Training engagement, baseline cognitive functioning, and cognitive gains with computerized cognitive training: A cross-diagnostic study
Training engagement, baseline cognitive functioning, and cognitive gains with computerized cognitive training: A cross-diagnostic study
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DOI：
10.1016/j.scog.2019.100150
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发表时间：
2020-03-01
影响因子：
2.8
通讯作者：
Kotwicki, Raymond J.
中科院分区：
文献类型：
--
作者：
Harvey, Philip D.;Balzer, Alexandra M.;Kotwicki, Raymond J.
计算机化认知训练(CCT)干预在门诊心理健康环境中的使用越来越多。当与康复干预相结合时，这些干预措施已证明在改善功能结果方面有效。最近有人提出，认知障碍较多的患者有更大的治疗反应，减少训练参与度可以发现从治疗中受益程度较低的病例。参与者是精神康复患者，被诊断为严重抑郁症、双相情感障碍和精神分裂症。新入院的患者接受了CCT，通过大脑总部进行，认知功能根据BACS t分40分或更低与更高进行分组。培训参与度是根据每天培训达到的培训级别数编制的。49例患者平均训练17天，平均完成150级。总体而言，患者在BACSt-Score(p<；.001)中平均提高了4.4分(0.44 SD)。改善与培训参与度呈正相关(r=0.30，p<；0.05)，但与培训天数(r=0.09)或收入水平(r=0.03)无关。基线认知表现水平较高的患者认知收益较低(p<；.003)，但培训参与度并未降低(p=.97)。诊断没有预测认知进步(p=.93)或目标投入(p=.74)。较差的基线表现和较高水平的培训参与度可以解释10%的认知收益独立差异。认知改善的平均水平远远超过练习效果。参与度指数，即每个培训日达到的水平，很容易从患者的培训记录中提取出来，这将允许及早和持续地监测治疗对有条件现金转移活动的参与度，并在需要时进行治疗师干预，以提高参与度。
Computerized cognitive training (CCT) interventions are increasing in their use in outpatient mental health settings. These interventions have demonstrated efficacy for improving functional outcomes when combined with rehabilitation interventions. It has recently been suggested that patients with more cognitive impairment have a greater therapeutic response and that reduced engagement in training can identify cases who manifest low levels of benefit from treatment. Participants were psychiatric rehabilitation clients, with diagnoses of major depression, bipolar disorder and schizophrenia. Newly admitted cases received CCT, delivered via Brain HQ, with cognitive functioning divided into groups on the basis of a BACS t-score of 40 or less vs. more. Training engagement was indexed by the number of training levels achieved per day trained. Forty-nine cases trained on average for 17 days and completed a mean of 150 levels. Overall, patients improved by an average of 4.4 points (0.44 SD) in BACS t-scores (p < .001). Improvements were positively correlated with training engagement (r = 0.30, p < .05), but not with days trained (r = 0.09) or levels earned (r = 0.03) alone. Patients with higher levels of baseline cognitive performance had reduced cognitive gains (p < .003), but did not have less training engagement (p = .97). Diagnoses did not predict cognitive gains (p = .93) or target engagement (p = .74). Poorer performance at baseline and higher levels of training engagement accounted for >10% in independent variance in cognitive gains. The mean level of cognitive improvement far exceeded practice effects. The index of engagement, levels achieved per training day, is easily extracted from the training records of patients, which would allow for early and continuous monitoring of treatment engagement in CCT activities and therapist intervention as needed to improve engagement.