Mahmood Zanjbeel, Kelsven Skylar, Cadenhead Kristin, Wyckoff Janae, Reyes-Madrigal Francisco, de la Fuente-Sandoval Camilo, Twamley Elizabeth W
San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, United States.
Research Service, VA San Diego Healthcare System, San Diego, CA, United States.
Front Psychiatry. 2020 Jan 10;10:951. doi: 10.3389/fpsyt.2019.00951. eCollection 2019.
Early psychosocial interventions targeting cognitive and functional outcomes in individuals at clinical high risk for psychosis are a research priority. An even greater need is the identification of effective interventions in underserved populations. Compensatory Cognitive Training (CCT) is a psychosocial intervention with demonstrated efficacy in chronic schizophrenia and first episode psychosis, but remains to be evaluated in pre-illness phases. The aim of this study was to describe the development and implementation of an ongoing pilot randomized controlled trial investigating the efficacy of group-based, manualized CCT, as compared to recreational therapy (RT), for Latino participants at clinical high risk for psychosis (CHR) in both the United States and Mexico. It is hypothesized that, in comparison to those receiving RT, participants receiving CCT will show significant improvements in neurocognitive performance and functional capacity (co-primary outcomes) and self-rated functioning and clinical symptoms (secondary outcomes). Latino CHR participants aged 12-30 years will be included in the study. Both CCT and RT will be delivered in either Spanish or English, depending on group preference. Additionally, all assessments will be administered in participants' preferred language. A comprehensive assessment of neurocognitive and functional performance and clinical symptomatology will be performed at baseline, mid-intervention (4 weeks, 8 weeks), post-intervention (12 weeks) and 3-month follow-up. The primary outcome measures are neurocognition and functional capacity, as assessed by the MATRICS (Measurement and Treatment Research in Cognition in Schizophrenia) Consensus Cognitive Battery and the University of California, San Diego Performance-Based Skills Assessment-Brief, respectively. Furthermore, secondary outcomes measures will be used to examine change in clinical symptoms and self-reported functioning in response to CCT versus RT. The evaluation of a novel treatment such as CCT in CHR youth will provide empirical support for a low risk, comprehensive cognitive intervention that could have important implications for public health if it improves neurocognition and functioning.
针对临床高危精神病个体的认知和功能结局开展早期社会心理干预是一项研究重点。更迫切需要的是在服务不足人群中确定有效的干预措施。代偿性认知训练（CCT）是一种社会心理干预措施，已在慢性精神分裂症和首发精神病中显示出疗效，但仍有待在疾病前期阶段进行评估。本研究的目的是描述一项正在进行的试点随机对照试验的开展和实施情况，该试验旨在调查与娱乐疗法（RT）相比，基于团体、手册化的CCT对美国和墨西哥临床高危精神病（CHR）的拉丁裔参与者的疗效。假设与接受RT的参与者相比，接受CCT的参与者在神经认知表现和功能能力（共同主要结局）以及自评功能和临床症状（次要结局）方面将有显著改善。年龄在12至30岁的拉丁裔CHR参与者将纳入本研究。CCT和RT都将根据小组偏好以西班牙语或英语进行。此外，所有评估都将以参与者喜欢的语言进行。将在基线、干预中期（4周、8周）、干预后（12周）和3个月随访时对神经认知和功能表现以及临床症状进行全面评估。主要结局指标分别是通过精神分裂症认知测量与治疗研究（MATRICS）共识认知电池和加利福尼亚大学圣地亚哥分校基于表现的技能评估简表评估的神经认知和功能能力。此外，次要结局指标将用于检查CCT与RT相比临床症状和自我报告功能的变化。对CHR青年中的CCT等新型治疗方法进行评估，将为低风险、全面的认知干预提供实证支持，如果它能改善神经认知和功能，可能对公共卫生具有重要意义。
