Objective
Individuals with schizophrenia demonstrate cognitive, social cognitive and motivational deficits that contribute to impairment in real-world functioning. In the current study, we investigated the effects of supplementing computerized neurocognitive training with social cognitive exercises, as compared to neurocognitive training alone.
Methods
In this ongoing, double-blind, randomized controlled trial of 111 participants with psychosis, we compare the effects of supplementing intensive targeted cognitive training with social cognitive training exercises (TCT+SCT), to the effects of targeted cognitive training alone (TCT-only). Participants were assessed on cognition, symptoms, functional capacity and functional outcomes, as well as social cognition and measures related to reward processing.
Results
Both treatment groups showed significant improvement in multiple cognitive domains and improvement in functional capacity. However, as predicted, TCT+SCT group participants showed significant improvement in prosody identification and reward processing relative to TCT-only participants.
Conclusions and Implications for Practice
Our findings indicate that supplementing intensive computerized cognitive training with social cognitive exercises in people with psychosis confers greater benefits in prosody identification and reward processing relative to cognitive training alone, even though both approaches drive significant improvements in cognition and functional capacity. Impairments in both prosody identification and reward processing have been associated with greater negative symptoms and poorer functional outcomes in schizophrenia, raising the possibility that this form of treatment may lead to better long-term outcomes than traditional cognitive training approaches. Follow-up assessments will determine if results are durable and generalize over time to improvements in symptoms and functioning.
ClinicalTrials.gov Identifier
NCT02105779
This study explores the role that socioeconomic status (SES), home and school language and literacy practices, and oral vocabulary play in the development of English reading skills in Latino English language learners (ELLs) and how these factors contribute differentially to English reading BILINGUAL CHILDREN'S ENGLISH READING DEVELOPMENT 121 outcomes for children of different ages and in different settings: 292 Spanish-speaking kindergarteners in mostly English instruction, 85 Spanish-speaking third graders in bilingual instruction, and 70 Spanish-speaking fifth graders in both English and bilingual settings. Data were analyzed using hierarchical regression. Findings indicate that for each sample, English oral vocabulary is a significant predictor of English reading accuracy and comprehension once SES and home and school language and literacy factors have been considered. Beyond oral vocabulary, however, there is considerable variability across samples in the home and school language and literacy variables that are predictive of English reading outcomes. The study points to the importance of looking closely at the texture of children's lives in coming to an understanding of second-language literacy development.
BackgroundDeficits in cognition, social cognition, and motivation are significant predictors of poor functional outcomes in schizophrenia. Evidence of durable benefit following social cognitive training is limited. We previously reported the effects of 70 h of targeted cognitive training supplemented with social cognitive exercises (TCT + SCT) verses targeted cognitive training alone (TCT). Here, we report the effects six months after training.Methods111 participants with schizophrenia spectrum disorders were randomly assigned to TCT + SCT or TCT-only. Six months after training, thirty-four subjects (18 TCT + SCT, 16 TCT-only) were assessed on cognition, social cognition, reward processing, symptoms, and functioning. Intent to treat analyses was used to test the durability of gains, and the association of gains with improvements in functioning and reward processing were tested.ResultsBoth groups showed durable improvements in multiple cognitive domains, symptoms, and functional capacity. Gains in global cognition were significantly associated with gains in functional capacity. In the TCT + SCT group, participants showed durable improvements in prosody identification and reward processing, relative to the TCT-only group. Gains in reward processing in the TCT + SCT group were significantly associated with improvements in social functioning.ConclusionsBoth TCT + SCT and TCT-only result in durable improvements in cognition, symptoms, and functional capacity six months post-intervention. Supplementing TCT with social cognitive training offers greater and enduring benefits in prosody identification and reward processing. These results suggest that novel cognitive training approaches that integrate social cognitive exercises may lead to greater improvements in reward processing and functioning in individuals with schizophrenia.
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