Prodromal Inventory for Negative Symptoms (PINS): A Development and Validation Study

阴性症状前驱清单 (PINS)：开发和验证研究

基本信息

批准号：
10320426
负责人：
VIJAY A MITTAL
金额：
$ 57.65万
依托单位：
UNIVERSITY OF GEORGIA
依托单位国家：
美国
项目类别：
财政年份：
2019
资助国家：
美国
起止时间：
2019-03-01 至 2023-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/10320426
关键词：
Address Adolescent Adult Affect Anhedonia Aphasia Behavior Clinical Communities Consensus Consensus Development Conferences Consultations Data Deterioration Development Dimensions Distress Ecological momentary assessment Effectiveness Emotions Equipment and supply inventories Etiology Face Factor Analysis Gender Gold Individual Interview Measurement Measures Mental disorders Methodology Modification Mood Disorders Motivation National Institute of Mental Health Needs Assessment Outcome Participant Pharmacology Play Population Prevention Process Property Psychometrics Psychopathology Psychoses Psychotic Disorders Research Research Personnel Research Priority Risk Role Sampling Schizophrenia Series Site Statistical Data Interpretation Statistical Methods Structure Symptoms Syndrome Testing Therapeutic Validation Validity and Reliability Variant Walkers Youth affective neuroscience base clinical predictors clinically relevant comorbidity design experience functional disability functional outcomes high risk high risk population improved instrument meetings next generation novel strategies personalized approach poor communities programs psychosocial response social media symposium theories therapy development tool validation studies working group young adult

项目摘要

Project Summary Negative symptoms are a core feature of schizophrenia defined as the loss of normative motivation and/or expression. This dimension of psychopathology is distinct from other aspects of the illness and highly predictive of poor community-based functional outcomes. However, pharmacological and psychosocial treatments for negative symptoms have demonstrated limited effectiveness. To address this critical unmet need in schizophrenia therapeutics, the NIMH sponsored a consensus development conference to delineate research priorities for the field and stimulate treatment development. The primary conclusion of this meeting was that next-generation negative symptom rating scales should be developed to address methodological and conceptual limitations of existing instruments. Two next-generation clinical rating scales resulted from the NIMH consensus development conference that were intended for use with adult populations presenting with established psychotic illnesses. However, the consensus conference did not discuss development of assessments specific to youth at ultra-high risk (UHR) for developing psychosis (i.e. adolescents/young adults meeting criteria for a prodromal syndrome). Given that negative symptoms are highly predictive of the transition to diagnosable psychotic illness, enhancing our ability to detect negative symptoms in UHR youth is paramount. Existing scales designed to assess negative symptoms in UHR youth have conceptual and methodological limitations and scales designed for adults with diagnosable illness do not meet the unique needs of the UHR population. New scales specifically designed to assess negative symptoms in UHR youth are needed to accurately chart mental illness trajectories and determine when, where, and how to intervene. The current study aims to extend the scale development aims of the NIMH consensus development conference to the UHR population by taking an iterative, data-driven approach to creating a new measure, the Prodromal Inventory for Negative Symptoms (PINS). A beta version of the PINS was developed that displayed promising psychometric properties. Two studies will be conducted to refine the beta version and arrive at a final scale based on state-of-the-art statistical methods, with data collected at 3 sites with ongoing UHR research programs. Study 1 will include a large, representative, and diverse sample of UHR youth (n = 180) and evaluate the psychometric properties of the beta version. To determine how the beta version should be revised, analyses will be conducted to determine item selection, modification, and retention, including Item Response Theory, confirmatory factor analysis, item-level analyses, within- and between-site inter-rater reliability, and analyses of convergent and discriminant validity. In study 2, psychometric properties of the revised scale will be evaluated in a sample of UHR youth (n = 120) who will be followed longitudinally. Analyses of the final scale will evaluate measurement stability, internal consistency, inter-rater reliability, prediction of the transition to diagnosable psychotic illness, factor structure, convergent validity, and discriminant validity. This iterative, data-driven scale development process will provide the field with a next-generation negative symptom scale that meets the unique assessment needs of the UHR population.

项目概要阴性症状是精神分裂症的核心特征，定义为规范动机和/或表达的丧失。精神病理学的这一维度与疾病的其他方面不同，并且高度预测基于社区的不良功能结果。然而，针对阴性症状的药物和心理社会治疗已证明效果有限。为了解决精神分裂症治疗中这一未满足的关键需求，NIMH 主办了一次共识发展会议，以界定该领域的研究重点并刺激治疗的发展。这次会议的主要结论是下一代阴性症状应制定评级量表以解决现有文书的方法和概念局限性。 NIMH 共识制定会议产生了两个下一代临床评级量表旨在用于患有已知精神病的成年人群。然而，共识会议没有讨论针对超高风险青少年 (UHR) 制定专门的评估出现精神病（即符合前驱综合症标准的青少年/年轻人）。鉴于负数症状高度预示着向可诊断的精神病的转变，因此提高我们检测 UHR 青少年阴性症状的能力至关重要。现有的旨在评估 UHR 青少年阴性症状的量表存在概念和方法上的局限性，而为患有可诊断疾病的成年人设计的量表不能满足 UHR 人群的独特需求。需要专门设计用于评估 UHR 青少年阴性症状的新量表，以准确绘制精神疾病轨迹并确定何时、何地以及如何进行干预。目前的研究旨在通过采用迭代、数据驱动的方法来创建新的测量方法——阴性症状前驱清单（PINS），将 NIMH 共识制定会议的规模开发目标扩展到 UHR 人群。 PINS 的测试版已开发出来，显示出有前景的心理测量特性。将进行两项研究来完善测试版本，并根据最先进的统计方法得出最终规模，并在 3 个正在进行的 UHR 研究项目的地点收集数据。研究 1 将包括大量、具有代表性和多样化的 UHR 青少年样本 (n = 180)，并评估 beta 版本的心理测量特性。为了确定如何修订测试版本，将进行分析以确定项目选择、修改和保留，包括项目响应理论、验证性因素分析、项目级分析、站点内和站点间评估者之间的可靠性以及收敛效度和判别效度分析。在研究 2 中，将在 UHR 青少年样本（n = 120）中评估修订后量表的心理测量特性，并对其进行纵向跟踪。最终量表的分析将评估测量稳定性、内部一致性、评估者间可靠性、向可诊断精神病转变的预测、因素结构、收敛效度和判别效度。这种迭代的、数据驱动的量表开发过程将为该领域提供下一代阴性症状量表，满足 UHR 人群的独特评估需求。