Enhancing Psychosis Risk Prediction Through Computational Cognitive Neuroscience.
Enhancing Psychosis Risk Prediction Through Computational Cognitive Neuroscience.
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DOI：
10.1093/schbul/sbaa091
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发表时间：
2020-12-01
影响因子：
6.6
通讯作者：
Mittal VA
中科院分区：
文献类型：
--
作者：
Gold JM;Corlett PR;Strauss GP;Schiffman J;Ellman LM;Walker EF;Powers AR;Woods SW;Waltz JA;Silverstein SM;Mittal VA
研究表明，对精神病临床高危（CHR）个体进行早期识别和干预可能能够改善病程。第一代研究表明，通过专门访谈评估减轻的精神病症状来识别 CHR 是探索与疾病进展、病因学相关的机制和确定新治疗目标的一种有前景的策略。关于精神病风险的下一代研究必须解决两个主要局限性：(1) 访谈方法的特异性有限，因为最近的估计表明，只有 15%–30% 被确定为 CHR 的个体会转变为精神病；(2) 只有少数学术中心才能获得进行 CHR 诊断所需的专业知识。在这里，我们引入了一种新的 CHR 评估方法，该方法有可能提高可及性和阳性预测价值。临床和计算认知神经科学的最新进展产生了新的行为测量，这些测量方法可以分析构成精神障碍特征的积极、消极和紊乱症状的认知机制和神经系统。我们假设，与症状产生相关的措施将导致相对于访谈方法和迄今为止研究的认知中间表型测量的敏感性和特异性增强，这些方法和认知中间表型测量通常是特质脆弱性的指标，因此转化为精神病的假阳性率很高。这些新的行为测量有可能以最低的成本在互联网上实施，从而提高评估的可及性。
Research suggests that early identification and intervention with individuals at clinical high risk (CHR) for psychosis may be able to improve the course of illness. The first generation of studies suggested that the identification of CHR through the use of specialized interviews evaluating attenuated psychosis symptoms is a promising strategy for exploring mechanisms associated with illness progression, etiology, and identifying new treatment targets. The next generation of research on psychosis risk must address two major limitations: (1) interview methods have limited specificity, as recent estimates indicate that only 15%–30% of individuals identified as CHR convert to psychosis and (2) the expertise needed to make CHR diagnosis is only accessible in a handful of academic centers. Here, we introduce a new approach to CHR assessment that has the potential to increase accessibility and positive predictive value. Recent advances in clinical and computational cognitive neuroscience have generated new behavioral measures that assay the cognitive mechanisms and neural systems that underlie the positive, negative, and disorganization symptoms that are characteristic of psychotic disorders. We hypothesize that measures tied to symptom generation will lead to enhanced sensitivity and specificity relative to interview methods and the cognitive intermediate phenotype measures that have been studied to date that are typically indicators of trait vulnerability and, therefore, have a high false positive rate for conversion to psychosis. These new behavioral measures have the potential to be implemented on the internet and at minimal expense, thereby increasing accessibility of assessments.
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影响因子：
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