The Effectiveness of Computerized Cognitive Rehabilitation Training Program in Improving Cognitive Abilities of Schizophrenia Clients
Abstract
The aim of this study was to evaluate the efficacy of a computer - based training program of attention, memory and executive functions in enhancing neuropsychological performances as well as functional outcome in clients with schizophrenia.A total of 15 clinically stable out patients with Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR) criteria for schizophrenia, diagnosed with different types of schizophrenia: paranoid, disorganized, residual, based on DSM- IV-TR were selected to participate in this study. All patients were randomly selected using a conventional sampling method and assigned to 60 hours individual sessions of computer - assisted cognitive remediation (CACR).This was a pre- experimental study with pretest and posttest in a single group. Cognitive functions were checked with Continuous Performance Test (CPT), Wechsler Adult Intelligence Scale (Wds) and Prospective and Retrospective Memory Questionnaire (PRMQ). The symptoms of patients were measured with the Positive and Negative Syndrome Scale (PANSS). Remediation was performed utilizing the Rehacome® software. Patients received the cognitive remediation program including attention, concentration and working memory. All participants were followed up after an interval of one month and three months. Data were analyzed using repeated measures analysis.After 3 months, the findings showed that patients' scores improved in the time factor. Also, a significant improvement favoring cognitive remediation was found in several cognitive measures including Reaction Time (F = 4015p<.05, Eta = 0.242), Wds (F = 11.806, p<.05,Eta = .48) PRMQ1(F = 3.314, p<.05, Eta = 0.20) PRMQ7(F = 2.85, p<.05, Eta = 0.18).Computer-assisted cognitive remediation training program was effective in improving the performance of schizophrenic patients. CACR did not have any effects on the positive and negative symptoms. Long- term follow-up studies are needed to confirm the maintenance of such improvements.
Jablensky A, Sartorius N, Ernberg G, Anker M, Korten A, Cooper JE, et al. Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychol Med Monogr Suppl 1992; 20: 1-97.
Mohammadi MR, Akhondzadeh S. Schizophrenia: etiology and pharmacotherapy. IDrugs 2001; 4: 1167-1172.
Andreasen NC. Schizophrenia: the fundamental questions. Brain Res Brain Res Rev 2000; 31: 106-112.
Akhondzadeh S. The 5-HT hypothesis of schizophrenia. IDrugs 2001; 4: 295-300.
Velligan DI, Kern RS, Gold JM. Cognitive rehabilitation for schizophrenia and the putative role of motivation and expectancies. Schizophr Bull 2006; 32: 474-485.
Green MF. What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry 1996; 153: 321-330.
Green MF. What are the functional consequences of neurocognitive deficits in schizophrenia? Am J Psychiatry 1996; 153: 321-330.
Green MF, Kern RS, Braff DL , Mintz J. Neurocognitive deficits and functional outcome in schizophrenia: are we measuring the "right stuff"? Schizophr Bull 2000; 26: 119-136.
Green MF, Kern RS, Heaton RK. Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophr Res 2004; 72: 41–51.
Velligan DI, Mahurin RK, Diamond PL, Hazleton BC, Eckert SL , Miller AL. The functional significance of symptomatology and cognitive function in schizophrenia. Schizophr Res 1997; 25: 21-31.
Keefe RS, Goldberg TE, Harvey PD, Gold JM, Poe MP, Coughenour L. The Brief Assessment of Cognition in Schizophrenia: reliability, sensitivity, and comparison with a standard neurocognitive battery. Schizophr Res 2004; 68: 283-297.
Lee J , Park S. Working memory impairments in schizophrenia: a meta-analysis. J Abnorm Psychol 2005; 114: 599-611.
Dickinson D, Ramsey ME , Gold JM. Overlooking the obvious: a meta-analytic comparison of digit symbol coding tasks and other cognitive measures in schizophrenia. Arch Gen Psychiatry 2007; 64: 532-542.
Knowles EE, David AS , Reichenberg A. Processing speed deficits in schizophrenia: reexamining the evidence. Am J Psychiatry 2010; 167: 828-835.
Vita A, De Peri L, Barlati S, Cacciani P, Deste G, Poli R, et al. Effectiveness of different modalities of cognitive remediation on symptomatological, neuropsychological, and functional outcome domains in schizophrenia: a prospective study in a real-world setting. Schizophr Res 2011; 133: 223-231.
Bell M, Bryson G, Greig T, Corcoran C , Wexler BE. Neurocognitive enhancement therapy with work therapy: effects on neuropsychological test performance. Arch Gen Psychiatry 2001; 58: 763-768.
Hogarty GE, Flesher S, Ulrich R, Carter M, Greenwald D, Pogue-Geile M, et al. Cognitive enhancement therapy for schizophrenia: effects of a 2-year randomized trial on cognition and behavior. Arch Gen Psychiatry 2004; 61: 866-876.
Sartory G, Zorn C, Groetzinger G, Windgassen K. Computerized cognitive remediation improves verbal learning and processing speed in schizophrenia. Schizophr Res 2005; 75: 219-223.
Grynszpan O, Perbal S, Pelissolo A, Fossati P, Jouvent R, Dubal S, et al. Efficacy and specificity of computer-assisted cognitive remediation in schizophrenia: a meta-analytical study. Psychol Med 2011; 41: 163-173.
Benedict RH, Harris AE, Markow T, McCormick JA, Nuechterlein KH , Asarnow RF. Effects of attention training on information processing in schizophrenia. Schizophr Bull 1994; 20: 537-546.
Field CD, Galletly C, Anderson D , Walker P. Computer-aided cognitive rehabilitation: possible application to the attentional deficit of schizophrenia, a report of negative results. Percept Mot Skills 1997; 85: 995-1002.
Medalia A, Revheim N, Casey M .Remediation of memory disorders in schizophrenia. Psychological Medicine 2000; 30: 1451–1459.
Wykes T, Van der Gaag M . Is it time to develop a new cognitive therapy for psychosis – Cognitive Remediation Therapy (CRT)? Clinical Psychology Review 2001; 21: 1227–1256.
Mc Guurk SR, Twamley EW, Sitzer DI, Mchugo GJ, Mueser KT. A Meta –analysis of cognitive remediation in schizophrenia .Am.J. Psychiatry 2007; 164:1791-1802.
Grynszpan O, Perbal S, Pelissolo A, Fossati P, Ouvent R, Perez-Diaz F. Efficacy and specificity of Computer-assisted cognitive remediation in schizophrenia: ameta-analytical study. Psychological Medicine 2011; 41: 163–173.
Benedict RH, Harris AE. Remediation of attention deficits in chronic schizophrenic patients : a preliminary study. British Journal of Clinical Psychology 1989; 28: 187–188.
d'Amato T, Bation R, Cochet A, Jalenques I, Galland F, Giraud-Baro E, et al. A randomized, controlled trial of computer-assisted cognitive remediation for schizophrenia. Schizophr Res 2011; 125: 284-290.
Kay SR, Fiszbein A, Opler LA. The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophr Bull 1987; 13: 261-276.
Lindenmayer JP, Grochowski S , Hyman RB. Five factor model of schizophrenia: replication across samples. Schizophr Res 1995; 14: 229-234.
Wechsler D.Wechsler Adult Intellignce Scale –Revised. Psychological corporation. New York: 1981.
Groth-Marnat G, Gallagher RE, Hale JB, Kaplan E. Neuropsychological Assessment in clinical practice: A Guide to Test Interpretation and Integration. New York: john wiley &sons; 2000.
Abedi MR. Standardization of Wechsler Adult Intelligence Scale-R (WAIS-R).Tehran: psychiatric Institute,Iran university of Medical sciences;1994.
Smith G, Della Sala S, Logie RH, Maylor EA. Prospective and retrospective memory in normal ageing and dementia: a questionnaire study Memory2000;vol 8: 311–321.
Crawford JR, Smith G, Maylor EA, Della Sala S, Logie RH. The Prospective and Retrospective Memory Questionnaire (PRMQ): Normative data and latent structure in a large non-clinical sample. Memory 2003; 11: 261-275.
Mateer CA. The rehabilitation of executive disorders. In Cognitive neurorehabilitation D.T. Stuss, G. Winocur & I. H. Robertson London: Cambridge University Press 1999.
Pfleger U. Computerunterstütztes kognitives Trainingsprogramm mit schizophrenen Patienten. Münster/New York: Waxmann Internationale Hochschulschriften; 1996.
Sablier J, Stip E, Franck N. [Cognitive remediation and cognitive assistive technologies in schizophrenia]. Encephale 2009; 35: 160-167.
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Issue | Vol 9 No 4 (2014) | |
Section | Articles | |
Keywords | ||
Computer-Assisted Cognitive Remediation Rehacom Software and Executive Function Schizophrenia |
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