Computer-assisted cognitive remediation in adolescents with psychosis or at risk for psychosis: a 6-month follow-up

Abstract

Objective: To investigate short-term outcomes of a computer-assisted cognitive remediation (CACR) for adolescents with psychotic disorders or at high risk for psychosis. Method: Cognitive abilities and clinical status were assessed at baseline (N = 32) and at 6-month follow-up (N = 22) after enrolment in either a CACR (treatment group) or a computer games (control group) program (8 weeks). Results: With regard to the cognitive abilities, no amelioration was found in the control group while, in the CACR group, significant improvements in inhibition (p = 0.040) and reasoning (p = 0.005) were observed. Furthermore, symptom severity decreased significantly in the control group (p = 0.046) and marginally in the CACR group (p = 0.088). Improvements in cognitive abilities were not associated with symptoms' amelioration. Finally, increase in reasoning abilities was related to the median effective work time in sessions of CACR (R = 0.64, p = 0.024). Conclusion: At follow-up, enhanced cognitive abilities (reasoning and inhibition), which are necessary for executing higher-order goals or adapting behaviour to the ever-changing environment, were reported in adolescents participants of the CACR. Thus, further studies are needed to confirm and extend these interesting results.

Cognitive Remediation in Schizophrenia: Current Status and Future Perspectives

“…The results indicate that prodromal patients can improve their long-term verbal memory, attention, and concentration after cognitive training. Another study investigated short-term outcomes of CACR in adolescents with psychotic disorders or at high risk of psychosis [41]. The analysis of data revealed significant differences between baseline and followup in executive function and reasoning abilities, with better performances at followup only in the CACR group.…”

Could training executive function improve treatment outcomes for eating disorders?

“…However, the training failed to yield improvements in depression symptoms, and other results suggest that clinical benefits of such a training can only be observed when administered in conjunction with psychotherapy (Bowie et al, 2013). Several studies have demonstrated that high-frequency, computerized cognitive training ameliorates deficits in cognitive flexibility among those with schizophrenia (Bellucci, Glaberman, & Haslam, 2003; Dickinson et al, 2010; Urben et al, 2012). Results on generalization of cognitive gains to clinical and psychosocial improvements are mixed (Cavallaro et al, 2009; Urben et al, 2012).…”

“…Several studies have demonstrated that high-frequency, computerized cognitive training ameliorates deficits in cognitive flexibility among those with schizophrenia (Bellucci, Glaberman, & Haslam, 2003; Dickinson et al, 2010; Urben et al, 2012). Results on generalization of cognitive gains to clinical and psychosocial improvements are mixed (Cavallaro et al, 2009; Urben et al, 2012). Indeed, most studies that yielded improved behavioral outcomes were confounded by the inclusion of psychotherapeutic intervention, which included practice of specific behavioral strategies to improve psychosocial functioning (Bowie & Gupta, 2013; Wykes et al, 2011).…”

Examining the durability of a hybrid, remote and computer‐based cognitive remediation intervention for adolescents with 22q11.2 deletion syndrome

“…In a recent, randomized, controlled CR study applied individually (40 sessions) to adolescent out‐patients using paper and pencil tasks, Puig et al reported that participants maintained cognitive gains in executive functions, verbal and working memory, and overall composite cognitive scores at 3 months post‐CR intervention. Compared to baseline measures only, cognitive improvements in reasoning and executive function were found 6 months following an 8‐week/16 session computer‐assisted CR intervention among another group of in‐patient adolescents with, or at risk for psychosis …”

“…Earlier durability studies with adult schizophrenia patients concluded that training effects endured 6 months and up to 1 year after the cessation of CR treatment. The positive effects of CR for adolescents at risk for, or with, early onset psychosis have also been found to persist at 3 months, 6 months and 12 months post‐intervention . Although effects in schizophrenia are promising, to our knowledge, no durability studies investigating CR and adolescents with 22q11DS currently exist: thus, the durability of CR effects in this population remains unknown.…”