Psychiatric Treatment and Violence Risk Management

精神病治疗和暴力风险管理

• 批准号: 6823536
• 负责人: JEFFREY W SWANSON
• 金额: $ 11.89万
• 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/6823536
• 关键词: antipsychotic agents; behavioral /social science research tag; conflict; disease /disorder proneness /risk; health care service utilization; health related legal; human data; human therapy evaluation; mental disorder chemotherapy; mental disorder prevention; mental health epidemiology; mental health services; piperazines; risperidone; schizophrenia; serotonin inhibitor; socioenvironment; substance abuse related disorder; therapy compliance; thiazoles; violence

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为杰弗里·斯旺森博士提供五年的薪酬支持，以开发和实施一个综合研究项目，以他以前的工作为基础，但纳入新的观点和方法来解决几个相关主题：暴力和精神障碍的流行病学、精神分裂症治疗的有效性、严重精神疾病（SMI）的决策能力丧失以及精神病学预先指示的实施。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一部分严重精神疾病患者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数据来调查在何种程度上，对于一些重度精神障碍患者，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，否则可能会防止暴力行为。第四，斯旺森博士的研究将解决一个新的法律文书的潜在影响-精神病学预先指示(pad)-对暴力和相关结果的严重精神障碍患者有决策能力的风险，使用1-R01-MH63949-01（有效实施精神病学预先指示）的数据。作为他职业发展计划的一部分，Swanson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，这将深化和拓宽他的智力努力：医学人类学和社会医学的Sue Estroff博士；医学心理学，创伤和药物滥用干预的John Fairbank博士；Martha Shumway博士，健康心理学，心理健康治疗结果和偏好测量；以及医学哲学、伦理学和法律精神病学的威廉·温斯莱德博士。拟议的奖项将使斯旺森博士能够将他的研究生涯集中在他最感兴趣的领域，并在未来做出重大贡献；开展一个综合的学术项目，综合他以前工作的发现，并以新的方式解决重要的、相互关联的问题。通过制定更多的r01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，以减少暴力风险并改善重度精神障碍患者的生活质量。