# YOUNG ADULTS WITH VIOLENT BEHAVIOR DURING EARLY PSYCHOSIS: A MIXED-METHODS ASSESSMENT AND INTERVENTION TRIAL

> **NIH NIH K23** · COLUMBIA UNIVERSITY HEALTH SCIENCES · 2022 · $192,456

## Abstract

Project Summary: Although the absolute risk of violence among persons with serious mental illnesses (SMI)
is small, young people experiencing early psychosis are a subgroup at highest violence risk. Violence is a
public health issue that contributes to health disparities experienced by adults with schizophrenia, including
caregiver burden, social isolation, and incarceration and subsequent early mortality. Cognitive behavioral
therapy (CBT) for psychosis and similar behavioral interventions have had efficacy in reducing impairment and
improving functioning among young adults with early psychosis. However, no identified studies have explored
using a behavioral intervention to reduce violence among young adults with early psychosis.
 In this application, Dr. Stephanie Rolin proposes a comprehensive path towards becoming an independent
physician investigator creating and adapting evidence-based approaches to assess and reduce violence risk.
Specifically, this proposal follows the CDC’s Map of Adaptation, a model for adapting evidence-based
interventions (EBI), to adapt and evaluate the feasibility of an early intervention services (EIS)-specific CBT-
based intervention to reduce violence with proposed targets consistent with the transdiagnostic nature of
Research Domain Criteria (RDoC). This research will occur at OnTrackNY, the largest EIS program in the
United States; OnTrackNY has provided evidence-based coordinated specialty care to over 1,800 individuals
at more than 20 clinics in New York State. First, Dr. Rolin will conduct individual semi-structured interviews with
EIS clients who have engaged in recent violent behavior (n=20) and clinicians who have worked with EIS
clients who have engaged in violent behavior (n=10). These interviews will use the Theory of Planned Behavior
to identify key areas of an existing CBT model called PICASSO (which has shown efficacy in reducing
violence) that require adaptation for the EIS setting. Next, Dr. Rolin will adapt the PICASSO model for the EIS
setting in an open pilot trial, through an iterative process that utilizes mixed methods assessment. Finally, Dr.
Rolin will evaluate the intervention’s feasibility through a pilot RCT.
 To further her long-term career goal of becoming an independent physician-investigator focused on creating
and adapting EBI to reduce violence risk, Dr Rolin will pursue training in the following four areas: (1) qualitative
research including mixed methods; (2) psychosocial intervention adaptation; (3) psychotherapy clinical trials;
and (4) grant writing. The product of this study will be an R01 of a large RCT to test the feasibility of the first
EBI of CBT to reduce violence in the EIS setting. Overall, this award will ensure Dr. Rolin’s successful
transition to an independent physician investigator studying the assessment and prevention of violence among
adults with SMI.

## Key facts

- **NIH application ID:** 10487544
- **Project number:** 5K23MH126312-02
- **Recipient organization:** COLUMBIA UNIVERSITY HEALTH SCIENCES
- **Principal Investigator:** Stephanie Rolin
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $192,456
- **Award type:** 5
- **Project period:** 2021-09-13 → 2026-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10487544

## Citation

> US National Institutes of Health, RePORTER application 10487544, YOUNG ADULTS WITH VIOLENT BEHAVIOR DURING EARLY PSYCHOSIS: A MIXED-METHODS ASSESSMENT AND INTERVENTION TRIAL (5K23MH126312-02). Retrieved via AI Analytics 2026-05-21 from https://api.ai-analytics.org/grant/nih/10487544. Licensed CC0.

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