YOUNG ADULTS WITH VIOLENT BEHAVIOR DURING EARLY PSYCHOSIS: A MIXED-METHODS ASSESSMENT AND INTERVENTION TRIAL

早期精神病期间有暴力行为的年轻人：混合方法评估和干预试验

基本信息

批准号：
10487544
负责人：
Stephanie Rolin
金额：
$ 19.25万
依托单位：
COLUMBIA UNIVERSITY HEALTH SCIENCES
依托单位国家：
美国
项目类别：
财政年份：
2021
资助国家：
美国
起止时间：
2021-09-13 至 2026-08-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10487544
关键词：
Adult Age Aggressive behavior Area Award Behavior Behavior Therapy Caregiver Burden Centers for Disease Control and Prevention (U.S.)Chronic Client Clinic Clinical Trials Clinical Trials Design Cognitive Therapy Conduct Disorder Coordinated Specialty Care Data Deltastab Development Diagnosis Early Intervention Ensure Evidence based intervention Forensic Medicine Goals Grant Guidelines Health Services Hospitalization Impairment Imprisonment Impulsivity Individual Inpatients Intervention Intervention Trial Interview Life Maps Matched Group Mentorship Methods Modeling National Institute of Mental Health Nature New York Onset of illness Outcome Outpatients Participant Patients Pattern Persons Physicians Planning Theory Population Process Psychiatrist Psychoses Psychotherapy Public Health Qualitative Methods Qualitative Research Quality of life Randomized Controlled Trials Recording of previous events Research Research Domain Criteria Research Personnel Research Support Risk Sampling Schizophrenia Schools Service setting Social isolation Strategic Planning Structure Subgroup Symptoms Testing Therapeutic Intervention Training Treatment Efficacy United States Violence Work Writing acceptability and feasibility antisocial behavior base career community setting convict critical period early experience early psychosis efficacy testing evidence base experience feasibility testing health disparity high risk improved improved functioning mortality non-affective psychoses peer pilot trial prevent psychosocial response service delivery service intervention service programs severe mental illness violence prevention violent crime young adult

项目摘要

Project Summary: Although the absolute risk of violence among persons with serious mental illnesses (SMI) is small, young people experiencing early psychosis are a subgroup at highest violence risk. Violence is a public health issue that contributes to health disparities experienced by adults with schizophrenia, including caregiver burden, social isolation, and incarceration and subsequent early mortality. Cognitive behavioral therapy (CBT) for psychosis and similar behavioral interventions have had efficacy in reducing impairment and improving functioning among young adults with early psychosis. However, no identified studies have explored using a behavioral intervention to reduce violence among young adults with early psychosis. In this application, Dr. Stephanie Rolin proposes a comprehensive path towards becoming an independent physician investigator creating and adapting evidence-based approaches to assess and reduce violence risk. Specifically, this proposal follows the CDC’s Map of Adaptation, a model for adapting evidence-based interventions (EBI), to adapt and evaluate the feasibility of an early intervention services (EIS)-specific CBT- based intervention to reduce violence with proposed targets consistent with the transdiagnostic nature of Research Domain Criteria (RDoC). This research will occur at OnTrackNY, the largest EIS program in the United States; OnTrackNY has provided evidence-based coordinated specialty care to over 1,800 individuals at more than 20 clinics in New York State. First, Dr. Rolin will conduct individual semi-structured interviews with EIS clients who have engaged in recent violent behavior (n=20) and clinicians who have worked with EIS clients who have engaged in violent behavior (n=10). These interviews will use the Theory of Planned Behavior to identify key areas of an existing CBT model called PICASSO (which has shown efficacy in reducing violence) that require adaptation for the EIS setting. Next, Dr. Rolin will adapt the PICASSO model for the EIS setting in an open pilot trial, through an iterative process that utilizes mixed methods assessment. Finally, Dr. Rolin will evaluate the intervention’s feasibility through a pilot RCT. To further her long-term career goal of becoming an independent physician-investigator focused on creating and adapting EBI to reduce violence risk, Dr Rolin will pursue training in the following four areas: (1) qualitative research including mixed methods; (2) psychosocial intervention adaptation; (3) psychotherapy clinical trials; and (4) grant writing. The product of this study will be an R01 of a large RCT to test the feasibility of the first EBI of CBT to reduce violence in the EIS setting. Overall, this award will ensure Dr. Rolin’s successful transition to an independent physician investigator studying the assessment and prevention of violence among adults with SMI.

项目摘要：尽管患有严重精神疾病的人（SMI）中暴力行为的绝对风险（SMI）很小，经历早期精神病的年轻人是暴力风险最高的亚组。暴力是一个公共卫生问题，有助于精神分裂症成年人经历的健康分配，包括护理人员伯恩（Burnen），社会隔离以及随后的早期死亡率。认知行为用于精神病和类似行为干预措施的治疗（CBT）在减少障碍和改善患有早期精神病的年轻人的功能。但是，尚未探索任何确定的研究使用行为干预来减少患有早期精神病的年轻人的暴力行为。在此应用程序中，斯蒂芬妮·罗林（Stephanie Rolin）博士提出了成为独立的综合途径医师研究者创建和调整基于证据的方法来评估和降低暴力风险。具体而言，该建议遵循CDC的适应地图，这是适应性证据的模型干预措施（EBI），以适应和评估早期干预服务（EIS）特定CBT-的可行性基于符合符合经诊断性质的拟议目标的基于干预措施研究领域标准（RDOC）。这项研究将在OnTrackny进行，这是该研究中最大的EIS计划美国; Ontrackny为1,800多个人提供了基于证据的协调专业护理在纽约州的20多个诊所。首先，罗林博士将与参与最近暴力行为（n = 20）的EIS客户和与EIS合作的临床医生从事暴力行为的客户（n = 10）。这些访谈将使用计划行为的理论识别现有CBT模型的关键领域，称为毕加索（这显示出降低效率暴力）需要适应EIS设置。接下来，Rolin博士将适应EIS的毕加索模型通过使用混合方法评估的迭代过程进行开放试验试验。最后，博士 Rolin将通过试点RCT评估干预措施的可行性。为了促进她成为一名专注于创建的独立物理评估者的长期职业目标 Rolin博士将在以下四个领域进行培训：（1）定性，请改编EBI以降低暴力风险。研究包括混合方法；（2）社会心理干预适应；（3）心理治疗临床试验；（4）赠款写作。这项研究的产物将是大型RCT的R01，以测试第一个的可行性 CBT的EBI减少EIS环境中的暴力行为。总体而言，该奖项将确保Rolin博士的成功过渡到研究评估和预防暴力行为的独立物理调查员成人SMI。