The earliest signs of schizophrenia and other psychotic disorders typically emerge during adolescence and early adulthood. Yet we know little about how to intervene during this critical period to avert the onset of illness and associated disability. An NIMH priority, now with heightened public support, is to have well trained investigators capable of developing new interventions for these youth at clinical high risk (CHR). Their task is to develop tools to better define risk and protective factors for mental illness and to develop interventions targeting the most robust and malleable factors. Altering the trajectory of major mental illness through targeted intervention for CHR youth will have high public health impact, reducing suffering, burden, and expense. The proposed integrated training and research project entitled, ?Innovative intervention for reducing stress reactivity and risk for psychosis? is designed to prepare the candidate, Dr. Kristen Woodberry, to be one of these researchers. A Harvard-trained research psychologist at Beth Israel Deaconess Medical Center (BIDMC) and Assistant Professor of Psychology at Harvard Medical School (HMS), she has over 25 years of clinical experience with CHR youth and their families, experience designing and managing clinical trials, and thirteen first author publications, including one that has become a classic. Her long-term career goal is to test psychosocial mechanisms for reducing risk and enhancing protective factors for CHR youth. To pursue this line of research, Dr. Woodberry has outlined a plan of courses to obtain additional statistical skills for analyzing complex longitudinal data and of advanced mentoring in grant-writing. Dr. Woodberry completed a feasibility study of a novel multiuser biofeedback game intervention with CHR youth and family members. Planned analyses of enrollment, engagement, credibility, satisfaction, and the direction and standard deviation of effects will answer questions of feasibility. A videogame substudy is also being completed to enrich our understanding of videogame use, preferences, and sources of gratification in youth at risk for or in the early course of a psychotic disorder to inform the design of future clinical interventions with this population. Dr. Woodberry's primary mentor, Dr. McFarlane, is a renowned schizophrenia researcher with substantial funding success and experience mentoring early career scientists. Dr. Woodberry's successful transition to independence will be supported by the enriched academic environments and resources of Maine Medical Center (MMC) and BIDMC. These include the infrastructure of the Maine Medical Center Research Institute, the Portland Identification and Early Referral (PIER) program, as well as the Psychosis Research Program led by Dr. Matcheri Keshavan. In summary, this project combines the talent of an outstanding early investigator, a superb scientific environment with relevant resources, a world-class team of mentors and a highly innovative, theory-driven line of research in an area of high priority for NIMH and for public health. This combination of talent and resources hold high promise for making a meaningful contribution to the prevention of psychosis.
The urgent need for new approaches to engage and treat youth with emerging mental illness has been highlighted by tragic events covered by the media. To address this major public health concern, the candidate's career development proposal would prepare her to develop and test new strategies for preventing the full expression of psychosis and the disability that so often accompanies it. The specific project proposed will explore whether a new intervention integrating videogames, biofeedback, and family involvement can 1) engage young people in the earliest stages of mental illness in strategies that build resilience and strengthen natural supports, and 2) shed light on how stress reactivity contributes to the emergence of psychosis.
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