Work Rehabilitation For Older Adults With Schizophrenia

描述（由候选人提供）：这个为期五年的培训奖的主要目标是进一步发展伊丽莎白·特沃姆利博士在以下领域的专业知识：1）精神分裂症和相关疾病患者的工作康复; 2）应用神经心理学研究，重点是神经心理测试表现与日常功能，特别是工作能力之间的关系;以及3）临床试验研究设计、方法学和可用于评估这些关系的统计分析。她的总体职业目标是为严重精神疾病患者的神经心理学和干预研究搭建桥梁。拟议的职业发展计划建立在她的临床心理学博士培训，她在临床神经心理学的专业培训，以及她在神经心理学和精神分裂症的研究背景。拟议的培训计划 将包括结构化的课程和精神病工作康复，神经心理学，老年精神病学和精神分裂症研究领域的专家的定期指导。该培训计划是由一个研究项目，旨在评估工作康复计划的中年和老年人精神分裂症患者的疗效。这些人中很少有人工作，但大约40%的人希望有报酬的工作或志愿工作。一种叫做个性化安置的工作康复 和支持（IPS），这已经取得了年轻人的循证实践的地位，将首次在中年和老年患者的随机对照试验中进行前瞻性研究。回顾性数据比较IPS项目中的老年精神分裂症患者与传统工作康复项目中的老年精神分裂症患者，显示有偿就业率分别为69%和29%。拟议的研究将解决IPS计划对工作活动，精神症状，功能能力和生活质量的差异影响，以及成功工作成果的认知，人口统计和临床预测因素。该研究的结果不仅有助于确定IPS对中老年消费者的疗效，而且有助于阐明这一人群的神经心理学表现、工作相关功能能力和最终工作成果之间的关系。培训和研究计划将使Twamley博士从博士后研究员过渡到UCSD精神病学系的独立研究员，并将为专注于认知和工作康复的研究职业生涯提供基础。

DESCRIPTION (provided by candidate): The primary goal of this five-year training award is to further develop Dr. Elizabeth Twamley's expertise in the following areas: 1) work rehabilitation for individuals with schizophrenia and related disorders; 2) applied neuropsychological research, focusing on the relationships between neuropsychological test performance and everyday functioning, particularly work abilities; and 3) clinical trials research design, methodology, and statistical analysis that can be used to evaluate these relationships. Her overarching career goal is to bridge neuropsychological and interventions research for persons with severe mental illness. The proposed career development plan builds on her doctoral training in clinical psychology, her specialty training in clinical neuropsychology, and her research background in neuropsychology and schizophrenia. The proposed training plan will include structured coursework and regular mentoring from experts in the fields of psychiatric work rehabilitation, neuropsychology, geriatric psychiatry, and schizophrenia research. The training plan is complemented by a research project designed to evaluate the efficacy of a work rehabilitation program for middle-aged and older individuals with schizophrenia. Few of these individuals work, yet about 40% desire paid employment or volunteer work. A type of work rehabilitation called Individualized Placement and Support (IPS), which has achieved the status of evidence-based practice for younger individuals, will be prospectively studied for the first time in a randomized controlled trial for middle-aged and older patients. Retrospective data comparing older schizophrenia patients in IPS programs with those in conventional work rehabilitation programs have shown rates of paid employment to be 69% vs. 29%, respectively. The proposed research will address the IPS program's differential effects on work activity, psychiatric symptoms, functional capacity, and quality of life, as well as cognitive, demographic, and clinical predictors of successful work outcomes. The results of the study will be useful not only in establishing the efficacy of IPS for middle-aged and older consumers, but also in illuminating the relationships between neuropsychological performance, work-related functional capacity, and ultimate work outcomes in this population. Together, the training and research plan will allow Dr. Twamley to transition from a postdoctoral research fellow to an independent investigator in the UCSD Department of Psychiatry, and will provide the foundation for a research career focused on cognition and work rehabilitation for individuals with severe psychiatric disorders.