Effectiveness Trial of Attention Shaping for Schizophrenia

注意力塑造治疗精神分裂症的有效性试验

• 批准号: 7091007
• 负责人: STEVEN M SILVERSTEIN
• 金额: $ 44.64万
• 依托单位: UNIV OF MED/DENT NJ-R W JOHNSON MED SCH
• 依托单位国家: 美国
• 财政年份: 2006
• 资助国家: 美国
• 起止时间: 2006-09-14 至 2011-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7091007
• 关键词: attention; behavior modification; behavior therapy; behavioral /social science research tag; clinical research; clinical trials; human subject; human therapy evaluation; medical rehabilitation related tag; neuropsychological tests; outcomes research; patient oriented research; psychosocial rehabilitation; reinforcer; schizophrenia

DESCRIPTION (provided by applicant): Among people with schizophrenia, attentional impairment is a major barrier to being able to engage in, and learn new skills in, psychosocial skills training interventions. Therefore, developing methods to promote attentiveness and learning during skills training is an important step in improving treatment outcomes. Prior case reports, one controlled study, and data from an ongoing R21 application indicate that attention shaping procedures (ASP) are highly effective methods to achieve these goals. ASP is a manualized, behavioral intervention that involves individualized goal-setting, and standardized observational rating, prompting, and reinforcement procedures to assist patients in increasing the duration and quality of their attentiveness in psychosocial interventions. To date, studies of ASP have been limited in their outcome evaluations to in- group attentiveness and learning of group material. Other cognitive outcomes, generalizability, functional outcomes and durability of gains have not been studied. This proposal, therefore, describes a controlled effectiveness study of ASP that would comprehensively assess relevant outcomes, generalizability, functional skills related to those taught in the intervention and maintenance of the gains over six months. ASP will be integrated within a standard form of social skills training [UCLA Basic Conversation Skills Module (BCS)], and compared to a BCS-alone condition. Specific aims of the study involve examinations of: 1) the generalizability of ASP's effects to relevant domains of non-study-group attentiveness, and standardized measures of neurocognition; 2) functional outcomes involving social skills, as assessed through self-report, other-report, interview, and role-play based measures; and 3) the durability of ASP-associated gains, by conducting a 6-month follow-up assessment on all subjects. Statistical analyses will involve time-series and growth curve models that make use of daily in-group performance data to model treatment response. These data, plus more traditional analyses will determine whether, and to what extent, ASP confers advantages in attention, and learning and/or performance of behavioral skills to patients who receive it. The long-term objective of this project is to demonstrate that ASP can narrow the gap between the existence of potentially effective psychosocial interventions (such as skills training) and patients who, at present, cannot benefit from them due to attentional difficulties.

描述（由申请人提供）：对于精神分裂症患者来说，注意力障碍是参与心理社会技能培训干预并学习新技能的主要障碍。因此，开发在技能培训期间促进注意力和学习的方法是改善治疗结果的重要一步。先前的案例报告、一项对照研究以及正在进行的 R21 应用程序的数据表明，注意力塑造程序 (ASP) 是实现这些目标的高效方法。 ASP 是一种手动行为干预，涉及个性化目标设定、标准化观察评级、提示和强化程序，以帮助患者增加心理社会干预中注意力的持续时间和质量。迄今为止，ASP 的研究仅限于对群体内注意力和群体材料学习的结果评估。其他认知结果、普遍性、功能结果和收益的持久性尚未研究。因此，本提案描述了 ASP 的受控有效性研究，该研究将全面评估与干预和维持六个月收益相关的相关结果、普遍性、功能技能。 ASP 将被整合到标准形式的社交技能培训 [加州大学洛杉矶分校基本对话技能模块 (BCS)] 中，并与单独的 BCS 条件进行比较。该研究的具体目标包括检查：1）ASP 对非研究组注意力相关领域的影响的普遍性，以及神经认知的标准化测量； 2）涉及社交技能的功能结果，通过自我报告、他人报告、访谈和基于角色扮演的措施进行评估； 3) 通过对所有受试者进行 6 个月的跟踪评估，确定 ASP 相关收益的持久性。统计分析将涉及时间序列和生长曲线模型，利用每日组内表现数据来模拟治疗反应。这些数据加上更传统的分析将确定 ASP 是否以及在多大程度上为接受 ASP 的患者带来注意力、学习和/或行为技能表现方面的优势。该项目的长期目标是证明 ASP 可以缩小潜在有效的心理社会干预措施（例如技能培训）与目前因注意力困难而无法从中受益的患者之间的差距。