Effectiveness of Attention Training in Schizophrenia

Medalia, Alice; Aluma, Manuel; Tryon, Warren W.; Merriam, Arnold E.

doi:10.1093/oxfordjournals.schbul.a033306

Cited by 171 publications

(94 citation statements)

References 25 publications

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“…Cognitive rehabilitation approaches that directly aim to promote task engagement through the use of intrinsic (Medalia et al 1998) or extrinsic ) reinforcers appear to be the only forms of cognitive rehabilitation for schizophrenia that demonstrate clinically meaningful real-world improvements in neuropsychological functioning.…”

Section: R122 Implications For Psychological Interventionsmentioning

confidence: 99%

Convergence of biological and psychological perspectives on cognitive coordination in schizophrenia

Phillips¹,

Silverstein²

2003

Behav Brain Sci

374

314

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Cognitive neuroscience provides a new conceptual framework for psychiatry by showing how psychological processes arise from neuronal activity (Kandel 1998). Conversely, it is possible that psychiatry will influence the future development of cognitive neuroscience by encouraging a better balance between localist and holistic conceptions of brain function. An apparent conflict between these conceptions has been central to the development of neuroscience, with the emphasis upon locally specialized functions emerging as clearly dominant. Neuroanatomy, neurophysiology, neuropsychology, and neuroimaging all show that different regions of the brain process information about different things, and that different cells within regions deal with different aspects of those things. Recent developments in experimental and theoretical neurobiology, however, are leading to an increased emphasis upon interactions that coordinate the activity of locally specialized processors. Here we argue that impairment of these coor-BEHAVIORAL AND BRAIN SCIENCES (2003) Abstract:The concept of locally specialized functions dominates research on higher brain function and its disorders. Locally specialized functions must be complemented by processes that coordinate those functions, however, and impairment of coordinating processes may be central to some psychotic conditions. Evidence for processes that coordinate activity is provided by neurobiological and psychological studies of contextual disambiguation and dynamic grouping. Mechanisms by which this important class of cognitive functions could be achieved include those long-range connections within and between cortical regions that activate synaptic channels via NMDAreceptors, and which control gain through their voltage-dependent mode of operation. An impairment of these mechanisms is central to PCP-psychosis, and the cognitive capabilities that they could provide are impaired in some forms of schizophrenia. We conclude that impaired cognitive coordination due to reduced ion flow through NMDA-channels is involved in schizophrenia, and we suggest that it may also be involved in other disorders. This perspective suggests several ways in which further research could enhance our understanding of cognitive coordination, its neural basis, and its relevance to psychopathology.Keywords: attention; cerebral cortex; cognitive coordination; cognitive neuropsychiatry; cognitive neuropsychology; context disorganization; Gamma rhythms; Gestalt theory; glutamate; grouping; memory; NMDA-receptors; PCP-psychosis; perceptual organization; schizophrenia William A. Phillips, Ph.D., is Professor of Neuropsychology at the University of Stirling, Scotland UK. He has published more than 70 papers on vision, visual memory, perceptual learning, childrens drawings, the effects of brain damage on reading and writing, and the theory of neuronal computation. He was a founder and the first Director of the Center for Cognitive and Computational Neuroscience at the University of Stirling.Steven M. Silverstein, Ph.D., is A...

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Section: R122 Implications For Psychological Interventionsmentioning

confidence: 99%

Convergence of biological and psychological perspectives on cognitive coordination in schizophrenia

Phillips¹,

Silverstein²

2003

Behav Brain Sci

374

314

View full text Add to dashboard Cite

show abstract

“…Thus, the allure of cognitive remediation for schizophrenia has grown in recent years following reports of reduced symptom expression (Medalia et al, 1998(Medalia et al, , 2000 and improved cognitive (Spaulding et al, 1999) and work functioning (Wexler and Bell, 2005) in schizophrenia patients undergoing training on attention and working memory tasks.…”

Section: Introductionmentioning

confidence: 99%

Prefrontal Cortical Changes Following Cognitive Training in Patients with Chronic Schizophrenia: Effects of Practice, Generalization, and Specificity

Haut

Lim

MacDonald

2010

Neuropsychopharmacol

152

120

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Cognitive training is increasingly used in the treatment of schizophrenia, but it remains unknown how this training affects functional neuroanatomy. Practice on specific cognitive tasks generally leads to automaticity and decreased prefrontal cortical activity, yet broadbased cognitive training programs may avoid automaticity and increase prefrontal cortex (PFC) activity. This study used quasirandomized, placebo-control design and pre/post neuroimaging to examine functional plasticity associated with attention and working memory-focused cognitive training in patients with schizophrenia. Twenty-one participants with schizophrenia or schizoaffective disorder split into two demographically and performance matched groups (nine scanned per group) and nine control participants were tested 6-8 weeks apart. Compared with both patient controls and healthy controls, patients receiving cognitive training increased activation significantly more in attention and working memory networks, including dorsolateral prefrontal cortex, anterior cingulate and frontopolar cortex. The extent to which activity increased in a subset of these regions predicted performance improvements. Although this study was not designed to speak to the efficacy of cognitive training as a treatment, it is the first study to show that such training can increase the ability of patients to activate the PFC regions subserving attention and working memory.

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“…The importance of the QLS in assessing outcome in schizophrenia research has also been highlighted by the observed relation between neurocognitive impairment and psychosocial status (Green, 1996;Buchanan et al, 1994;Medalia et al, 1998;Wykes et al, 1999).…”

Section: Introductionmentioning

confidence: 99%

Development of an Abbreviated Schizophrenia Quality of Life Scale Using a New Method

Bilker

Brensinger

Kurtz

et al. 2002

Neuropsychopharmacol

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The goal of the study was to develop and apply a predictive model approach to reduce the number of items collected for scales that yield a total summary score. A parsimonious subset of items from the 21-item Quality of Life Scale (QLS) that can accurately predict the total scale score was sought and evaluated in 198 patients with schizophrenia, using a statistical modeling approach. Two additional data sets were used for model validation: the subset of 101 patients used in the model construction who had the QLS administered approximately 1 year later and a new sample of 37 patients. Using only seven QLS items as predictors, the correlation was 0.9831 between the predicted and true QLS totals. Applying the model based for these seven QLS items, the correlations from the first and second validation data sets were 0.9791 and 0.9637, respectively. The study demonstrates that a small subset of items of the QLS predicts the entire 21-item scale with high accuracy. Two validation samples have confirmed the finding. This reduces the effort associated with scale administration and is likely to increase the assessment of an important functional domain. Such models can guide efforts for item reduction in other rating instruments.

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Effectiveness of Attention Training in Schizophrenia

Cited by 171 publications

References 25 publications

Convergence of biological and psychological perspectives on cognitive coordination in schizophrenia

Convergence of biological and psychological perspectives on cognitive coordination in schizophrenia

Prefrontal Cortical Changes Following Cognitive Training in Patients with Chronic Schizophrenia: Effects of Practice, Generalization, and Specificity

Development of an Abbreviated Schizophrenia Quality of Life Scale Using a New Method

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