Schizophrenia is a prevalent, debilitating psychiatric disorder that is diagnosed based on clinical interviews that are subjective and highly variable; in fact, two patients can have no overlapping symptoms and be diagnosed with the same disease. While cardiologists have blood tests to help diagnose heart attacks and oncologists have PET scans to find hidden cancers, psychiatrists don’t have objective diagnostic tests. This proposal will utilize machine learning to analyze cognitive tests, brain electrical activity, and genetic signatures from 1,415 patients with schizophrenia and 1,062 controls to uncover biomarkers of schizophrenia. By incorporating biomarkers into diagnostic standards, psychiatrists could one day order a simple test that could help them confidently diagnose schizophrenia and make better treatment decisions based on quantitative rather than subjective measures.
Geographic Area: University of Washington
Self-directed mindfulness in medically hospitalized patients: a pragmatic trial
Consultation-liaison psychiatrists are often asked to manage mood and anxiety symptoms experienced by patients admitted to medical and surgical floors of the hospital. This study aims to determine the feasibility and effectiveness of a self-directed mindfulness intervention as an adjunctive treatment for improving mood, anxiety, and perceived stress in medically hospitalized patients. Participants, consisting of patients evaluated by the consultation-liaison psychiatry service, will be randomized to an adjunctive mindfulness intervention group or a treatment-as-usual control group. Feasibility and acceptability of implementing a mindfulness intervention will be assessed. Group differences in the changes in symptom severity and psychotropic medication administration will be investigated.
Family and Caregiver Training and Support Program (FACTS) pilot
We know from decades of research that caregiver involvement, including family and non‐family members, in a patient’s mental health treatment can make a tremendous difference in the trajectory of their loved one’s life by supporting recovery, reducing relapse, and decreasing mental health crises. Family and caregiver involvement also decreases provider stress, improves caregiver well-being, and can lead to lower patient healthcare utilization and costs. But despite their importance, many family members and caregivers struggle to engage in the kind of support that can benefit the patient and themselves. They often lack access to education, resources, or skills to step into this critical role despite a desire to help. Our initiative intends to develop a pilot Family and Caregiver Training and Support Program (FACTS) program that aims to decrease barriers to caregiver involvement and improve caregiver support.
Our team will develop online training that will include an orientation to having a loved one who is psychiatrically hospitalized and will teach families and caregivers practical communication skills while their loved one is in our care. These topics would be relevant regardless of a patient’s diagnosis and will be adapted from existing evidence‐based models. The pilot will be tested with caregivers of patients hospitalized at the Frank Chopp Center for Behavioral Health and Learning and we will proactively integrate input and feedback from participants to inform program improvements along the way.
We will also build a public-facing website to host FACTS training materials as well as mental health information and resources that we will curate for accuracy and reliability. We expect the FACTS pilot content will serve as a foundation for additional offerings that will include diagnosis specific skills trainings as well opportunities for in-person sessions and Family Peer Support programming.
Training psychiatry residents in complex communication skills for working with clients and their supports
Individuals with serious persistent mental illness (SPMI) and their families and communities face significant challenges during psychiatric hospitalization. Persons with SPMI and their supporters express a need for enhanced communication from their behavioral healthcare teams during these pivotal periods of time where symptoms are new or intense. Yet, a substantial number of mental health providers have limited training in communicating complex topics such as diagnosis and prognosis. This can lead to providers avoiding essential conversations; individuals with SPMI can be unheard or excluded from participating in treatment planning.
This educational initiative seeks to craft an innovative curriculum for psychiatry residents focused on person-centered communication skills. Drawing from proven communication training frameworks within palliative care, the training will equip residents with strategies such as: utilizing person-centered language; conducting family meetings; delivering diagnostic and prognostic information. The curriculum will be developed with guidance from individuals with lived experienced of SPMI and their supporters. Moreover, the project will deliver a dedicated online portal featuring educational materials, recorded presentations, role-play scripts, and communication guides. Tools, such as self-assessment and evaluation rubrics, will be created to evaluate efficacy.
Improving the implementation of smartphone-based contingency management in medical settings for the treatment of methamphetamine use disorder: a qualitative analysis of patient and clinician experiences
The proposed research is a qualitative analysis of patient and clinician experiences during a pilot study of mHealth-delivered contingency management for the treatment of methamphetamine use disorder and will address perceived facilitators and reinforcing factors, barriers and limitations, and proposals for future improvements including specific recommendations regarding the intervention and its mode of delivery.
Debriefing after adverse events using the RECover Framework
This project will evaluate the effect of a debriefing workshop on the knowledge, attitudes, and practice of giving debriefs after adverse events among physicians and their trainees.
Examining the cross-cultural applicability of the Spanish PMQ-9: a comparative validation study
The purpose of this project is to enhance the usefulness and cultural relevance of the Spanish version of the PMQ-9, a questionnaire that assesses manic symptoms in individuals with bipolar disorder.
Acceptability and feasibility of a single-session + digital mental health intervention for people with psychosis on an acute psychiatric inpatient unit
People with psychosis are admitted more frequently to inpatient psychiatric units and have a longer length of stay once admitted compared to those with other psychiatric conditions. Cognitive Behavioral Therapy for psychosis (CBTp) reduces hospital admissions when delivered in outpatient settings and facilitates quicker symptom improvement when delivered in inpatient settings. Despite this, implementation of CBTp is exceedingly rare in practice. The purpose of this study is to test the feasibility and acceptability of a conjoint single-session CBTp intervention + FOCUS digital mental health intervention for people with psychosis admitted to inpatient psychiatry units.
Alcohol-focused Support of Survivors In Sororities Training (ASSIST)
The purpose of this study is to develop and evaluate a new online program called ASSIST – Alcohol-focused Support of Survivors In Sororities Training. The training is designed to help sorority members learn how to support friends who have had an unwanted sexual experience, both during the initial discussion of the experience and when navigating recovery in the longer-term. This multiphase study involves (1) developing the training in collaboration with students and campus stakeholders, (2) improving the training content and design through individual interviews with sorority members, (3) conducting an open trial of the training within one chapter, and then (4) conducting a pilot cluster randomized trial to evaluate feasibility and initial efficacy of the training. If found to be effective, this training could be widely disseminated and facilitate positive change in social contexts where survivors recover.
THRIVE Study
This is a study of an app intended to support recent sexual assault survivors, called THRIVE. In a prior grant, we pilot tested THRIVE and found that it reduced risk for alcohol misuse and posttraumatic stress. In the first year of this grant, we aim to revise the app to increase usability and inclusivity. In the second through fifth years of the grant, we will conduct a larger randomized controlled trial of multiple versions of the app among college students who have experienced sexual assault in the past 12 weeks. This will allow us to identify the most effective and low-burden version of THRIVE. If we are successful in identifying a highly effective and efficient version of THRIVE, this intervention would represent a highly-scalable strategy to reduce the substantial burden of posttraumatic stress and alcohol misuse on student survivors and campus service systems.
