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Cognitive functioning as a predictor of response to comprehensive cognitive remediation
Nicole R DeTore1, Kim T Mueser1, Jessica A Byrd1
1Department of Occupational Therapy, Boston University, Center for Psychiatric Rehabilitation, 940 Commonwealth Avenue, Boston, MA, 02215, USA.
Journal of Psychiatric Research
|April 2, 2019
Summary
Cognitive remediation helps severe mental illness patients with cognitive impairments. Those with greater cognitive impairment showed more improvement with this therapy compared to standard care.
Area of Science:
- Neuroscience
- Psychiatry
- Cognitive Psychology
Background:
- Cognitive impairments are a core deficit in severe mental illnesses like schizophrenia.
- Cognitive remediation aims to improve cognitive functioning in affected individuals.
- Predictors of treatment response, particularly baseline impairment severity, remain unclear.
Purpose of the Study:
- To determine if the severity of baseline cognitive impairment predicts differential benefit from cognitive remediation.
- To analyze data from multiple randomized controlled trials of a specific cognitive remediation program.
Main Methods:
- Aggregated data from five randomized controlled trials (N=300) of the Thinking Skills for Work program.
- Categorized participants into "low average," "moderate," and "severe" cognitive impairment levels based on neuropsychological testing.
- Compared improvement in cognitive functioning between cognitive remediation and usual care groups, analyzing baseline impairment as a moderator.
Main Results:
- Participants with greater baseline cognitive impairment demonstrated significantly greater improvement from cognitive remediation compared to usual care.
- This differential benefit was observed across varying levels of impairment, with the most impaired benefiting the most.
- Results remained consistent after controlling for demographic and clinical variables.
Conclusions:
- Individuals with severe cognitive impairment, the target population for cognitive remediation, show the most significant benefits from this intervention.
- Cognitive remediation is a valuable treatment for severe mental illness, particularly for those with pronounced cognitive deficits.
- Treatment allocation could consider baseline cognitive impairment severity to maximize therapeutic outcomes.
Keywords:
CognitionCognitive remediationNeuropsychological functioningSevere mental illnessThinking skills for workMore Related Videos
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