labor-intensive resources required for EMA research and the little work using EMA with this population, the K99 project will consist of a pilot study to test the feasibility and acceptability of the EMA protocol, will identify barriers to compliance, and will refine the protocol. (Aims 1a-1c). The R00 project (N = 80 adolescents) will consist of a 10-week study during which participants will complete two 3-week bursts of EMA reports. Aims of the R00 project are to examine prospective momentary associations between emotion regulation skill use and momentary treatment outcomes (Aim 2), to characterize the extent of change in emotion regulation skill use across treatment (Aim 3a) and examine whether changes in emotion regulation skill use coincide with changes in treatment outcomes across treatment (Aim 3b). Findings will serve as pilot data to a larger NIAAA R01 grant submission in this area of work. Importantly, this K99/R00 application will serve as foundational training for Dr. Jenzer's development as an independent scientist. Mentors (Drs. Miranda, Magill, Weiss, Litt) are committed to the candidate's training and each will provide unique expertise to the research and training plan.