Work Rehabilitation For Older Adults With Schizophrenia

描述(候选人提供)：这个为期五年的培训奖项的主要目标是进一步发展Elizabeth Twamley博士在以下领域的专业知识：1)精神分裂症和相关障碍患者的工作康复；2)应用神经心理学研究，重点研究神经心理测试成绩和日常功能，尤其是工作能力之间的关系；3)可用于评估这些关系的临床试验研究的设计、方法和统计分析。她的首要职业目标是为严重精神疾病患者搭建神经心理学和干预研究之间的桥梁。拟议的职业发展计划基于她在临床心理学方面的博士培训，她在临床神经心理学方面的专业培训，以及她在神经心理学和精神分裂症方面的研究背景。拟议的培训计划 将包括有组织的课程作业和来自精神康复、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。培训计划还得到了一个研究项目的补充，该项目旨在评估针对中老年精神分裂症患者的工作康复计划的效果。这些人中很少有人工作，但约40%的人渴望有报酬的工作或志愿者工作。一种称为个性化安置的工作康复 和支持(IPS)已经达到了针对年轻个体的循证实践的状态，将首次在针对中老年患者的随机对照试验中进行前瞻性研究。对参加IPS计划的老年精神分裂症患者和参加传统工作康复计划的老年精神分裂症患者进行回顾比较的数据显示，有偿就业率分别为69%和29%。这项拟议的研究将解决IPS计划对工作活动、精神症状、功能能力和生活质量的不同影响，以及对成功工作结果的认知、人口统计学和临床预测因素。这项研究的结果不仅有助于确定IPS对中老年消费者的有效性，还将有助于阐明这一人群的神经心理表现、与工作相关的功能能力和最终工作结果之间的关系。培训和研究计划将使特瓦姆利博士从一名博士后研究员转变为加州大学圣地亚哥分校精神病学系的独立研究员，并将为他专注于严重精神障碍患者的认知和工作康复的研究生涯奠定基础。

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.