Efficacy of a novel, accessible, transdiagnostic, compassion-focused ecological momentary intervention for enhancing resilience in help-seeking youth

一种新颖的、易于使用的、跨诊断的、以同情心为中心的生态瞬时干预对于增强寻求帮助的青少年的复原力的功效

• 批准号: 389626655
• 负责人: Professor Dr. Ulrich Reininghaus
• 金额: --
• 依托单位: Abteilung Public Mental Health
• 依托单位国家: 德国
• 项目类别: Research Grants
• 财政年份: 2017
• 资助国家: 德国
• 起止时间: 2016-12-31 至 2020-12-31
• 项目状态: 已结题
• 来源: https://gepris.dfg.de/gepris/projekt/389626655?language=en
• 关键词: Efficacy; novel; accessible; transdiagnostic; compassion

Most mental disorders first emerge in youth and, as such, contribute substantially to global disease burden. In recent years, this has become particularly evident for psychotic disorders, for which risk manifests already at a developmentally earlier stage in the form of subclinical psychotic experiences. Contemporary research further suggests that subclinical psychotic experiences often co-occur with anxiety, depression and mania, reflecting a transdiagnostic phenotype associated with a range of subsequent psychopathological outcomes. Elevated stress sensitivity is one of the most widely studied psychological mechanism underlying psychotic and affective mental health problems. Thus, screening for, and targeting stress sensitivity as an underlying mechanism of, this transdiagnostic phenotype in youth is a promising indicated and translational strategy for preventing adverse outcomes later in life. Psychological help, however, remains difficult to access for youth and has limited efficacy under real-world conditions, calling for novel approaches. Compassion-Focused Interventions (CFIs) offer a wide range of innovative therapeutic techniques for targeting stress sensitivity and enhancing emotional resilience in psychosis, especially when co-occurring with affective disturbances. What is more, the recent rapid technological advances provide a unique opportunity to deliver youth-friendly, accessible, personalized, real-time, mobile health (mHealth) interventions, most prominently, ecological momentary interventions (EMIs) that enable youth to access interventions that are tailored to what a young person needs in a given moment and context in daily life. EMIs further allow for investigating several causal criteria of candidate underlying psychological mechanisms, but robust, trial-based evidence on these interventions remains very limited. The proposed research aims to examine the efficacy and clinical feasibility of a novel, accessible, transdiagnostic, ecological momentary, compassion-focused intervention for improving emotional resilience to stress (EMOCOMPASS) in help-seeking youth. In an exploratory randomized controlled trial, youth aged 12-25 with psychotic, depressive, anxiety, and/or manic symptoms presenting to mental health services of the Central Institute of Mental Health, Mannheim, will be randomly allocated to the EMOCOMPASS intervention in addition to treatment as usual (TAU) (experimental condition) or a control condition of TAU only. Stress sensitivity, emotional resilience, psychotic, depressive, anxiety and manic symptoms will be the primary outcomes obtained at baseline, post-intervention, and 4-week follow-up. Ecological interventionist causal models will be tested to improve our understanding of several causal criteria of underlying psychological mechanisms and contribute to enhancing efficacy of mHealth interventions for promoting resilience in youth, with the ultimate goal of preventing adverse outcomes later in life.

大多数精神障碍首先出现在青年人中，因此大大加重了全球疾病负担。近年来，这一点在精神障碍中变得尤为明显，因为这种风险已经在发展的早期阶段以亚临床精神病经历的形式表现出来。当代研究进一步表明，亚临床精神病经历往往与焦虑，抑郁和躁狂症共同发生，反映了与一系列后续精神病理学结果相关的转诊断表型。应激敏感性升高是精神病性和情感性心理健康问题的潜在心理机制之一。因此，筛选和靶向应激敏感性作为青年中这种转诊断表型的潜在机制，是预防以后生活中不良后果的有希望的指示和转化策略。然而，青年人仍然难以获得心理帮助，而且在现实条件下效果有限，需要采取新的方法。同情为重点的干预（CFIs）提供了广泛的创新治疗技术，以针对精神病的压力敏感性和增强情绪弹性，特别是当与情感障碍同时发生时。此外，最近技术的迅速进步提供了一个独特的机会，可以提供方便青年、方便使用、个性化、实时、移动的保健干预措施，最突出的是生态瞬时干预措施，使青年能够获得针对青年人在特定时刻和日常生活背景下的需要的干预措施。 EMIs还允许调查候选潜在心理机制的几个因果标准，但这些干预措施的可靠的，基于试验的证据仍然非常有限。拟议的研究旨在研究一种新颖的，可访问的，transdiagnosis的，生态瞬时的，同情为重点的干预措施，以提高寻求帮助的青少年的情绪弹性压力（EMOCOMPASS）的有效性和临床可行性。在一项探索性随机对照试验中，在曼海姆中央精神卫生研究所精神卫生服务中心就诊的12-25岁患有精神病、抑郁、焦虑和/或躁狂症状的青年将被随机分配至EMOCOMPASS干预组，除常规治疗（TAU）（实验条件）或仅TAU对照条件外。压力敏感性、情绪弹性、精神病性、抑郁、焦虑和躁狂症状将是基线、干预后和4周随访时获得的主要结局。生态干预因果模型将进行测试，以提高我们对潜在心理机制的几个因果标准的理解，并有助于提高移动健康干预措施的有效性，以促进青年的复原力，最终目标是防止以后生活中的不良后果。