Cognitive Training vs. Treatment as Usual to Improve Functioning and Reduce Transition Rates in Tunisian CHR Youth: A Feasibility Study

简要描述/摘要： 这项研究将使用标准化和完善的方法，这些方法在文化上已经适应了早期 检测、识别、评估和治疗突尼斯的临床高风险青年， 北非中等收入国家（LMIC）。在2000年意味着这些年轻人在更大的 患精神病的风险比一般人群高，精神病是一种严重的精神疾病（SMI）。本研究提出 使用积极的、教育性的、社区外展方法来减少耻辱感， 提高对旨在早期干预的精神卫生服务的可用性和重要性的认识。这 该方法将有助于确定可接受研究相关治疗服务的个体。 将由经过培训的临床团队进行高准确度评估， 在高收入国家成功使用的评估工具， 在突尼斯等低收入国家使用是可行的。一旦确定身份，这些突尼斯年轻人将被 提供非污名化的治疗，这是一个基于证据的做法（EBP）用于高收入 提供精神卫生保健的国家。干预将包括基于计算机的认知 培训对青年友好，并在文化上进行了调整，以供突尼斯青年使用。这种形式的 认知训练已被证明可以改善认知功能，并减少与 功能受损治疗将在康复环境中提供， 以增加成功的可能性。增加参与可能性的动机因素将是 确认并加强。参与和改善认知表现和日常功能是 降低高危人群转化为更严重精神疾病的比率的拟议作用机制 青年目标是通过改善学校、工作、 和社会功能。这些功能上的改进旨在减少高水平的痛苦， 在功能上有困难的人总是会经历这种情况。通过这种方式， 改善认知功能被假设为改善日常功能并减少向下的 发展成严重的精神疾病随着时间的推移，将重复进行可靠和有效的测量， 用于评估这种创新治疗方法的影响和成功。本研究涉及 加强首席研究员之间的持续合作，他是加州大学洛杉矶分校的研究 心理学家，加州大学洛杉矶分校精神病学系成员， 突尼斯，埃尔马纳尔谁是出版的研究人员和经验丰富的临床医生。这一模式的发展 突尼斯正在提出的可持续发展计划将被手册化并传播到其他中东国家。 北非（MENA）国家鼓励使用类似的评估和治疗方案， 青年

Brief Description / Abstract: This study will use standardized and well-established approaches that have been culturally adapted for early detection, identification, assessment, and treatment of Clinical High Risk (CHR) youth in Tunisia, a low- and middle-income country (LMIC) in North Africa. Being at CHR means that these are young people are at greater risk than the general population for developing psychosis, a serious mental illness (SMI). This study proposes to use an active, educational, community outreach approach to reduce both stigma and increase community awareness about the availability and importance of mental health services aimed at early intervention. This approach will aid in the identification of individuals at CHR who can receive study related treatment services. Assessment of the CHR state will be performed by a clinical team trained to high levels of accuracy on assessment tools that were used successfully in high income countries and have been culturally adapted and found to be feasible for use in LMIC such as Tunisia. Once identified, these young Tunisian individuals will be provided with a non-stigmatizing treatment that is an evidence-based practice (EBP) used in high income countries in the delivery of mental health care. The intervention will consist of computer-based cognitive training which is youth friendly and has been adapted culturally for use with Tunisian youth. This form of cognitive training has been shown to improve cognitive functioning and reduce key symptoms related to impaired functioning. The treatment will be provided in the type of rehabilitation setting which has been shown to increase the likelihood of success. Motivational factors that increase the likelihood of participation will be identified and strengthened. Engaging and improving cognitive performance and daily functioning is the proposed mechanism of action for reducing the rate of conversion to more severe mental illness in these at risk youth. The goal is to reduce the risk of progression to more serious mental illness by improving school, work, and social functioning. These improvements in functioning are aimed at reducing the high level of distress that is invariably experienced by individuals who suffer from difficulties in functioning. In this way, reducing stress and improving cognitive functioning is hypothesized to improve daily functioning and decrease the downward trajectory toward serious mental illness. Reliable and valid measurements that will be repeated over time will be used to evaluate the impact and success of this innovative use of treatment. This study involves strengthening an ongoing collaboration between the Principal Investigator who is a UCLA Research Psychologist and member of the UCLA Department of Psychiatry faculty and professors from the University of Tunis, El Manar who are published researchers and experienced clinicians. The development of this model CHR program in Tunisia that is being proposed will be manualized and disseminated to other Middle East North African (MENA) countries to encourage the use of similar assessment and treatment programs for CHR youth.