Comparing Cognitive Remediation Approaches for Schizophrenia

摘要 过去30年的证据表明，70%-80%的精神分裂症患者表现出 在注意力、学习和记忆、解决问题、 语言和感觉运动技能(例如，Reichenberg&Harvey，2007)。特别重要的是 由于这些缺陷的严重性与社区功能受损、社会功能受损有关 心理社会康复方案中的问题解决和进展(Green等人，2000；Green等人， 2015年)。认知补救(CR)是一种行为干预，旨在解决认知障碍 通过恢复丢失的认知技能或通过任务提供绕过缺陷的策略来治疗精神分裂症 练习一下。元分析(Wykes等人，2011；McGurk等人，2007)揭示了认知 矫正是改善精神分裂症患者认知功能的有效方法，但缺乏 关于干预的积极因素的准确性使其无法将其建议作为 这种疾病的标准治疗(Dixon等人，2010年)。目前的三年建议旨在确定 改善精神分裂症认知功能最有效的认知训练机制 通过比较不同侧重点的CR两种不同的系统化方案：演练和练习练习与不同侧重点的练习。 补偿策略。这两个项目都有很强的初步经验支持。100 35名被诊断为精神分裂症或分裂情感障碍的患者将被随机分配到 三组之一：基于神经可塑性的计算机辅助认知训练和练习计划 旨在恢复失去的认知能力的训练练习；一种用于 绕过认知缺陷或电脑游戏控制条件。学习措施，有组织的 根据一种实验治疗学方法，目标与结果不同，将 评估任何观察到的培训效果的概括性。

Abstract Evidence over the past 30 years has revealed that 70-80% of individuals with schizophrenia exhibit marked neurocognitive deficits on measures of attention, learning and memory, problem-solving, language and sensory-motor skill (e.g., Reichenberg & Harvey, 2007). Particular significance has been attached to these deficits as their severity has been linked to impaired community function, social problem-solving and progress in psychosocial rehabilitation programs (Green et al., 2000; Green et al., 2015). Cognitive remediation (CR) is a type of behavioral intervention that addresses cognitive deficits in schizophrenia by restoring lost cognitive skills or providing strategies for bypassing deficits through task practice. Meta-analyses (Wykes et al., 2011; McGurk et al., 2007) have revealed that cognitive remediation is a validated approach to improving cognitive function in schizophrenia, however a lack of precision regarding the active elements of the intervention have prevented its recommendation as a standard treatment for the illness (Dixon et al., 2010). The present three-year proposal seeks to identify cognitive training mechanisms that are most effective at improving cognitive function in schizophrenia by comparing two different systematic programs of CR with different foci: drill-and-practice exercises vs. compensatory strategies. Both programs have strong preliminary empirical support. One-hundred and thirty-five clients diagnosed with schizophrenia or schizoaffective disorder will be randomly assigned to one of three groups: a neuroplasticity-based, drill-and-practice program of computer-assisted cognitive training exercises designed to restore lost cognitive capacity; a manualized strategy training method for bypassing deficits in cognition, or a computer games control condition. Study measures, organized according to an experimental therapeutics approach, with targets distinguished from outcomes, will assess generalization of any observed training effects.