Psychiatric Treatment and Violence Risk Management

精神病治疗和暴力风险管理

• 批准号: 7276126
• 负责人: JEFFREY W SWANSON
• 金额: $ 12.57万
• 依托单位: DUKE UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-09-02 至 2009-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7276126
• 关键词: Address; Adherence; Advance Directives; Affect; Anthropology; Antipsychotic Agents; Area; Assaultive Behavior; Award; Behavior; Caring; Categories; Classification; Clinical; Clozapine; Communities; Condition; Conflict (Psychology); Data; Data Set; Databases; Development Plans; Disadvantaged; Discipline; Economics; Effectiveness; Effectiveness of Interventions; Environmental Risk Factor; Epidemiology; Ethics; Exposure to; Face; Frequencies; Future; Generations; Health Psychology; Independent Scientist Award; Intervention; Intervention Trial; Lead; Legal; Letters; Measurement; Medical; Medical Philosophy; Medical Psychology; Mental Health; Mental disorders; Methods; National Institute of Mental Health; Outcome; Pathway interactions; Patients; Pattern; Perphenazine; Persons; Pharmaceutical Preparations; Policies; Population; Poverty; Psychiatric therapeutic procedure; Psychiatry; Psychopathology; Published Comment; Quality of life; Rate; Recording of previous events; Relapse; Relative (related person); Research; Research Methodology; Risk; Risk Assessment; Risk Factors; Risk Management; Risperidone; Role; Schizophrenia; Scholarship; Severities; Social Environment; Social Medicine; Subgroup; Substance abuse problem; Symptoms; Testing; Theoretical model; Therapeutic; Trauma; Treatment Effectiveness; Treatment outcome; Typology; Victimization; Violence; Wages; Work; atypical antipsychotic; base; career; clinical effect; comparative; effectiveness trial; improved; insight; instrument; interest; novel; olanzapine; preference; prevent; programs; severe mental illness; social; treatment effect; ziprasidone

DESCRIPTION (provided by applicant): The proposed Independent Scientist Award provides five years of salary support for Dr. Jeffrey Swanson to develop and carry out an integrated program of research, building on his previous work but incorporating new perspectives and methods to address several related topics: epidemiology of violence and psychiatric disorder, schizophrenia treatment effectiveness, decisional incapacity in severe mental illness (SMI), and implementation of psychiatric advance directives. First, he will conduct systematic comparative analysis of several datasets to provide a better understanding of the multifaceted problem of violent behavior that affects a proportion of persons with severe mental illness in the community. Second, he will use new data from the NIMH Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) to examine and compare the effects of treatment with specific antipsychotic medications on violence risk in persons with schizophrenia. Third, he will use CATIE data to investigate the extent to which, for some persons with SMI, fluctuating insight into illness and decisional incapacity may limit access to effective treatment that might otherwise prevent violent behavior. Fourth, Dr. Swanson's research will address the potential impact of a new legal instrument--psychiatric advance directives (PADs)--on violence and related outcomes for persons with SMI at risk of decisional incapacity, using data from 1-R01-MH63949-01 (Effectively Implementing Psychiatric Advance Directives.) As part of his career development plan, Dr. Swanson also proposes to work with experts in several disciplines to develop a theoretical model of violence, mental disorder, and treatment effectiveness. These experts will bring novel viewpoints and methods that will both deepen and broaden his intellectual endeavors: Dr. Sue Estroff in medical anthropology and social medicine; Dr. John Fairbank in medical psychology, trauma and substance abuse interventions; Dr. Martha Shumway in health psychology, mental health treatment outcomes and preferences measurement; and Dr. William Winslade in medical philosophy, ethics, and legal psychiatry. The proposed award will enable Dr. Swanson to concentrate his research career in the areas of his greatest interest and potential to make a significant contribution in the future; to conduct an integrated program of scholarship, synthesizing findings from his previous work and addressing important, inter-connected questions in new ways. Through additional R01-fundable projects to be developed, this work will lead eventually to better-targeted interventions and policies for reducing violence risk and improving quality of life for persons with SMI.

描述（由申请人提供）：拟议的独立科学家奖提供五年的工资支持博士杰弗里斯旺森开发和开展研究的综合计划，建立在他以前的工作，但纳入新的观点和方法，以解决几个相关的主题：暴力和精神障碍的流行病学，精神分裂症治疗效果，严重精神疾病中的决策能力（SMI），和精神病预先指示的实施。首先，他将对几个数据集进行系统的比较分析，以更好地了解影响社区中严重精神疾病患者比例的暴力行为的多方面问题。其次，他将使用NIMH临床抗精神病药物干预有效性试验（CATIE）的新数据来检查和比较特定抗精神病药物治疗对精神分裂症患者暴力风险的影响。第三，他将使用CATIE数据来调查对于一些患有SMI的人来说，对疾病和决策能力的波动洞察力可能会限制获得有效治疗的程度，否则可能会防止暴力行为。Swanson博士的研究将探讨一种新的法律的工具-精神病学预先指令（PAD）-对有决策能力风险的SMI患者的暴力和相关结果的潜在影响，使用1-R 01-MH 63949 -01（有效实施精神病学预先指令）的数据。作为他职业发展计划的一部分，斯旺森博士还建议与多个学科的专家合作，开发暴力、精神障碍和治疗效果的理论模型。这些专家将带来新颖的观点和方法，这将深化和扩大他的智力努力：医学人类学和社会医学的苏·埃斯特罗夫博士;医学心理学，创伤和药物滥用干预的约翰·费尔班克博士;健康心理学，心理健康治疗结果和偏好测量的玛莎·沙姆韦博士;和医学哲学，伦理学和法律的精神病学的威廉·温斯莱德博士。斯旺森集中在他最感兴趣的领域，并有潜力在未来做出重大贡献他的研究生涯;进行奖学金的综合计划，从他以前的工作和解决重要的研究结果，以新的方式相互关联的问题。通过制定更多的R 01资助项目，这项工作将最终导致更有针对性的干预措施和政策，以减少暴力风险和改善重度精神创伤患者的生活质量。