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Does the Fast Track Intervention Prevent Later Psychosis Symptoms?

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Abstract

The Fast Track (FT) intervention was a multimodal preventive intervention addressing antisocial development across 10 years of childhood and early adolescence. The intervention included parent management training, child social-cognitive skills training, peer coaching and mentoring, academic skills tutoring, and a classroom social-emotional learning program. While not specifically designed to target psychosis symptoms (e.g., social withdrawal, thought abnormalities), the present study aimed to examine whether the FT intervention prevented psychosis symptoms through childhood and adolescence and into adulthood. Participants included the FT intervention and high-risk control samples (N = 891; 69% male; M age = 6.58 years, SD = .48). Psychosis symptoms were assessed using the “thought problems” subscale of the parent-report Child Behavior Checklist during grades 1, 2, 4, 5, and 7, and the self-report Adult Behavior Checklist at age 25 years, in line with prior research using this measure. Growth models included the FT condition and covariates (i.e., initial risk screen score, cohort, socioeconomic status, rural/urban status, race, and sex) as predictors; and child, adolescent, and adult psychosis symptoms as outcomes. Intervention status was not significantly associated with the slope of psychosis symptoms; however, after controlling for concurrent cannabis use, intervention participants reported lower levels of psychosis symptoms over time. Findings suggest that interventions targeting antisocial behavior may prevent psychosis symptoms in the long term.

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Notes

  1. Analyses were repeated with grade 1 removed and findings remained the same with the exception of the final model (i.e., whether the FT intervention prevented later psychosis symptoms after controlling for adolescent cannabis use), which no longer provided adequate fit to the data (χ2(104) = 649.879, p < .001, CFI = .382, RMSEA = .078, 90% CI [.072, .084]).

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Acknowledgments

Members of the Conduct Problems Prevention Research Group, in alphabetical order, are Karen L. Bierman, Pennsylvania State University; John D. Coie, Duke University; D. Max Crowley, Pennsylvania State University; Kenneth A. Dodge, Duke University; Mark T. Greenberg, Pennsylvania State University; John E. Lochman, University of Alabama; Robert J. McMahon, Simon Fraser University and B.C. Children’s Hospital Research Institute; and Ellen E. Pinderhughes, Tufts University.

We are grateful for the collaboration of the Durham Public Schools, the Metropolitan Nashville Public Schools, the Bellefonte Area Schools, the Tyrone Area Schools, the Mifflin County Schools, the Highline Public Schools, and the Seattle Public Schools. We appreciate the hard work and dedication of the many staff members who implemented the project, collected the evaluation data, and assisted with data management and analyses.

Funding

The Fast Track project has been supported by National Institute of Mental Health (NIMH) Grants R18MH48043, R18MH50951, R18MH50952, R18MH50953, R01MH062988, K05MH00797, and K05MH01027; National Institute on Drug Abuse (NIDA) Grants R01DA016903, K05DA15226, RC1DA028248, and P30DA023026; National Institute of Child Health and Human Development Grant R01HD093651; and Department of Education Grant S184U30002. The Center for Substance Abuse Prevention also provided support through a memorandum of agreement with the NIMH. Additional support for this study was provided by a B.C. Children’s Hospital Research Institute Investigator Grant Award and a Canada Foundation for Innovation Award to Robert J. McMahon.

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Correspondence to Natalie Goulter.

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Conflict of Interest

Drs. Bierman, Coie, Dodge, Greenberg, Lochman, McMahon, and Pinderhughes are the Principal Investigators on the Fast Track Project and have a publishing agreement with Guilford Publications, Inc. Royalties from that agreement will be donated to a professional organization. They are also authors of the PATHS curriculum and donate all royalties from Channing-Bete, Inc. to a professional organization. Dr. Greenberg is a developer of the PATHS curriculum and has a separate royalty agreement with Channing-Bete, Inc. Bierman, Coie, Dodge, Greenberg, Lochman, and McMahon are the developers of the Fast Track curriculum and have publishing and royalty agreements with Guilford Publications, Inc. Dr. McMahon is a coauthor of Helping the Noncompliant Child and has a royalty agreement with Guilford Publications, Inc.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants in the study.

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Goulter, N., McMahon, R.J., Dodge, K.A. et al. Does the Fast Track Intervention Prevent Later Psychosis Symptoms?. Prev Sci 20, 1255–1264 (2019). https://doi.org/10.1007/s11121-019-01041-1

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