Compensatory Cognitive Training in Clinical High Risk Latino Youth

临床高危拉丁裔青少年的补偿性认知训练

基本信息

批准号：
8789627
负责人：
KRISTIN S. CADENHEAD
金额：
$ 21.68万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
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：
2014-09-12 至 2017-08-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8789627
关键词：
Activities of Daily Living Adolescent and Young Adult Affect Age Algorithms Area California Caring Child Chronic Chronic Schizophrenia Cities Clinical Clinical Treatment Clinical Trials Design Cognition Cognitive Cognitive remediation Collaborations Communities Community Outreach Comorbidity County Coupled Deterioration Development Disease Doctor of Philosophy Double-Blind Method Early identification Ethics Evaluation Family history of Funding Grant Individual Institutes Intervention Laboratories Latino Measures Mediator of activation protein Mental Health Services Methodology Mexican Americans Mexico Minority Neurocognition Neurocognitive Neurocognitive Deficit Outcome Measure Patient Self-Report Patients Performance Persons Phase Population Preparation Prevention Psychotic Disorders Public Health Quality Control Randomized Randomized Clinical Trials Randomized Controlled Trials Rehabilitation therapy Research Risk Sampling Schizophrenia Schools Severities Site Special Equipment Staging Symptoms Syndrome Time Training Training Technics Translating Underserved Population United States Universities Work Youth base cognitive enhancement cognitive training disability first episode psychosis follow-up functional outcomes functional status help-seeking behavior high risk improved indexing interest meetings neuroprotection novel prevent primary outcome programs psychotic symptoms public health relevance response secondary outcome skills therapy development treatment response

项目摘要

DESCRIPTION (provided by applicant): An increasing emphasis in the development of treatments for psychotic illness, especially in early stages, has been in the area of cognitive enhancement, neuroprotection and cognitive remediation. Individuals at Clinical High Risk (CHR) develop a psychotic illness at rates between 20-40% over a 1-2 year period but the majority have neurocognitive and functional deficits whether they develop psychosis or not. Neurocognitive deficits predict a later psychotic illness and also poor functional status at follow up. By intervening early in the course of psychosis to target neurocognitive deficits, it might be possible to affect the functional outcome of this devastating disease. The proposed R34 Application, in response to RFA-MH-14-212 - Research to Improve the Care of Persons at Clinical High Risk for Psychotic Disorders, will assess Compensatory Cognitive Training (CCT) versus Recreational Training (RT) in Latino Clinical High Risk (CHR) subjects in the US and Mexico. Although CCT has been studied extensively in chronic psychotic illness, demonstrating moderate to large effect sizes on neurocognitive domains and functional capacity, it has never been studied in CHR subjects. In a 12 week randomized clinical trial design, 120 CHR Latino subjects will be randomized by groups into CCT or RT. Subjects will be assessed 4 times, at the beginning and end of the study, and at intermediary monthly intervals. The Specific Aims are to 1) Compare CCT augmentation versus RT on Primary Neurocognitive (Global Cognitive Index) and Functional Capacity (UCSD Performance-based Skill Assessment - UPSA) measures and Secondary Self-Rated Functioning (Specific Level of Functioning) and Clinical Symptom (Scale of Prodromal Syndromes - SOPS) measures; 2) Explore predictors (moderators) of treatment response (eg, age, baseline symptoms, neurocognition) and 3) explore mediators of treatment response (change in neurocognition and functioning). Also unique to this proposal will be the focus on Latino subjects at CHR for psychosis. The Latino community is underserved yet represents 55% of school children in San Diego county. The inclusion of a Mexico City site will enable an accelerated recruitment, given their access to large numbers of early psychosis subjects, increase sample diversity and minority representation by including large numbers of Latino subjects and assist in the implementation of a Spanish version of CCT. The laboratories of Kristin Cadenhead, MD, at University of California San Diego (UCSD) and Camilo de la Fuente MD, PhD, from the Laboratorio de Psiquiatr�a Experimental, Instituto Nacional de Neurolog�a y Neurocirug�a (INNN), Mexico City, have an existing collaborative relationship, funded by grants through the University of California Institute for Mexico and the United States (UC MEXUS), that allowed establishment of comparability of early psychosis populations across sites and implementation of reliability and quality control methodology in preparation for the proposed study.

描述（由适用提供）：越来越重视精神病治疗的发展，尤其是在早期阶段，一直在认知增强，神经保护和认知补救领域。临床高风险（CHR）的个体在1 - 2年内以20-40％的速度发展出精神病，但无论他们是否发展精神病，大多数人都具有神经认知和功能性缺陷。神经认知定义预测后来的精神病性疾病，功能状况也不佳。向上。通过介入精神病的早期，以靶向神经认知能力缺陷，可能会影响这种毁灭性疾病的功能结果。拟议的R34应用于响应RFA-MH-14-212-改善精神病临床高风险的人的研究，将评估美国和墨西哥的拉丁裔临床高风险（CHR）受试者的补偿性认知培训（CCT）与娱乐性培训（RT）。尽管CCT已广泛研究了慢性精神病性疾病，表现出对神经认知领域和功能能力的中等至大效应，但它从未在CHR受试者中进行研究。在一个为期12周的随机临床试验设计中，组将被组成120名CHR拉丁裔受试者，分为CCT或RT。在研究的开始和结束时，将对受试者进行4次评估，并在每月间隔中进行评估。具体目的是1）将CCT增强与RT进行比较与原发性神经认知（全球认知指数）和功能能力（基于UCSD绩效的技能评估-UPSA）测量和次级自我评估功能（功能的特定水平）和临床症状（特定的功能水平）（前脑综合症的规模）测度； 2）探索治疗反应的预测因子（主持人）（例如，年龄，基线症状，神经认知）和3）探索治疗反应的介体（神经认知和功能的变化）。此提案所独有的也将重点关注CHR的拉丁裔主题。拉丁裔社区服务不足，但占圣地亚哥县的55％的小学生。鉴于他们可以通过包括大量的拉丁裔受试者并协助实施西班牙版CCT的实施，包括墨西哥城市现场将促进加速招聘，增加样本多样性和少数群体代表。来自加利福尼亚大学圣地亚哥分校（UCSD）的Kristin Cadenhead的实验室和来自实验室的实验室，实验性，墨西哥人与墨西哥人的合作关系，由墨西哥人的合作伙伴关系，来自墨西哥人的合作，来自墨西哥人的合作，来自墨西哥人的合作，来自墨西哥人的合作，来自墨西哥人的合作，来自墨西哥人，美国（UC Mexus）允许建立跨站点早期精神病人群的可比性，并实施可靠性和质量控制方法，以准备拟议的研究。