Neurocognitive Rehabilitation for Schizophrenia

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DESCRIPTION (provided by applicant): We propose an integrated training and research plan designed to provide the PI with the experiences and skills necessary for transition to independence as a clinical research scientist with a focus on cognitive rehabilitation in schizophrenia. The centerpiece of the training plan is designed to provide the PI with skills in approaches to rehabilitation of neurocognitive deficits in schizophrenia and to help the PI conceptualize and test potential mechanisms of action of changes in neurocognitive function on more distal measures of psychosocial status. The program consists of three formal training modules that are designed to provide conceptual and practical skills in: (1) drill-and-practice restorative approaches to cognitive remediation; (2) how changes in neurocognitive skill may relate to simulated measures of functional skills, and (3) how change in neurocognitive function may relate to change in actual psychosocial status, e.g., community function and competitive vocational success. The last module will also include more general training in behavioral treatment trials research and biostatistics. Training will occur through interactions with the sponsor and through training visits to Cambridge University, the University of California at San Diego, the University of Southern California and the University of Maryland. While several recent studies have investigated the efficacy of cognitive remediation treatment for deficits in attention, memory and problem-solving in schizophrenia no study, to our knowledge, has: (1) compared the effects of extended, computer-assisted cognitive remediation training to a control condition consisting of equivalent duration and quality of clinician interaction and experience on a computer, and (2) investigated effects of remediation on a variety of neuropsychological and psychosocial outcome measures over time to help assess duration of effects, generalization and potential mechanisms of action. We propose a study of 105 patients with schizophrenia in outpatient rehabilitation who will be randomly assigned to either: (1) computer-assisted cognitive remediation training, (2) computer-literacy training, or (3) a non-computer-trained control group to help address these limitations.