Project 5 ACISR

在过去的几年里，越来越明显的是，预防与精神分裂症相关的功能障碍与治疗明显的精神病一样重要。在许多精神分裂症患者中，日常功能障碍往往是严重的，治疗困难，无论药物控制精神病的效果如何，都会限制康复。对成人慢性精神分裂症的研究表明，神经心理功能障碍和阴性症状与功能结果的关系比阳性症状更直接，而且功能可以分为能力和现实世界成就(Green等人。1996、2000、2004；Harvey等人。2009年)。在提议的方法改进中 在这个项目中，我们的目标是开发一种多维功能电池，专门适合处于精神病前驱或非常早期阶段的年轻人(从青少年到年轻人)。该小组将包括五项衡量标准，两项衡量社会和角色成就的全球访谈，以及三项衡量社会/角色能力和新出现的残疾情况的自我报告或计算机化评估。这五项措施正处于不同的发展阶段，其中两项全球访谈迄今得到了最广泛的验证(Auther等人。2006年；Cornblatt等人。2007a；Cannon等人。2008年；另见临床评估战略股)。《公约》的总体目标 目前的项目将以三种方式验证这些措施，评估：1)这些措施在多大程度上反映了“真实世界”的功能；2)这些措施是否对疾病状况敏感；3)与认知的关系。在横断面数据收集作为该项目的一部分之后，计划使用R01来前瞻性地研究纵向数据中的发育轨迹。该项目的具体目标包括： 1.确定拟议测试组合中所有五项措施的心理测量学特性，包括： A.评分者间的可靠性； B.五种测试之间的相互关系，以确定融合效度以及在功能成就和能力之间可以进行有效区分的程度； C.构建效度，即基于家长、教师和成绩单提供的信息，这些措施在多大程度上反映了现实世界的运作； D.所有措施的年龄和性别标准。 2.评估功能组合的敏感性，即这些指标系统地区分前驱受试者和健康对照的程度。一旦疾病前的缺陷被可靠地证明，最终的电池可以被引入到更大的未来研究中，确定这些评估的发展进程和预测价值。 3.评估功能缺陷与神经认知异常之间的关系，采用Matrics成套测验(参见。临床评估战略股和生物标志物股)。

Over the past several years, it has become increasingly apparent that prevention of the functional disability associated with schizophrenia is as important as the treatment of overt psychosis. In many patients with schizophrenia, disability in every day functioning is often profound and treatment resistant, limiting recovery regardless of how well psychosis is controlled with medication. Research in adults with chronic schizophrenia has indicated that neuropsychological dysfunction and negative symptoms are more directly related to functional outcome than are positive symptoms, and that function can be separated into capacity and real-world achievement (Green et al. 1996, 2000, 2004; Harvey et al. 2009). In the proposed method advancement project, we aim to develop a multi-dimensional functional battery specifically suited to young (adolescent to young adult) individuals in the prodromal or very early stages of psychosis. The battery will consist of five measures, two global interviews measuring social and role achievement and three self-report or computerized assessments measuring social/role capacity and emerging disability. The five measures are in various stages of development, with the two global interviews most extensively validated thus far (Auther et al. 2006; Cornblatt et al. 2007a; Cannon et al. 2008; see also Clinical Assessment Strategies Unit). The overall goals of the current project are to validate these measures in three ways, by assessing: 1) the extent to which these measures reflect "real world" functioning; 2) whether these are sensitive to illness status; 3) relationship to cognition. Following cross-sectional data collection as part of this project, an R01 is planned to prospectively investigate developmental trajectories in longitudinal data. Specific aims for this project include: 1. To establish the psychometric properties of all five measures in the proposed test battery, including: a. Inter-rater reliability; b. Inter-relationships among the five tests to determine convergent validity and the extent to which a valid distinction can be made between functional achievement vs. capacity; c. Construct validity, i.e., the extent to which the measures reflect real world functioning based on information provided by parents, teachers and report cards; d. Age and gender norms for all measures. 2. To assess the sensitivity of the functional battery, i.e. the extent to which these measures systematically distinguish prodromal subjects from healthy controls. Once pre-illness deficits have been reliably demonstrated, the resulting final battery can be introduced into larger, future studies determining developmental course and predictive value of these assessments. 3. To evaluate the relationship between functional deficits and neurocognitive abnormality, as measured by the MATRICS battery (cf. Clinical Assessment Strategies Unit and Biomarkers Unit).