Publication Date

5-2017

Advisor(s)

Matthew M. Kurtz, Charles A. Sanislow, Helen B. Treloar

Department

Neuroscience & Behavior

Language

English

Abstract

Neurocognitive deficits represent one of the major factors contributing to poor functional outcome in patients with schizophrenia. Therefore, cognitive deficit remediation therapy, a novel form of skills-training intervention that aims to improve neurocognitive deficits, is being implemented more frequently at in- and out-patient psychiatric facilities. Though this practice is increasingly widespread, the type of cognitive remediation therapy used varies greatly. While several forms of cognitive remediation therapy have demonstrated some efficacy, questions remain regarding which cognitive remediation therapies are most efficacious at specified parameters.

One of the oldest and most well-established forms of cognitive remediation therapy is a drill-and-practice restorative computerized cognitive training program called Neuropsychonline Cognitive Rehabilitation Therapy System (PSSCogRehab) (Bracy, 1994). There have been 32 studies conducted investigating the efficacy of this specific computer program. More recently, a strategy-based compensatory cognitive remediation training program called the Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) was developed by Elizabeth Twamley, PhD (Twamley, Vella, Burton, Heaton, & Jeste, 2012). Fifteen studies have investigated the efficacy of CogSMART, but no study has compared the efficacy of a strategy-based compensatory approach to cognitive remediation (CogSMART) to a program of restorative cognitive remediation (PSSCogRehab).

Data was collected from nine patients diagnosed with schizophrenia or schizoaffective disorder. Patients were given a baseline battery of neuropsychological tests, a clinical scale, and functional outcome measures and were then randomly assigned to one of three conditions (drill-and-practice restorative cognitive remediation, strategy-based compensatory cognitive remediation, or wait-list control). Interventions were administered for three weeks, and then participants were reassessed immediately post-training on several of the neurocognitive tests and one measure of function.

The results demonstrated that 1) neither type of cognitive remediation therapy improved outcome measures, as demonstrated by nonsignificant difference between baseline and follow-up assessments, and 2) neither type of cognitive remediation therapy was more efficacious than the other. However, these findings were probably observed because of the small sample size and short duration of training. Therefore, completion of a longer duration of training with larger cohorts of patients is required to better address the research question at hand.

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