The PI?s career goal is to become an independent investigator developing and evaluating novel interventions for underserved, vulnerable youth with anxiety and depressive disorders. This proposal outlines a plan to achieve this goal, through culmination of the training and research plans into an extremely competitive R01 proposal. The training plan takes full advantage of the candidate?s strong institutional support and environment at Northwestern University?s Feinberg School of Medicine, as well as relations with the broader community of researchers working with youth in high risk social environments. Training will include multidisciplinary mentorship, coursework, conferences, seminars, systematic professional interactions, readings, collaboration with a youth advisory board, and a mentored publication plan. Training goals necessary to the PI?s career goal involve growth in: 1) intervention development and evaluation;2) adolescent psychology;3) cultural issues pertinent to vulnerable youth;and 4) general career development. This plan builds on the PI?s background in clinical psychology, which has focused on technology- based treatments for depression and anxiety, contextual models of mental health disparities, implications of co- occurring psychiatric disorders on treatment outcomes, and cognitive behavioral therapy (CBT). In this K08, the PI will extend her work to include youth, increasing the impact of her research through earlier intervention. The long-term goal of the research is to open a new avenue to culturally competent care by: 1) applying treatment principles efficacious in general populations to unique concerns of underserved youth facing multiple risks to their physical and mental health;2) developing a mobile treatment that provides real-time, context- specific intervention;and 3) extending population-level care, via Internet and mobile phone technologies, to youth unable to access existing services. To this end, the research plan will: 1) identify context-specific risk factors for anxiety and depressive symptoms in vulnerable youth;2) identify treatment targets accordingly;and 3) develop an engaging, accessible intervention tailored to vulnerable adolescents with Major Depressive Disorder (MDD) and Generalized Anxiety Disorder (GAD). The intervention, delivered via an advanced mobile phone application, the Internet, and brief telephone support, will be grounded in validated CBT techniques and more recent advances in transdiagnostic CBT.
Research aims will be achieved via: 1) Study 1, analysis of an existing longitudinal, epidemiological dataset to identify context-specific social stressors that predict increased anxiety and depressive symptoms, and cognitive mechanisms by which the social stressors impact anxiety and depression;2) Study 2, development, usability testing, and a subsequent feasibility trial of a new, transdiagnostic Internet and mobile phone intervention teaching CBT skills to vulnerable adolescents with MDD and GAD, and applying these skills to targets identified from Study 1;and 3) Study 3, a pilot randomized controlled trial (RCT) comparing the intervention to an attention control. Studies 2 and 3 will provide preliminary data for an R01 proposing a larger RCT.

Public Health Relevance

The proposed research will identity group-specific intervention targets to reduce anxiety and depression symptoms in vulnerable youth, through analysis of an existing longitudinal study in a sample of youth in high risk social environments. Findings will be translated to develop and conduct early testing of an intervention designed to decrease symptoms in vulnerable youth with Major Depressive Disorder and Generalized Anxiety Disorder, using Internet and mobile phone formats that are widely accessible, cost-effective, scalable, private, and familiar to youth.

National Institute of Health (NIH)
National Institute of Mental Health (NIMH)
Clinical Investigator Award (CIA) (K08)
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Interventions Committee for Disorders Involving Children and Their Families (ITVC)
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Hill, Lauren D
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Northwestern University Chicago
Public Health & Prev Medicine
Schools of Medicine
United States
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Bry, Laura Jane; Mustanski, Brian; Garofalo, Robert et al. (2018) Resilience to Discrimination and Rejection Among Young Sexual Minority Males and Transgender Females: A Qualitative Study on Coping With Minority Stress. J Homosex 65:1435-1456
Fleming, John B; Hill, Yvette N; Burns, Michelle Nicole (2017) Usability of a Culturally Informed mHealth Intervention for Symptoms of Anxiety and Depression: Feedback From Young Sexual Minority Men. JMIR Hum Factors 4:e22
Bry, Laura Jane; Mustanski, Brian; Garofalo, Robert et al. (2017) Management of a Concealable Stigmatized Identity: A Qualitative Study of Concealment, Disclosure, and Role Flexing Among Young, Resilient Sexual and Gender Minority Individuals. J Homosex 64:745-769
Burns, Michelle Nicole; Ryan, Daniel T; Garofalo, Robert et al. (2015) Mental health disorders in young urban sexual minority men. J Adolesc Health 56:52-8
Burns, M N; Nawacki, E; Kwasny, M J et al. (2014) Do positive or negative stressful events predict the development of new brain lesions in people with multiple sclerosis? Psychol Med 44:349-59
Burns, Michelle Nicole; Nawacki, Ewa; Siddique, Juned et al. (2013) Prospective examination of anxiety and depression before and during confirmed and pseudoexacerbations in patients with multiple sclerosis. Psychosom Med 75:76-82
Burns, Michelle Nicole; Montague, Enid; Mohr, David C (2013) Initial design of culturally informed behavioral intervention technologies: developing an mHealth intervention for young sexual minority men with generalized anxiety disorder and major depression. J Med Internet Res 15:e271