PROJECT SUMMARY/ABSTRACT Alcohol and cannabis are the first and second most commonly used substances among adolescents. Adolescence is a period of considerable development, making the adolescent brain particularly vulnerable to negative effects of alcohol and cannabis use. Developing and testing interventions that target both alcohol and cannabis use during adolescence are vital to decreasing costly consequences. Biases in cognitive processing of drug-related stimuli play an important role in the development and maintenance of problematic substance use. The Approach-Avoidance Task (AAT) is a computerized program, effective in assessing implicit approach biases for both alcohol and cannabis, in which participants push or pull a joystick in response to an irrelevant feature of an image presented on a computer screen (e.g., push when in portrait, pull when in landscape). A modified version of the AAT (mAAT) is also used as a Cognitive Bias Modification (CBM) intervention, to retrain participants’ implicit biases toward or away from stimuli by presenting the target stimuli predominantly in one format (e.g., push or pull). Despite research demonstrating the effectiveness of mAAT interventions to reduce problematic alcohol and cannabis use, there is a dearth of research examining this intervention among adolescents. The proposed research will test a pilot randomized controlled trial of an integrated mAAT intervention to target co-occurring alcohol and cannabis use among treatment-seeking adolescents (N=52). Specific aims include to test the effect of the intervention on approach biases for cannabis/alcohol stimuli (Aim 1) and cannabis/alcohol use at 1- and 3-months post-intervention (Aim 2), and to examine the role of intentions and cravings as mediators in the relationship between treatment condition and use. The research environment, facilities, and resources at MUSC are ideally suited for mentored career development in addiction research. K23 training objectives are to: 1) increase knowledge of etiological and treatment mechanisms for cannabis use; 2) acquire essential knowledge and experience across the stages of clinical trial research among treatment-seeking adolescents with substance use problems, including incorporating EMA methods; 3) develop expertise in CBM; 4) gain experience incorporating EEG to identify change mechanisms in substance use interventions; and 5) enhance scientific communication and overall academic productivity. Structured mentorship from Drs. Carla Kmett Danielson, Lindsay Squeglia, Lisa McTeague, and Robert Miranda Jr. will ensure training goals are met. The candidate’s long-term career goal Is to direct a research portfolio that: 1) develops and tests innovative intervention approaches for substance use problems among adolescents and emerging adults; 2) delivers these innovative interventions in existing real-world settings; and 3) identifies change mechanisms within interventions using multiple units of analysis. The tra...