Train Your Brain 2.0 - Improving Memory and Decision Making Among Youth

The goal of this clinical trial is to deliver a computer-based working memory training program to improve delay discounting (DD) and prevent substance misuse among at-risk adolescents in a traditionally underserved area. Results from the study will inform future substance use prevention efforts targeted at youth exposed to adverse childhood experiences. Findings will also refine future models of intervention delivery in traditionally underserved communities.

The main aims of the project are are:

1) To examine to examine changes in hypothesized mechanisms of substance use initiation and escalation, and 2) to assess whether changes in DD are a mechanism for reducing substance misuse during early adolescence. The investigators will evaluate whether changes in DD following active treatment predict substance use outcomes over the three-month follow-up period.

Youth exposed to early childhood adversity are at increased risk for engaging in problematic substance use, leading to myriad negative health outcomes, including HIV exposure, injury, and impaired driving. Adolescents from low-resource communities evidence elevated rates of exposure to adverse childhood experiences, yet have limited access to evidence-based preventative interventions. Thus, there is a critical need for services that can feasibly target specific mechanisms linking early adversity to the onset and escalation of substance use in traditionally underserved communities.

One such target is delay discounting (DD), the tendency to select small, immediately available rewards relative to larger, delayed, rewards. DD has been linked to early substance use initiation and more frequent and severe use across adolescence. Moreover, youth exposed to early childhood adversity evidence more problematic levels of DD, indicating that DD may be a pathway by which early trauma exposure leads to drug and alcohol use.

Research from the investigative team suggests that computer-based interventions targeting proximal cognitive skills, specifically working memory, can improve rates of DD. Moreover, computerized interventions are highly transportable and scalable, making them ideal for dissemination in low-resource communities. The current project proposes to pilot a computer-based working memory (WM) training program to improve DD and prevent substance use among at-risk adolescents in a traditionally underserved area.

Eligibility Criteria:
Adolescent Inclusion Criteria:

1. Between the ages of 11 and 15 and have a parent/guardian willing to provide consent for their participation
2. Proficient in English
3. Willing to commit to participate in computer-based trainings over the course of 5-8 weeks (duration dependent on site)
4. Access to internet services, cell phone, and/or email
5. Willing to receive/send study-related text messages

Adolescent Exclusion Criteria:

1. Self-disclosure or identification with psychological disturbance, suicidality, or evidence of active suicide ideation
2. Self-disclosure of current substance use disorder

Parent Inclusion Criteria:

1. Provide consent for child's participation in study
2. Proficient in English
3. Access to internet services, cell phone, and/or email
4. Willing to receive/send study-related text messages

Parent Exclusion Criteria:

1. Self-disclosure or identification with psychosis, suicidality, or evidence of active suicide ideation
2. Self-disclosure of current substance use disorder