Developing a Cognitive Training Strategy for First-Episode Schizophrenia: Integrating Bottom-Up and Top-Down Approaches.

It is clear that people with schizophrenia typically have cognitive problems in multiple domains as part of their illness. The cognitive deficits are among the main contributors to limitations in their everyday functioning, including their work recovery. Cognitive remediation has been applied succes...

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Publicado en:American Journal of Psychiatric Rehabilitation Vol. 17; no. 3; pp. 225 - 254
Autores principales: Nuechterlein, Keith H., Ventura, Joseph, Subotnik, Kenneth L., Hayata, Jacqueline N., Medalia, Alice, Bell, Morris D.
Formato: tables/charts Journal Article
Publicado: Taylor & Francis Ltd Jul-Sep2014
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jul-Sep2014
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      pub: Taylor & Francis Ltd
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        atl: Developing a Cognitive Training Strategy for First-Episode Schizophrenia: Integrating Bottom-Up and Top-Down Approaches.
      aug:
        au:
          Nuechterlein, Keith H.
          Ventura, Joseph
          Subotnik, Kenneth L.
          Hayata, Jacqueline N.
          Medalia, Alice
          Bell, Morris D.
        affil: Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, and Department of Psychology, UCLA, Los Angeles, California, USA
      sug:
        subj:
          Cognitive Therapy Methods
          Schizophrenia Psychosocial Factors
          Schizophrenia Therapy
          Cognition
          Schizophrenia Rehabilitation
          Rehabilitation, Psychosocial
          Psychiatrists
          Skill Acquisition
          Employment, Supported
          Therapy, Computer Assisted
      ab: It is clear that people with schizophrenia typically have cognitive problems in multiple domains as part of their illness. The cognitive deficits are among the main contributors to limitations in their everyday functioning, including their work recovery. Cognitive remediation has been applied successfully to help people with long-term, persistent schizophrenia to improve their cognitive functioning, but it is only beginning to be applied with individuals who have recently had a first episode of psychosis. Several different approaches to cognitive training have been developed. Some approaches emphasize extensive systematic practice with lower-level cognitive processes and building toward higher-level processes (bottom-up), while others emphasize greater focus on high-level cognitive processes that normally integrate and organize lower-level processes (top-down). Each approach has advantages and disadvantages for a disorder like schizophrenia, with its multiple levels of cognitive dysfunction. In addition, approaches to cognitive remediation differ in the extent to which they systematically facilitate transfer of learning to everyday functioning. We describe in this article the cognitive training approach that was developed for a UCLA study of people with a recent first episode of schizophrenia, a group that may benefit greatly from early intervention that focuses on cognition and recovery of work functioning. This approach integrated bottom-up and top-down computerized cognitive training and incorporated an additional weekly group session to bridge between computerized training and application to everyday work and school functioning.
      pubtype: Academic Journal
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        tables/charts
        Journal Article
      ougenre: Article
    language: English
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