We propose a novel program for post-doctoral training in early detection and prevention of psychotic disorders, mood disorders, and anxiety disorders. Because these disorders strike relatively early in life and tend to be chronic and debilitating, individuals with these conditions utilize a disproportionate share of public funds for medical services and disability. Existing treatments are only partially effective in reducing symptom severity, generally requiring on-going maintenance therapy to do so (with accumulating side effect burden), and do not ameliorate the deficits in occupational and social functioning associated with these syndromes or the vulnerability to future episodes. In addition, for some of these conditions, the earlier treatment is initiated after the onset of illness, the better the long-term outcome, suggesting that progressive aspects of the underlying disease processes make these illnesses increasingly less responsive to interventions. This program will integrate didactic coursework, seminars, and supervised research training in early detection and prevention of psychiatric disorders. We integrate mechanisms to evaluate trainees and the program in relation to four objectives. First, progress toward effective prevention programs for these disorders will be more rapid if the next generation of researchers is armed with the tools needed both to ascertain risk markers and mechanisms and to develop and test preventive interventions. Second, given that these forms of psychopathology are complexly determined phenomena, involving biological and psychosocial processes, the next generation of researchers must be able to integrate effectively across these different levels of analysis in their approach to risk detection and preventive intervention. Third, our focus on transitional age populations will help to overcome the traditional boundaries between research in adolescent and adult forms of psychopathology, facilitating the integration of a developmental perspective. Finally, exposure of trainees to early detection and prevention approaches to multiple domains of psychopathology will provide useful points of comparison and contrast and will stimulate cross-fertilization between areas.
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