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A Randomized Controlled Trial of the Effectiveness of Computer-Assisted Cognitive Remediation (CACR) in Adolescents with Psychosis or at High Risk of Psychosis

Published online by Cambridge University Press:  01 May 2013

Laurent Holzer*
Affiliation:
Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Lausanne, Switzerland
Sebastien Urben
Affiliation:
Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Lausanne, Switzerland
Christina Moses Passini
Affiliation:
Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Lausanne, Switzerland
Laure Jaugey
Affiliation:
Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Lausanne, Switzerland
Michael H. Herzog
Affiliation:
Ecole Polytechnique Fédérale de Lausanne (EPFL), Switzerland
Olivier Halfon
Affiliation:
Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Lausanne, Switzerland
Sandrine Pihet
Affiliation:
Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, Lausanne, Switzerland
*
Reprint requests to Laurent Holzer, Centre Thérapeutique de Jour pour Adolescents, Avenue de Beaumont 48, 1012 Lausanne, Switzerland. E-mail: [email protected]

Abstract

Background: Computer assisted cognitive remediation (CACR) was demonstrated to be efficient in improving cognitive deficits in adults with psychosis. However, scarce studies explored the outcome of CACR in adolescents with psychosis or at high risk. Aims: To investigate the effectiveness of a computer-assisted cognitive remediation (CACR) program in adolescents with psychosis or at high risk. Method: Intention to treat analyses included 32 adolescents who participated in a blinded 8-week randomized controlled trial of CACR treatment compared to computer games (CG). Cognitive abilities, symptoms and psychosocial functioning were assessed at baseline and posttreatment. Results: Improvement in visuospatial abilities was significantly greater in the CACR group than in CG. Other cognitive functions, psychotic symptoms and psychosocial functioning improved significantly, but at similar rates, in the two groups. Conclusion: CACR can be successfully administered in this population; it proved to be effective over and above CG for the most intensively trained cognitive ability.

Type
Research Article
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

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References

Anderson, C. A. (2004). An update on the effects of playing violent video games. Journal of Adolescence, 27, 113122.CrossRefGoogle ScholarPubMed
APA (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) (4th edn.). Washington, DC: American Psychiatric Association.Google Scholar
Bellucci, D. M., Glaberman, K. and Haslam, N. (2003). Computer-assisted cognitive rehabilitation reduces negative symptoms in the severely mentally ill. Schizophrenia Research, 59, 225232.CrossRefGoogle ScholarPubMed
Bremer, J. and Rauch, P. K. (1998). Children and computers: risks and benefits. Journal of the American Academy of Child and Adolescent Psychiatry, 37, 559560.CrossRefGoogle ScholarPubMed
Choi, J. and Medalia, A. (2009). Intrinsic motivation and learning in a schizophrenia spectrum sample. Schizophrenia Research, 118, 1219.CrossRefGoogle Scholar
Cohen, J. (1992). A power primer. Psychological Bulletin, 112, 155159.CrossRefGoogle ScholarPubMed
Eack, S. M., Greenwald, D. P., Hogarty, S. S., Cooley, S. J., DiBarry, A. L., Montrose, D. M., et al. (2009). Cognitive enhancement therapy for early-course schizophrenia: effects of a two-year randomized controlled trial. Psychiatric Services, 60, 14681476.CrossRefGoogle ScholarPubMed
Eack, S. M., Hogarty, G. E., Cho, R. Y., Prasad, K. M., Greenwald, D. P., Hogarty, S. S., et al. (2010). Neuroprotective effects of cognitive enhancement therapy against gray matter loss in early schizophrenia: results from a 2-year randomized controlled trial. Archives of General Psychiatry, 67, 674682.CrossRefGoogle ScholarPubMed
Gowers, S. G., Harrington, R. C., Whitton, A., Lelliott, P., Beevor, A., Wing, J., et al. (1999). Brief scale for measuring the outcomes of emotional and behavioural disorders in children. Health of the Nation Outcome Scales for Children and Adolescents (HoNOSCA). The British Journal of Psychiatry, 174, 413416.Google Scholar
Grynszpan, O., Perbal, S., Pelissolo, A., Fossati, P., Jouvent, R., Dubal, S., et al. (2011). Efficacy and specificity of computer-assisted cognitive remediation in schizophrenia: a meta-analytical study. Psychological Medecine, 41, 163173.CrossRefGoogle ScholarPubMed
Hogarty, G. E., Flesher, S., Ulrich, R., Carter, M., Greenwald, D., Pogue-Geile, M., et al. (2004). Cognitive enhancement therapy for schizophrenia: effects of a 2-year randomized trial on cognition and behavior. Archives of General Psychiatry, 61, 866876.Google Scholar
Holzer, L., Chinet, L., Jaugey, L., Plancherel, B., Sofia, C., Halfon, O., et al. (2007). Detection of cognitive impairment with the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) in adolescents with psychotic symptomatology. Schizophrenia Research, 95, 4853.CrossRefGoogle ScholarPubMed
Howell, D. C. (2008). The treatment of missing data. In Outhwaite, W. and Turner, S. (Eds.), Handbook of Social Science Methodology (pp. 208224). London: Sage.Google Scholar
Kay, S. R., Fiszbein, A. and Opler, L. A. (1987). The positive and negative syndrome scale (PANSS) for schizophrenia. Schizophrenia Bulletin, 13, 261276.Google Scholar
Keefe, R. S., Vinogradov, S., Medalia, A., Silverstein, S. M., Bell, M. D., Dickinson, D., et al. (2011). Report from the working group conference on multisite trial design for cognitive remediation in schizophrenia. Schizophrenia Bulletin, 37, 10571065.Google Scholar
Kurtz, M. M., Seltzer, J. C., Shagan, D. S., Thime, W. R. and Wexler, B. E. (2007). Computer-assisted cognitive remediation in schizophrenia: what is the active ingredient? Schizophrenia Research, 89, 251260.Google Scholar
McGurk, S. R., Twamley, E. W., Sitzer, D. I., McHugo, G. J. and Mueser, K. T. (2007). A meta-analysis of cognitive remediation in schizophrenia. The American Journal of Psychiatry, 164, 17911802.CrossRefGoogle ScholarPubMed
Medalia, A., Aluma, M., Tryon, W. and Merriam, A. E. (1998). Effectiveness of attention training in schizophrenia. Schizophrenia Bulletin, 24, 147152.CrossRefGoogle ScholarPubMed
Medalia, A. and Richardson, R. (2005). What predicts a good response to cognitive remediation interventions? Schizophrenia Bulletin, 31, 942953.CrossRefGoogle ScholarPubMed
Miller, T. J., McGlashan, T. H., Woods, S. W., Stein, K., Driesen, N., Corcoran, C. M., et al. (1999). Symptom assessment in schizophrenic prodromal states. The Psychiatric Quarterly, 70, 273287.CrossRefGoogle ScholarPubMed
Nurnberger, J. I., Blehar, M. C., Kaufmann, C. A., Yorkcooler, C., Simpson, S. G., Harkavyfriedman, J., et al. (1994). Diagnostic Interview for Genetic-Studies: rationale, unique features, and training. Archives of General Psychiatry, 51, 849859.CrossRefGoogle ScholarPubMed
Palmer, B. W., Dawes, S. E. and Heaton, R. K. (2009). What do we know about neuropsychological aspects of schizophrenia? Neuropsychology Review, 19, 365384.CrossRefGoogle ScholarPubMed
Preisig, M., Fenton, B. T., Matthey, M. L., Berney, A. and Ferrero, F. (1999). Diagnostic Interview for Genetic Studies (DIGS): inter-rater and test-retest reliability of the French version. European Archives of Psychiatry and Clinical Neuroscience, 249, 174179.CrossRefGoogle ScholarPubMed
Randolph, C., Tierney, M. C., Mohr, E. and Chase, T. N. (1998). The Repeatable Battery for the Assessment of Neuropsychological Status (RBANS): preliminary clinical validity. Journal of Clinical and Experimental Neuropsychology, 20, 310319.CrossRefGoogle ScholarPubMed
Sanford, J. A. and Brown, R. J. (1988). Captain's Log Cognitive System. Richmond, VA: Brain Train, Inc.Google Scholar
Ueland, T. and Rund, B. R. (2004). A controlled randomized treatment study: the effects of a cognitive remediation program on adolescents with early onset psychosis. Acta Psychiatrica Scandinavica, 109, 7074.CrossRefGoogle Scholar
Uhlmann, E. and Swanson, J. (2004). Exposure to violent video games increases automatic aggressiveness. Journal of Adolescence, 27, 4152.CrossRefGoogle ScholarPubMed
Urben, S., Pihet, S., Jaugey, L., Halfon, O. and Holzer, L. (2012). Computer-assisted cognitive remediation in adolescents with psychosis or at risk for psychosis: a 6-month follow-up. Acta Neuropsychiatrica, 24, 328335.CrossRefGoogle ScholarPubMed
Wykes, T., Huddy, V., Cellard, C., McGurk, S. R. and Czobor, P. (2011). A meta-analysis of cognitive remediation for schizophrenia: methodology and effect sizes. The American Journal of Psychiatry, 168, 472485.CrossRefGoogle ScholarPubMed
Wykes, T., Reeder, C., Corner, J., Williams, C. and Everitt, B. T. (1999). The effects of neurocognitive remediation on executive processing in patients with schizophrenia. Schizophrenia Bulletin, 25, 291307.CrossRefGoogle ScholarPubMed
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