A Pilot Study Comparing the Effectiveness and Durability of Two Therapeutic Models of Cognitive Remediation in Psychosis-Spectrum Disorders

Schizophrenia is known for its multitude of symptoms that impair every-day functioning, such as interpersonal relationships or vocational life. Symptoms and features include positive (hallucinations, delusions, etc.), negative (anhedonia, alogia, etc.), and cognitive (poor memory/concentration, etc.). Cognitive features manifest independently of the clinical impairments presented by positive and negative symptoms, while also not being well treated by antipsychotic medications. Alternative treatment methods for schizophrenia that specifically target cognitive deficits are needed. Cognitive remediation (CR) is a growing field in schizophrenia. However, the effectiveness and durability of CR still requires further research. Prior research shows the effectiveness of two therapeutic models: a computerized drill-and-practice approach and practice strategy-based compensatory cognitive training group. The present study aims to compare the effectiveness and analyze the durability of these two therapeutic models. It was hypothesized that participants in both conditions will demonstrate improvements in cognitive features in comparison to the control group; however, participants in the CCT condition will show larger improvements in functional outcome compared the PSSCogRehab condition. Furthermore, assessing the durability of CR at RVS will demonstrate significant results for each CR condition compared to control group. Participants were recruited from River Valley Services in Middletown, CT and randomly assigned to either one of two CR groups or treatment as usual (control). Effectiveness of the CR approaches was assessed by multimodal evaluation of symptoms and functioning, collected at baseline, immediately after the intervention, and after 3-months. The results demonstrate mostly non-significant differences between the treatment and control; however, effect sizes are demonstrating promising improvements amongst the treatment groups compared to the control. Furthermore, the study is currently not indicating strong durable effects.