Effects of Multidimensional Treatment Foster Care on Psychotic Symptoms in Girls: RH = MTFC and Psychotic Symptoms

Objective—Neurodevelopmental theories of psychosis highlight the potential benefits of early intervention, prevention, and/or preemption. How early intervention should take place has not been established, nor if interventions based on social learning principles can have preemptive effects. The objective was to test if a comprehensive psychosocial intervention can significantly © 2014 American Academy of Child and Adolescent Psychiatry. All rights reserved. Correspondence to Leslie D. Leve, PhD, University of Oregon, 6217 University of Oregon, Eugene, OR 97403; [email protected]. Disclosure: Dr. Chamberlain is a partner in TFC Consultants Inc., which disseminates multidimensional treatment foster care. Drs. Poulton, Ryzin, Harold, Cannon, Arseneault, and Leve and Mr. Fowler report no biomedical financial interests or potential conflicts of interest. Clinical trial registration information—Juvenile Justice Girls Randomized Control Trial: Young Adult Follow-up; http:// clinicaltrials.gov/; NCT01341626. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author Manuscript J Am Acad Child Adolesc Psychiatry. Author manuscript; available in PMC 2015 December 01. Published in final edited form as: J Am Acad Child Adolesc Psychiatry. 2014 December ; 53(12): 1279–1287. doi:10.1016/j.jaac. 2014.08.014. N IH -P A A uhor M anscript N IH -P A A uhor M anscript N IH -P A A uhor M anscript alter psychotic symptom trajectories during adolescence – a period of heightened risk for a wide range of psychopathology. Method—This study was a randomized controlled trial (RCT) of Multidimensional Treatment Foster Care (MTFC) for delinquent adolescent girls. Assessment of psychotic symptoms took place at baseline and then 6, 12, 18, and 24 months post-baseline using a standardized self-report instrument (Brief Symptom Inventory). A second source of information about psychotic symptoms was obtained at baseline or 12 months, and again at 24 months using a structured diagnostic interview (the Diagnostic Interview Schedule for Children [DISC]). Results—Significant benefits for MTFC over treatment-as-usual for psychosis symptoms were observed over a 24-month period. Findings were replicated across both measures. Effects were independent of substance use and initial symptom severity, and persisted beyond the initial intervention period. Conclusion—Ameliorating non-clinical psychotic symptoms trajectories beginning in early adolescence via a multifaceted psychosocial intervention is possible. Developmental research on non-clinical psychotic symptoms and their prognostic value should be complemented by more psychosocial intervention research aimed at modifying these symptom trajectories early in their natural history.