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针对高危大学生的跨诊断预防项目的基本原理、方法、可行性及初步结果

Rationale, Methods, Feasibility, and Preliminary Outcomes of a Transdiagnostic Prevention Program for At-Risk College Students.

作者信息

Burke Anne S, Shapero Benjamin G, Pelletier-Baldelli Andrea, Deng Wisteria Y, Nyer Maren B, Leathem Logan, Namey Leah, Landa Carrie, Cather Corinne, Holt Daphne J

机构信息

Department of Psychiatry, Massachusetts General Hospital, Boston, MA, United States.

Harvard Medical School, Boston, MA, United States.

出版信息

Front Psychiatry. 2020 Feb 25;10:1030. doi: 10.3389/fpsyt.2019.01030. eCollection 2019.

Abstract

PURPOSE

Early adulthood represents one period of increased risk for the emergence of a serious mental illness. The college campus provides a unique opportunity to assess and monitor individuals in this at-risk age group. However, there are no validated early detection programs that are widely implemented on college campuses. In an effort to address this gap, we designed and tested an early detection and prevention program tailored to college students. A transdiagnostic approach was employed because of evidence for shared risk factors across major mental illnesses.

DESIGN

Single arm, prospective study evaluating outcomes following a 4-week intervention.

METHOD

Three in-person mental health screenings were conducted on the campus of one university. Undergraduate students with at least mildly elevated, self-reported levels of depressive or subclinical psychotic symptoms, who were not receiving treatment for these symptoms, were invited to participate in a 4-session workshop focused on increasing self- and other- awareness and emotion regulation using established mindfulness, self-compassion, and mentalization principles and experiential exercises. Symptoms, resilience-promoting capacities, and aspects of social functioning were assessed pre- and post- intervention.

RESULTS

416 students were screened and a total of 63 students participated in the workshop. 91% attended at least 3 of the 4 sessions. The majority of participants found the workshop interesting and useful and would recommend it to a friend. Significant pre-to-post reductions in symptoms (depression, anxiety, and subclinical psychotic symptoms, s < 0.004) and improvements in resilience-promoting capacities (self-compassion and self-efficacy, s < 0.006) and indices of social functioning (social motivation, activity, and a measure of comfort with the physical presence of others, s < 0.04) were observed. Moreover, the significant increases in resilience-promoting capacities correlated with the reductions in affective symptoms (s < 0.03).

CONCLUSIONS

These findings suggest that an on-campus mental health screening and early intervention program is feasible, acceptable, and may be associated with improvements in resilience-related capacities and symptom reductions in young adults with non-impairing, subclinical symptoms of psychopathology. Follow-up work will determine whether this program can improve both shorter and longer-term mental health and functional outcomes in this at-risk population.

摘要

目的

成年早期是严重精神疾病出现风险增加的一个时期。大学校园为评估和监测这个高危年龄组的个体提供了独特的机会。然而,目前尚无经过验证且在大学校园广泛实施的早期检测项目。为了填补这一空白,我们设计并测试了一个针对大学生的早期检测与预防项目。由于有证据表明主要精神疾病存在共同的风险因素,因此采用了一种跨诊断方法。

设计

单臂前瞻性研究,评估为期4周干预后的结果。

方法

在一所大学的校园内进行了三次面对面的心理健康筛查。邀请自我报告抑郁或亚临床精神病性症状水平至少轻度升高且未针对这些症状接受治疗的本科生参加一个为期4节的工作坊,该工作坊聚焦于运用既定的正念、自我同情和心理化原则及体验式练习来提高自我意识、他人意识和情绪调节能力。在干预前后对症状、促进复原力的能力以及社会功能方面进行了评估。

结果

共筛查了416名学生,共有63名学生参加了工作坊。91%的学生参加了4节工作坊中的至少3节。大多数参与者认为工作坊有趣且有用,并会向朋友推荐。观察到干预前后症状(抑郁、焦虑和亚临床精神病性症状,P<0.004)显著减轻,促进复原力的能力(自我同情和自我效能感,P<0.006)以及社会功能指标(社会动机、活动以及对他人身体在场的舒适度测量,P<0.04)得到改善。此外,促进复原力的能力显著提高与情感症状减轻相关(P<0.03)。

结论

这些发现表明,校园心理健康筛查和早期干预项目是可行的、可接受的,并且可能与改善有非损害性亚临床精神病理症状的年轻人的复原力相关能力以及减轻症状有关。后续工作将确定该项目能否改善这一高危人群的短期和长期心理健康及功能结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fec/7051934/7970ba82f1b8/fpsyt-10-01030-g001.jpg

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