1/3 Cognitive Behavioral Social Skills Training for Youth at Risk of Psychosis

1/3 针对精神病风险青少年的认知行为社交技能培训

基本信息

批准号：
9304884
负责人：
JEAN M ADDINGTON
金额：
$ 27.37万
依托单位：
UNIVERSITY OF CALGARY
依托单位国家：
美国
项目类别：
财政年份：
2014
资助国家：
美国
起止时间：
2014-09-26 至 2019-07-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9304884
关键词：
Address Adult Aftercare Anxiety Attenuated Behavior assessment Behavioral Belief Caring Clinical Clinical Treatment Cognitive Cognitive Therapy Collaborations Communities Community Practice Community of Practice Competence Data Data Analyses Data Collection Development Disease Early Intervention Early identification Educational Intervention Effectiveness Elements Enrollment Frequencies Genetic Risk Goals Health Care Costs Healthcare Systems Individual Intervention Lead Legal system Longitudinal Studies Matched Group Mediating Mediator of activation protein Mental Depression Mental Health Mental disorders Modeling Moods Nature Neurocognitive Deficit Participant Pathologic Processes Patients Performance Placebos Policies Prevention Preventive Intervention Problem Solving Process Productivity Protocols documentation Psychosocial Assessment and Care Psychotic Disorders Publications Randomized Recovery Research Research Personnel Risk Role Sample Size Sampling Schizophrenia Severities Single-Blind Study Site Social Functioning Societies Structure Substance abuse problem Support Groups Supportive care Symptoms Syndrome Testing Time Training Treatment Effectiveness Vulnerable Populations Youth adverse outcome arm clinical risk cognitive skill cost effectiveness trial evidence base follow-up functional decline high risk improved functioning improved outcome insight meetings prevent primary outcome psychoeducation psychosocial psychosocial rehabilitation public health relevance secondary outcome skills training social social skills socioeconomics symposium treatment as usual treatment group treatment program young adult

项目摘要

DESCRIPTION (provided by applicant): Schizophrenia and other psychotic disorders are serious and debilitating mental illnesses that incur substantial suffering for patients and major challenges to our health care and legal systems. The prodrome is the period prior to onset of psychosis when functional decline and clinical symptoms gradually emerge. The presence of a clinical high-risk (CHR) syndrome in young adults is associated with heightened risk (25-35%) for the later development of psychosis, and for those who do not necessarily go on to develop a psychotic illness, research has suggested that the majority continue to have fluctuating subthreshold symptoms and poor social and role functioning. There are no specific treatments to help with these functional difficulties. However, recent findings suggest that in people with schizophrenia, Cognitive Behavioral and Social Skills Training (CBSST) leads to significantly greater increase in the frequency of social functioning activities compared to treatment as usual or goal- focused supportive therapy, and preliminary data suggest CBSST is a feasible treatment for CHR. This application is a competitive application for a three-site, longitudinal study aimed at testing the effectiveness and feasibility as well as mediators and mechanisms of action of a manualized CBSST intervention that will target functional difficulties associated with clinical risk states for psychosis. The goals are 1) to examine whether CBSST compared to a placebo intervention (psychoeducation) matched for group involvement and therapist time improves functioning in youth at CHR and 2) to determine whether reduction in defeatist beliefs and improvement in social competence mediate change in psychosocial functioning in CHR youth in the CBSST. In this single-blind randomized 2-arm trial participants will be randomized to one of two treatments: CBSST, an 18-week group comprised of three modules; 1) Cognitive Skills; 2) Social Skills; and 3) Problem Solving, or a psychoeducation support group that does not teach active cognitive behavioral therapy or social skills training. Over a five-year period, te multi-site collaboration will follow large CHR sample that will undergo comprehensive assessments of psychosocial and behavioral changes, to examine changes in social and role functioning, as well as symptom changes from baseline to the end of treatment, and to 6 month follow-up. This approach will demonstrate the feasibility of a treatment for which it is easy to train therapists and which can readily be disseminated to regular clinical community practice. In addition, it will provide insights into likely approaches to halting or mitigating the pathological process and advance our understanding of risk prediction; both critical steps in prevention.

描述（由申请人提供）：精神分裂症和其他精神疾病是严重且使人衰弱的精神疾病，会对患者造成重大痛苦，以及对我们的医疗保健和法律体系的重大挑战。该前代是精神病发作之前的时期，功能下降和临床症状逐渐出现。年轻人中临床高风险（CHR）综合征的存在与以后的精神病发展的风险增加有关（25-35％），对于那些不一定继续发展精神病疾病的人，研究表明，大多数人持续不断波动的亚率症状波动，社交和作用差。没有特定的治疗方法可以帮助解决这些功能困难。然而，最近的发现表明，与像往常或以目标的支持治疗相比，在精神分裂症，认知行为和社交技能培训（CBSST）的人中，社交活动活动频率的增加显着增加，而初步数据表明，CBSST表明CBSST是CHR的可行治疗方法。该应用是针对三个站点的纵向研究的竞争应用，该研究旨在测试手动CBSST干预的有效性和可行性以及介体和作用机制，该干预将针对与精神病临床风险状态相关的功能困难。目标是1）检查CBSST与安慰剂干预（心理教育）相比是否相匹配的小组参与和治疗师时间可以改善CHR和2）的功能，以确定降低失败者信念和社会能力的降低是否介导CBSST CHR青年的心理社会功能的变化是否介导。在这个单盲随机分配的2臂试验中，参与者将被随机分为两种治疗方法之一：CBSST，一个由三个模块组成的18周组； 1）认知技能； 2）社交技能； 3）解决问题，或者不教积极认知行为疗法或社交技能培训的心理教育支持小组。在五年的时间里，多站点的合作将遵循大量的CHR样本，该样本将对社会心理和行为变化进行全面评估，以检查社交和角色功能的变化，以及从基线到治疗结束的症状变化以及6个月的随访。这种方法将证明一种易于培训治疗师的治疗方法的可行性，并且可以轻松地将其传播到常规的临床社区实践中。此外，它将提供有关停止或缓解病理学的可能方法的见解处理并提高我们对风险预测的理解；这两个关键步骤预防。