Integrative cognitive remediation for early psychosis: Results from a randomized controlled trial

Vidarsdottir, Olina G.; Roberts, David L.; Twamley, Elizabeth W.; Guðmundsdóttir, Berglind; Sigurðsson, Engilbert; Magnúsdóttir, Brynja B.

doi:10.1016/j.psychres.2019.02.007

Cited by 30 publications

(16 citation statements)

References 52 publications

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“…Future studies should investigate if the individuals with greatest GM loss in these regions (who may also have the greatest vulnerability for more subsequent and severe psychotic episodes) can benefit from more intensive and integrative therapies of combined pharmacotherapy, CT 44 and neuromodulation 45 . If identified early in young adulthood, cerebellum-temporal-thalamic-prefrontal GM loss may reflect an important indicator to provide early and intensive interventions to mitigate and reduce the impact of future and more severe psychotic episodes on functioning 46 , 47 .…”

Section: Discussionmentioning

confidence: 99%

Multivariate pattern analysis of brain structure predicts functional outcome after auditory-based cognitive training interventions

et al. 2021

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Cognitive gains following cognitive training interventions are associated with improved functioning in people with schizophrenia (SCZ). However, considerable inter-individual variability is observed. Here, we evaluate the sensitivity of brain structural features to predict functional response to auditory-based cognitive training (ABCT) at a single-subject level. We employed whole-brain multivariate pattern analysis with support vector machine (SVM) modeling to identify gray matter (GM) patterns that predicted higher vs. lower functioning after 40 h of ABCT at the single-subject level in SCZ patients. The generalization capacity of the SVM model was evaluated by applying the original model through an out-of-sample cross-validation analysis to unseen SCZ patients from an independent validation sample who underwent 50 h of ABCT. The whole-brain GM volume-based pattern classification predicted higher vs. lower functioning at follow-up with a balanced accuracy (BAC) of 69.4% (sensitivity 72.2%, specificity 66.7%) as determined by nested cross-validation. The neuroanatomical model was generalizable to an independent cohort with a BAC of 62.1% (sensitivity 90.9%, specificity 33.3%). In particular, greater baseline GM volumes in regions within superior temporal gyrus, thalamus, anterior cingulate, and cerebellum predicted improved functioning at the single-subject level following ABCT in SCZ participants. The present findings provide a structural MRI fingerprint associated with preserved GM volumes at a single baseline timepoint, which predicted improved functioning following an ABCT intervention, and serve as a model for how to facilitate precision clinical therapies for SCZ based on imaging data, operating at the single-subject level.

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Section: Discussionmentioning

confidence: 99%

Multivariate pattern analysis of brain structure predicts functional outcome after auditory-based cognitive training interventions

et al. 2021

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“…The test‐retest reliability of the Icelandic versions of the social‐cognitive measures was reported in a previous study by our group (Vidarsdottir et al ., ).…”

Section: Methodsmentioning

confidence: 99%

Social and non‐social measures of cognition for predicting self‐reported and informant‐reported functional outcomes in early psychosis

Vidarsdottir

Twamley

Roberts

et al. 2019

Scandinavian J Psychology

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The main aim of this study was to investigate the individual contributions of neurocognitive and social‐cognitive domains to self‐reported and informant‐reported functional outcome in early psychosis. We also sought to further characterize the nature of cognitive impairments in this sample and explore the interrelationships between the social‐cognitive measures and how they correlate with measures of neurocognition and clinical symptoms. In this study, 70 patients (mean age: 24.1; 87.1% males) with primary psychotic disorder diagnosed in the previous 5 years were assessed on multiple neurocognitive (processing speed, attention, working memory, immediate verbal memory, delayed recall, visual reasoning, inhibition, planning, cognitive flexibility), and social‐cognitive domains (theory of mind (ToM), emotion recognition, attributional style, metacognitive overconfidence) as well as measures of clinical symptoms. Functional outcome was assessed with three self‐reports and two informant‐reports. On average, patients performed one or more SD below healthy controls on measures of delayed recall, ToM and metacognitive overconfidence. Emotion recognition and ToM were intercorrelated and correlated with multiple neurocognitive domains and negative symptoms. Attributional style correlated with positive symptoms. In the context of multiple variables, self‐reported functional outcomes were predicted by attributional style, whereas emotion recognition and immediate verbal memory predicted variance in informant‐reported community functioning. These results support the suggestion of a likely distinction between the predictive factors for self‐reported and informant‐reported functional outcome in early psychosis and suggest that consideration of self‐assessment of functional outcome is critical when attempting to evaluate the effects attributional style has on functional disability.

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“…Harnessing cognitive strengths and addressing relative weaknesses may mitigate the potential negative impact of cognitive impairment on community functioning (Bowie & Harvey, 2006; Bryce et al, 2019; Nuechterlein et al, 2011; Santesteban‐Echarri et al, 2017), and support recovery. The efficacy of behavioural interventions that address cognitive dysfunction at the time of first episode are supported by the research literature (Kidd et al, 2019; Medalia & Saperstein, 2019; Mendella et al, 2015; Vidarsdottir et al, 2019, 2020).…”

Section: Introductionmentioning

confidence: 91%

Toolkit for assessing and addressing cognitive health in early psychosis: Evaluation of feasibility and utility in a coordinated specialty care setting

Saperstein

Medalia

Malinovsky

et al. 2020

Early Intervention Psych

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Aim Methods to identify and harness individual cognitive strengths while addressing relative weaknesses have the potential to complement recovery services for first‐episode psychosis but systematic implementation is needed. We developed a cognitive health toolkit, trained teams from OnTrackNY, a network of coordinated specialty care (CSC) programs and examined toolkit feasibility and clinical utility during the first year of roll‐out. Methods The toolkit includes a clinician manual, assessment and decision‐making tools, and a menu of cognitive health service options. Assessment uses the WRAT5‐Reading subtest and a new Self‐Assessment of Cognitive Functioning which, together, determine participant‐ and clinician‐perceived cognitive health need. Program‐level data were analysed for rates of assessment, identification of cognitive health needs and cognitive health service provision. Results Data from 18 OnTrackNY teams included 933 participants, including 310 new admissions. Across teams, 43.9% of newly admitted participants received a WRAT5‐Reading and 41.3% received a self‐assessment. Of all assessments completed in the study period, 50.7% were at or within 3‐months of admission and 69.1% were within the first year of program participation. Cognitive health need was identified by self‐report (57.6%) and clinician‐report (69.9%) and led to provision of specific services, including psychoeducation, compensatory skills training and in some cases restorative cognitive training. Conclusions Preliminary feasibility data are encouraging but barriers to assessment need to be identified and addressed. Rates of identified cognitive health need warrant further study of the implementation process and outcomes so that cognitive health assessment and treatment practices may ultimately be disseminated to CSC programs more broadly.

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Integrative cognitive remediation for early psychosis: Results from a randomized controlled trial

Cited by 30 publications

References 52 publications

Multivariate pattern analysis of brain structure predicts functional outcome after auditory-based cognitive training interventions

Multivariate pattern analysis of brain structure predicts functional outcome after auditory-based cognitive training interventions

Social and non‐social measures of cognition for predicting self‐reported and informant‐reported functional outcomes in early psychosis

Toolkit for assessing and addressing cognitive health in early psychosis: Evaluation of feasibility and utility in a coordinated specialty care setting

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