Examining the durability of a hybrid, remote and computer-based cognitive remediation intervention for adolescents with 22q11.2 deletion syndrome.
Examining the durability of a hybrid, remote and computer-based cognitive remediation intervention for adolescents with 22q11.2 deletion syndrome.
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DOI：
10.1111/eip.12367
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发表时间：
2018-08
影响因子：
2
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
精神分裂症和 22q11.2 缺失综合征 (22q11DS) 具有相似的认知缺陷模式。高达 30% 的 22q11DS 患者在成年早期会患上精神分裂症。最近发现认知能力下降可以预测 22q11DS 青少年精神病的发生，因此有必要在青春期进行认知矫正 (CR) 等早期干预措施。本文研究了针对 22q11DS 青少年的远程计算机化 CR 计划的持久性。我们的目的是确定 CR 的积极效果是否在干预完成后持续 6 个月。采用纵向设计，21 名参与者作为自己的对照。研究人员在治疗前、8 个月目标干预后、治疗后以及 6 个月随访时对青少年进行神经认知评估。在干预期间，认知教练每周通过视频会议 3 次与 CR 参与者进行远程会面，并提供特定任务策略。为了确定干预措施的改善是否在 6 个月的随访期内持续有效，通过从治疗前到随访的重复测量方差分析对神经认知测量进行了统计检查。事实证明，我们的 CR 干预是持久的。治疗后的改善包括认知灵活性、执行功能、反应时间和工作记忆在随访期间得到维持。结果证实了之前关于 CR 治疗持久性的研究，并将这些发现扩展到患有 22q11DS 的青少年。本研究可能有助于为 22q11DS 青少年的认知和功能相关康复目标的早期干预工作提供信息，并表明 22q11DS 可以作为检查精神病之前轨迹的合适模型。
Schizophrenia and 22q11.2 deletion syndrome (22q11DS) share similar patterns of cognitive deficits. Up to 30% of those with 22q11DS develop schizophrenia during early adulthood. As cognitive decline has recently been found to predict onset of psychosis in adolescents with 22q11DS, early interventions such as cognitive remediation (CR) during adolescence are warranted. This paper investigates the durability of a remote, computerized, CR program for youth with 22q11DS. Our aim was to determine if the positive effects of CR persisted 6 months beyond intervention completion. A longitudinal design with 21 participants serving as their own controls was used. Youth were seen for neurocognitive assessments at pre-treatment, after the targeted 8-month intervention, at post-treatment, and 6 months after for follow-up. During the intervention, cognitive coaches met remotely with participants for CR via video conferencing 3 times a week, and offered task specific strategies. To determine if intervention improvements held across the 6 month follow-up period, neurocognitive measures were statistically examined with repeated measures ANOVAs from pre-treatment through follow-up. Our CR intervention proved durable. Post-treatment improvements comprising cognitive flexibility, executive function, reaction time, and working memory were maintained over the follow-up period. Results confirm previous research regarding the durability of CR treatment and extend these findings to youth with 22q11DS. The present study may serve to inform early intervention efforts focused on cognitive and functionally relevant rehabilitation goals for youth with 22q11DS and suggests that 22q11DS can potentially serve as a suitable model for examining the trajectory preceding psychosis.