This Mentored Patient-Oriented Research Career Development Award (K23) will enable Dr. Dana Rofey to conduct interdisciplinary, longitudinal intervention research in adolescents with behavioral (obesity, sleep), emotional (depression), and physical (insulin, glucose, ghrelin, leptin, IL-6, and CRP) disturbances. This application will investigate adolescents with Polycystic Ovary Syndrome (PCOS) which will serve as a model physical illness consisting of high rates of obesity, depression, and sleep disturbances. The candidate is a licensed clinical psychologist, specialized in obesity, who also has prior training in a) the etiology, assessment, and treatment of depression;b) experience in the conduct of treatment-outcome research (i.e., manual development, pilot testing, evaluation);c) basic techniques in multivariate statistics;d) an understanding of the interdisciplinary aspects of childhood obesity;and e) clinical trial design and implementation. Dr. Rofey's short-term goals are to pursue training in neurobiological factors related to PCOS with a focus on sleep as a marker of brain activity;endocrine and metabolic aspects of obesity, and statistical modeling for the analysis of longitudinal treatment outcomes. Training will be accomplished via (a) meetings and guided readings with mentors Ronald Dahl MD and Silva Arslanian MD, and an expert team of consultants;(b) formal coursework;(c) attendance at conferences, journal clubs, and research meetings;and (d) supervised hands-on experiences in the collection and analysis of data. The University Of Pittsburgh School Of Medicine will be the primary site of this training, offering a combination of excellence in pediatrics, psychiatry, endocrinology, and biostatistics. Within the infrastructure of the Polycystic Ovary Syndrome Center and The Adolescent Medicine Clinic, the proposed research will include 126, 11-21.-year-old adolescents with PCOS. The study aims to investigate the effects of an enhanced cognitive behavioral therapy on physical (weight, sleep) and emotional (mood) disturbances, as well as to explore the relationship between remediation of symptoms and underlying physiological changes (e.g., insulin, inflammation). The proposed plan incorporates an innovative methodology that bridges objective laboratory measures of weight, emotion, and sleep and more ecologically valid measurements within the adolescents'real-world environment utilizing ecological momentary assessment (EMA). Insights into efficacious interventions for adolescents with complex chronic illness alongside of physical and emotional disturbances will place the applicant in a strong position to conduct translational research for adolescents with obesity.

Public Health Relevance

Complex and interrelated processes in adolescents with obesity make efficacious interventions challenging. This enhanced cognitive behavioral therapy creates a synergistic effect across domains (weight, mood, and sleep) in ways that become increasingly salient during adolescence. This research will lay the groundwork for future interventions targeting important physical, emotional, and behavioral facets.

National Institute of Health (NIH)
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Mentored Patient-Oriented Research Career Development Award (K23)
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Pediatrics Subcommittee (CHHD)
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Eisenberg, Esther
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University of Pittsburgh
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United States
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Zeller, Meg H; Hunsaker, Sanita; Mikhail, Carmen et al. (2016) Family factors that characterize adolescents with severe obesity and their role in weight loss surgery outcomes. Obesity (Silver Spring) 24:2562-2569
Rofey, Dana L; Miller, Elizabeth; McCauley, Heather L (2016) Gender Norms and Obesity: Incorporating Gender Norms Change Into Clinical Interventions. Obesity (Silver Spring) 24:280
Rofey, Dana L; Zeller, Meg H; Brode, Cassie et al. (2015) A multisite view of psychosocial risks in patients presenting for bariatric surgery. Obesity (Silver Spring) 23:1218-25
Michael, Julie C; El Nokali, Nermeen E; Black, Jessica J et al. (2015) Mood and Ambulatory Monitoring of Physical Activity Patterns in Youth with Polycystic Ovary Syndrome. J Pediatr Adolesc Gynecol 28:369-72
Rofey, Dana L; Arslanian, Silva A; El Nokali, Nermeen E et al. (2015) Brain volume and white matter in youth with type 2 diabetes compared to obese and normal weight, non-diabetic peers: A pilot study. Int J Dev Neurosci 46:88-91
Hannon, Tamara S; Rofey, Dana L; Lee, SoJung et al. (2013) Depressive symptoms and metabolic markers of risk for type 2 diabetes in obese adolescents. Pediatr Diabetes 14:497-503
Rofey, Dana L; McMakin, Dana L; Shaw, Daniel et al. (2013) Self-regulation of sleep, emotion, and weight during adolescence: implications for translational research and practice. Clin Transl Sci 6:238-43
Verstynen, Timothy D; Weinstein, Andrea M; Schneider, Walter W et al. (2012) Increased body mass index is associated with a global and distributed decrease in white matter microstructural integrity. Psychosom Med 74:682-90
Jakubowski, Karen P; Black, Jessica J; El Nokali, Nermeen E et al. (2012) Parents' Readiness to Change Affects BMI Reduction Outcomes in Adolescents with Polycystic Ovary Syndrome. J Obes 2012:298067
Hannon, Tamara S; Rofey, Dana L; Ryan, Christopher M et al. (2012) Relationships among obstructive sleep apnea, anthropometric measures, and neurocognitive functioning in adolescents with severe obesity. J Pediatr 160:732-5

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