IRT-based Self-report Screener for Prodromal Schizophrenia & Early Psychosis

基于 IRT 的前驱精神分裂症自我报告筛查

基本信息

批准号：
8252856
负责人：
BENJAMIN B BRODEY
金额：
$ 26.27万
依托单位：
TELESAGE, INC.
依托单位国家：
美国
项目类别：
财政年份：
2011
资助国家：
美国
起止时间：
2011-09-23 至 2012-06-22
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8252856
关键词：
Age-Years American Charge Client Clinical Clinical Research Clinical Trials Cognitive Cognitive deficits Computers Development Diagnosis Diagnostic Direct Costs Early identification Early treatment Evaluation Exhibits Facilities and Administrative Costs Family Generations Goals Incidence Incipient Schizophrenia Individual Internet Intervention Interview Longitudinal Studies Measurement Measures Mental Health Mental disorders Methodology Methods Mission Moods N.I.H. Research Support National Institute of Mental Health Neurologic Outcome Outpatients Paper Participant Patient Self-Report Phase Population Predictive Value Preparation Prevention Psychotic Disorders Public Sector Recovery Recruitment Activity Reporting Research Research Personnel Risk Sampling Schizophrenia Screening procedure Secure Sensitivity and Specificity Severities Staging Structure Symptoms Target Populations Testing Time United States Validation Validity of Self Report Visit aged base computerized cost effective design follow-up high risk improved instrument meetings method development novel prevent programs response software development statistics success theories touchscreen web site

项目摘要

DESCRIPTION (provided by applicant): Schizophrenia is one of the most debilitating and costly mental illnesses in the United States, with peak incidence in individuals aged 14-25 and causing annual direct and indirect costs of over $62.7 billion (Wu et al., 2005). Several studies suggest that early identification and treatment can delay onset and decrease the severity of schizophrenia, leading to a significant reduction in the irreversible neuroanatomical changes and cognitive deficits often associated with the onset of schizophrenia (McGlashan et al, 2006; Piontkewitz, et al, 2009; Simon et al., 2007). The critical barrier to advances in prodromal and early psychosis (PEP) research and treatment has been the identification of PEP individuals who are at risk of conversion to a psychotic disorder. Clinician-administered PEP screening assessments are time-consuming and costly, both in terms of required expertise and administration time (Lindenmayer et al, 2007). The proposed project will facilitate PEP screening and clinical research recruitment with the development of brief paper and computerized self-report PEP assessments that are appropriate for public sector mental health outpatients, 14-25 years of age. To accomplish this, we will utilize state-of-the art self- report item development methodology that is novel to PEP research, namely cognitive interviewing (CI) with 50 PEP outpatients as well as item response theory (IRT) analysis of responses from 1000 outpatients with varying levels of severity, including no symptoms, PEP, and a psychotic disorder. These methods will reduce population-specific biases and increase measurement precision and thereby, predictive validity. We will establish the convergent and predictive validit of our assessments against the SIPS and 12-month SCID-based diagnostic outcomes, respectively, as well as the predictive validity of the PQ-92 against the same outcomes. Computerized versions of the new PEP screeners will permit rapid scoring, clinical and research report generation, and follow-up with a computerized structured diagnostic assessment, the NetSCID, when integrated into our existing secure diagnostic Web portal. We have partnered with highly skilled consultants including three NIMH North American Prodrome Longitudinal Study (NAPLS) PIs, two PIs from the NIMH Recovery After an Initial Schizophrenia Episode (RAISE) clinical trial, a researcher representing the foremost ultra-high risk (UHR) research center outside the U.S., and a quantitative expert in IRT. This project is likely to have a substantial impact on the identification and treatment of PEP. It will facilitate PEP research by increasing the predictive validity of self-report screening thereby improving clinical trial recruitment. Routine screening of outpatients with our instruments may enable a greater number of PEP individuals to gain access to NAPLS-validated interventions, which may delay or prevent onset of a psychotic disorder; thereby serving to improve the lives of people suffering from psychosis and their families; prominent components of NIMH's overall mission. PUBLIC HEALTH RELEVANCE: Once developed, the proposed prodromal and early psychosis (PEP) assessments (the PEPS & PEPSS) will give researchers and clinicians the potential to use a multidimensional self-report instrument to identify individuals at risk of converting to a psychotic disorder; thereby, facilitating screening and clinical research recruitment of PEP outpatients who may benefit from further evaluation and possible inclusion in a validated PEP treatment intervention. As such, this project is likely to have a substantial impact on the identification, treatment, and possible prevention of psychosis as well as the lives of individuals at-risk for and suffering from psychotic disorders and their families; two prominent components of NIMH's overall mission.

描述（由申请人提供）：精神分裂症是美国最使人衰弱和代价最高的精神疾病之一，发病高峰在 14-25 岁的人群中，每年造成的直接和间接费用超过 627 亿美元（Wu 等人，2005 年））。多项研究表明，早期识别和治疗可以延迟精神分裂症的发病并降低其严重程度，从而显着减少通常与精神分裂症发作相关的不可逆的神经解剖学变化和认知缺陷（McGlashan 等，2006；Piontkewitz 等， 2009；西蒙等人，2007）。前驱期和早期精神病（PEP）研究和治疗取得进展的关键障碍是识别有转化为精神病风险的 PEP 个体。就所需专业知识和管理时间而言，临床医生实施的 PEP 筛查评估既耗时又昂贵（Lindenmayer 等，2007）。拟议项目将通过开发适合公共部门 14-25 岁心理健康门诊患者的简短论文和计算机化自我报告 PEP 评估，促进 PEP 筛查和临床研究招募。为了实现这一目标，我们将利用 PEP 研究中新颖的最先进的自我报告项目开发方法，即对 50 名 PEP 门诊患者进行认知访谈 (CI)，并对 1000 名患者的回答进行项目反应理论 (IRT) 分析。门诊患者的严重程度各不相同，包括无症状、PEP 和精神障碍。这些方法将减少特定人群的偏差并提高测量精度，从而提高预测的有效性。我们将分别根据 SIPS 和 12 个月基于 SCID 的诊断结果确定我们的评估的收敛和预测有效性，以及 PQ-92 针对相同结果的预测有效性。当集成到我们现有的安全诊断门户网站时，新型 PEP 筛查仪的计算机化版本将允许快速评分、生成临床和研究报告，并进行计算机化结构化诊断评估 NetSCID 的后续操作。我们与高技能顾问合作，包括三名 NIMH 北美前驱症状纵向研究 (NAPLS) PI、两名来自 NIMH 初次精神分裂症恢复 (RAISE) 临床试验的 PI、一名代表最重要的超高风险 (UHR) 研究的研究人员美国境外的中心，IRT 的定量专家。该项目可能会对 PEP 的识别和治疗产生重大影响。它将通过提高自我报告筛查的预测有效性来促进 PEP 研究，从而改善临床试验招募。使用我们的仪器对门诊患者进行常规筛查可以使更多的 PEP 个体获得经 NAPLS 验证的干预措施，这可能会延迟或预防精神障碍的发作；从而改善精神病患者及其家人的生活； NIMH 整体使命的重要组成部分。公共健康相关性：一旦开发出来，拟议的前驱期和早期精神病（PEP）评估（PEPS＆PEPSS）将使研究人员和临床医生有可能使用多维自我报告工具来识别有转化为精神障碍风险的个体；因此，促进 PEP 门诊患者的筛选和临床研究招募，这些患者可能受益于进一步的评估并可能纳入经过验证的 PEP 治疗干预措施。因此，该项目可能会对精神病的识别、治疗和可能的预防以及有精神病风险和患有精神病的个人及其家人的生活产生重大影响；两个突出的 NIMH 总体使命的组成部分。