# Developing Clinical Translational Tools to Communicate Genetic Risk to Individuals who are at Clinical High Risk for Psychosis

> **NIH NIH R21** · NEW YORK UNIVERSITY · 2020 · $248,622

## Abstract

Great strides are being made in identifying early signs that put people in a ‘high risk state’ for illnesses,
enabling identification during what has been called a ‘high risk state’. Individuals in a ‘high-risk state’ are
starting to show signs of a disorder, but do not yet have the full disorder. At the same time, advances are being
made in identifying genes associated with ‘high-risk states’. How people interpret the increased genetic risk of
developing the full disorder carries important consequences for how they choose to respond, which may range
from fatalistic acceptance of the disorder to proactive preventative behavior. One way of framing genetic risk,
‘genetic malleability’, stresses that genes confer a modifiable risk that may be turned on or off by risky or
protective behavior, or by engaging in treatment. Specifically, the ‘malleability’ framing may promote personal
efficacy, and hence improved treatment engagement, in potentially averting the expression of genes that
induce a disorder. With the aim to encourage an active pro-health response, we seek to develop two tools to
convey genetic risk information to youth and young adults identified as in a ‘clinical high-risk state’ (CHR) for
psychosis. The two tools will consist of: 1) a clinician manual, designed to be used by non-genetic trained
clinicians to communicate risk to CHR youth; 2) a high-impact, computerized tutorial (‘AutoTutor’) that has
been used to convey genetic risk for the BRCA gene for breast cancer. We assess primary outcomes of
increased intent to promote treatment and healthy behaviors, and secondary outcomes of reduction in stigma.
For each tool, participants will be conveyed hypothetical information proposing being identified as having a
substantially elevated, genetically-malleable risk for developing psychosis. Development of a manual has the
potential to guide clinical interactions among non-genetics trained clinicians with CHR youth, while an
interactive, computer-based tool for CHR youth supports self-management. Understanding how this genetic
framing may impact ‘high risk’ individuals’ orientation to treatment is crucial because the ‘high-risk’ state is a
juncture where preventive actions or early intervention may alter the illness trajectory itself. Because of the
relatively large innovation involved in our project, we seek to establish initial acceptability, safety, and efficacy
of each tool. We then test a nonrandomized, within-subject, pre- vs. post design by examining whether
providing the ‘genetic malleable’ framing via each tool (n=27 CHR youth per tool, N=54 total) leads to improved
outcomes. Because the CHR is prototypical of ‘high-risk states’ in that CHR has identifiable genetic and
environmental/behavioral risk factors, these new translational tools could greatly facilitate dissemination of a
beneficial genetic malleability framing to high-risk individuals. This study could be transformative in providing
genetic information to maximize treatment ...

## Key facts

- **NIH application ID:** 9995015
- **Project number:** 5R21HG010420-02
- **Recipient organization:** NEW YORK UNIVERSITY
- **Principal Investigator:** LAWRENCE H YANG
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $248,622
- **Award type:** 5
- **Project period:** 2019-08-13 → 2022-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9995015

## Citation

> US National Institutes of Health, RePORTER application 9995015, Developing Clinical Translational Tools to Communicate Genetic Risk to Individuals who are at Clinical High Risk for Psychosis (5R21HG010420-02). Retrieved via AI Analytics 2026-05-22 from https://api.ai-analytics.org/grant/nih/9995015. Licensed CC0.

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