Meta‐cognitive skills training enhances computerized cognitive remediation outcomes among individuals with first‐episode psychosis

Breitborde, Nicholas J. K.; Woolverton, Cindy; Dawson, Spencer C.; Bismark, Andrew W.; Bell, Emily K.; Bathgate, Christina J.; Norman, Kaila R.

doi:10.1111/eip.12289

Cited by 43 publications

(24 citation statements)

References 19 publications

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“…Central to this is cognitive remediation, an intervention grounded in understanding the mechanisms of behaviour with a goal of improving functioning (Breitborde et al, 2017). It aims to enhance cognitive skills, such as sustained attention, to modify behaviour (Virk, Williams, Brunsdon, Suh and Morrow, 2015) and has demonstrated to be successful among disorders with similar cognitive abnormalities to psychopathy (e.g.…”

Section: How Effective Is Existing Psychological Treatment For Psychomentioning

confidence: 99%

Treatment of psychopathy: a conceptual and empirical review

Lewis

2018

JCRPP

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For decades, psychopathy has been thought to be untreatable. Yet, conceptualisations, and indeed its assessment, have deviated away from viewing the disorder as personality pathology towards a behavioural focus where the core underlying deficits in cognition and affect have been ignored. Interventions have followed suit leading to a premature discounting of the role of therapy in adjusting psychopathic traits. Design/methodology/approach: The review critically evaluates the conceptual and empirical evidence relevant to the treatment of psychopathy, deciphering components integral to the disorder that require intervention. Psychopathy is approached from a developmental perspective, with the review identifying several mechanisms thought to be responsible for precipitating and perpetuating its expression. Findings: There appears some utility in targeting psychopathy from multiple angles, addressing experiences of trauma, associated schemas and the underlying cognitive-affective dysfunction noted to give rise to psychopathic traits. A new model for treatment was proposed integrating these factors in the hope that this will encourage the design of effective interventions that will address the origins and underlying deficits of the disorder, rather than symptomology. Originality/value: The review encourages future research to consider the aetiology of psychopathy, with the aim of informing early intervention and containing the disorder whilst in its infancy, as well as addressing neurobiological dysfunction when most malleable.

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Section: How Effective Is Existing Psychological Treatment For Psychomentioning

confidence: 99%

Treatment of psychopathy: a conceptual and empirical review

Lewis

2018

JCRPP

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“…For the current study, participants will complete two, one-hour cognitive remediation sessions per week for 6 months (i.e., 26 weeks; 52 visits). In a previous study of MCR among individuals with first-episode psychosis (Breitborde et al 2014 ), we found that individuals who received this dosage of MCR experienced greater cognitive and functional improvements (e.g., increased educational/occupational functioning) than individuals who completed only the PSSCogRehab computer activities (i.e., no metacognitive discussion).…”

Section: Methodsmentioning

confidence: 59%

“…For the current study, we will provide participants metacognitive remediation (MCR: (Breitborde et al 2014 )). As part of MCR, participants complete computerized cognitive training activities that are included in the program PSSCogRehab (Bracy 1995 )--a computerized cognitive training program frequently used in past studies of cognitive remediation in serious mental illness (Kurtz et al 2007 ; Greig et al 2007 ; Bell et al 2001 ; Fiszdon et al 2004 ; Fiszdon et al 2005 ; Fiszdon et al 2006 ; Hogarty et al 2004 ; Eack et al 2009 ; Eack et al 2007 ; Breitborde et al 2011 ).…”

Section: Methodsmentioning

confidence: 99%

A randomized controlled trial of cognitive remediation and d-cycloserine for individuals with bipolar disorder

et al. 2014

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BackgroundCognitive remediation (CR) has shown significant promise in addressing the cognitive deficits that accompany serious mental illness. However, this intervention does not appear to completely ameliorate the cognitive deficits that accompany these illnesses. D-cycloserine (DCS), an NMDA receptor partial agonist, has been shown to enhance the therapeutic benefits of learning-based psychosocial interventions for psychiatric disorders. Thus, the goal of this study is to examine the utility of combining cognitive remediation and d-cycloserine in the treatment of cognitive deficits among individuals with bipolar disorder.Methods/DesignApproximately forty individuals with bipolar disorder will be recruited to participate in this study. Participants will be randomized to one of two study arms: CR + DCS or CR + placebo. The primary outcome for this study is change in cognitive functioning. We will also examine several secondary outcomes, including the rate of change of cognitive functioning, social functioning, and symptomatology.DiscussionCognitive deficits are a rate-limiting factor in functional recovery among individuals with bipolar disorder. Unfortunately, treatment options for these deficits are limited. The results of the proposed study may reveal a valuable intervention strategy (i.e., CR with concurrent DCS) to improve cognitive functioning among individuals with bipolar disorder. Ultimately, this treatment strategy may prove useful in addressing the cognitive deficits that are ubiquitous across serious mental illnesses.Trial registrationClinicalTrials.gov NCT01934972.

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“…The resulting step-based care model inspired by these data is displayed in figure 1. The psychotherapy track was influenced by the step-based model of psychotherapy proposed by Nelson et al 20 and ranges from (i) brief psychoeducation on the clinical high-risk phase and substance use reduction programme to (ii) the unified protocol (ie, a transdiagnostic CBT protocol developed by Barlow et al 46 to address emotional disorders such as anxiety and depression) to (iii) targeted psychotherapies designed specifically to address attenuated psychotic symptoms (CBT CHR ) and functional difficulties and cognitive deficits (metacognitive remediation therapy) 47…”

Section: Methods and Analysismentioning

confidence: 99%

The Ohio State University Early Psychosis Intervention Center (EPICENTER) step-based care programme for individuals at clinical high risk for psychosis: study protocol for an observational study

et al. 2020

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IntroductionIn October 2018, the Substance Abuse and Mental Health Services Administration funded 21 sites throughout the USA to develop, implement and evaluate specialised care programmes for individuals at clinical high risk for developing a psychotic disorder (CHR-P). Per the funding requirements, such programmes were required to provide ‘step-based care’—a model in which individuals are initially provided with low-intensity, non-psychosis-specific and more benign (ie, least side effects) interventions and only progress onto higher-intensity, psychosis-specific interventions with a greater risk of more severe side effects should they not meet a priori criteria for clinical response to such lower-intensity interventions. Here, we outline the evaluation component of the step-based care programme for individuals at CHR-P at The Ohio State University Early Psychosis Intervention Center (EPICENTER).Methods and analysesThe EPICENTER CHR-P programme provides a step-based care model comprising psychotherapy, medication management, family support/education, peer support and vocational/educational support. All participants who opt to receive care at the EPICENTER will complete a standardised assessment battery as part of usual care. This battery will be administered on enrolment and will be re-administered at 6-month intervals throughout individuals’ participation in EPICENTER clinical services. Participants will have the opportunity to allow for data from these usual care assessments to be used as part of an evaluation project for this new clinical service. The primary outcome for this evaluation project is time to remission of symptomatic and functional deficits commonly experienced by individuals at CHR-P. Participants will also have the opportunity to participate in a supplemental research project designed to further evaluate treatment outcomes and patient characteristics among individuals participating in EPICENTER clinical services.Ethics and disseminationThis project was approved by The Ohio State University Institutional Review Board. Results from this project will be disseminated through publications and presentations.Trial registration numberNCT03970005.

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Meta‐cognitive skills training enhances computerized cognitive remediation outcomes among individuals with first‐episode psychosis

Abstract: MST may be an important component within cognitive remediation programmes for first-episode psychosis.

Cited by 43 publications

References 19 publications

Treatment of psychopathy: a conceptual and empirical review

Treatment of psychopathy: a conceptual and empirical review

A randomized controlled trial of cognitive remediation and d-cycloserine for individuals with bipolar disorder

The Ohio State University Early Psychosis Intervention Center (EPICENTER) step-based care programme for individuals at clinical high risk for psychosis: study protocol for an observational study

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