3/3-Cognitive Behavioral Social Skills Training for Youth at Risk of Psychosis

3/3-针对患有精神病风险的青少年的认知行为社交技能培训

• 批准号: 9107490
• 负责人: KRISTIN S. CADENHEAD
• 金额: $ 46.2万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-09-26 至 2019-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9107490
• 关键词: Address; Adult; Aftercare; Anxiety; Attenuated; Behavioral; Belief; Caring; Clinical; Clinical Treatment; Cognitive; Cognitive Therapy; Collaborations; Communities; Community Practice; Community of Practice; Competence; Data; Data Analyses; Data Collection; Development; Disease; Early Intervention; Early identification; Educational Intervention; Educational process of instructing; Effectiveness; Elements; Enrollment; Frequencies; Genetic Risk; Goals; Health; Health Care Costs; Healthcare Systems; Individual; Intervention; Lead; Legal system; Longitudinal Studies; Matched Group; Mediating; Mediator of activation protein; Mental Depression; Mental Health; Mental disorders; Modeling; Moods; Nature; Neurocognitive Deficit; Participant; Pathologic Processes; Patients; Performance; Placebos; Policies; Prevention; Preventive Intervention; Problem Solving; Process; Productivity; Protocols documentation; Psychosocial Assessment and Care; Psychotic Disorders; Publications; Randomized; Recovery; Research; Research Personnel; Risk; Role; Sample Size; Sampling; Schizophrenia; Severities; Single-Blind Study; Site; Social Functioning; Societies; Structure; Substance abuse problem; Support Groups; Supportive care; Symptoms; Syndrome; Testing; Time; Training; Treatment Effectiveness; Vulnerable Populations; Youth; adverse outcome; arm; base; clinical risk; cognitive skill; cost; effectiveness trial; evidence base; follow-up; functional decline; high risk; improved functioning; improved outcome; insight; meetings; prevent; primary outcome; psychoeducation; psychosocial; psychosocial rehabilitation; secondary outcome; skills training; social; social skills; socioeconomics; symposium; treatment as usual; treatment group; treatment program; young adult

DESCRIPTION (provided by applicant): Schizophrenia and other psychotic disorders are serious and debilitating mental illnesses that incur substantial suffering for patients and major challenges to our health care and legal systems. The prodrome is the period prior to onset of psychosis when functional decline and clinical symptoms gradually emerge. The presence of a clinical high-risk (CHR) syndrome in young adults is associated with heightened risk (25-35%) for the later development of psychosis, and for those who do not necessarily go on to develop a psychotic illness, research has suggested that the majority continue to have fluctuating subthreshold symptoms and poor social and role functioning. There are no specific treatments to help with these functional difficulties. However, recent findings suggest that in people with schizophrenia, Cognitive Behavioral and Social Skills Training (CBSST) leads to significantly greater increase in the frequency of social functioning activities compared to treatment as usual or goal- focused supportive therapy, and preliminary data suggest CBSST is a feasible treatment for CHR. This application is a competitive application for a three-site, longitudinal study aimed at testing the effectiveness and feasibility as well as mediators and mechanisms of action of a manualized CBSST intervention that will target functional difficulties associated with clinical risk states for psychosis. The goals are 1) to examine whether CBSST compared to a placebo intervention (psychoeducation) matched for group involvement and therapist time improves functioning in youth at CHR and 2) to determine whether reduction in defeatist beliefs and improvement in social competence mediate change in psychosocial functioning in CHR youth in the CBSST. In this single-blind randomized 2-arm trial participants will be randomized to one of two treatments: CBSST, an 18-week group comprised of three modules; 1) Cognitive Skills; 2) Social Skills; and 3) Problem Solving, or a psychoeducation support group that does not teach active cognitive behavioral therapy or social skills training. Over a five-year period, te multi-site collaboration will follow large CHR sample that will undergo comprehensive assessments of psychosocial and behavioral changes, to examine changes in social and role functioning, as well as symptom changes from baseline to the end of treatment, and to 6 month follow-up. This approach will demonstrate the feasibility of a treatment for which it is easy to train therapists and which can readily be disseminated to regular clinical community practice. In addition, it will provide insights into likely approaches to halting or mitigating the pathological process and advance our understanding of risk prediction; both critical steps in prevention.

描述（由申请人提供）：精神分裂症和其他精神障碍是严重且使人衰弱的精神疾病，给患者带来巨大痛苦，并对我们的医疗保健和法律体系构成重大挑战。前驱症状是精神病发作前的一段时期，此时功能衰退，临床症状逐渐出现。年轻人中存在临床高危 (CHR) 综合征与后期发展为精神病的风险较高 (25-35%) 相关，研究表明，对于那些不一定会继续发展为精神病的人来说，大多数人仍然存在波动的阈下症状以及较差的社会和角色功能。没有特定的治疗方法可以帮助解决这些功能性困难。然而，最近的研究结果表明，在精神分裂症患者中，与常规治疗或目标导向的支持治疗相比，认知行为和社交技能训练（CBSST）可显着增加社交功能活动的频率，初步数据表明 CBSST 是治疗 CHR 的可行方法。该应用程序是一项三中心纵向研究的竞争性应用程序，旨在测试手动 CBSST 干预的有效性和可行性以及中介和作用机制，该干预将针对与精神病临床风险状态相关的功能困难。目标是 1) 检验与安慰剂干预（心理教育）相比，CBSST 是否与团体参与和治疗时间相匹配，改善了 CHR 青少年的功能；2) 确定失败主义信念的减少和社会能力的提高是否会介导 CBSST 中 CHR 青少年心理社会功能的变化。在这项单盲随机 2 组试验中，参与者将被随机分配接受两种治疗方法之一：CBSST，为期 18 周的组，由三个模块组成； 1）认知能力； 2）社交技能； 3) 问题解决或心理教育支持小组，不教授主动认知行为疗法或社交技能培训。在五年的时间内，多站点合作将跟踪大型 CHR 样本，对社会心理和行为变化进行全面评估，检查社会和角色功能的变化，以及从基线到治疗结束以及 6 个月随访的症状变化。这种方法将证明一种治疗方法的可行性，这种治疗方法很容易培训治疗师，并且可以很容易地传播到常规临床社区实践中。此外，它将提供有关阻止或减轻病理性疾病的可能方法的见解。 处理并增进我们对风险预测的理解；这都是预防的关键步骤。