Commonwealth Research Center

Monitoring At-Risk Adolescents and Young Adults

Mission Statement – Background – Research Participation – Faculty/Staff – Contact Information

Mission Statement

This is a new longitudinal clinical at-risk study initiated by the Commonwealth Research Center (CRC).  The purpose of the study is to increase our ability to identify early clinical (or “prodromal”) at-risk states for psychotic disorders and other forms of serious mental illness in teenagers and young adults ages 13-25.  (At-risk symptoms involve changes in thinking, perception, mood and/or behavior.  “Prodromal” means early symptoms and signs of an illness that may precede the beginning of the acute, fully developed illness.) Participants of this study are followed for 2-5 years and receive a range of comprehensive assessments at regular intervals.  By monitoring individuals over time, we hope to understand how cognition, thought processes, social and adaptive functioning, and brain structure and function changes.  Accurate identification and understanding of early clinical risk states will provide an important foundation for future research in prevention and early treatment of serious mental illness.  Early detection and intervention will likely lead to significantly better outcomes and promote healthy functioning for individuals and their families.

 

Our goal is to recruit approximately 80 individuals who are showing early signs and symptoms of possible psychosis. 

 

The three major aims of this study include:

 

1. To characterize the clinical, neuropsychological, social-behavioral, and brain structural-functional features of clinical at-risk or “prodromal” states.

 

2. To understand the nature and degree of changes in clinical, adaptive-functional, neuropsychological, and brain structure and function over time.  One key aim is to identify the range of outcomes in those who show prodromal symptoms but do not progress to showing a serious mental illness.  This aim reflects our interest in understanding the developmental trajectory of other mental illnesses in youth.

 

3. To identify clinical, biologic and psychosocial risk and protective factors that predict different kinds of outcomes.  Our goal is to contribute to the development of a model that will help us identify prospectively who is most likely to develop a psychotic disorder over time and to develop and study preventive interventions for people at-risk.

 

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Background

Emotional and behavioral changes in an adolescent or young adult can be a confusing and upsetting experience for an individual and his/her family members.  Though difficult to describe to others or not always noticeable at first, certain kinds of changes in thoughts, perceptions, feelings and behavior may become a source of concern or worry for young people, their families, or their teachers.  Changes in social, school and/or work functioning may also begin to appear.  Taken together, these changes may represent the earliest signs that someone is at-risk for psychosis or other mental illness.

  

Developmental models of psychosis suggest that years before the onset of a psychotic illness there are deficits in attention and verbal memory (often by late childhood) and social and behavioral impairments and thinking disturbances that emerge or intensify in early adolescence or young adulthood.  These changes may be difficult to capture in a DSM-IV diagnosis, yet they remain a source of concern for the young person, his/her family, and clinicians.  Many of these individuals will present with depression and/or anxiety, some will have been diagnosed with ADHD, and many show subtle but ongoing “low-grade” positive or negative symptoms of a psychotic disorder such as unusual thoughts or perceptions but not meet diagnostic criteria for a specific mental disorder. Symptoms typically have begun in the past year or have seemed to worsen in the past year.

The Commonwealth Research Center team, comprised of psychiatrists, psychologists, nurses, and research assistants, provides initial screening and comprehensive assessment in the context of clinical research studies aimed at early identification and referral for treatment of at-risk mental states.   Participants and their referring clinicians will be provided with any available diagnostic information and/or referrals to other clinical services.

 

Referrals can be made by family physicians, pediatricians, psychiatrists, mental health professionals, family members or individuals themselves. 

 

This study, along with the CRC genetic high-risk study (ADS), is being conducted in collaboration with the NIMH-sponsored North American Prodromal Longitudinal Studies (NAPLS) and its researchers are participants in the International Prodromal Research Network (IPRN).  Funding for the Monitoring study is provided in part by NIMH MH 43518 (L. Seidman, PI of the Harvard site) and the Commonwealth Research Center. 

 

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Research Participation

For more information, please contact:

Caroline Patterson, Study Coordinator

Phone:  (617) 998-5020

Email: [email protected]

Fran Schopick, M.S.W., Recruiter

Phone: (603) 953-3022

Email:  [email protected]

Characteristics of someone who may qualify

• 13-25 years of age
• Decline in functioning over the past year (30% drop in GAF)
• Social withdrawal and impairment of role functioning
• Increased anxiety or depression
• Increasing difficulty with concentration or thinking
• Loss of motivation, energy or interests
• Uncharacteristic, peculiar behavior or odd speech
• Greater sensitivity to sounds, sights, smells or physical feelings
• Feeling suspicious of others
• Unusual ideas or intense beliefs
• Feeling out of touch or disconnected

Exclusion Criteria

• DSM-IV diagnosis of a psychotic disorder or mental retardation
• Significant neurological disease or history of a serious brain injury
• Current substance dependence

Individuals who are eligible and choose to participate in this research study will be assessed with the following procedures (repeated over a two year period):

• Clinical interview
• Psychosocial evaluations
• Neurocognitive testing
• Magnetic resonance imaging (MRI) scans
• Blood draw (one time) for future genetic study

 

Participants can earn up to $600.

Parents/caregivers can earn up to $150 for completing the study.

 

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Faculty/Staff

Principal Investigator

Larry J. Seidman, Ph.D.

Professor of Psychology

Study Director

Anthony J. Giuliano, Ph.D.

Clinical Instructor in Psychology

Clinical Interview and Diagnostic Assessment Staff

James C. Beck, M.D., Ph.D.

Brina Caplan, Ph.D., Ed.D.

Ann Cousins, M.S.N., APRN, BC

Melissa Frumin, M.D.

Margaret Lanca, Ph.D.

Joanne Wojcik, M.S., APRN, BC

Suzanna Zimmet, M.D.

Investigators at MGH

Nikos Makris, M.D., Ph.D.

Heidi Thermenos, Ph.D.

Study Coordinator

Caroline Patterson, B.A.

 

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Contact Information

Attn: Caroline Patterson

The Commonwealth Research Center of

Massachusetts Mental Health Center and

Beth Israel Deaconess Medical Center

Department of Psychiatry

The Landmark Center

401 Park Drive, 2nd Floor East Wing

Boston, MA 02215

Phone: (617) 998-5020

Fax: (617) 998-5007

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