Motivational Negative Symptoms in Schizophrenia: Intervention and Biomarkers

精神分裂症的动机性负面症状：干预和生物标志物

• 批准号: 8865892
• 负责人: Lena F Reddy
• 金额: --
• 依托单位: VA GREATER LOS ANGELES HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2015
• 资助国家: 美国
• 起止时间: 2015-06-01 至 2020-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8865892
• 关键词: Accounting; Address; Affect; Affective; Anhedonia; Aphasia; Area; Attenuated; Behavior; Behavioral; Behavioral Model; Belief; Biological Markers; Budgets; Clinical; Clinical Trials; Cognitive; Cognitive Therapy; Communities; Community Integration; Development; Disabled Persons; Electroencephalography; Employment; Enrollment; Evidence based intervention; Exercise; Funding; Gambling; Goals; Healthcare; Hour; Independent Living; Individual; Intervention; Life; Manuals; Measurement; Measures; Mental disorders; Motivation; Outcome; Pathway interactions; Pharmacological Treatment; Population; Post-Traumatic Stress Disorders; Procedures; Psychotic Disorders; Public Health; Quality of life; Randomized; Randomized Controlled Trials; Recovery; Relaxation; Research Personnel; Resources; Schizophrenia; Severities; Symptoms; Techniques; Testing; Training; Traumatic Brain Injury; Veterans; Volition; base; causal model; chronic pain; daily functioning; design; disability; effective therapy; experience; follow-up; functional disability; functional outcomes; improved; motivational enhancement therapy; motivational intervention; neurophysiology; psychosocial; public health relevance; satisfaction; severe mental illness; skills; skills training; social; standard care; substance abuse treatment; therapy development; tool; treatment adherence; treatment effect; treatment response; treatment trial

 DESCRIPTION: Negative symptoms significantly interfere with daily functioning and contribute to the poor community outcomes of Veterans with schizophrenia. There are two main types of negative symptoms: expressive (flat affect, alogia) and motivational (avolition and asociality). It is the motivational negative symptoms that interfere with obtaining and maintaining employment [1], forming social relationships [2] and living independently [3]. Negative symptoms in schizophrenia are considered an unmet treatment need. They also offer us a treatment target that would vastly improve the daily lives of many Veterans with SCZ. Treatment development is a primary goal of the current proposal, as is the examination of potential neurophysiological biomarkers of motivation. Biomarkers for motivational negative symptoms can be used as sensitive endpoints in clinical trials and can help us understand the causes and treatments of motivational negative symptoms. The current CDA proposal will assess the feasibility of a treatment for motivational negative symptoms adapted from established motivational enhancement (MI) techniques and augmented with cognitive-behavioral approaches, in a randomized controlled trial. I will assess the efficacy of MI with measures from multiple outcome domains: 1) clinically-rated motivational negative symptoms; 2) functional outcomes (real-world improvements in social, instrumental, and independent living); and 3) neurophysiological biomarkers (pupillometry and electroencephalography (EEG)). Veterans will be randomly assigned to the MI treatment or a control treatment for weekly 1-hour sessions for 12 weeks. The assessment battery will be administered at baseline, at completion of treatment, and at 3-month follow-up. We will enroll 100 Veterans with schizophrenia and high motivational negative symptoms across the 4 years of the study. This proposal is designed to examine group-based MI for reducing motivational negative symptoms and investigating biomarkers of motivation with pupillometry and EEG. It is expected that this recovery-oriented group MI treatment for Veterans with disabling motivational negative symptoms will yield results to inform larger treatment trials and enhance neurophysiological measurement of motivational negative symptoms in Veterans with schizophrenia.

 描述： 负面症状会严重干扰日常功能，并导致精神分裂症退伍军人的社区结果不佳。负面症状有两种主要类型：表达性（平坦的情感，alogia）和动机（Avolition and Associative）。动机负面症状会干扰获得和维持就业[1]，形成社会关系[2]并独立生活[3]。精神分裂症的负面症状被认为是未满足的治疗需求。他们还为我们提供了一个治疗目标，可以大大改善许多用SCZ的退伍军人的日常生活。治疗开发是当前建议的主要目标，对潜在的动机神经生理生物标志物的检查也是如此。动机负症状的生物标志物可以用作临床试验中的敏感终点，并可以帮助我们了解动机负面症状的原因和治疗方法。当前的CDA提案将评估一项随机对照试验中改善的动机增强（MI）技术的动机负面症状（MI）技术的可行性，并通过认知行为的方法增强。我将通过来自多个结果领域的措施来评估MI的有效性：1）临床评价的动机负面症状； 2）功能结果（社会，工具和独立生活的现实世界改善）； 3）神经生理生物标志物（瞳孔计和脑电图（EEG））。退伍军人将被随机分配到MI治疗或每周1小时疗程的对照处理中，持续12周。评估电池将在基线，治疗完成后以及3个月的随访时进行管理。在研究的四年中，我们将招募100名精神分裂症和高动机负面症状的退伍军人。该建议旨在检查基于小组的MI，以减少动机负面症状并通过成绩计和EEG研究动机的生物标志物。可以预期，这种面向恢复的MI治疗对残疾动机负面症状的退伍军人将产生结果，以告知大型治疗试验并增强精神分裂症退伍军人的动机阴性症状的神经生理测量。