A Randomized, Controlled Trial of Computer-Assisted Cognitive Remediation for Schizophrenia.
Objective: There is considerable interest in cognitive remediation for schizophrenia, but its essential components are still unclear. The goal of the current study was to develop a broadly targeted computer-assisted cognitive remediation program and conduct a rigorous clinical trial in a large group...
| Published in: | American Journal of Psychiatry Vol. 167; no. 2; pp. 170 - 181 |
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| Main Authors: | , , , , , , , , |
| Format: | Article |
| Published: |
American Psychiatric Publishing, Inc.
February 2010
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| Subjects: | |
| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ssf&AN=513188075&site=ehost-live header: @attributes: shortDbName: ssf uiTerm: 513188075 longDbName: Social Sciences Full Text (H.W. Wilson) uiTag: AN controlInfo: bkinfo: jinfo: jid: 0002953X API jtl: American Journal of Psychiatry issn: 0002953X maglogo: N pubinfo: dt: February 2010 vid: 167 iid: 2 pid: 37323 pub: American Psychiatric Publishing, Inc. artinfo: ui: 513188075 10.1176/appi.ajp.2009.09020264 ppf: 170 ppct: 11 formats: tig: atl: A Randomized, Controlled Trial of Computer-Assisted Cognitive Remediation for Schizophrenia. aug: au: Dickinson, Dwight Tenhula, Wendy Morris, Sarah Brown, Clayton Peer, Jason Spencer, Katrina Li, Lan Gold, James M. Bellack, Alan S. su: Schizophrenia Rehabilitation of people with mental illness Psychotherapy Computer software sug: subj: Schizophrenia Rehabilitation of people with mental illness Psychotherapy Computer software ab: Objective: There is considerable interest in cognitive remediation for schizophrenia, but its essential components are still unclear. The goal of the current study was to develop a broadly targeted computer-assisted cognitive remediation program and conduct a rigorous clinical trial in a large group of schizophrenia patients. Method: Sixty-nine people with schizophrenia or schizoaffective disorder were randomly assigned to 36 sessions of computer-assisted cognitive remediation or an active control condition. Remediation broadly targeted cognitive and everyday performance by providing supportive, graduated training and practice in selecting, executing, and monitoring cognitive operations. It used engaging computer-based cognitive exercises and one-on-one training. A total of 61 individuals (34 in remediation group, 27 in control group) engaged in treatment, completed posttreatment assessments, and were included in intent-to-treat analyses. Primary outcomes were remediation exercise metrics, neuropsychological composites (episodic memory, working memory, attention, executive functioning, and processing speed), and proxy measures of community functioning. Results: Regression modeling indicated that performance on eight of 10 exercise metrics improved significantly more in the remediation condition than in the control condition. The mean effect size, favoring the remediation condition, was 0.53 across all 10 metrics. However, there were no significant benefits of cognitive remediation on any neuropsychological or functional outcome measure, either immediately after treatment or at the 3-month follow-up. Conclusions: Cognitive remediation for people with schizophrenia was effective in improving performance on computer exercises, but the benefits of training did not generalize to broader neuropsychological or functional outcome measures. The evidence for this treatment approach remains mixed. Reprinted by permission of the publisher. pubtype: Academic Journal doctype: Article src: R language: English refInfo: copyright: @attributes: flag: N holdings: @attributes: islocal: N |
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