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Compensatory Cognitive Training in Clinical High Risk Latino Youth

临床高危拉丁裔青少年的补偿性认知训练

基本信息

批准号：
9137719
负责人：
KRISTIN S. CADENHEAD
金额：
$ 20.89万
依托单位：
UNIVERSITY OF CALIFORNIA, SAN DIEGO
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：
2014-09-12 至 2019-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/9137719
关键词：
Activities of Daily Living Adolescent and Young Adult Affect Age Algorithms Area California Caring Child Chronic Chronic Schizophrenia Cities Clinical Clinical Treatment Cognition Cognitive Cognitive remediation Collaborations Communities Community Outreach Comorbidity County Coupled Deterioration Development Disease Doctor of Philosophy Double-Blind Method Early identification Ethics Evaluation Family history of Funding Grant Individual Institutes Intervention Laboratories Latino Measures Mediator of activation protein Mental Health Services Methodology Mexican Americans Mexico Minority Neurocognition Neurocognitive Neurocognitive Deficit Outcome Measure Patient Self-Report Patients Performance Persons Phase Population Preparation Prevention Psychotic Disorders Public Health Quality Control Randomized Randomized Clinical Trials Randomized Controlled Trials Recruitment Activity Rehabilitation therapy Research Risk Sampling Schizophrenia Schools Severities Site Special Equipment Symptoms Syndrome Time Training Training Technics Translating Underserved Population United States Universities Work Youth base clinical risk cognitive enhancement cognitive training disability first episode psychosis follow-up functional outcomes functional status help-seeking behavior high risk high risk population improved indexing individualized medicine interest neuroprotection novel prevent primary outcome programs psychotic symptoms public health relevance response secondary outcome skills therapy development treatment response trial design

项目摘要

DESCRIPTION (provided by applicant): An increasing emphasis in the development of treatments for psychotic illness, especially in early stages, has been in the area of cognitive enhancement, neuroprotection and cognitive remediation. Individuals at Clinical High Risk (CHR) develop a psychotic illness at rates between 20-40% over a 1-2 year period but the majority have neurocognitive and functional deficits whether they develop psychosis or not. Neurocognitive deficits predict a later psychotic illness and also poor functional status at follow up. By intervening early in the course of psychosis to target neurocognitive deficits, it might be possible to affect the functional outcome of this devastating disease. The proposed R34 Application, in response to RFA-MH-14-212 - Research to Improve the Care of Persons at Clinical High Risk for Psychotic Disorders, will assess Compensatory Cognitive Training (CCT) versus Recreational Training (RT) in Latino Clinical High Risk (CHR) subjects in the US and Mexico. Although CCT has been studied extensively in chronic psychotic illness, demonstrating moderate to large effect sizes on neurocognitive domains and functional capacity, it has never been studied in CHR subjects. In a 12 week randomized clinical trial design, 120 CHR Latino subjects will be randomized by groups into CCT or RT. Subjects will be assessed 4 times, at the beginning and end of the study, and at intermediary monthly intervals. The Specific Aims are to 1) Compare CCT augmentation versus RT on Primary Neurocognitive (Global Cognitive Index) and Functional Capacity (UCSD Performance-based Skill Assessment - UPSA) measures and Secondary Self-Rated Functioning (Specific Level of Functioning) and Clinical Symptom (Scale of Prodromal Syndromes - SOPS) measures; 2) Explore predictors (moderators) of treatment response (eg, age, baseline symptoms, neurocognition) and 3) explore mediators of treatment response (change in neurocognition and functioning). Also unique to this proposal will be the focus on Latino subjects at CHR for psychosis. The Latino community is underserved yet represents 55% of school children in San Diego county. The inclusion of a Mexico City site will enable an accelerated recruitment, given their access to large numbers of early psychosis subjects, increase sample diversity and minority representation by including large numbers of Latino subjects and assist in the implementation of a Spanish version of CCT. The laboratories of Kristin Cadenhead, MD, at University of California San Diego (UCSD) and Camilo de la Fuente MD, PhD, from the Laboratorio de Psiquiatr�a Experimental, Instituto Nacional de Neurolog�a y Neurocirug�a (INNN), Mexico City, have an existing collaborative relationship, funded by grants through the University of California Institute for Mexico and the United States (UC MEXUS), that allowed establishment of comparability of early psychosis populations across sites and implementation of reliability and quality control methodology in preparation for the proposed study.

描述（由申请人提供）：精神疾病治疗的发展越来越受到重视，特别是在早期阶段，已经在认知增强，神经保护和认知补救领域。临床高危人群（CHR）在1-2年内发展为精神病的比率在20-40%之间，但无论他们是否发展为精神病，大多数人都有神经认知和功能缺陷。神经认知缺陷预示着以后的精神疾病和随后的不良功能状态