Modeling mood course to detect markers for effective adaptive interventions

项目摘要 双相(BP)障碍是一种情绪发生深刻变化的慢性病，从躁狂症到抑郁症。BP是 通过药物治疗和心理社会治疗相结合成功治疗，但治疗可能被证明是不够的 练习一下。覆盖范围和药物方面的差距，以及关于何时、何地和如何治疗的不准确指导方针 干预，有希望的心理社会治疗需要适应性战略，以更好地满足 及时为个人服务(NIMH战略2)。然而，要做到这一点，需要以证据为基础。 适应心理社会治疗的实践。这项指导性研究科学家发展奖旨在 通过以下方式解决这一知识鸿沟：(1)建立一个移动健康平台，用于翻译心理社会疗法 在BP中转变为有效的适应性干预措施，以及(2)促进初级研究员的过渡，在 数学和精神病学的接口，转变为有效的适应性干预的独立研究人员。 这项研究工作建立在一个移动健康平台上，该平台结合了基于证据的情绪标记物 通过微随机试验进行长期监测，旨在优化移动健康自适应 干预措施。在目标1中，我们使用建模来刻画和测试新的心境过程标记物 波动性，这是一种掩盖治疗对情绪影响的特征。在目标2中，我们探索了长期 用活动描记中可解释的标志物监测血压。在目标3中，目标1和目标2的最佳实践是 与微随机试验整合为移动健康平台。然后，我们测试使用 将心理社会治疗，临床电话，转化为适应性干预的平台。如果成功，这将是 这项工作将推进候选人的独立目标，即自适应地安排与英国石油公司个人的电话通话。 为了补充研究议程，该奖项将扩大候选人在计算方面的背景 通过在五个战略领域提供培训，将精神病学纳入转化精神病学领域：(1)临床 评估，(2)心理社会治疗，(3)流动卫生干预，(4)适应性临床试验，和(5) 开放存取调度。梅尔文·麦金尼斯博士、托马斯·B和南希·厄普约翰·伍德沃斯双相情感障碍教授 密歇根大学精神病学教授、精神障碍和抑郁症将成为主要导师 并将指导临床方面的培训(培训目标1-3)；艾米·基尔本教授 精神病学和退伍军人事务部/HSR&D质量提高研究计划代理主任将指导培训 应用涉及心理社会治疗的适应性试验设计(培训目标2、4-5)； 赫伯特·E·罗宾斯统计学杰出教授苏珊·墨菲将指导培训进入方法论 用于适应性试验设计和流动保健干预(培训目标3-4)。 拟议的K01奖项承诺培训初级学者，以解决在技术上具有挑战性的问题 心理健康。这项工作与NIH和NIMH提供精确临床护理的使命相一致。

Project Summary Bipolar (BP) disorder is a chronic illness of profound shifts in mood ranging from mania to depression. BP is successfully treated by combining medication with psychosocial therapy, but care can prove inadequate in practice. With gaps in coverage and medication, along with imprecise guidelines on when, where, and how to intervene, promising psychosocial therapies require adaptive strategies to better address the specific needs of individuals in a timely manner (NIMH Strategy 2). To accomplish this, however, requires evidence-based practices for adapting a psychosocial therapy. This Mentored Research Scientist Development Award aims to address this knowledge gap, by (1) establishing a mobile health platform for translating a psychosocial therapy in BP into an effective adaptive intervention and (2) facilitating the transition of a junior researcher, at the interface of mathematics and psychiatry, into an independent researcher of effective adaptive interventions. The research effort is founded on a mobile health platform that combines evidence-based markers of mood for long-term monitoring with a micro-randomized trial, designed for optimizing mobile health adaptive interventions. In Aim 1, we use modeling to characterize and test new markers of mood course that account for volatility, a feature that masks effects of a therapy on mood. In Aim 2, we explore the potential for long-term monitoring of BP with interpretable markers from actigraphy. In Aim 3, best practices from Aim 1 and 2 are integrated with a micro-randomized trial into a mobile health platform. We then test the feasibility of using the platform to translate a psychosocial therapy, clinical phone call, into an adaptive intervention. If successful, this work will advance the Candidate's independent goal of adaptive scheduling of phone-calls with BP individuals. To complement the research agenda, the award will expand the Candidate's background in Computational Psychiatry into the area of Translational Psychiatry by providing training in five strategic areas: (1) clinical assessments, (2) psychosocial therapy, (3) mobile health interventions, (4) adaptive clinical trials, and (5) open-access scheduling. Dr. Melvin McInnis, Thomas B and Nancy Upjohn Woodworth Professor of Bipolar Disorder and Depression and Professor of Psychiatry at the University of Michigan, will be the primary mentor and will guide clinical aspects of the training (Training Objectives 1–3); Dr. Amy Kilbourne, Professor of Psychiatry and Acting Director of VA/HSR&D's Quality Enhancement Research Initiative, will guide training in the application of adaptive trial designs that involve psychosocial therapy (Training Objectives 2,4–5); and Dr. Susan Murphy, Herbert E. Robbins Distinguished Professor of Statistics, will guide training into methodology for adaptive trial design and mobile health interventions (Training Objectives 3–4). The proposed K01 award promises to train a junior scholar to address technically-challenging problems in mental health. This work is aligned with the NIH and NIMH missions of providing precise clinical care.