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.
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.
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DOI：
10.1016/j.schres.2015.05.030
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发表时间：
2015-08
影响因子：
4.5
通讯作者：
Kates WR
中科院分区：
文献类型：
--
作者：
Mariano MA;Tang K;Kurtz M;Kates WR
22 q11 DS是一种多发异常综合征，涉及智力和行为缺陷，并增加精神分裂症的风险。由于认知补救（CR）最近被发现可以改善年轻精神分裂症患者的认知，我们研究了远程混合策略计算机化CR程序在22 q11 DS青年患者中的疗效、可行性和保真度。实施了纵向设计，其中21名参与者作为自己的控制。在没有提供干预措施的8个月基线期之后，认知教练通过视频会议每周三次与参与者进行远程CR，并在8个月的目标时间范围内促进他们通过干预措施取得进展，提供特定任务的策略。一个子集的策略进行了检查的保真度。在基线、治疗前和治疗后使用神经认知测试组合评价结局。所有参与者都坚持干预。平均治疗期为7.96个月。一个适度的高相关性（组内相关系数，0.73）被发现的数量和类型的教练提供的策略。参与者在工作记忆、转移注意力和认知灵活性方面表现出显著改善（ES = 0.36 - 0.55，p ≤ 0.009）。所有显著模型均由治疗前至治疗后评分的改善驱动。根据我们的初步调查，一个远程的，混合策略，计算机化的CR程序可以实施与22 q11 DS青年，尽管地理位置，健康和认知缺陷。它似乎有效地提高认知技能，在青春期的发展阶段，使这种类型的CR交付有用的青少年与22 q11 DS过渡到学校后的环境。
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. 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. 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. 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.