A randomized controlled trial examining a cognitive behavioral therapy intervention enhanced with cognitive remediation to improve work and neurocognition outcomes among persons with schizophrenia spectrum disorders

SCHIZOPHRENIA RESEARCH

卷:197

Article

Kukla, Marina^1,2  Bell, Morris D.^3,4  Lysaker, Paul H.^5,6 

[1] Richard L Roudebush VA Med Ctr, HSR&D Ctr Hlth Informat & Commun, 1481 W 10th St, Indianapolis, IN USA

[2] Indiana Univ Purdue Univ, Dept Psychol, 402 N Blackford St, Indianapolis, IN 46202 USA

[3] Yale Univ, Sch Med, 300 George St, New Haven, CT USA

[4] VA Connecticut Healthcare Syst, Psychol Serv 116B, 950 Campbell Ave, West Haven, CT 06516 USA

[5] Roudebush VA Med Ctr, 1481 W 10th St, Indianapolis, IN 46202 USA

[6] Indiana Univ Sch Med, 340 W 10th St,Suite 6200, Indianapolis, IN 46202 USA

关键词: Cognitive remediation;    Cognitive behavioral therapy;    Neurocognition;    Work;    Employment;    Schizophrenia;   

DOI  :  10.1016/j.schres.2018.01.012

来源: Elsevier

【 摘 要 】

This single blind, three-armed randomized controlled trial compared cognitive behavioral therapy (CBT) enhanced with cognitive remediation (CBT + CR) to CBT alone and an active control condition on work and neurocognition outcomes for persons with schizophrenia spectrum disorders. Seventy-five adult outpatients with schizophrenia or schizoaffective disorder were randomized to three study conditions (N = 25 per group). The CBT intervention was the Indianapolis Vocational Intervention program (IVIP), consisting of weekly group and individual sessions focused on work-related content. Participants in the CBT + CR group received IVIP and Posit Science computer-based cognitive training. The active control group consisted of weekly vocational support groups and individual vocational support sessions. All participants were placed into a noncompetitive work assignment and were followed for 26 weeks. Data collection included hours worked, weekly work performance ratings, and neurocognition assessed at baseline and 6 months. Neurocognition was also assessed at 12 months. Data were analyzed using multilevel linear models to account for nested, repeated measures data. Results indicate that participants in the CBT + CR condition worked significantly more hours and had a more positive trajectory of improving global work performance and work quality across the study compared with the CBT alone and vocational support condition. Compared to the other conditions, CBT + CR also had a significant increase in overall neurocognition that continued to the 12 month follow-up, particularly in the domains of verbal learning and social cognition. In conclusion, CBT + CR may be an effective intervention to improve work functioning and neurocognition in persons with schizophrenia. (C) 2018 Elsevier B.V. All rights reserved.

【 授权许可】

Free