Coping, Community Functioning and Severe Mental Illness

描述（由申请人提供）：候选人正在申请为期五年的辅导病人导向职业发展奖（K23）项目的资助，以提高他在精神卫生服务研究方面的方法技能，特别是更好地研究被诊断患有严重精神疾病的人的应对和功能结果之间的关系。最终目标是从行为科学文献中发展评估应对的创新方法的专业知识，并利用这些专业知识进行临床相关研究，以增强关于严重精神疾病患者应对努力与社区功能之间关系本质的现有知识基础。候选人在这一人群的强大临床背景和在其中应对研究的研究背景为这项工作提供了良好的基础。建议的培训目标包括提高以下技能：1)定性访谈和事件结构数据分析；2)日常过程评估方法；3)多层次建模统计分析；4)临床结果研究和精神病学评级评估方法；5)应对理论。这些培训活动将使候选人能够在今后的工作中纳入方法学和统计方面的进展，以便更好地了解诊断患有严重精神疾病的人使用应对策略与社区功能之间关系的性质。该奖项的研究计划分为两项探索性研究，这两项研究将通过确定其可行性和为RO1申请进行更大规模研究奠定基础来补充拟议的培训活动。在第一项研究中，候选人将在两个时间点对30名被诊断患有严重精神疾病的人进行密集的临床和定性访谈：在开始参加专业和消费者经营的疾病自我管理计划之前，以及6个月后。将使用事件结构分析来分析两轮访谈的叙事数据，以将用于特定社区功能结果的应对策略的类型和顺序联系起来。在第二项研究中，同样的参与者将在参加疾病自我管理小组的两段不同的14天时间内完成对症状、应对策略和社会功能行为的每日自我评估。这些数据将使用多层次建模方法进行分析，并将为第一次研究的回顾性数据提供重要补充。

DESCRIPTION (provided by applicant): The candidate is requesting five years of funding through the Mentored Patient-Oriented Career Development Award (K23) program to improve his methodological skills in mental health services research, specifically to better study the relationship between coping and functional outcomes among persons diagnosed with severe mental illness. The ultimate goal is to develop expertise in innovative methods of assessing coping from the behavioral science literature, and to use this expertise to conduct clinically relevant research that will enhance the existing knowledge base on the nature of the relationship between coping efforts and community functioning of persons diagnosed with severe mental illness. The candidate's strong clinical background with this population and research background in the study of coping within it provide an excellent foundation for this work. The proposed training goals include enhanced skills in: 1) qualitative interviewing and event-structure data analysis, 2) daily process assessment methods, 3) multilevel modeling statistical analysis, 4) clinical outcomes research and psychiatric rating assessment approaches, and 5) coping theory. These training activities will allow the candidate to incorporate methodological and statistical advances to better understand the nature of the relationship between the use of coping strategies and community functioning among persons diagnosed with severe mental illness in his future work. The research plan for this award is divided into two exploratory studies that will complement the proposed training activities by establishing their feasibility and laying the groundwork for an RO1 application to conduct a larger study. In the first study, the candidate will conduct intensive clinical and qualitative interviews with a sample of 30 persons diagnosed with severe mental illness at two points in time: just before beginning participation in professional and consumer-run illness self-management programs, and 6 months later. Narrative data from both rounds of interviews will be analyzed using event-structure analysis to relate types and sequences of coping strategies used to specific community functioning outcomes. In the second study, the same participants will complete daily self-assessments of symptoms, coping strategies, and social functioning behavior for two separate periods of 14 days as they participate in the illness self-management groups. This data will be analyzed using multilevel modeling approaches and will provide a crucial adjunct to the retrospective data from the first study.