Cognitive Training vs. Treatment as Usual to Improve Functioning and Reduce Transition Rates in Tunisian CHR Youth: A Feasibility Study

简要说明/摘要： 这项研究将使用标准化和成熟的方法，这些方法已经在文化上适应了早期 突尼斯临床高危(CHR)青年的检测、识别、评估和治疗 北非的中等收入国家。在CHR意味着这些年轻人在更大的 患精神病的风险高于普通人群，这是一种严重的精神疾病(SMI)。这项研究提出 使用积极的、教育的、社区外展的方法来减少污名和增加社区 对旨在进行早期干预的心理健康服务的可获得性和重要性的认识。这 该方法将有助于在中国研究中心确定哪些人可以接受与学习有关的治疗服务。 CHR状态的评估将由经过高水平培训的临床团队执行 在高收入国家成功使用并经过文化调整的评估工具 发现在突尼斯等LMIC中使用是可行的。一旦确认身份，这些年轻的突尼斯人将被 提供非污名化治疗，这是一种基于证据的做法(EBP)，用于高收入 各国在提供精神卫生保健方面的合作。干预将包括基于计算机的认知 培训对青年友好，并在文化上进行了调整，以供突尼斯青年使用。这种形式的 认知训练已被证明可以改善认知功能，并减少与 功能受损。治疗将在已显示的康复环境类型中提供 以增加成功的可能性。增加参与可能性的激励因素将是 识别和加强。参与和改善认知表现和日常功能是 建议的行动机制，以降低这些高危人群转向更严重精神疾病的比率 青春年华。目标是通过改善学校，工作， 和社交功能。这些功能上的改善旨在减少高度的痛苦， 患有功能障碍的人总是会经历这种情况。通过这种方式，减轻压力 而改善认知功能被认为是为了改善日常功能，减少 会导致严重的精神疾病。将随着时间的推移重复进行的可靠和有效的测量将 用于评估这一创新治疗方法的影响和成功。这项研究涉及 加强加州大学洛杉矶分校首席研究员之间的持续合作 心理学家，加州大学洛杉矶分校精神病学系成员 突尼斯，El Manar，他们是出版的研究人员和经验丰富的临床医生。这一模式的发展 正在提议的突尼斯CHR计划将被手册化并传播到其他中东地区 北非(中东和北非)国家鼓励使用类似的评估和治疗方案 青春年华。

Brief Description / Abstract: This study will use standardized and well-established approaches that have been culturally adapted for early detection, identification, assessment, and treatment of Clinical High Risk (CHR) youth in Tunisia, a low- and middle-income country (LMIC) in North Africa. Being at CHR means that these are young people are at greater risk than the general population for developing psychosis, a serious mental illness (SMI). This study proposes to use an active, educational, community outreach approach to reduce both stigma and increase community awareness about the availability and importance of mental health services aimed at early intervention. This approach will aid in the identification of individuals at CHR who can receive study related treatment services. Assessment of the CHR state will be performed by a clinical team trained to high levels of accuracy on assessment tools that were used successfully in high income countries and have been culturally adapted and found to be feasible for use in LMIC such as Tunisia. Once identified, these young Tunisian individuals will be provided with a non-stigmatizing treatment that is an evidence-based practice (EBP) used in high income countries in the delivery of mental health care. The intervention will consist of computer-based cognitive training which is youth friendly and has been adapted culturally for use with Tunisian youth. This form of cognitive training has been shown to improve cognitive functioning and reduce key symptoms related to impaired functioning. The treatment will be provided in the type of rehabilitation setting which has been shown to increase the likelihood of success. Motivational factors that increase the likelihood of participation will be identified and strengthened. Engaging and improving cognitive performance and daily functioning is the proposed mechanism of action for reducing the rate of conversion to more severe mental illness in these at risk youth. The goal is to reduce the risk of progression to more serious mental illness by improving school, work, and social functioning. These improvements in functioning are aimed at reducing the high level of distress that is invariably experienced by individuals who suffer from difficulties in functioning. In this way, reducing stress and improving cognitive functioning is hypothesized to improve daily functioning and decrease the downward trajectory toward serious mental illness. Reliable and valid measurements that will be repeated over time will be used to evaluate the impact and success of this innovative use of treatment. This study involves strengthening an ongoing collaboration between the Principal Investigator who is a UCLA Research Psychologist and member of the UCLA Department of Psychiatry faculty and professors from the University of Tunis, El Manar who are published researchers and experienced clinicians. The development of this model CHR program in Tunisia that is being proposed will be manualized and disseminated to other Middle East North African (MENA) countries to encourage the use of similar assessment and treatment programs for CHR youth.