Adaptation of Cognitive Enhancement Therapy for persons at Psychosis High Risk

 描述(由申请人提供)：处于精神病临床高危状态的人的特征是精神病发作减弱或短暂，性格脆弱和功能 赤字。如果不治疗，相当大比例的慢性阻塞性肺病患者会产生不良后果，包括转化为精神病、其他精神病理学和功能退化。尽管在过去十年中加强了对CHR的研究，但几乎没有既定的预防方法。这项建议旨在开发、评估可行性和可接受性，并获得关于认知增强的新方法的初步数据，该方法是一种用于认知增强的新方法，用于学习和理解日常社交情况(线索)，适用于临床高危精神病患者。这一方法是基于认知增强疗法(CET)的原理和方法，该研究小组表明，CET具有有效性、对功能结果的概括性、持久性和可能的神经保护作用。 在第一阶段(0-6个月)，我们将使CET技术适应CHR的症状、功能和发育特征，培训工作人员，并在焦点小组和专家咨询小组的帮助下制定评估程序和线索干预手册。在第二阶段，使用可行性试验(n=8)，我们将评估可接受性、耐受性、治疗依从性、治疗忠诚度，并获得目标参与的初步证据(即认知和社会认知的变化)。在第三阶段(19-36个月)，我们将进行一项随机对照试验，以产生关于慢性阻塞性肺疾病患者(n=30)线索的飞行员疗效、对功能结果的概化、耐受性和耐受性数据。这些数据将作为以后对CHR人群中的线索进行更大规模的干预性研究的先决条件。

 DESCRIPTION (provided by applicant): Persons at clinical high risk (CHR) state for psychosis are characterized by attenuated or transient psychotic episodes, trait vulnerability and functional deficits. If untreated, a significant proportion of CHR individuals have adverse outcomes, including conversion to psychosis, other psychopathology and functional deterioration. Despite enhanced CHR research focus over the past decade there are few established prevention approaches. This proposal seeks to develop, evaluate feasibility, acceptability and obtain preliminary data on efficacy of a novel manualized approach for cognitive enhancement, the Cognition for Learning and for Understanding Everyday Social Situations (CLUES) in individuals at clinical high risk (CHR) for psychosis. This approach is based on the principles and approaches of cognitive enhancement therapy (CET), shown by this research group to have efficacy, generalizability to functional outcome, durability and possible neuroprotective effects. In Phase 1 (0-6 months) we will adapt CET techniques to the symptomatic, functional, and developmental features of CHR, train staff and develop assessment procedures and a manual for the CLUES intervention with the help of a focus group and input from an advisory group of experts. In phase 2, using a feasibility trial (n=8) we will assess acceptability, tolerability, treatment adherence, treatment fidelity, and obtain preliminary evidence of target engagement (i.e. change in cognition and social cognition). .In Phase 3 (19-36 months) we will conduct a randomized control trial to generate pilot efficacy, generalization to functional outcome, durability and tolerability data on CLUES in CHR individuals (n=30). These data will serve as a prerequisite to a later, larger-scale intervention study of CLUES in the CHR population.