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.
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.
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