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

Holzer, Laurent; Urben, Sébastien; Passini, Christina Moses; Jaugey, Laure; Herzog, Michael H.; Halfon, Olivier; Pihet, Sandrine

doi:10.1017/s1352465813000313

Cited by 53 publications

(31 citation statements)

References 29 publications

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“…Recent studies have suggested a positive effect of cognitive remediation in adolescents at risk for or affected by psychosis. 55,56 Research should also consider whether psychotherapeutic interventions, which are specifically designed for abused and neglected children 57 and which already address trauma consequences, such as dissociation, disorganized attachment and distorted attributions/mentalization, could normalize the cognitive risk trajectory.…”

Section: Visual Episodic Memorymentioning

confidence: 99%

Childhood abuse and neglect may induce deficits in cognitive precursors of psychosis in high-risk children

Berthelot

Paccalet

Gilbert

et al. 2015

jpn

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Section: Visual Episodic Memorymentioning

confidence: 99%

Childhood abuse and neglect may induce deficits in cognitive precursors of psychosis in high-risk children

Berthelot

Paccalet

Gilbert

et al. 2015

jpn

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“…Significant improvements have been reported in attention, memory, problem solving ability, and global cognition (Kern et al, 2009; Wykes et al, 2011). Recent studies suggest that CR is beneficial for early-course vs. long-term (Bowie et al, 2014) patients and adolescents with early-onset schizophrenia (Holzer et al, 2014; Puig, 2014; Ueland and Rund, 2005; Wykes et al, 2007). Studies of successful CR programs support the feasibility of utilizing computer-based interventions with both adult (Kurtz et al, 2007) and adolescent populations (Holzer et al, 2014).…”

Section: Introductionmentioning

confidence: 99%

“…Recent studies suggest that CR is beneficial for early-course vs. long-term (Bowie et al, 2014) patients and adolescents with early-onset schizophrenia (Holzer et al, 2014; Puig, 2014; Ueland and Rund, 2005; Wykes et al, 2007). Studies of successful CR programs support the feasibility of utilizing computer-based interventions with both adult (Kurtz et al, 2007) and adolescent populations (Holzer et al, 2014). Current studies have successfully employed a remote, computer based CR program for stable patients (Ventura et al, 2013) and younger individuals (Fisher et al, 2015) with recent onset psychosis.…”

Section: Introductionmentioning

confidence: 99%

Cognitive remediation for adolescents with 22q11 deletion syndrome (22q11DS): A preliminary study examining effectiveness, feasibility, and fidelity of a hybrid strategy, remote and computer-based intervention

Mariano¹,

Tang²,

Kurtz³

et al. 2015

Schizophrenia Research

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Background 22q11DS is a multiple anomaly syndrome involving intellectual and behavioral deficits, and increased risk for schizophrenia. As cognitive remediation (CR) has recently been found to improve cognition in younger patients with schizophrenia, we investigated the efficacy, feasibility, and fidelity of a remote, hybrid strategy, computerized CR program in youth with 22q11DS. Methods A longitudinal design was implemented in which 21 participants served as their own controls. Following an eight month baseline period in which no interventions were provided, cognitive coaches met with participants remotely for CR via video conferencing three times a week over a targeted 8 month timeframe and facilitated their progress through the intervention, offering task-specific strategies. A subset of strategies were examined for fidelity. Outcomes were evaluated using a neurocognitive test battery at baseline, pre-treatment and post-treatment. Results All participants adhered to the intervention. The mean length of the treatment phase was 7.96 months. A moderately high correlation (intraclass correlation coefficient, 0.73) was found for amount and type of strategies offered by coaches. Participants exhibited significant improvements (ES = .36–.55, p ≤ .009) in working memory, shifting attention and cognitive flexibility. All significant models were driven by improvements in pre to post-treatment scores. Conclusions Based on our preliminary investigation, a remote, hybrid strategy, computerized CR program can be implemented with 22q11DS youth despite geographic location, health, and cognitive deficits. It appears effective in enhancing cognitive skills during the developmental period of adolescence, making this type of CR delivery useful for youth with 22q11DS transitioning into post-school environments.

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“…154, 160, 166-169 Building on demonstrated efficacy with established illness, CR with PR has used established computerized cognitive remediation programs like COGPACK, Lumosity, or PositScience . 170,171 These programs provide training in cognitive domains such as attention, speed of processing, executive function, learning and memory, and social perception.…”

Section: Intervening In Psychosis Riskmentioning

confidence: 99%

Progress and Future Directions in Research on the Psychosis Prodrome

Woodberry¹,

Shapiro²,

Bryant³

et al. 2016

Harvard Review of Psychiatry

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The psychosis prodrome, or period of clinical and functional decline leading up to acute psychosis, offers a unique opportunity for identifying mechanisms of psychosis onset and testing early intervention strategies. We summarize major findings and emerging directions in prodromal research and provide recommendations for clinicians working with individuals suspected to be at high risk for psychosis. The past two decades of research have led to three major advances. First, tools and criteria have been developed that can reliably identify imminent risk for a psychotic disorder. Second, longitudinal clinical and psychobiological data from large multisite studies are strengthening individual risk assessment and offering insights into potential mechanisms of illness onset. Third, psychosocial and pharmacological interventions are demonstrating promise for delaying or preventing the onset of psychosis in help-seeking, high-risk individuals. The dynamic psychobiological processes implicated in both risk and onset of psychosis, including altered gene expression, cognitive dysfunction, inflammation, gray and white matter brain changes, and vulnerability-stress interactions suggest a wide range of potential treatment targets and strategies. The expansion of resources devoted to early intervention and prodromal research worldwide raises hope for investigating them. Future directions include identifying psychosis-specific risk and resilience factors in children, adolescents, and non-help-seeking community samples, improving study designs to test hypothesized mechanisms of change, and intervening with strategies that better engage youth, their environmental contexts, and neurodevelopmental targets to improve functional outcomes. Prospective research on putatively prodromal samples has the potential to substantially reshape our understanding of mental illness and our efforts to combat it.

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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

Abstract: CACR can be successfully administered in this population; it proved to be effective over and above CG for the most intensively trained cognitive ability.

Cited by 53 publications

References 29 publications

Childhood abuse and neglect may induce deficits in cognitive precursors of psychosis in high-risk children

Childhood abuse and neglect may induce deficits in cognitive precursors of psychosis in high-risk children

Cognitive remediation for adolescents with 22q11 deletion syndrome (22q11DS): A preliminary study examining effectiveness, feasibility, and fidelity of a hybrid strategy, remote and computer-based intervention

Progress and Future Directions in Research on the Psychosis Prodrome

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