Computer-assisted cognitive remediation in schizophrenia: What is the active ingredient?
Computer-assisted cognitive remediation in schizophrenia: What is the active ingredient?
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DOI：
10.1016/j.schres.2006.09.001
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发表时间：
2007-01-01
影响因子：
4.5
通讯作者：
Wexler, Bruce E.
中科院分区：
文献类型：
--
作者：
Kurtz, Matthew M.;Seltzer, James C.;Wexler, Bruce E.
一个新兴的研究机构已经表明，计算机辅助认知补救，包括注意力，记忆力，语言和/或解决问题的训练，产生神经认知功能的改善，推广到未经训练的神经认知测试，也可能影响精神分裂症患者的症状和工作功能。然而，这些干预措施的有效成分仍然是未知的，因为这些研究中的对照组通常很少包括这些复杂行为治疗的元素。本研究比较了所有延长（12个月），标准化，计算机辅助认知补救干预与计算机技能培训控制条件的影响，该条件包括实验干预的许多要素，包括在计算机上花费的时间，与临床医生的互动和非特异性认知刺激。42例精神分裂症患者被随机分配到两种情况之一，并在治疗前后进行了全面的神经心理测试。结果显示，认知补救训练产生了显着的改善工作记忆，相对于计算机技能训练控制条件，但在两组的工作记忆，推理/执行功能，言语和空间情景记忆，和处理速度的措施有整体改善。综上所述，这些发现表明，针对注意力、记忆力和语言的神经认知练习中的具体实践，产生了神经认知功能的改善，这些改善不仅仅归因于与计算机工作、与临床医生互动或认知挑战相关的非特异性刺激，而且非特异性刺激对神经认知也有有益的影响。(c)2006 Elsevier B. V.保留所有权利。
An emerging body of research has shown that computer-assisted cognitive remediation, consisting of training in attention, memory, language and/or problem-solving, produces improvement in neurocognitive function that generalizes to untrained neurocognitive tests and may also impact symptoms and work functioning in patients with schizophrenia. The active ingredient of these interventions, however, remains unknown as control groups in these studies have typically included few, if any, of the elements of these complex behavioral treatments. This study compared the effects of ail extended (12-month), standardized, computer-assisted cognitive remediation intervention with those of a computer-skills training control condition that consisted of many of the elements of the experimental intervention, including hours spent on a computer, interaction with a clinician and non-specific cognitive stimulation. Forty-two patients with schizophrenia were randomly assigned to one of two conditions and were assessed with a comprehensive neuropsychological test battery before and after treatment. Results revealed that cognitive-remediation training produced a significant improvement in working memory, relative to the computers-skills training control condition, but that there was overall improvement in both groups on measures of working memory, reasoning/executive-function, verbal and spatial episodic memory, and processing speed. Taken together, these findings suggest that specific practice in neurocognitive exercises targeted at attention, memory and language, produce improvements in neurocognitive function that are not solely attributable to non-specific stimulation associated with working with a computer, interacting with a clinician or cognitive challenge, but that non-specific stimulation has a salutary effect on neurocognition as well. (c) 2006 Elsevier B.V. All rights reserved.