Characterization of Variability in Motivation and Reward in Psychosis

精神病动机和奖励变异性的表征

• 批准号: 9314825
• 负责人: KATHRYN Eve LEWANDOWSKI
• 金额: $ 20.25万
• 依托单位: MCLEAN HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2017
• 资助国家: 美国
• 起止时间: 2017-06-01 至 2019-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9314825
• 关键词: Anhedonia; Behavior Therapy; Behavioral Paradigm; Biological; Characteristics; Chronic; Clinical; Cluster Analysis; Cognition; Cognitive; Cognitive remediation; Communities; Data; Decision Making; Development; Diagnosis; Diagnostic; Dimensions; Disease; Executive Dysfunction; Exhibits; Functional disorder; Gold; Grouping; Impairment; Intervention; Interview; Learning; Linear Regressions; Maps; Measurable; Measures; Modeling; Motivation; National Institute of Mental Health; Nature; Neurobiology; Outcome; Outcome Measure; Patient Self-Report; Patients; Performance; Positioning Attribute; Positive Valence; Principal Component Analysis; Process; Psychotic Disorders; Research; Research Domain Criteria; Research Personnel; Research Project Grants; Rewards; Role; Sampling; Schizophrenia; Structure; Symptoms; Syndrome; System; Techniques; Testing; Treatment Efficacy; Treatment outcome; Validation; Work; affective psychoses; anxiety symptoms; base; career; clinical diagnostics; cognitive function; disability; disabling symptom; effective intervention; improved; improved functioning; improved outcome; interest; mood symptom; motivated behavior; neurobiological mechanism; profiles in patients; programs; response; therapeutic target; therapy development; therapy outcome; trait; treatment adherence; treatment response; young adult

Project Summary/Abstract This is an NIMH Exploratory/Developmental Research Grant Program (R21) proposal entitled, “Characterization of Variability in Motivation and Reward in Psychosis.” Motivational deficits are a hallmark of schizophrenia and related disorders and are associated with poor community outcomes and reduced treatment adherence and efficacy during behavioral interventions such as cognitive remediation. Motivation and reward are not unitary constructs but are comprised of measurable and separable domains, as delineated in the RDoC Positive Valence Systems Domain, which may be differentially associated with illness traits, outcomes, and treatment response. However, characterization of dysfunction across the PVS domain using multiple measures across units of analysis has not been undertaken in psychosis, and whether profiles of deficits emerge and are differentially associated with clinical and community functioning or predictive of treatment outcomes has not yet been tested. In the present proposal we aim to measure multiple constructs across the PVS Domain using a multivariate battery across units of analysis in a cross-diagnostic sample of patients with psychosis (n=200) and healthy controls (n=50), and examine the structure of this domain using principal components analysis. We will use emergent factors to then a) examine associations between factors and clinical, cognitive, and community functioning measures, and with motivated behaviors using validation measures; and b) identify groups of patients who share similar PVS factor profiles using cluster analysis. Similar approaches have successfully uncovered meaningful groupings previously obscured by group-level means comparisons (5, 8) using such techniques, permitting the examination of profiles of patients along constructs of interest map more closely to outcomes and neurobiological correlates than do heterogeneous groupings like diagnosis (6,7). Findings from this project will position us to examine biological mechanisms that underpin these factors (3), and – critically – guide treatment efforts toward targeting these specific processes in our ongoing program of research. The PI is an early stage investigator and K23 Awardee with a career focus on characterization of the nature and course of multidimensional symptom domains such as cognition and PVS symptoms across the psychosis spectrum, and treatments such as cognitive remediation to target these deficits.

项目概要/摘要 这是 NIMH 探索性/发展性研究资助计划 (R21) 提案，题为： “精神病中动机和奖励的变异性特征。”动机不足是一个标志 精神分裂症和相关疾病，与社区结果不佳和治疗减少有关 认知矫正等行为干预期间的依从性和有效性。动机和奖励 不是单一结构，而是由可测量和可分离的域组成，如 RDoC 中所述 正价系统域，可能与疾病特征、结果和 治疗反应。然而，使用多种措施来表征整个 PVS 域的功能障碍 尚未对精神病进行跨单位的分析，以及缺陷的概况是否出现并正在发生 与临床和社区功能的差异相关或治疗结果的预测尚未 经测试。 在本提案中，我们的目标是使用 精神病患者交叉诊断样本中跨分析单元的多变量组合 (n=200) 和健康对照 (n=50)，并使用主体检查该域的结构 成分分析。我们将使用紧急因素 a) 检查因素和 临床、认知和社区功能测量，以及使用验证的动机行为 措施； b) 使用聚类分析确定具有相似 PVS 因素特征的患者组。 类似的方法已经成功地发现了以前被组级别掩盖的有意义的分组 意味着使用此类技术进行比较 (5, 8)，允许检查患者的概况 与异质性相比，感兴趣的构建更接近结果和神经生物学相关性 分组如诊断 (6,7)。该项目的研究结果将使我们能够研究生物机制 支撑这些因素 (3)，并且至关重要的是，指导治疗工作针对这些特定过程 我们正在进行的研究计划。 PI 是一名早期研究员和 K23 获奖者，其职业重点是 多维症状域（例如认知和 PVS）的性质和过程的表征 整个精神病谱系的症状，以及针对这些症状的认知疗法等治疗方法 赤字。