Large-Scale Longitudinal Biopsychosocial Health Study
Goal: The goal of this project is to attack health disparities experienced by persons with schizophrenia spectrum disorders (SSDs). We intend to accomplish this by identifying and accurately measuring various biopsychosocial factors (e.g., biological, psychological, social, cognitive, and environmental), and health-related behaviors that contribute to physical and mental health. We will identify biopsychosocial factors that shape lifestyle behavior, impacting trajectories of health and wellness across time, among vulnerable young adults experiencing physical (e.g., asthma) and mental health symptoms (e.g., attenuated psychotic symptoms or APS) in a non-clinical, emerging adult sample. APS are symptoms associated with psychosis, such as peculiar ideas or hallucinations, that are experienced at levels of severity that do not meet diagnostic criteria for a psychotic disorder. Subjects with APS often provide a useful starting point for schizophrenia spectrum research because they have psychological and social characteristics comparable to people with more severe psychosis in clinical settings, but without various methodological difficulties. These methodological difficulties frequently include the confounding role of overall impairment in personal and social functioning often found in people with schizophrenia and, in this case, the fact that people with schizophrenia often experience external constraints on their preferred levels of engagement in health-related behaviors (e.g., limited personal finances or living in an inpatient or restricted setting). People endorsing significantly greater APS and related distress are thought to have genetic endophenotypes and acquired vulnerabilities that elevate the risk for the eventual onset of an actual psychotic disorder. Therefore, they are studied in a broad range of psychopathology research. Attenuated psychosis itself is also associated with health disparities, and so that population will also benefit directly from this research project.
Significance: Considering the promise that virtual interventions hold for clinical practices across healthcare disciplines, this proposed project will inform pilot digital interventions that can be implemented through mobile, online, computer, and other digital platforms. Such digital interventions can also be tested in vulnerable college student populations. Accurate treatment targeting is a vital prerequisite for effective intervention. Biopsychosocial factors co-occur and interrelate within their relationships between and contributions to persons' physical and mental health, prompting a dire need to identify novel treatment targets that better capture persons' health and wellness in a more holistic or “person-systems” fashion. Examining these contributions mutually exclusive from one another is likely insufficient to determine optimal interventions aimed at simultaneously improving persons' physical and mental health.
Impact: Understanding biopsychosocial contributions to physical and mental health will improve treatment outcomes by identifying unique intervention targets associated with vulnerability related to specific biopsychosocial factors. This will inform the development of interventions to reduce biopsychosocial risk factors (e.g., sleep quality, stress), on physical and mental health. This, in turn, will reduce health disparities among persons with SSDs and related vulnerable populations.