Cognitive Remediation in Schizophrenia

Medalia, Alice; Choi, Julie

doi:10.1007/s11065-009-9097-y

Cited by 266 publications

(180 citation statements)

References 85 publications

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“…This suggestion is consistent with the work of Medalia and others, who have argued for a contextualized approach to rehabilitation that maximizes internal motivation. 235,236 Lastly, if the literature continues to support the crucial importance of individual differences in the degree to which schizophrenia have deficits in these different processes, this may suggest a basis for more individually tailored treatment approaches.…”

Section: Summary Suggestions For Future Research and Significancementioning

confidence: 99%

Goal Representations and Motivational Drive in Schizophrenia: The Role of Prefrontal-Striatal Interactions

Deanna

Dowd

2010

Schizophrenia Bulletin

424

325

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The past several years have seen a resurgence of interest in understanding the psychological and neural bases of what are often referred to as ''negative symptoms'' in schizophrenia. These aspects of schizophrenia include constructs such as asociality, avolition (a reduction in the motivation to initiate or persist in goal-directed behavior), and anhedonia (a reduction in the ability to experience pleasure). We believe that these dimensions of impairment in individuals with schizophrenia reflect difficulties using internal representations of emotional experiences, previous rewards, and motivational goals to drive current and future behavior in a way that would allow them to obtain desired outcomes, a deficit that has major clinical significance in terms of functional capacity. In this article, we review the major components of the systems that link experienced and anticipated rewards with motivated behavior that could potentially be impaired in schizophrenia. We conclude that the existing evidence suggests relatively intact hedonics in schizophrenia, but impairments in some aspects of reinforcement learning, reward prediction, and prediction error processing, consistent with an impairment in ''wanting.'' As of yet, there is only indirect evidence of impairment in anterior cingulate and orbital frontal function that may support value and effort computations. However, there are intriguing hints that individuals with schizophrenia may not be able to use reward information to modulate cognitive control and dorsolateral prefrontal cortex function, suggesting a potentially important role for cortical-striatal interactions in mediating impairment in motivated and goal-directed behavior in schizophrenia.

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Section: Summary Suggestions For Future Research and Significancementioning

confidence: 99%

Goal Representations and Motivational Drive in Schizophrenia: The Role of Prefrontal-Striatal Interactions

Deanna

Dowd

2010

Schizophrenia Bulletin

424

325

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“…A number of studies involving antipsychotic treatments, behavior therapy and rehabilitation are present. Trials of medication have met with little success, potentially requiring exploration of non-drug treatment [115]. Antipsychotic effects on cognition and pharmacological augmentation as a cognitive enhancement strategy have met with limited success.…”

Section: Neurocognitive Function and Schizophreniamentioning

confidence: 99%

Resilience Improves Neurocognition and Treatment Outcomes in Schizophrenia: A Hypothesis

Shrivastava¹,

Sousa²,

Sonavane³

et al. 2016

OJPsych

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There has been a revolutionary advance in the treatment and management of schizophrenia from a clinical aspect yet the social and functional outcomes remain poor. Cognitive function is impaired in schizophrenia and shows various domains of dysfunction like verbal memory, processing speed and working memory. It is also known to be a factor associated with poor outcome in schizophrenia. Resilience is a new concept psychobiological concept which is defined as individual's ability to adapt swiftly to adverse life events and bounces back to normalcy. Resilience has genetic, neurobiological, neurochemical and psychological underpinnings. It is the ability to effectively deal with psychosocial stressors and appears to be one of the many factors associated with favourable outcomes in schizophrenia. Besides several neurobiological abnormalities associated with resilience, neucognitive functions are of particular interest. Persistent psychosocial stressors also lead to significant neurobiological changes which may be synergetic to poor outcome due to cognitive changes. Though there has been extensive research in the field of cognitive function in schizophrenia, the trajectory of its pathway of poor outcome remains undetermined. Resilience being a protective factor may be one of the psychobiological functions which modulate the effect of neurocognition on the outcome of schizophrenia. There has been some success with interventions aimed at improving cognitive function in schizophrenia whether pharmacological or non pharmacological. In this paper, we discuss a hypothesis that resilience may be a "linkage" between cognition and outcome. There is a need for interventions aimed at increasing resilience in patients with schizophrenia and we hypothesize giving evidence that this may in turn improve outcome and neurocognitive functioning in schizophrenia.

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“…Also, these remediation effects are durable up to at least 6 months after the interventions are withdrawn [168]. Finally, and most importantly, these neuropsychological gains translate to improvements in real-world activities [169][170][171]. Similarily, cogni tive remediation programmes address prominent, complementary functional domains such as social cognition -and studies have furthermore observed beneficial effects on functional outcome measures in patient's posttreatment [172,173].…”

Section: Alternatives For Use Of Ce-drugsmentioning

confidence: 99%

Doping for Chess Performance

Golf¹

2015

J Sports Med Doping Stud

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During a chess game, the needed energy is first derived instantly from ATP and creatine-phosphate, then within a few seconds later from glycogen stores in brain, glycogen, muscle and liver and finally, 1-2 hours later from adipose tissue. Anaerobic oxidation of glucose-derivative from glycogen delivers energy 6 times faster than aerobic oxidation of glucose and oxidation of fatty acids; correspondingly, mental activity can perform as well 6 times faster as long as glycogen is available.The mental profile of chess players correlates with cerebral processes such as attention, conflict solution, memory, motivation and recognition, which together constitute a specific chess-domain expertise.A chess player may compete best when a) regularly physical exercise is carried out to compete in strenuous chess tournaments and to stimulate mental cognition, b) super compensated glycogen is accumulated in brain, muscle and liver by corresponding nutrition and physical and mental activities, and c. an active mental disposition is available for complex brain tasks during chess by complementary treatment schemes e.g., cogni-tive enhancement (CE) by chess training with chess boards, chess books, building chess images, visual observation of chess games, vocational training with chess, metacognitive training, and additionally regular light physical stress. An illicit improvement of brain performance for chess playing may be achieved by several measures:1.Increase of O 2 supply by therapy with erythropoietin (EPO) for chess tournaments at high altitudes and for chess players with lung diseases 2.Increase of body glycogen by therapy with insulin Regular non-medical use of steroid and proteohormones in elevated concentrations and CE-drugs must also consider numerous side effects ranging from simple metabolic disturbances through cardiac problems to cognitive decline to tumorgenesis and sudden death.

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Cognitive Remediation in Schizophrenia

Cited by 266 publications

References 85 publications

Goal Representations and Motivational Drive in Schizophrenia: The Role of Prefrontal-Striatal Interactions

Goal Representations and Motivational Drive in Schizophrenia: The Role of Prefrontal-Striatal Interactions

Resilience Improves Neurocognition and Treatment Outcomes in Schizophrenia: A Hypothesis

Doping for Chess Performance

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