Role of learning potential in cognitive remediation: Construct and predictive validity

Abstract

Background The construct, convergent, discriminant, and predictive validity of Learning Potential (LP) was evaluated in a trial of cognitive remediation for adults with schizophrenia-spectrum disorders. LP utilizes a dynamic assessment approach to prospectively estimate an individual's learning capacity if provided the opportunity for specific related learning. Methods LP was assessed in 75 participants at study entry, of whom 41 completed an eight-week cognitive remediation (CR) intervention, and 22 received treatment-as-usual (TAU). LP was assessed in a “test-train-test” verbal learning paradigm. Incremental predictive validity was assessed as the degree to which LP predicted memory skill acquisition above and beyond prediction by static verbal learning ability. Results Examination of construct validity confirmed that LP scores reflected use of trained semantic clustering strategy. LP scores correlated with executive functioning and education history, but not other demographics or symptom severity. Following the eight-week active phase, TAU evidenced little substantial change in skill acquisition outcomes, which related to static baseline verbal learning ability but not LP. For the CR group, LP significantly predicted skill acquisition in domains of verbal and visuospatial memory, but not auditory working memory. Furthermore, LP predicted skill acquisition incrementally beyond relevant background characteristics, symptoms, and neurocognitive abilities. Conclusions Results suggest that LP assessment can significantly improve prediction of specific skill acquisition with cognitive training, particularly for the domain assessed, and thereby may prove useful in individualization of treatment.

Social vs. non-social measures of learning potential for predicting community functioning across phase of illness in schizophrenia

“…Although post-training scores were significantly correlated, the remaining learning potential indices were unrelated to each other. These findings support the notion that learning potential is domain specific (see also Davidson et al, 2016;Rempfer et al, 2017).…”

“…Unlike the negative findings for community functioning, learning potential has consistently outperformed pre-training scores when predicting response to rehabilitation and skills training in schizophrenia (Davidson et al, 2016;Fiszdon et al, 2006;Rempfer et al, 2011;Sergi et al, 2005;Watzke et al, 2008;Wiedl, 1999;Wiedl et al, 2001b;cf. Tenhula et al, 2007), which was the impetus for learning potential research in schizophrenia (e.g., Green et al, 2000;Wiedl and Wienöbst, 1999).…”

“…Tenhula et al, 2007), which was the impetus for learning potential research in schizophrenia (e.g., Green et al, 2000;Wiedl and Wienöbst, 1999). A recent study demonstrated that learning potential predicts skills acquisition, but only in the context of an intervention (Davidson et al, 2016). That is, learning potential predicted increased skills acquisition in the context of cognitive remediation, but not in treatment as usual (TAU).…”

“…One other study has examined learning potential for two different domains and found that learning potential from an executive functioning task showed small-to-medium correlations with learning potential from a memory task (Rempfer et al, 2017), suggesting that some task specific abilities were uniquely assessed by the two measures. Additional support for the domain specificity of learning potential comes from a study of cognitive remediation (Davidson et al, 2016) in which learning potential on a memory task was more strongly related to skills acquisition for verbal memory than for skills acquisition for spatial memory or memory of number sequences.…”

Can Digital Games Be a Way of Improving the Neuroplasticity in Stroke Damage? Can the Adult Brain Grow New Cells or Rewire Itself in Response to a New Experience?

“…Using observation, existing evidence, a theory is developed and tested against new evidence. The hypothesis is then accepted, rejected or revised [26].…”