Evaluation And Improvement Of The Implementation Of The Intention To Treat Model In Controlled Trials Of Psychotherapies
Funder
National Health and Medical Research Council
Funding Amount
$409,000.00
Summary
Randomized controlled trials (RCTs) are the best way to determine whether patients benefit from a new treatment. In these trials patients are randomly assigned to the new, active treatment, or to a placebo or existing treatment. The groups are compared at the end of the trial. RCTs may be mounted for psychotherapy and educational programs as well as for new drugs and other medical procedures. A major problem for RCTs concerns their statistical analysis when some participants drop out before the ....Randomized controlled trials (RCTs) are the best way to determine whether patients benefit from a new treatment. In these trials patients are randomly assigned to the new, active treatment, or to a placebo or existing treatment. The groups are compared at the end of the trial. RCTs may be mounted for psychotherapy and educational programs as well as for new drugs and other medical procedures. A major problem for RCTs concerns their statistical analysis when some participants drop out before the end of the trial. Dropout is common in trials. Participants may drop out because they feel no benefit from the treatment, dislike side effects, or even because they have recovered quickly. Thus, to compare the groups remaining at the end of trial may introduce serious bias. The Intention to Treat (ITT) principle which has been widely adopted states that outcomes from all patients who enter a trial should be compared at its end. To achieve this, the last available observation for a participant who withdraws is often 'carried forward' to the end of the trial. While currently believed to be conservative, there is evidence that this approach is not always optimal. This project will examine the way in which dropout is treated in trials of two common psychiatric conditions: depression and anxiety disorders. The project will also undertake simulation research to investigate which of a number of modern methods of data analysis yield the most accurate results when participants drop out, and how changes in the design of trials might improve accuracy. The project is important because it will enable researchers to improve the conduct of trials in the future. Erroneous conclusions drawn from RCTs stand to condemn those suffering from disorders to ineffective treatment and to lead to the premature abandonment of potentially useful interventions which are falsely claimed to lack efficacy.Read moreRead less
First-Line Management Of Youth Depression: A Randomised Placebo-Controlled Trial Of Fluoxetine And Cognitive Behavioural Therapy
Funder
National Health and Medical Research Council
Funding Amount
$1,316,648.00
Summary
The study aims to establish how to best treat adolescents and young adults when they present to mental health clinics with moderate-to-severe depression. There is, at present, considerable uncertainty as to whether young people should be started on antidepressant treatment at the same time as psychotherapy, or whether psychotherapy alone be commenced first. The study aims to clarify this important issue by implementing a trial that compares both treatment approaches.
Stress Vulnerability In Youth With Borderline Personality Disorder
Funder
National Health and Medical Research Council
Funding Amount
$873,689.00
Summary
Borderline personality disorder (BPD) is a severe mental disorder with adverse long-term outcomes, including suicide. BPD is characterised by vulnerability to stressful life events and catastrophic responses to stress. This study of youth early in the course of BPD examines the baseline biological characteristics of the stress response system, how these characteristics might be influenced by treatment and how this relates to treatment outcome. The findings will inform early intervention for BPD.
Neural Predictors Of Treatment Response In Youth Depression
Funder
National Health and Medical Research Council
Funding Amount
$519,596.00
Summary
Depression is the single greatest cause of disability and morbidity in young people. In order to reduce its substantial burden on individuals and society, there is a need to optimise the early provision of existing treatments. In this study, we will use cutting-edge neuroimaging technology to identify “biomarkers” in the brain that will help to more accurately determine which available treatments are likely to be most effective and safe for an individual patient.
Deakin Family Options: engaging youth with high prevalence mental health problems using family based interventions. Youth depression, anxiety and substance abuse are prevalent, distressing and costly problems impacting one in five young Australians. This collaborative project - called ‘Deakin Family Options’ - will evaluate a family based intervention in order to broaden the therapeutic approaches used for young people and their families.
Plasma protein profiles in normal brain ageing and early stages of dementia. Brain changes related to ageing and dementia are associated with altered proteins that can be detected in the blood. This project will examine blood samples from a number of well-characterised ageing cohorts to discover proteins that may serve as potential markers of brain ageing and the early stages of dementia.
Bereavement of suicide and sudden death. Losing someone to suicide can have devastating affects on the survivors left behind. The aims of the present study include the identification of the processes and impacts of bereavement on survivors in various age groups. It also aims to identify critical points during the bereavement and factors which exacerbate and moderate negative impacts. This has been previously neglected in suicide research in Australia and its findings will add a multi-dimensional ....Bereavement of suicide and sudden death. Losing someone to suicide can have devastating affects on the survivors left behind. The aims of the present study include the identification of the processes and impacts of bereavement on survivors in various age groups. It also aims to identify critical points during the bereavement and factors which exacerbate and moderate negative impacts. This has been previously neglected in suicide research in Australia and its findings will add a multi-dimensional aspect to postvention not currently understood. It is expected that findings will help develop guidelines to ensure more effective detection and intervention for survivors, as well as enhancing social support and personal resilience.Read moreRead less
Poor social functioning in schizophrenia: understanding its causes and developing better treatments. This project will advance knowledge of the thinking processes and the associated neural changes that cause the lifelong social disability which characterises schizophrenia. Findings will, in turn, contribute to better identifying young people, at risk of developing schizophrenia, and inform the design of new interventions and treatments.
Moral reasoning and mental illness: towards a model of moral judgment and moral accountability. This research examines capacities for moral judgment in people with schizophrenia, some of whom act on their delusional beliefs and commit crimes. Findings will, in turn, inform legal and philosophical consideration of the moral accountability of mentally ill defendants, and advance theoretical knowledge of healthy moral decision making.
The electrophysiological signature of inner speech. This project aims to develop an objective neurophysiological marker that identifies when a person is talking silently to themselves in their head (inner speech), and what they are saying internally. Such a marker would be an important development in the field of cognitive science. It could reveal the fundamental nature of inner speech (whether inner speech is actually a special form of overt speech), and lead to ‘brain-computer interface’ techn ....The electrophysiological signature of inner speech. This project aims to develop an objective neurophysiological marker that identifies when a person is talking silently to themselves in their head (inner speech), and what they are saying internally. Such a marker would be an important development in the field of cognitive science. It could reveal the fundamental nature of inner speech (whether inner speech is actually a special form of overt speech), and lead to ‘brain-computer interface’ technologies that can decipher inner speech and communicate it with the outside world.Read moreRead less