Computer-assisted cognitive remediation combined with strategic instruction achieves greater improvement in cognition than an active control in schizophrenia
Year: 2018
Type: conference-paper
Study designs: Randomized Controlled Trial, Clinical Trial
Abstract: Background and aims: Cognitive impairment is a core feature of schizophrenia and predicts psychosocial disability. Cognitive remediation (CR) has shown promise for addressing cognitive dysfunction in this illness. A limitation of past research, however, is that CR often occurs alongside other psychosocial interventions, preventing assessment of unique efficacy. Active control conditions and follow-up assessments are also inconsistently utilized. This study explored whether computer-assisted ‘drill-and-strategy’ cognitive remediation would produce greater improvements in cognition, living skills and selfefficacy than a computer gaming (CG) control. Method: Fifty-six outpatients with schizophrenia were randomized into CR or CG, and offered 20 one-hour computer sessions over 10 weeks. Cognition, psychiatric symptoms, independent living skills, self-efficacy and quality of life were assessed at baseline, end-group and 3 months follow-up. Results: Primary analysis was conducted for participants who completed the end-group assessment (CR=22; Control=21). Linear mixedeffect analysis found a significant interaction effect for cognition (p=.028). Bonferroni-adjusted pairwise comparisons revealed that cognition was better at end-group and 3 month follow-up than baseline for CR participants (both p<.01), with no differences between timepoints for control participants. A significant time effect was evident for self-efficacy (p=.028), with both conditions showing higher self-efficacy at end-group than baseline. No other significant effects were observed. Conclusions: CR combined with internal cognitive strategies may achieve unique improvements in cognition in people with schizophrenia, whereas broader participation in facilitated social groups may achieve improvements in everyday selfefficacy. An explicit focus on the translation of learning experiences may, however, be needed to achieve significant functional improvements.
Authors: Bryce, S., Lawrence, R., Ponsford, J., Rossell, S. L., Carruthers, S., Tan, E., Lee, S.
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7046254066