Journal or Book Title
Few studies have investigated predictors of response to cognitive remediation interventions in patients with schizophrenia. Predictor studies to date have selected treatment outcome measures that were either part of the remediation intervention itself or closely linked to the intervention with no studies investigating factors that predict generalization to measures of everyday life-skills as an index of treatment-related improvement. In the current study we investigated the relationship between four measures of neurocognitive function, crystallized verbal ability, auditory sustained attention and working memory, verbal learning and memory, and problem-solving, two measures of symptoms, total positive and negative symptoms, and the process variable of treatment intensity to change on a performance-based measure of everyday life-skills after a year of computer-assisted cognitive remediation offered as part of intensive outpatient rehabilitation treatment. Forty patients with schizophrenia or schizoaffective disorder were studied. Results of a linear regression model revealed that auditory attention and working memory predicted a significant amount of the variance in change in performance-based measures of everyday life skills after cognitive remediation, even when variance for all other neurocognitive variables in the model was accounted for. Stepwise regression revealed that auditory attention and working memory predicted change in everyday life-skills across the trial even when baseline life-skill scores, symptoms and treatment intensity variables were controlled. These findings emphasize the importance of sustained auditory attention and working memory for benefiting from extended cognitive remediation and suggest the addition of supplementary training in elementary attention and working memory skills prior to remediation in those patients unlikely to show benefit.
Kurtz MM, Seltzer JC, Fujimoto M, Shagan DS, Wexler BE. (2009). Predictors of Change in Life Skills in Schizophrenia after Cognitive Remediation. Schizoph Res, 107, 267-274.