Treatment Development Targeting Severe and Persistent Negative Symptoms

针对严重和持续的阴性症状的治疗开发

• 批准号: 8414843
• 负责人: Dawn Irene Velligan
• 金额: $ 16.15万
• 依托单位: UNIVERSITY OF TEXAS HLTH SCIENCE CENTER
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-03-01 至 2015-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8414843
• 关键词: Adaptive Behaviors; Address; Adverse effects; Affect; Behavior; Behavioral; Behavioral Symptoms; Characteristics; Clinical Trials; Clinical Trials Design; Cognitive; Cognitive Therapy; Consensus; Cues; Development; Emotional; Evidence based practice; Evidence based treatment; Health Services Research; Home environment; Individual; Intervention; Intervention Studies; Length; Manuals; Measures; Mental Depression; Mental Health; Modeling; Motivation; National Institute of Mental Health; Outcome; Paranoia; Participant; Patients; Pharmaceutical Preparations; Poverty; Preparation; Procedures; Process; Psychological reinforcement; Quality of life; Randomized; Recommendation; Recruitment Activity; Research Project Grants; Sampling; Schizophrenia; Social Behavior; Specific qualifier value; Specificity; Speech; Symptoms; Techniques; Testing; Therapeutic; Thinking; Time; Training; Visit; Work; active control; base; clinically significant; cohort; design; effective therapy; efficacy trial; functional outcomes; improved; in vivo; information gathering; interest; meetings; novel; pleasure; primary outcome; programs; prospective; psychosocial; public health relevance; randomized trial; remediation; response; screening; skills; skills training; social; therapy development; treatment as usual; treatment effect

DESCRIPTION (provided by applicant): Individuals with schizophrenia who have persistent and clinically significant negative symptoms (PNS) including, restricted affect, diminished emotional range, poverty of speech, decreased motivation and interests, diminished sense of purpose and diminished social drive typically have the poorest functional outcomes and quality of life. The NIMH-MATRICS Consensus Statement on Negative Symptoms indicated that these symptoms were a distinct therapeutic indication representing an unmet therapeutic need for large numbers of individuals with schizophrenia. In addition, the group suggested design features necessary to prove efficacy for PNS. While aspects of negative symptoms may be lessened with existing evidence-based practices, no model addresses the entire constellation of PNS. Based upon decades of work developing and employing evidence-based treatments for schizophrenia, we have developed a novel psychosocial treatment called the MOtiVation and Engagement (MOVE) Program specifically to target multiple domains of severe and persistent negative symptoms and their functional consequences. MOVE is a home based, manual-driven, multi-modal treatment that employs a number of cognitive and behavioral principles to address the broad range of factors contributing to a PNS presentation. The purpose of this study is to examine the feasibility of delivering this intervention while implementing the stringent sample selection and assessment procedures required to clearly demonstrate efficacy for PNS. We will further refine the treatment manual and test a measure to assess ongoing treatment fidelity, train a group of mental health clinicians to conduct MOVE, and examine the feasibility of recruiting and retaining PNS patients in a 9 month trial in which prospective evidence of persistent negative symptoms is required prior to randomization. We will randomize 60 individuals to either MOVE or treatment as usual and examine outcomes for global negative symptoms as well as specific symptom domains.

描述（由申请人提供）：具有持久和临床上显着的负面症状（PN）的精神分裂症患者，包括情感受限制，情绪范围减少，言语贫困，动机和兴趣减少，目标意识减少，社交驱动力减少，通常具有最差的功能和质量。 NIMH摩托学关于负症状的共识声明表明，这些症状是一种独特的治疗指示，代表了大量精神分裂症患者的治疗需求。此外，该小组提出了证明PN功效所必需的设计功能。尽管现有的基于证据的实践可能会减少负面症状的各个方面，但没有模型解决PNS的整个星座。基于数十年来开发和采用基于证据的精神分裂症治疗的工作，我们开发了一种新型的社会心理治疗方法，称为动机和参与计划（Move）计划，专门针对严重和持续的负面症状及其功能后果的多个领域。 Move是一种基于家庭的，手动驱动的多型式治疗方法，采用多种认知和行为原理来解决有助于PNS呈现的广泛因素。这项研究的目的是检查提供此干预措施的可行性，同时实施明确证明PNS功效所需的严格样本选择和评估程序。我们将进一步完善治疗手册，并测试一项评估持续治疗保真度的措施，训练一组心理健康临床医生进行移动，并在9个月的试验中检查招募和保留PNS患者的可行性，在9个月的试验中，在随机化之前需要持续的负面症状证据。我们将像往常一样将60个人随机移动或治疗，并检查全球阴性症状以及特定症状领域的结果。

项目成果

A randomized pilot study of MOtiVation and Enhancement (MOVE) Training for negative symptoms in schizophrenia.

• DOI: 10.1016/j.schres.2015.04.008
• 发表时间: 2015-07
• 期刊: SCHIZOPHRENIA RESEARCH
• 影响因子: 4.5
• 作者: Velligan, Dawn I.;Roberts, David;Mintz, Jim;Maples, Natalie;Li, Xueying;Medellin, Elisa;Brown, Matt
• 通讯作者: Brown, Matt