Visual perceptual remediation for individuals with schizophrenia: Rationale, method, and three case studies.

Abstract

Objective Few studies have evaluated the effects of visual-remediation strategies in schizophrenia despite abundant evidence of visual-processing alterations in this condition. Here we report preliminary, case study-based evidence regarding the effects of visual remediation in this population. Methods We describe the implementation of a visual-perceptual training program called ULTIMEYES (UE) and initial results through three brief case studies of individuals with schizophrenia. UE targets broad-based visual function, including low-level processes (e.g., acuity, contrast sensitivity), as well as higher-level visual functions. Three inpatients, recruited from a research unit, participated in at least 38 sessions 3–4 times per week for approximately 25 minutes per session. Contrast sensitivity (a trained task), as well as acuity and perceptual organization (untrained tasks), were assessed before and after the intervention. Levels of progression through the task itself are also reported. Results UE was well-tolerated by the participants and led to improvements in contrast sensitivity, as well as more generalized gains in visual acuity in all three participants and perceptual organization in two participants. Symptom profiles were somewhat different for each participant, but all were actively symptomatic during the intervention. Despite this, they were able to focus on and benefit from the training. The adaptive nature of the training was well-suited to the slower progression of two participants. Conclusions and Implications for Practice These case studies set the stage for further research, such as larger, randomized controlled trials of the intervention that include additional assessments of perceptual function and measures of cognition, social cognition, and functional outcomes.

Early Visual Processing Is Associated With Social Cognitive Performance in Recent-Onset Schizophrenia

“…As expected, the ROSz participants exhibited significant neurocognitive impairment relative to the HC group [t (50) = 6.20, p < 0.001, Cohen's d = 1.75]. The magnitude of impairment was similar to our previous findings with a different ROSz patient cohort (43).…”

Development and Evaluation of a Visual Remediation Intervention for People with Schizophrenia

“…This is also comparable to the 93% retention rate of CST in healthy young adults carried out by the second author (co-investigator and developer of Sightseeing) and colleagues. Our preliminary work with participants with schizophrenia show that CST is well tolerated, and even enjoyed, as described in our recent publication [141]. Across our pilot-study participants, CS improved 32%, with an increase in the peak contrast spatial frequency of 1 cycle/degree (pre-training peak spatial frequency of 3.14 ± 0.24 vs post-training of 4.15 ± 0.70, p = 0.14, d = 0.96).…”

Changes in visual size perception in Schizophrenia and Depression

“…visual integration (Keane, Paterno, Kastner, & Silverstein, 2016;Postmes et al, 2014;Silverstein et al, 2009;Silverstein et al, 2012;Silverstein et al, 2015), visual search (Ferguson & Cane, 2017;Waszczuk, Brown, Eley, & Lester, 2015;Platt, Murphy, & Lau, 2015;Chen, 2011;Dias, Bickel, Epstein, Sehatpour, & Javitt, 2013), spatial frequencies perception (Butler, Thompson, Seitz, Deveau, & Silverstein, 2017;Flevaris, Martínez, & Hilyard, 2014;Graham & Meng, 2011;Green et al, 2009;Kim, Shim, Song, Im, & Lee, 2015;Shoshina, Shelepin, Vershinina, & Novikova, 2015;Silverstein, Demmin, & Bednar, 2017), color perception (Kogata & Iidaka, 2018;Malone et al, 2013;Silver & Bilker, 2015) and movement perception (Jahshan, Wynn, Mathis, & Green, 2015;O´Bryan, Brenner, Hetrick, & O´Donnell, 2014;Golomb et al, 2009) as well as visual illusions (King, Hodgekins, Chouinard, Chouinard, & Sperandio, 2017). Weckowics and Witney (1960), for instance, studied the effect of visual size perception of the Muller-Lyer illusion in patients with Schizophrenia and found that schizophrenics perceived larger illusion effects than controls, but the group of non-schizophrenic psychiatric patients also showed larger magnitude effects than controls but, in turn, lower than schizophrenics.…”