A review of cognitive remediation approaches for schizophrenia: from top-down to bottom-up, brain training to psychotherapy
- 24 May 2017
- journal article
- review article
- Published by Taylor & Francis Ltd in Expert Review of Neurotherapeutics
- Vol. 17 (7), 713-723
- https://doi.org/10.1080/14737175.2017.1331128
Abstract
Introduction: Individuals with psychotic disorders experience profound impairment in neurocognition, which is consistently found to be the best predictor of independent community functioning. Several diverse behavioural treatments designed to enhance neurocognitive abilities have been developed, with subtle to stark differences among them. Various approaches, to varying degrees, have demonstrated success across diffuse outcomes: improved brain structure and function, performance on neuropsychological tests, and community activities associated with daily living. Areas covered: This paper reviews the different approaches to cognitive remediation and the differential effects these approaches have on neurophysiological function, neurocognitive abilities, and real-world community functioning. Cognitive remediation approaches can be broadly classified along two dimensions: 1) treatment target, and 2) treatment modality. Some approaches target more basic perceptual skills, some target higher level executive processes, while some are non-targeted and seek to improve general cognitive ability. With regard to modality, approaches might have little/no therapist involvement and rely exclusively on computerized practice or they may include intensive therapist involvment to generalize neurocognitive change to community functioning. Expert commentary: Compared to other widely implemented treatments for schizophrenia, cognitive remediation produces better effects on outcome measures. It is time for cognitive remediation to be adopted as a best practice in the treatment of schizophrenia.Keywords
Funding Information
- Ministry of Research and Innovation (Early Investigator Award)
- National Alliance for Research on Schizophrenia and Depression (Independent Investigator Award)
- CIHR Vanier Doctoral Award (N/A)
This publication has 101 references indexed in Scilit:
- Mismatch Negativity, Social Cognition, and Functioning in Schizophrenia PatientsBiological Psychiatry, 2010
- Putting brain training to the testNature, 2010
- Meta-analysis of 41 Functional Neuroimaging Studies of Executive Function in SchizophreniaArchives of General Psychiatry, 2009
- Neuroplasticity-Based Cognitive Training in Schizophrenia: An Interim Report on the Effects 6 Months LaterSchizophrenia Bulletin, 2009
- A comparison of remediation techniques on the Wisconsin Card Sorting Test in schizophreniaSchizophrenia Research, 2009
- A Randomized Controlled Trial of Cognitive Remediation in SchizophreniaSchizophrenia Bulletin, 2008
- Development and Pilot Testing of a Novel Compensatory Cognitive Training Intervention for People with PsychosisAmerican Journal of Psychiatric Rehabilitation, 2008
- Predicting Schizophrenia Patients’ Real-World Behavior with Specific Neuropsychological and Functional Capacity MeasuresBiological Psychiatry, 2008
- Computer-assisted cognitive remediation in schizophrenia: What is the active ingredient?Schizophrenia Research, 2007
- EEG alpha and theta oscillations reflect cognitive and memory performance: a review and analysisBrain Research Reviews, 1999