Perceived autonomy support in the NIMH RAISE early treatment program

Julia Browne; David L. Penn; Daniel J. Bauer; Piper Meyer-Kalos; Kim T. Mueser; Delbert G. Robinson; Jean Addington; Nina R. Schooler; Shirley M. Glynn; Susan Gingerich; Patricia Marcy; John M. Kane

doi:10.1176/appi.ps.201600480

Perceived autonomy support in the NIMH RAISE early treatment program

Julia Browne
, David L. Penn
, Daniel J. Bauer
, Piper Meyer-Kalos
, Kim T. Mueser
, Delbert G. Robinson
, Jean Addington
, Nina R. Schooler
, Shirley M. Glynn
, Susan Gingerich
, Patricia Marcy
, John M. Kane

Psychiatry & Behavioral Sciences

Research output: Contribution to journal › Article › peer-review

19 Scopus citations

Abstract

Objective: This study examined perceived support for autonomy-the extent to which individuals feel empowered and supported to make informed choices-among participants in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). The aims of this study were to evaluate whether NAVIGATE, the active treatment studied in RAISE ETP, was associated with greater improvements in perceived autonomy support over the two-year intervention, compared with community care, and to examine associations between perceived autonomy support and quality of life and symptoms over time and across treatment groups. Methods: This study examined perceived autonomy support among the 404 individuals with first-episode psychosis who participated in the RAISE ETP trial (NAVIGATE, N=223; community care, N=181). Three-level conditional linear growth modeling was used given the nested data structure. Results: The results indicated that perceived autonomy support increased significantly over time for those in NAVIGATE but not in community care. Once treatment began, higher perceived autonomy support was related to higher quality of life at six, 12, and 18 months in NAVIGATE and at 12, 18, and 24 months in community care. Higher perceived autonomy support was related to improved scores on total symptoms and on excited symptoms regardless of treatment group and time. Conclusions: Overall, perceived autonomy support increased in NAVIGATE but not for those in community care and was related to improved quality of life and symptoms across both treatment groups. Future research should examine the impact of perceived autonomy support on a wider array of outcomes, including engagement, medication adherence, and functioning.

Original language	English (US)
Pages (from-to)	916-922
Number of pages	7
Journal	Psychiatric Services
Volume	68
Issue number	9
DOIs	https://doi.org/10.1176/appi.ps.201600480
State	Published - Sep 1 2017

Bibliographical note

Funding Information:
Ms. Browne, Dr. Penn, and Dr. Bauer are with the Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill. Dr. Penn is also with the School of Psychology, Australian Catholic University, Melbourne. Dr. Meyer-Kalos is with the School of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul. Dr. Mueser is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Robinson, Dr. Schooler, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York. Dr. Robinson is also with Departments of Psychiatry and Molecular Medicine, Hofstra University–North Shore Long Island Jewish School of Medicine, Hempstead, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Addington is with the Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada. Dr. Glynn is with the Semel Institute for Neuroscience and Brain Behavior, University of California, Los Angeles, Los Angeles. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Send correspondence to Ms. Browne (e-mail: [email protected]). The RAISE ETP study was supported in whole or in part with funds from the American Recovery and Reinvestment Act and the National Institute of Mental Health (NIMH HHSN-271-2009-00019C). Additional support was provided by an NIMH Advanced Centers for Intervention Services Research award (P30MH090590) to Dr. Kane. The authors thank the core collaborators and consultants for their invaluable contributions, without whom this study would not have been possible. In addition to Dr. Penn, Dr. Mueser, Dr. Robinson, Dr. Addington, Dr. Schooler, Ms. Marcy, and Dr. Kane, the executive committee included Robert A. Rosenheck, M.D., Mary F. Brunette, M.D., Christoph U. Correll, M.D., Sue E. Estroff, Ph.D., and James Robinson, M.Ed. NIMH collaborators included Robert K. Heinssen, Ph.D., A.B.P.P., Joanne B. Severe, M.S., Susan T. Azrin, Ph.D., and Amy B. Goldstein, Ph.D. [Full acknowledgments of the many contributors and participating sites are included in an online supplement.] Dr. Meyer-Kalos reports serving as a consultant for Sumitomo Dainippon Pharma Co., Ltd. Dr. Robinson has been a consultant to Asubio, Costello Medical Consulting, Innovative Science Solutions, Janssen, Neurocrine, Otsuka, and Shire, and he has received research support from Otsuka. The authors and their associates provide training and consultation about implementing NAVIGATE treatment that can include compensation. These activities started only after data collection for the article was completed. At the time of publication, Dr. Robinson had received compensation for these activities. Dr. Schooler reports receiving honoraria and travel expenses as an advisory board member or consultant from Alkermes, Allergan, Forum, Roche, and Sunovion as well as grant support from Otsuka. Ms. Marcy reports owning shares of Pfizer stock. Dr. Kane reports serving as a consultant or on an advisory board for or receiving honoraria from Alkermes, Eli Lilly, EnVivo Pharmaceuticals (Forum), Forest (Allergan), Genentech, H. Lundbeck, Intracellular Therapies, Janssen Pharmaceutica, Johnson and Johnson, Neurocrine, Otsuka, Pierre Fabre, Reviva, Roche, Sunovion, Takeda, and Teva and receiving grant support from Janssen and Otsuka. Dr. Kane is a shareholder in MedAvante, Inc., Vanguard Research Group, and LB Pharmaceuticals, Inc. The other authors report no financial relationships with commercial interests.

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10.1176/appi.ps.201600480

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@article{a8fd4bb159194c5f8864405392d15916,

title = "Perceived autonomy support in the NIMH RAISE early treatment program",

abstract = "Objective: This study examined perceived support for autonomy-the extent to which individuals feel empowered and supported to make informed choices-among participants in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). The aims of this study were to evaluate whether NAVIGATE, the active treatment studied in RAISE ETP, was associated with greater improvements in perceived autonomy support over the two-year intervention, compared with community care, and to examine associations between perceived autonomy support and quality of life and symptoms over time and across treatment groups. Methods: This study examined perceived autonomy support among the 404 individuals with first-episode psychosis who participated in the RAISE ETP trial (NAVIGATE, N=223; community care, N=181). Three-level conditional linear growth modeling was used given the nested data structure. Results: The results indicated that perceived autonomy support increased significantly over time for those in NAVIGATE but not in community care. Once treatment began, higher perceived autonomy support was related to higher quality of life at six, 12, and 18 months in NAVIGATE and at 12, 18, and 24 months in community care. Higher perceived autonomy support was related to improved scores on total symptoms and on excited symptoms regardless of treatment group and time. Conclusions: Overall, perceived autonomy support increased in NAVIGATE but not for those in community care and was related to improved quality of life and symptoms across both treatment groups. Future research should examine the impact of perceived autonomy support on a wider array of outcomes, including engagement, medication adherence, and functioning.",

author = "Julia Browne and Penn, \{David L.\} and Bauer, \{Daniel J.\} and Piper Meyer-Kalos and Mueser, \{Kim T.\} and Robinson, \{Delbert G.\} and Jean Addington and Schooler, \{Nina R.\} and Glynn, \{Shirley M.\} and Susan Gingerich and Patricia Marcy and Kane, \{John M.\}",

note = "Funding Information: Ms. Browne, Dr. Penn, and Dr. Bauer are with the Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill. Dr. Penn is also with the School of Psychology, Australian Catholic University, Melbourne. Dr. Meyer-Kalos is with the School of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul. Dr. Mueser is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Robinson, Dr. Schooler, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York. Dr. Robinson is also with Departments of Psychiatry and Molecular Medicine, Hofstra University–North Shore Long Island Jewish School of Medicine, Hempstead, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Addington is with the Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada. Dr. Glynn is with the Semel Institute for Neuroscience and Brain Behavior, University of California, Los Angeles, Los Angeles. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Send correspondence to Ms. Browne (e-mail: [email protected]). The RAISE ETP study was supported in whole or in part with funds from the American Recovery and Reinvestment Act and the National Institute of Mental Health (NIMH HHSN-271-2009-00019C). Additional support was provided by an NIMH Advanced Centers for Intervention Services Research award (P30MH090590) to Dr. Kane. The authors thank the core collaborators and consultants for their invaluable contributions, without whom this study would not have been possible. In addition to Dr. Penn, Dr. Mueser, Dr. Robinson, Dr. Addington, Dr. Schooler, Ms. Marcy, and Dr. Kane, the executive committee included Robert A. Rosenheck, M.D., Mary F. Brunette, M.D., Christoph U. Correll, M.D., Sue E. Estroff, Ph.D., and James Robinson, M.Ed. NIMH collaborators included Robert K. Heinssen, Ph.D., A.B.P.P., Joanne B. Severe, M.S., Susan T. Azrin, Ph.D., and Amy B. Goldstein, Ph.D. [Full acknowledgments of the many contributors and participating sites are included in an online supplement.] Dr. Meyer-Kalos reports serving as a consultant for Sumitomo Dainippon Pharma Co., Ltd. Dr. Robinson has been a consultant to Asubio, Costello Medical Consulting, Innovative Science Solutions, Janssen, Neurocrine, Otsuka, and Shire, and he has received research support from Otsuka. The authors and their associates provide training and consultation about implementing NAVIGATE treatment that can include compensation. These activities started only after data collection for the article was completed. At the time of publication, Dr. Robinson had received compensation for these activities. Dr. Schooler reports receiving honoraria and travel expenses as an advisory board member or consultant from Alkermes, Allergan, Forum, Roche, and Sunovion as well as grant support from Otsuka. Ms. Marcy reports owning shares of Pfizer stock. Dr. Kane reports serving as a consultant or on an advisory board for or receiving honoraria from Alkermes, Eli Lilly, EnVivo Pharmaceuticals (Forum), Forest (Allergan), Genentech, H. Lundbeck, Intracellular Therapies, Janssen Pharmaceutica, Johnson and Johnson, Neurocrine, Otsuka, Pierre Fabre, Reviva, Roche, Sunovion, Takeda, and Teva and receiving grant support from Janssen and Otsuka. Dr. Kane is a shareholder in MedAvante, Inc., Vanguard Research Group, and LB Pharmaceuticals, Inc. The other authors report no financial relationships with commercial interests.",

year = "2017",

month = sep,

day = "1",

doi = "10.1176/appi.ps.201600480",

language = "English (US)",

volume = "68",

pages = "916--922",

journal = "Psychiatric Services",

issn = "1075-2730",

publisher = "American Psychiatric Association",

number = "9",

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TY - JOUR

T1 - Perceived autonomy support in the NIMH RAISE early treatment program

AU - Browne, Julia

AU - Penn, David L.

AU - Bauer, Daniel J.

AU - Meyer-Kalos, Piper

AU - Mueser, Kim T.

AU - Robinson, Delbert G.

AU - Addington, Jean

AU - Schooler, Nina R.

AU - Glynn, Shirley M.

AU - Gingerich, Susan

AU - Marcy, Patricia

AU - Kane, John M.

N1 - Funding Information: Ms. Browne, Dr. Penn, and Dr. Bauer are with the Department of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chapel Hill. Dr. Penn is also with the School of Psychology, Australian Catholic University, Melbourne. Dr. Meyer-Kalos is with the School of Social Work, Minnesota Center for Chemical and Mental Health, St. Paul. Dr. Mueser is with the Center for Psychiatric Rehabilitation, Boston University, Boston. Dr. Robinson, Dr. Schooler, Ms. Marcy, and Dr. Kane are with the Department of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, New York. Dr. Robinson is also with Departments of Psychiatry and Molecular Medicine, Hofstra University–North Shore Long Island Jewish School of Medicine, Hempstead, New York. Dr. Schooler is also with the Department of Psychiatry and Behavioral Sciences, SUNY Downstate Medical Center, Brooklyn, New York. Dr. Addington is with the Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada. Dr. Glynn is with the Semel Institute for Neuroscience and Brain Behavior, University of California, Los Angeles, Los Angeles. Ms. Gingerich is an independent consultant and trainer in Narberth, Pennsylvania. Send correspondence to Ms. Browne (e-mail: [email protected]). The RAISE ETP study was supported in whole or in part with funds from the American Recovery and Reinvestment Act and the National Institute of Mental Health (NIMH HHSN-271-2009-00019C). Additional support was provided by an NIMH Advanced Centers for Intervention Services Research award (P30MH090590) to Dr. Kane. The authors thank the core collaborators and consultants for their invaluable contributions, without whom this study would not have been possible. In addition to Dr. Penn, Dr. Mueser, Dr. Robinson, Dr. Addington, Dr. Schooler, Ms. Marcy, and Dr. Kane, the executive committee included Robert A. Rosenheck, M.D., Mary F. Brunette, M.D., Christoph U. Correll, M.D., Sue E. Estroff, Ph.D., and James Robinson, M.Ed. NIMH collaborators included Robert K. Heinssen, Ph.D., A.B.P.P., Joanne B. Severe, M.S., Susan T. Azrin, Ph.D., and Amy B. Goldstein, Ph.D. [Full acknowledgments of the many contributors and participating sites are included in an online supplement.] Dr. Meyer-Kalos reports serving as a consultant for Sumitomo Dainippon Pharma Co., Ltd. Dr. Robinson has been a consultant to Asubio, Costello Medical Consulting, Innovative Science Solutions, Janssen, Neurocrine, Otsuka, and Shire, and he has received research support from Otsuka. The authors and their associates provide training and consultation about implementing NAVIGATE treatment that can include compensation. These activities started only after data collection for the article was completed. At the time of publication, Dr. Robinson had received compensation for these activities. Dr. Schooler reports receiving honoraria and travel expenses as an advisory board member or consultant from Alkermes, Allergan, Forum, Roche, and Sunovion as well as grant support from Otsuka. Ms. Marcy reports owning shares of Pfizer stock. Dr. Kane reports serving as a consultant or on an advisory board for or receiving honoraria from Alkermes, Eli Lilly, EnVivo Pharmaceuticals (Forum), Forest (Allergan), Genentech, H. Lundbeck, Intracellular Therapies, Janssen Pharmaceutica, Johnson and Johnson, Neurocrine, Otsuka, Pierre Fabre, Reviva, Roche, Sunovion, Takeda, and Teva and receiving grant support from Janssen and Otsuka. Dr. Kane is a shareholder in MedAvante, Inc., Vanguard Research Group, and LB Pharmaceuticals, Inc. The other authors report no financial relationships with commercial interests.

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Objective: This study examined perceived support for autonomy-the extent to which individuals feel empowered and supported to make informed choices-among participants in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). The aims of this study were to evaluate whether NAVIGATE, the active treatment studied in RAISE ETP, was associated with greater improvements in perceived autonomy support over the two-year intervention, compared with community care, and to examine associations between perceived autonomy support and quality of life and symptoms over time and across treatment groups. Methods: This study examined perceived autonomy support among the 404 individuals with first-episode psychosis who participated in the RAISE ETP trial (NAVIGATE, N=223; community care, N=181). Three-level conditional linear growth modeling was used given the nested data structure. Results: The results indicated that perceived autonomy support increased significantly over time for those in NAVIGATE but not in community care. Once treatment began, higher perceived autonomy support was related to higher quality of life at six, 12, and 18 months in NAVIGATE and at 12, 18, and 24 months in community care. Higher perceived autonomy support was related to improved scores on total symptoms and on excited symptoms regardless of treatment group and time. Conclusions: Overall, perceived autonomy support increased in NAVIGATE but not for those in community care and was related to improved quality of life and symptoms across both treatment groups. Future research should examine the impact of perceived autonomy support on a wider array of outcomes, including engagement, medication adherence, and functioning.

AB - Objective: This study examined perceived support for autonomy-the extent to which individuals feel empowered and supported to make informed choices-among participants in the Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP). The aims of this study were to evaluate whether NAVIGATE, the active treatment studied in RAISE ETP, was associated with greater improvements in perceived autonomy support over the two-year intervention, compared with community care, and to examine associations between perceived autonomy support and quality of life and symptoms over time and across treatment groups. Methods: This study examined perceived autonomy support among the 404 individuals with first-episode psychosis who participated in the RAISE ETP trial (NAVIGATE, N=223; community care, N=181). Three-level conditional linear growth modeling was used given the nested data structure. Results: The results indicated that perceived autonomy support increased significantly over time for those in NAVIGATE but not in community care. Once treatment began, higher perceived autonomy support was related to higher quality of life at six, 12, and 18 months in NAVIGATE and at 12, 18, and 24 months in community care. Higher perceived autonomy support was related to improved scores on total symptoms and on excited symptoms regardless of treatment group and time. Conclusions: Overall, perceived autonomy support increased in NAVIGATE but not for those in community care and was related to improved quality of life and symptoms across both treatment groups. Future research should examine the impact of perceived autonomy support on a wider array of outcomes, including engagement, medication adherence, and functioning.

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JO - Psychiatric Services

JF - Psychiatric Services

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ER -

Perceived autonomy support in the NIMH RAISE early treatment program

Abstract

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