Presented by Dr. Diana Fishbein and Dr. Emma Jane Rose
On September 19, 2023, this symposium presented research showing that biological and neuroscience technologies and findings incorporated into intervention protocols can improve effectiveness and benefit a greater number of prevention and treatment recipients. Speakers discussed their work and those of others that are aligned with a translational basic science approach to developing interventions that more effectively disrupt pathways to substance use disorders (SUDs). Presentations spanned the translational spectrum, from preclinical and basic research, to program development and efficacy trials, to implementation in real-world settings. As such, beginning with a discussion of relevant neuroscience findings, applications of mechanistic information was reviewed that have been amassed as a blueprint to develop adaptive intervention strategies that more specifically target underlying generators of the phenomenon we seek to prevent. From there, the discussion turned to methodological advances that enable optimization of programs and clinical trials to compare personalized intervention models to one-size-fits-all” approaches. And finally, speakers addressed translation of this growing science to clinicians, practitioners, and policymakers.
This was the second symposium in the summer series on Translational Neuroscience Perspectives on Substance Use Prevention hosted by Dr. Fishbein and Dr. Rose and supported by NIDA/NIH Grant Number 1 R13 DA047833-01A1.
Keynote Speakers Included:
During this symposium, participants learned:
To identify advances in neuroscience that directly address outstanding questions in the prevention and intervention sciences.
To describe how evidence-based interventions have potential to improve neurodevelopmental trajectories of children and adolescents and, in turn, lead to more positive and adaptive outcomes.
To describe how neuroscience-informed interventions can be targeted to benefit specific subtypes of recipients more so than programs we currently offer.
To explain how public health policies can be informed by this knowledge to improve on their ability to effectuate positive change.
To explain the implications of this work for the design of a larger social fabric that protects children and adolescents from adverse social conditions that otherwise lead to negative outcomes.
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Speaker Background and Abstracts
1. Ty Ridenour, Ph.D., Developmental Behavioral Epidemiologist, RTI International and PI for NIH’s Helping End Addiction Long-Term (HEAL) Prevention Coordinating Center
Title: From Liability-Threshold Model to Personalized Prevention: Tools to Translate Etiology Research into Prevention Practice
Bio: Dr. Ridenour is a developmental behavioral epidemiologist at RTI International. For over 25 years, his NIH-funded research has supported two lines of investigation. The first concentration of research has been to develop evidence-based tools and strategies for translating findings from etiology research on substance use disorder into sustainable selective/indicated prevention services. His second focus has advanced methods for conducting rigorous idiographic clinical trials to elucidate within-person responses to treatment, understand mechanisms leading to individual differences in treatment response, improve comparative effectiveness research, and enhance the rigor of clinical trials for which traditional randomized controlled trials are not feasible or inappropriate. Dr. Ridenour is currently the Principal Investigator for NIH’s Helping End Addiction Long-term (HEAL) Prevention Coordinating Center.
Abstract: The liability-threshold model provides a fundamental basis for much etiology research of substance use disorder (SUD) with similar theoretical models underlying etiology research of associated conditions such as conduct problems or internalizing symptoms. The liability-threshold model also frequently underlies prevention strategies and therefore can guide translation from science into practice. The liability-threshold model’s three fundamental features serve as the basis for the clinical tools to translate etiology science into prevention practice that will be described in this presentation. First, is that the population distribution of people’s overall liability to SUD is normally distributed (Gaussian). Second, individuals’ overall liability at a specific timepoint (and thus probability for experiencing SUD in the near future) can be quantified as the aggregate of their levels of all risk factors (vulnerabilities and resiliencies). Third, the liability threshold at which SUD occurs (or for other forms of lesser substance use involvement) can be approximately quantified in terms of prevalence rates of SUD (or the other forms of use). This presentation will review at a high level the etiology research and methods to develop a system of tools that are designed to quantify individual youths’ (and groups’) overall liabilities, profile of risk factors, and statistical forecasting of outcomes (e.g., substance use, conduct problems) to inform personalized prevention strategies.
2. Hamed Ekhtiari, MD, PhD, Department of Psychiatry, University of Minnesota
Title: A New Classification of Interventions for Substance Use Disorder Prevention: A Neuroscience-based Approach Using RDoC
Bio: Dr. Ekhtiari’s lab is focused to reshape the future of prevention and treatments for addictive disorders with brain stimulation and cognitive technologies. Dr Ekhtiari serves as the board member and co-chair of the neuroscience section at the International Society for Addiction Medicine (ISAM) which is the largest international organization in the field of addiction treatment with over 10.000 members globally (https://isamweb.org). Dr. Ekhtiari is also the director of the ISAM Global Expert Network which supports international surveys among addiction medicine professionals (https://isamweb.org/global-expert-network/). Dr Ekhtiari directs the brain awareness for recovery initiative (BARI). BARI materials are translated and culturally adopted by scientific authorities in 22 languages in 5 continents so far (https://www.laureateinstitute.org/bari-posters.html).
Abstract: In contrast to treatment development for substance use disorder as a brain disease, thus far, little attempt has been made to convey neuroscience knowledge as a framework for prevention studies. In this talk, I will introduce an RDoC-based (NIMH Research Domain Criteria) framework to organize current and future preventive interventions in a neuroscience-based map. This neuroscience-informed framework categorizes addiction risk factors within the dysfunction of the five major RDoC constructs (Negative Valence Systems, Positive Valence Systems, Cognitive Systems, Arousal and Regulatory Systems, and Social Processes). Several existing prevention approaches are categorized within this framework based on their potential functional target (s). By using this novel and neuropsychologically structured framework, we hope to target distinct neurocognitive trajectories which have been recognized as risk factors for substance use disorder development in adolescents and more importantly evaluate their changes that may correspond to these neuroscience-based programs.
3. Donna Volpitta, EdD
Title: Pathways to Empower: Using the Why to Inform the How
Bio: Donna Volpitta, Ed.D. is an educator, author, and speaker who loves making the brain science of resilience and mental health easy to understand and apply. She is Co-Founder of the Mental Health Literacy Collaborative, a board member of One Revolution Foundation, a member of the Mental Wellness Initiative and Children's Wellness Initiative of the Global Wellness Institute, a Global Presence Ambassador for Parenting 2.0, and a member of the Character Collaborative. Donna is a former classroom teacher with experience in both general and special education and the mother of four young adults.
Abstract: The field of neuroscience has come a long way over the past 20 years. However, so much of the critical knowledge from the field is not being utilized effectively because of its complexity. The Resilient Mindset Model translates complex neuroscience, making it easy for any audience to understand and apply. In this short presentation, Dr. Donna Volpitta shares the model, demonstrating how it can teach people how the brain is wired to respond to challenges in order to demystify the “why?” Behind our behaviors. She then explains how this unique model is being applied to teach the brain science of resilience and mental health, including substance use prevention. Participants will leave with a clearer understanding of the power of neuroscience for behavior transformation.
4. Nathaniel Riggs, Ph.D. Professor, HDFS and Executive Director of the Colorado State University Prevention Research Center.
Title: A Role for Executive Function in Prevention Research: Opportunities and challenges to informing prevention program development and interpretation of outcomes
Bio: Dr. Riggs received his PhD in Human Development and Family Studies (2003) at Penn State University where he was a graduate student at the Penn State Prevention Research Center. He is currently a professor of Human Development and Family Studies and Executive Director of the Colorado State University Prevention Research Center, a campus-wide trans-disciplinary center committed to studying the development, implementation, and evaluation of effective and sustainable preventive interventions across the lifespan. His personal research interests include testing preventive interventions that promote youth socioemotional development and prevent adolescent risk behaviors. A primary research interest of his is translating basic research in developmental neuroscience to school-based and family-focused interventions that prevent child and adolescent behavioral health problems including substance use. He is an engaged scholar who works alongside community partners to support the implementation of evidence-based preventive interventions and is the principal investigator on several federally-funded projects with community partners from around the state of Colorado.
Abstract: Executive function refers to the neuro-cognitive skills that facilitate young people’s management of thoughts, behaviors, and actions to achieve goals and engage in adaptive, goal-directed behavior. These functions include working memory, inhibitory control, and cognitive flexibility and are essential for planning, organizing, problem-solving, initiating tasks, regulating emotions, focusing attention, and making decisions. Research suggests a vital role for executive function in young people’s social-emotional and behavioral development, including substance use and misuse. However, executive function is rarely considered when developing or testing substance use prevention programs. This presentation reviews the literature linking executive function to children's social-emotional and behavioral development and proposes three testable models by which executive function may be relevant for prevention: As an outcome, mediator, and moderator of preventive intervention outcomes. Implications and challenges to testing the role of executive function in prevention research will also be discussed.
5. Judy L. Cameron, Ph.D., Professor of Psychiatry; Neuroscience; Behavioral & Community Health Sciences; Obstetrics, Gynecology & Reproductive Sciences; and the Clinical Translational Science Institute at the University of Pittsburgh
Title: Prevention Interventions to strengthen children’s abilities to thrive even in the face of life adversities
Bio: Judy Cameron, Ph.D., is a Professor of Psychiatry; Neuroscience; Behavioral & Community Health Sciences; Obstetrics, Gynecology & Reproductive Sciences; and the Clinical Translational Science Institute at the University of Pittsburgh. She is currently a member of the National Scientific Council on the Developing Child at Harvard University and the Scientific Council of the Child Mind Institute in New York. Dr. Cameron’s research focuses on the effects of everyday life stresses on behavioral development and long-term health. Areas of interest in her laboratory include identification of factors that lead to stress sensitivity versus stress resilience, and lifestyle factors that improve brain health by impacting neuroplasticity during development and aging. Dr. Cameron is the founder and director of Working for Kids: Building SkillsTM (www.workingforkids.com), which is a novel community-based educational program that teaches the fundamentals of brain development to those who work with children and adolescents at a community level. Working For Kids has won several innovation awards in Pittsburgh, as well as from the National Science Foundation. The newest materials produced by Working for Kids are visual novels for adolescents that strengthen decision-making skills.
Abstract: Adversity in early childhood exerts an enduring impact on mental and physical health, academic achievement, lifetime productivity, and the probability of interfacing with the criminal justice system. Our recent studies in young children whose families use social services have shown that poverty, facing adversities and low parent education levels all contribute to the impact of adversity on children’s brain development. Surprisingly, we have found that in many cases poor sleep is a mediator for how these stresses impact cognitive and social-emotional brain development. In contrast, strong caregiver-child interactions strengthen brain development and this too is mediated by the quantity and quality of sleep. Sleep and caregiver-child interactions offer two targets for prevention research that have the potential to mitigate the impacts of adversity on children’s brain development. This presentation will present three intervention programs designed to strengthen children’s brain development and present evidence from recent studies showing their effectiveness. The first is the Working For Kids: Building SkillsTM educational program that involves 6 hours of training on promoting strong parent-child interactions. The second is the First Pathways Game that is a freely available app with 250 age-appropriate activities caregivers and children can do together from birth to age 8 to strengthen children’s skill development. The third is The Healthy Sleep Habits education program that provides caregivers with strategies to improve children’s sleep quality and quantity.