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Personalizing Interventions Using Real-World Interactions

10. Dezember 2020 aktualisiert von: Kyle S. Minor, Indiana University

Personalizing Interventions Using Real-World Interactions: Improving Symptoms and Social Functioning in Schizophrenia With Tailored Metacognitive Therapy

Social functioning deficits are among the most disabling and difficult to treat aspects of schizophrenia. An essential component of social functioning is metacognition-a process that is profoundly disrupted in schizophrenia and represents the ability to reflect upon the mental states of oneself and others. To date, treatment efforts in schizophrenia have been hindered by barriers in accurately monitoring client's real-world social interactions. Recently, wearable technologies have evolved to provide therapists with innovative, ecologically-valid tools. The Electronically Activated Recorder is a wearable audio recorder that collects behavioral samples at pre-programmed intervals; it holds great promise as a method for yielding concrete, real-world examples of social interactions that can be used by therapists in session to enhance metacognition. Despite the immense costs of social functioning deficits, no previous studies have investigated whether functioning can be improved by integrating wearable audio recorders with psychosocial interventions.

By enhancing therapy using a wearable recording device, this proposal's primary goal is to implement a novel intervention that targets metacognitive deficits to improve social functioning. The novel intervention will be tailored to individual clients-based on the content of recorded social interactions-in a way that is not possible using traditional psychotherapy. This will allow clients and therapists to step out of the therapy room by offering a window into how clients process material in real-world interactions. In this study, a randomized controlled trial will be conducted with two schizophrenia groups receiving six months of individualized: 1) Metacognition Reflection and Insight Therapy (MERIT) alone (Standard MERIT); and 2) Tailored MERIT using wearable audio recorders. In this study, our specific aims will test feasibility, effectiveness, and acceptability of Tailored MERIT.

Studienübersicht

Status

Abgeschlossen

Bedingungen

Intervention / Behandlung

Studientyp

Interventionell

Einschreibung (Tatsächlich)

34

Phase

  • Unzutreffend

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

18 Jahre bis 60 Jahre (Erwachsene)

Akzeptiert gesunde Freiwillige

Nein

Studienberechtigte Geschlechter

Alle

Beschreibung

Inclusion Criteria:

  • Positive screen for metacognitive dysfunction
  • Serious Mental Illness diagnosis (schizophrenia-spectrum)
  • Age 18-60
  • English fluency
  • Currently in non-acute phase of illness

Exclusion Criteria:

  • Inability to provide informed consent
  • Current substance dependence
  • Documented intellectual disability

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Behandlung
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Single

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Aktiver Komparator: Standard MERIT
24 sessions of Metacognition Reflection and Insight Therapy
see arm description
Experimental: Tailored MERIT
24 sessions of personalized Metacognition Reflection and Insight Therapy (sessions personalized using real-world interactions)
see arm description

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Global Functioning Scale: Social (GFS)
Zeitfenster: Change from baseline social functioning to social functioning after 6 months of MERIT
10-point measure of social functioning (1 to 10, with increasing scores indicating greater social functioning)
Change from baseline social functioning to social functioning after 6 months of MERIT
Metacognitive Beliefs Questionnaire-Brief (MCQ-30)
Zeitfenster: Change from baseline metacognition to metacognition after 6 months of MERIT
30 item measure of metacognition; each item is rated on a 1 to 4 scale with decreasing scores representing better metacognitive functioning.
Change from baseline metacognition to metacognition after 6 months of MERIT
The Positive and Negative Syndrome Scale (PANSS)
Zeitfenster: Change from baseline symptoms to symptoms after 6 months of MERIT
30 item measure of symptoms; each item is rated 1 to 7, with greater scores representing more severe symptoms (and lower scores indicating better functioning)
Change from baseline symptoms to symptoms after 6 months of MERIT
EAR Adherence
Zeitfenster: Average of EAR adherence from baseline and 6 month assessment sessions
Objective measure of how often EAR was worn; 0 (not worn) and 1 (worn) scores given at each of 48 potential time points. Total score represents frequency that the EAR is worn across all time points.
Average of EAR adherence from baseline and 6 month assessment sessions
EAR Experiential Questionnaire
Zeitfenster: Average of EAR acceptability from baseline and 6 month assessment sessions
Assessment of how acceptable wearing the EAR was and how typical days were that EAR was worn. Scores for each item range from 1 to 5 with greater scores indicating greater problems (and lower acceptability).
Average of EAR acceptability from baseline and 6 month assessment sessions

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Quality of Life Scale
Zeitfenster: Change from baseline quality of life to quality of life after 6 months of MERIT
21 item measure of quality of life; each item is rated from 0 to 6, with greater scores indicating greater quality of life.
Change from baseline quality of life to quality of life after 6 months of MERIT
Metacognition Assessment Scale- Abbreviated (MAS-A)
Zeitfenster: Change from baseline metacognitive capacity to metacognitive capacity after 6 months of MERIT
Clinician-rated measure of metacognition using a semi structured clinical interview; four areas of capacity are rated (0 to 28 on overall scale); for each, increasing scores represent greater capacity.
Change from baseline metacognitive capacity to metacognitive capacity after 6 months of MERIT
Short Form Health Survey (SF-36
Zeitfenster: Change from baseline functioning to functioning after 6 months of MERIT
36 item measure of social functioning and general health behaviors; each item on a different scale but greater scores indicate better overall functioning.
Change from baseline functioning to functioning after 6 months of MERIT
Objective Behaviors from the Electronically Activated Recorder
Zeitfenster: Baseline, 3 months into MERIT, 6 months into MERIT (MERIT completed)
EAR coding can be implemented to rate different forms of objective behaviors; codes generated using different scales but primarily use a 0 (not present) or 1 (present) coding scheme. Greater scores typically represent presence of that which is being coded.
Baseline, 3 months into MERIT, 6 months into MERIT (MERIT completed)
Scale to Assess Unawareness of Mental Disorder
Zeitfenster: Baseline, 3 months into MERIT, 6 months into MERIT (MERIT completed)
Insight measure; three items rated on 1 to 5 scale, with increasing scores indicating poorer insight.
Baseline, 3 months into MERIT, 6 months into MERIT (MERIT completed)

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

1. Juli 2016

Primärer Abschluss (Tatsächlich)

15. März 2020

Studienabschluss (Tatsächlich)

15. März 2020

Studienanmeldedaten

Zuerst eingereicht

5. Dezember 2020

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

10. Dezember 2020

Zuerst gepostet (Tatsächlich)

11. Dezember 2020

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

11. Dezember 2020

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

10. Dezember 2020

Zuletzt verifiziert

1. Dezember 2020

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • MERIT EAR Study

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

NEIN

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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