(PS7-69) A Pilot Study of a Transdiagnostic Preventative Intervention for High School Students

Abstract Text: Background
Psychotic experiences (PEs), defined as subclinical delusions and hallucinations, are most prevalent in children and adolescents and represent a transdiagnostic risk factor for mental illness. PE’s have been associated with a 3-4-fold increase in risk for mood disorders and anxiety disorders, an almost 10-fold increase in risk for psychotic disorders, and a greater vulnerability to suicide and overall disability. Despite this, there are few psychosocial interventions aimed at preventing poor mental health outcomes for teens experiencing PEs. Resilience Training for Teens (RTT), a 6-week, group-based intervention, was therefore developed for high school students with PEs. This ongoing study is aimed at assessing the feasibility, acceptability, and preliminary impact of RTT on clinical symptoms and functioning.

Method
Twelve students with PEs were recruited to participate in RTT and complete pre and post assessments. Two students withdrew during the baseline assessment period, and two students attended two RTT sessions, then withdrew due to scheduling difficulties, not completing the post assessment. A total of eight students (mean age in years: 15.67) completed pre and post assessments. Assessments included interview-based assessments (Structured Interview for Psychosis-Risk Syndromes (SIPS); Global Assessment of Functioning (GAF); Brief Negative Symptom Scale (BNSS)), task-based assessments (Hinting Task) and self-report surveys (Prodromal Questionnaire-Brief (PQB); Reflective Function Questionnaire for Youth (RFQ-Y)). Paired t-tests were conducted to measure change from pre to post intervention.

Results
Of the 8 students with data, all 8 attended at least 3 of the 6 sessions, and half attended all 6 sessions. All students rated RTT as enjoyable, beneficial, and that they would recommend RTT to a friend, with 75% endorsing that they enjoyed it “a lot”. Students performed better on measures of mentalizing on the Hinting Task (t=-2.97, p=.021), and Scale A of the RFQ-Y (t=-2.63, p=.034) following RTT. Additionally, we found significant decreases pre-post in measures of PEs, such as the PQB (t=3.72, p=.007) and two SIPS items: Unusual Thought Content (t=5.35, p=.001) and Perceptual Abnormalities (t=3.74, p=.007). Decreases in negative symptoms were also seen in the BNSS (t=3.76, p=.007), and Avolition (t=3.87, p=.006), and Occupational Functioning (t=2.97, p=.021) sections in the SIPS. Finally, there was a significant increase in GAF (t=-3.82, p=.0066).

Discussion
This study provides preliminary evidence that RTT is feasible and acceptable in high school students. RTT may also be effective in increasing mentalization and lowering PEs and negative symptoms following the intervention. This study is currently enrolling additional high school students in this pilot study, to further assess feasibility and acceptability. This pilot study will be followed by a randomized controlled trial, comparing the effects of RTT to that of a waitlist control. RTT may be a useful, brief psychosocial intervention for high school students who are at transdiagnostic risk for mental illness.