Cognitive Training vs. Treatment as Usual to Improve Functioning and Reduce Transition Rates in Tunisian CHR Youth: A Feasibility Study

认知训练与常规治疗以改善突尼斯 CHR 青年的功能并降低过渡率：可行性研究

• 批准号: 10741697
• 负责人: JOSEPH VENTURA
• 金额: $ 36.14万
• 依托单位: UNIVERSITY OF CALIFORNIA LOS ANGELES
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-09-01 至 2025-08-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10741697
• 关键词: Adolescent Psychiatry; Adult; Agreement; Algeria; Applications Grants; Area; Assessment tool; Awareness; Bipolar Disorder; Caring; Child Psychiatry; Chronic; Clinic; Clinical; Clinical Treatment; Cognitive; Cognitive deficits; Collaborations; Communities; Community Outreach; Computers; Consultations; Country; Development; Distress; Early Diagnosis; Early Intervention; Economics; Education; Educational Intervention; Educational workshop; Enrollment; Evidence based practice; Faculty; Family; Feasibility Studies; Friends; General Population; Goals; Health Professional; Health system; Home; Impairment; Income; Individual; Institution; Intervention; Intervention Studies; Intuition; Language; Manuals; Measurement; Measures; Mental Health; Mental Health Services; Mental disorders; Middle East; Modeling; Morocco; Motivation; Neurocognitive; Neuropsychology; North African; Northern Africa; Outcome; Participant; Pathway interactions; Patients; Persons; Populations at Risk; Principal Investigator; Psychiatry; Psychologist; Psychoses; Psychotic Disorders; Publishing; Quality of life; Rehabilitation therapy; Reporting; Research; Research Personnel; Resources; Risk; Risk Factors; Risk Reduction; Role; Schedule; Schizophrenia; Schools; Signs and Symptoms; Social Functioning; Standardization; Students; Symptoms; Time; Training; Tunisia; Universities; University Hospitals; Work; Youth; cognitive enhancement; cognitive function; cognitive performance; cognitive training; daily functioning; design; disability; experience; functional disability; functional improvement; health knowledge; help-seeking behavior; high risk; high risk population; higher education; improved; indexing; innovation; low and middle-income countries; member; mental health education; model development; professor; programs; progression risk; reduce symptoms; remediation; response; screening; service intervention; service utilization; severe mental illness; social stigma; stress reduction; success; teacher; treatment as usual; treatment program; treatment services

Brief Description / Abstract: This study will use standardized and well-established approaches that have been culturally adapted for early detection, identification, assessment, and treatment of Clinical High Risk (CHR) youth in Tunisia, a low- and middle-income country (LMIC) in North Africa. Being at CHR means that these are young people are at greater risk than the general population for developing psychosis, a serious mental illness (SMI). This study proposes to use an active, educational, community outreach approach to reduce both stigma and increase community awareness about the availability and importance of mental health services aimed at early intervention. This approach will aid in the identification of individuals at CHR who can receive study related treatment services. Assessment of the CHR state will be performed by a clinical team trained to high levels of accuracy on assessment tools that were used successfully in high income countries and have been culturally adapted and found to be feasible for use in LMIC such as Tunisia. Once identified, these young Tunisian individuals will be provided with a non-stigmatizing treatment that is an evidence-based practice (EBP) used in high income countries in the delivery of mental health care. The intervention will consist of computer-based cognitive training which is youth friendly and has been adapted culturally for use with Tunisian youth. This form of cognitive training has been shown to improve cognitive functioning and reduce key symptoms related to impaired functioning. The treatment will be provided in the type of rehabilitation setting which has been shown to increase the likelihood of success. Motivational factors that increase the likelihood of participation will be identified and strengthened. Engaging and improving cognitive performance and daily functioning is the proposed mechanism of action for reducing the rate of conversion to more severe mental illness in these at risk youth. The goal is to reduce the risk of progression to more serious mental illness by improving school, work, and social functioning. These improvements in functioning are aimed at reducing the high level of distress that is invariably experienced by individuals who suffer from difficulties in functioning. In this way, reducing stress and improving cognitive functioning is hypothesized to improve daily functioning and decrease the downward trajectory toward serious mental illness. Reliable and valid measurements that will be repeated over time will be used to evaluate the impact and success of this innovative use of treatment. This study involves strengthening an ongoing collaboration between the Principal Investigator who is a UCLA Research Psychologist and member of the UCLA Department of Psychiatry faculty and professors from the University of Tunis, El Manar who are published researchers and experienced clinicians. The development of this model CHR program in Tunisia that is being proposed will be manualized and disseminated to other Middle East North African (MENA) countries to encourage the use of similar assessment and treatment programs for CHR youth.

简要说明/摘要： 这项研究将使用标准化和行之有效的方法，这些方法已经在文化上适应了早期 突尼斯是一个低风险和高风险国家，对临床高风险 (CHR) 青少年进行检测、识别、评估和治疗 北非的中等收入国家（LMIC）。在 CHR 意味着这些年轻人处于更大的水平 患精神病（一种严重的精神疾病 (SMI)）的风险高于一般人群。本研究提出 使用积极的、教育性的社区外展方法来减少耻辱并增加社区 对旨在早期干预的精神卫生服务的可用性和重要性的认识。这 方法将有助于确定 CHR 中可以接受研究相关治疗服务的个人。 CHR 状态的评估将由受过高准确度培训的临床团队进行 评估工具已在高收入国家成功使用，并已在文化上进行了调整和 发现在突尼斯等中低收入国家使用是可行的。一旦确定身份，这些突尼斯年轻人将被 提供非污名化治疗，这是高收入人群中使用的循证实践 (EBP) 国家提供精神卫生保健。干预措施将包括基于计算机的认知 该培训对青年人友好，并在文化上进行了调整，适合突尼斯青年人使用。这种形式的 认知训练已被证明可以改善认知功能并减少与以下相关的关键症状 功能受损。治疗将在所示的康复环境中提供 以增加成功的可能性。增加参与可能性的动机因素是 确定并加强。参与并改善认知表现和日常功能是 拟议的降低高危人群转化为更严重精神疾病的比率的行动机制 青年。目标是通过改善学校、工作、 和社会功能。这些功能方面的改进旨在减少严重的痛苦， 患有功能障碍的人总是会经历这种情况。这样，减轻压力 假设改善认知功能可以改善日常功能并减少下降 走向严重精神疾病的轨迹。随着时间的推移将重复进行可靠且有效的测量 用于评估这种创新治疗方法的影响和成功。这项研究涉及 加强加州大学洛杉矶分校研究中心首席研究员之间的持续合作 心理学家、加州大学洛杉矶分校精神病学系成员以及加州大学洛杉矶分校教授 突尼斯市的埃尔马纳尔是发表过论文的研究人员和经验丰富的临床医生。该模型的发展 突尼斯正在提议的 CHR 计划将被手动化并传播到其他中东地区 北非 (MENA) 国家鼓励对 CHR 使用类似的评估和治疗计划 青年。