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Specific cognitive flexibility rehabilitation in schizophrenia

Published online by Cambridge University Press:  09 July 2009

Ann Delahunty ,
Rodney Morice  and
Barry Frost
Ann Delahunty*
Affiliation:
Mental Health Services, South-West Region, Department of Health, Albury; Division of Mental Health Services, Hunter Area Health Service, Newcastle, NSW, Australia
Rodney Morice
Affiliation:
Mental Health Services, South-West Region, Department of Health, Albury; Division of Mental Health Services, Hunter Area Health Service, Newcastle, NSW, Australia
Barry Frost
Affiliation:
Mental Health Services, South-West Region, Department of Health, Albury; Division of Mental Health Services, Hunter Area Health Service, Newcastle, NSW, Australia
*
1Address for correspondence: Dr A. Delahunty. Mental Health Unit, South-West Region, Department of Health, 481 George Street, Albury, NSW 2640, Australia.
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Synopsis

A Cognitive Shift neurocognitive training module was developed in the attempt to ameliorate cognitive flexibility deficits in chronic schizophrenic patients. A procedural training approach hypothesized the exercise of specific neural network processes, identified from theories of frontal and prefrontal lobe functioning. Three male patients who underwent the intensive program demonstrated significant gains in Wisconsin Card Sorting Test performance, gains that were maintained at a six month reassessment. Expanded Brief Psychiatric Rating Scale (a measure of symptomatology) and Life Skills Profile (a measure of daily functioning) measures showed smaller improvements. The ability to improve cognitive flexibility could have important implications for the treatment of schizophrenia.

Type
Preliminary Communication
Information
Psychological Medicine , Volume 23 , Issue 1 , February 1993 , pp. 221 - 227
Copyright
Copyright © Cambridge University Press 1993

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References

REFERENCES

Bellack, A., Mueser, K. T., Morrison, R. L., Tierney, A. & Podell, K. (1990). Remediation of cognitive deficits in schizophrenia. American Journal of Psychiatry 147, 1650–1655.Google ScholarPubMed
Berg, E. A. (1948). A simple objective technique for measuring flexibility in thinking. Journal of General Psychology 39, 15–22.CrossRefGoogle ScholarPubMed
Bleuler, E. (1950). Dementia Praecox, or the Group of Schizophrenias. (Translated by Zinken, J..) International Universities Press: New York.Google Scholar
Brenner, H. D. (1987). On the importance of cognitive disorders in treatment and rehabilitation. In Psychological Treatment of Schizophrenia (ed. Strauss, J. S., Bokar, W. and Brenner, H. D.), pp. 136–151. Hans Huber Publications: Bern.Google Scholar
Brenner, H. D., Kraemer, S., Hermanutz, M. & Hodel, B. (1990). Cognitive treatment in schizophrenia. In Schizophrenia: Models and Interventions (ed. Straube, E. and Hahlweg, K.), pp. 161–191. Springer: Heidelberg.CrossRefGoogle Scholar
Bruner, J. S., Goodnow, J. J. & Austin, G. A. (1956). A Study of Thinking. Wiley: New York.Google Scholar
DeRenzi, E. & Vignolo, L. A. (1962). The Token Test. A sensitive test to detect receptive disturbances in aphasics. Brain 85, 665–678.CrossRefGoogle Scholar
Drewe, E. (1974). The effect of type and area of brain lesion on Wisconsin Card Sorting Test performance. Cortex 10, 159–170.CrossRefGoogle ScholarPubMed
Fey, E. T. (1951). The performance of young schizophrenics and young normals on the Wisconsin Card Sorting Test. Journal of Consulting Psychology 15, 311–319.CrossRefGoogle Scholar
Frost, B., Morice, R. D., Delahunty, A., Gulliver, S., Ryan, M., Frampton, G., Connolly, S. & Hunter, M. (1991). Neurocognitive and psychosocial rehabilitation of chronic schizophrenia: a clinical study.In Brain Impairment: Proceedings of the Fifteenth Brain Impairment Conference (ed. Levick, W., Frost, B., Watson, M. and Pfister, P.), pp. 49–57. Australian Society for the Study of Brain Impairment: Melbourne.Google Scholar
Fuster, J. M. (1980). The Prefrontal Cortex. Raven Press: New York.Google Scholar
Goldberg, E. & Tucker, D. (1979). Motor perseveration and longterm memory for visual forms. Journal of Clinical Neuropsychology 1, 273–288.CrossRefGoogle Scholar
Goldberg, T. E., Weinberger, D. R., Berman, K. F., Pliskin, N. H. & Podd, M. H. (1987). Further evidence for dementia of the prefrontal type in schizophrenia? Archives of General Psychiatry 44, 1008–1014.CrossRefGoogle ScholarPubMed
Golden, C. J., Purisch, A. D. & Hammeke, T. A. (1986). Manual for Luria-Nebraska Neuropsychological Battery: Forms I and II. Western Psychological Services: California.Google Scholar
Grattan, L. M. & Eslinger, P. J. (1989). Higher cognition and social behaviour: changes in cognitive flexibility and empathy after cerebral lesions. Neuropsychology 3, 175–185.Google Scholar
Heaton, R. K. (1981). A Manual for the Wisconsin Card Sorting Test. Psychological Assessment Resources: Odessa, Florida.Google Scholar
Hecaen, H. & Albert, M. L. (1978). Human Neuropsychology. Wiley: New York.Google Scholar
Heidbreder, E. (1947). The attainment of concepts: III. The process. Journal of Psychology 24, 93–138.CrossRefGoogle Scholar
Heinrichs, R. W. (1989). Frontal cerebral lesions and violent incidents in chronic neuropsychiatric patients. Biological Psychiatry 25, 174–178.CrossRefGoogle ScholarPubMed
Hull, C. L. (1920). Quantitative aspects of the evolution of concepts. Psychological Monographs No. 123.CrossRefGoogle Scholar
Kleist, J. (1960). Schizophrenic symptoms and cerebral pathology. Journal of Mental Science 106, 246–255.CrossRefGoogle ScholarPubMed
Kolb, B. & Wishaw, I. R. (1983). Performance of schizophrenic patients on tests sensitive to left or right frontal, temporal or parietal function in neurological patients. Journal of Nervous and Mental Disease 171, 435–443.CrossRefGoogle ScholarPubMed
Kraepelin, E. (1971). Dementia Praecox and Paraphrenia (translated by Barclay, R. M.) (facsimile of 1919 edition). Robert E. Kreiger Publishing Co.: Huntington, New York.Google Scholar
Laine, M. & Butters, N. (1982). A preliminary study of the problem-solving strategies of detoxified long-term alcoholics. Drugs and Alcohol Dependence 10, 235–242.CrossRefGoogle ScholarPubMed
Levin, S., Yurgelun-Todd, D. & Craft, S. (1989). Contributions of clinical neuropsychology to the study of schizophrenia. Journal of Abnormal Psychology 98, 341–356.CrossRefGoogle Scholar
Lukoff, D., Neuchterlein, K. H. & Ventura, J. (1986). Manual for Expanded Brief Psychiatric Rating Scale (BPRS). Schizophrenia Bulletin 12, 594–602.Google Scholar
Luria, A. R. (1965). Two kinds of motor perseveration in massive injury of the frontal lobes. Brain 88, 1–10.CrossRefGoogle ScholarPubMed
Luria, A. R. (1966). Higher Cortical Functions in Man. Basic Books: New York.Google Scholar
Malmo, H. P. (1974). On frontal lobe functions: psychiatric patient controls. Cortex 10, 231–237.CrossRefGoogle ScholarPubMed
Milner, B. (1963). Effects of different brain lesions on card sorting. Archives of Neurology 9, 90–100.CrossRefGoogle Scholar
Morice, R. (1990). Cognitive inflexibility and prefrontal dysfunction in schizophrenia and mania. British Journal of Psychiatry 157, 50–54.CrossRefGoogle ScholarPubMed
Olbrich, R. & Mussgay, L. (1990). Reduction of schizophrenia deficits by cognitive training: an evaluative study. European Archives of Psychiatry & Neurological Sciences 239, 366–369.CrossRefGoogle ScholarPubMed
Robins, L. N., Helzer, J. E., Croughan, J. & Ratcliff, K. S. (1981). National Institute of Mental Health Diagnostic Interview Schedule (DIS). Archives of General Psychiatry 38, 381–389.CrossRefGoogle Scholar
Robinson, A. L., Heaton, R. K., Lehman, R. A., Stilson, D. W. (1980). The utility of the Wisconsin Card Sorting Test in detecting and localising frontal lobe lesions. Journal of Consulting and Clinical Psychology 48, 605–614.CrossRefGoogle ScholarPubMed
Rosen, A., Parker, G., Hadzi-Pavlovic, D. & Hartley, R. (1987). Developing Evaluation Strategies for Area Mental Health Services in NSW. State Health Publication: Sydney.Google Scholar
Sandson, J. & Albert, M. L. (1984). Varieties of perseveration. Neuropsychologica 22, 715–732.CrossRefGoogle ScholarPubMed
Shallice, T. (1982). Specific impairments of planning. Philosophical Transactions of the Royal Society of London B 298, 199–209.Google ScholarPubMed
Shallice, T., Burgess, P. W. & Frith, C. D. (1991). Can the neuropsychological case-study approach be applied to schizophrenia? Psychological Medicine 21, 661–673.CrossRefGoogle Scholar
Sneesby, P. (1990). Neuropsychological and electrophysiological associations of computerised neurocognitive therapy in the rehabilitation of chronic schizophrenia: A case study approach. University of Newcastle, NSW: unpublished Honours thesis.Google Scholar
Sohlberg, M. & Mateer, C. A. (1987). Effectiveness of an attention training program. Journal of Clinical and Experimental Neuropsychology 9, 117–130.CrossRefGoogle ScholarPubMed
Spaulding, W. (1978). The relationships of some information processing factors to severely disturbed behaviours. Journal of Nervous and Mental Disease 166, 417–428.CrossRefGoogle Scholar
Stuss, D. T. & Benson, D. F. (1986). The Frontal Lobes. Raven: New York.Google Scholar
Tompkins, L., Goldman, R. S. & Axelrod, B. N. (1991). Modifying the Wisconsin Card Sorting Test performance of schizophrenic patients. American Journal of Psychiatry, 148, 1613.Google ScholarPubMed
Weinberger, D. R., Berman, K. F. & Zee, R. (1986). Physiological dysfunction of dorsolateral prefrontal cortex in schizophrenia. 1. Regional cerebral blood flow evidence. Archives of General Psychiatry 43, 114–124.CrossRefGoogle Scholar
Zubin, J. & Spring, B. (1977). Vulnerability – new view of schizophrenia. Journal of Abnormal Psychology 86, 103–126.CrossRefGoogle ScholarPubMed