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早期精神病协调专科护理中的认知与动机干预:资助报告

Targeting Cognition and Motivation in Coordinated Specialty Care for Early Psychosis: A Grant Report.

作者信息

Roisum Rachel, Jenkins Danielle, Fisher Melissa, Currie Ariel, Ma Sisi, Lindgren Christopher, Meyer-Kalos Piper, Vinogradov Sophia

机构信息

Department of Psychiatry & Behavioral Sciences, University of Minnesota, Minneapolis, MN 55454, USA.

Division of General Internal Medicine, University of Minnesota, Minneapolis, MN 55455, USA.

出版信息

J Psychiatr Brain Sci. 2020;5. doi: 10.20900/jpbs.20200023. Epub 2020 Oct 16.

Abstract

In this grant report, we describe our project to expand measurement-based psychiatric care across 6 early psychosis treatment teams in Minnesota, and to provide a neuroscience-informed cognitive training and motivation enhancement program for individuals with early psychosis. This project is part of the NIMH Early Psychosis Intervention Network (EPINET) initiative which seeks to link data from treatment centers nationally that offer evidence-based specialty care to persons experiencing early psychosis. Systematic analyses of pooled data collected in EPINET will help inform methods for early psychosis care, psychosis risk factors, and pre-emptive interventions. As part of the national EPINET, our hub (Early Psychosis Intervention-Minnesota, EPI-MINN), will: (1) provide measurement-based care in coordinated specialty care programs for early psychosis, (2) determine whether a structured feedback report provides benefit to stakeholders-service users, family members, and primary clinicians, and (3) explore whether deficits in cognition and motivated behavior-two domains that significantly impact functioning and overall quality of life in early psychosis-can be addressed as key treatment goals by implementing a 12-week mobile intervention. Using a regression discontinuity design, participants will be randomized to the cognitive training and motivational enhancement intervention or to treatment as usual. The intervention consists of neuroscience-informed, computerized auditory and social cognitive training exercises, as well as a mobile app where participants interact with each other and with a motivational coach. Participants will complete assessments at 4 time points: baseline and post-intervention (i.e., at 6 months), and again at 12 and 18 months to test the long-term effects of the intervention. All assessments and interventions in this project can be completed entirely remotely.

摘要

在本资助报告中,我们描述了我们的项目,即在明尼苏达州的6个早期精神病治疗团队中扩大基于测量的精神病护理,并为早期精神病患者提供基于神经科学的认知训练和动机增强计划。该项目是美国国立精神卫生研究所早期精神病干预网络(EPINET)倡议的一部分,该倡议旨在将全国治疗中心的数据联系起来,这些中心为早期精神病患者提供循证专科护理。对EPINET收集的汇总数据进行系统分析,将有助于为早期精神病护理方法、精神病风险因素和预防性干预提供信息。作为全国EPINET的一部分,我们的中心(明尼苏达州早期精神病干预,EPI-MINN)将:(1)在早期精神病的协调专科护理计划中提供基于测量的护理;(2)确定结构化反馈报告是否对利益相关者——服务使用者、家庭成员和初级临床医生有益;(3)探索认知和动机行为方面的缺陷——这两个领域对早期精神病患者的功能和整体生活质量有重大影响——是否可以通过实施为期12周的移动干预作为关键治疗目标来解决。使用回归间断设计,参与者将被随机分配到认知训练和动机增强干预组或常规治疗组。干预包括基于神经科学的计算机化听觉和社会认知训练练习,以及一个移动应用程序,参与者可以在其中相互交流并与动机教练互动。参与者将在4个时间点完成评估:基线、干预后(即6个月时),以及在12个月和18个月时再次评估,以测试干预的长期效果。本项目中的所有评估和干预都可以完全远程完成。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4475/7891550/e5c203674b48/nihms-1638878-f0001.jpg

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