Neurocognitive Rehabilitation for Schizophrenia

描述(由申请人提供)：我们提出了一个综合的培训和研究计划，旨在为PI提供必要的经验和技能，以过渡到作为临床研究科学家的独立，重点是精神分裂症的认知康复。培训计划的核心是向PI提供康复精神分裂症神经认知缺陷的方法的技能，并帮助PI概念化和测试神经认知功能变化在更远端的心理社会状态测量中的潜在作用机制。该计划由三个正式培训模块组成，旨在提供以下方面的概念和实践技能：(1)认知补救的演练和实践恢复方法；(2)神经认知技能的变化如何与功能技能的模拟测量相关；(3)神经认知功能的变化如何与实际心理社会状况的变化相关，例如社区功能和竞争性职业成功。最后一个模块还将包括行为治疗试验、研究和生物统计学方面的更一般培训。培训将通过与赞助商的互动以及对剑桥大学、加州大学圣地亚哥分校、南加州大学和马里兰大学的培训访问进行。虽然最近的几项研究调查了认知补救治疗对精神分裂症患者注意力、记忆和解决问题能力缺陷的疗效，但据我们所知，没有一项研究：(1)将延长的计算机辅助认知补救训练的效果与由同等时间和质量的临床医生互动和在计算机上的体验组成的对照条件进行比较；以及(2)研究随着时间的推移，补救对各种神经心理和心理社会结果指标的影响，以帮助评估影响的持续时间、概化和潜在的作用机制。我们建议对105名门诊康复中的精神分裂症患者进行研究，他们将被随机分配到：(1)计算机辅助认知补救训练，(2)计算机素养训练，或(3)非计算机训练的控制组，以帮助解决这些限制。

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.