Principle investigators and team

Prof. Dr. Yulia Golub

Dr. Lisa Dandolo

Meret Asara Paululat

Evgenii Shvedovskii

Cooperation partners:

• Dr Sören Kuitunen-Paul, Chair of Clinical Child and Adolescent Psychology and Psychotherapy and Chair of Clinical Psychology and Psychotherapy, Chemnitz University of Technology

Duration: 12/2017 - 07/2029

Background

Substance use disorders (SUD) in adolescence have a profound impact on brain functioning and behaviour, as substance use affects the normal development of the nervous system. Adolescents with SUD are particularly vulnerable, as they often experience cognitive impairments, including deficits in memory and concentration, which can persist even after abstinence. These cognitive challenges can hinder therapeutic engagement and academic performance, making it more difficult for affected individuals to fully participate in treatment. Despite the high need, there is still a significant lack of both psychotherapeutic interventions and cognitive rehabilitation programmes specifically designed for this age group. Our working group addressed this gap by developing DELTA, Germany's first outpatient therapy programme for adolescents with chronic substance use. DELTA combines evidence-based therapeutic models, including the MATRIX model, Dialectical Behavioural Therapy (DBT), and cognitive-behavioural techniques, to treat addiction and co-occurring psychiatric disorders. Additionally, the DELTA-TRAIN project was introduced to address the cognitive impairments common in adolescents with SUD, using a cognitive training programme delivered through the NeuroNation app. This project aims to improve memory and concentration and in this way support adolescents in overcoming cognitive barriers to successful treatment and recovery.

Project description

The DELTA program is a 16-session outpatient therapy for adolescents with chronic substance use, combining the MATRIX model, Dialectical Behavioural Therapy (DBT), and cognitive-behavioural techniques. It focuses on relapse prevention, coping skills, and emotion regulation, with initial evaluations showing reductions in substance use and psychiatric symptoms. To address cognitive impairments in these adolescents, DELTA-TRAIN offers cognitive training through the NeuroNation app, aiming to improve memory and concentration, including a non-substance-using control group. Study objectives include:

1. Evaluation of the effectiveness of the DELTA and DELTA-TRAIN programmes:
   We are currently collecting data to evaluate the effectiveness of the DELTA programme in reducing substance use and psychiatric symptoms. Furthermore, we are evaluating the effectiveness of the DELTA-TRAIN programme to improve cognitive performance and school outcomes, using psychological evaluations, cognitive assessments, and academic performance measures.
2. Investigation of epigenetic and immunological changes:
   Our aim is to Investigate epigenetic and immunological changes in adolescent substance users compared to non-users by collecting blood, hair, and buccal swabs, focusing on DNA methylation patterns and stress system activity.

Funding

• Sächsische Aufbaubank - Development Bank (SAB)
• Roland Ernst Foundation for Healthcare
• Heidehof Foundation

Study registration: NCT03444974 (MATRIX-A), DRKS00027913 (DELTA-JU), DRKS00030364 (DELTA-TRAIN)

Project-related publications

Basedow, L. A., Kuitunen-Paul, S., Wiedmann, M. F., Roessner, V., & Golub, Y. (2024). Evaluation of the multimodal DELTA therapy for adolescents with substance use disorders: an exploratory pilot trial. Frontiers in psychiatry, 14, 1284342.https://doi.org/10.3389/fpsyt.2023.1284342

Kuitunen-Paul, S., Basedow, L. A., Roessner, V., & Golub, Y. (2023). Study protocol: the pragmatic, exploratory DELTA-JU trial of the group-based multimodal DELTA intervention for abstinent adolescents with substance use disorders living in youth welfare institutions. Frontiers in psychiatry, 14, 1025347. doi. org/10.3389/fpsyt.2023.1025347

Plank, A. C., Wiedmann, M., Kuitunen-Paul, S., Wagner, W., Perez-Correa, J. F., Franzen, J., Ioannidis, C., Mirtschink, P., Roessner, V., & Golub, Y. (2024). DNA methylation and gene expression of immune cell markers in adolescents with chronic cannabis use: an exploratory study. BMC psychiatry, 24(1), 676. https://doi.org/10.1186/s12888-024-06043-0

Wiedmann, M., Kuitunen-Paul, S., Basedow, L. A., Wolff, M., DiDonato, N., Franzen, J., Wagner, W., Roessner, V., & Golub, Y. (2022). DNA methylation changes associated with cannabis use and verbal learning performance in adolescents: an exploratory whole genome methylation study. Translational psychiatry, 12(1), 317.https://doi.org/10.1038/s41398-022-02025-6

Basedow, L. A., Kuitunen-Paul, S., Roessner, V., & Golub, Y. (2020). Traumatic Events and Substance Use Disorders in Adolescents. Frontiers in psychiatry, 11, 559.https://doi.org/10.3389/fpsyt.2020.00559