Adaptation of Cognitive Enhancement Therapy for persons at Psychosis High Risk

针对精神病高危人群的认知增强疗法的调整

基本信息

批准号：
8976169
负责人：
MATCHERI S. KESHAVAN
金额：
$ 26.1万
依托单位：
BETH ISRAEL DEACONESS MEDICAL CENTER
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：
2014-12-01 至 2017-11-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8976169
关键词：
Address Adolescent Development Adult Antipsychotic Agents Attention Attenuated Caring Chronic Clinical Cognition Cognitive Therapy Cognitive remediation Communities Data Deterioration Development Dose Early Intervention Family Fatty Acids Focus Groups Goals Health Impaired cognition Impairment Individual Innovative Therapy Intervention Intervention Studies Learning Manuals Memory Meta-Analysis Neuronal Plasticity Omega-3 Fatty Acids Participant Persons Phase Population Prevention approach Procedures Psychopathology Psychotic Disorders Public Health Randomized Controlled Trials Recruitment Activity Research Schizophrenia Speed Supervision Symptoms Techniques Testing Training adverse outcome base clinical practice cognitive disability cognitive enhancement executive function experience functional disability functional outcomes gray matter high risk improved indicated prevention novel open label psychiatric symptom psychosocial social social cognition social situation trait treatment adherence treatment response

项目摘要

DESCRIPTION (provided by applicant): Persons at clinical high risk (CHR) state for psychosis are characterized by attenuated or transient psychotic episodes, trait vulnerability and functional deficits. If untreated, a significant proportion of CHR individuals have adverse outcomes, including conversion to psychosis, other psychopathology and functional deterioration. Despite enhanced CHR research focus over the past decade there are few established prevention approaches. This proposal seeks to develop, evaluate feasibility, acceptability and obtain preliminary data on efficacy of a novel manualized approach for cognitive enhancement, the Cognition for Learning and for Understanding Everyday Social Situations (CLUES) in individuals at clinical high risk (CHR) for psychosis. This approach is based on the principles and approaches of cognitive enhancement therapy (CET), shown by this research group to have efficacy, generalizability to functional outcome, durability and possible neuroprotective effects. In Phase 1 (0-6 months) we will adapt CET techniques to the symptomatic, functional, and developmental features of CHR, train staff and develop assessment procedures and a manual for the CLUES intervention with the help of a focus group and input from an advisory group of experts. In phase 2, using a feasibility trial (n=8) we will assess acceptability, tolerability, treatment adherence, treatment fidelity, and obtain preliminary evidence of target engagement (i.e. change in cognition and social cognition). .In Phase 3 (19-36 months) we will conduct a randomized control trial to generate pilot efficacy, generalization to functional outcome, durability and tolerability data on CLUES in CHR individuals (n=30). These data will serve as a prerequisite to a later, larger-scale intervention study of CLUES in the CHR population.

描述（由申请人提供）：处于精神病临床高风险 (CHR) 状态的人的特点是精神病发作减弱或短暂、特质脆弱性和功能性障碍。如果不进行治疗，很大一部分 CHR 个体会出现不良后果，包括转化为精神病、其他精神病理学和功能恶化。，可接受性并获得关于认知增强的新型手动方法的有效性的初步数据，该方法是在精神病临床高风险（CHR）个体中学习和理解日常社交情境（CLUES）的认知。该研究小组证明认知增强疗法（CET）的原理和方法具有有效性、功能结果的普遍性、持久性和可能的神经保护作用。在第 1 阶段（0-6 个月），我们将根据 CHR 的症状、功能和发育特征调整 CET 技术，在焦点小组的帮助下以及来自专家的意见的帮助下，培训工作人员并制定评估程序和 CLUES 干预手册。在第二阶段，我们将通过可行性试验（n=8）评估可接受性、耐受性、治疗依从性、治疗保真度，并获得目标参与度的初步证据（即认知和社会认知的变化）。第 3 阶段（19-36 个月）我们将进行一项随机对照试验，以生成 CHR 个体 (n=30) 中 CLUES 的试点功效、功能结果概括、耐久性和耐受性数据，这些数据将作为后续的先决条件。，CHR人群中CLUES的更大规模干预研究。