School of Psychology, University of South Australia, Adelaide, South Australia, Australia.
Neuropsychol Rehabil. 2009 Oct;19(5):733-41. doi: 10.1080/09602010902732892. Epub 2009 Aug 21.
Cognitive impairment is common in schizophrenia, and has adverse effects on functional outcome. Cognitive remediation strategies in which people with schizophrenia speak aloud (verbalise) during task performance have demonstrated some success in improving performance on the Wisconsin Card Sorting Test. This study extends previous research by assessing whether verbalisation also improves performance on tasks selected from the Delis-Kaplan Executive Function System (D-KEFS). Twenty two subjects with schizophrenia participated in the study. We used a within subjects design to compare performance on the D-KEFS Tower Test and Trail Making Test when participants (a) produced concurrent verbalisation, or (b) remained silent. Results demonstrated selective benefits of verbalisation on a neuropsychological task requiring multiple executive functions (number-letter switching task), while performance on tasks requiring simpler single-component cognitive functions (visual scanning and motor speed tasks) was adversely affected. The effects of verbalisation on the cognitive task performance of patients with schizophrenia differ depending on the nature of the task. Benefits are seen in tests of executive skills but performance worsens in single component cognitive tasks. When developing cognitive remediation strategies for people with schizophrenia, consideration should be given to the nature and cognitive demands of each task before recommending verbalisation strategies.
认知障碍在精神分裂症中很常见，并且对功能结果有不良影响。在任务执行过程中让精神分裂症患者大声说出（言语化）的认知矫正策略已经证明在提高威斯康星卡片分类测试的表现方面取得了一些成功。这项研究通过评估言语化是否也能提高从德利斯-卡普兰执行功能系统（D-KEFS）中选择的任务的表现，扩展了以前的研究。22 名精神分裂症患者参加了这项研究。我们使用了一个被试内设计，比较了参与者（a）进行并发言语化或（b）保持沉默时在 D-KEFS 塔测试和追踪测试上的表现。结果表明，言语化对需要多种执行功能的神经心理学任务（数字-字母转换任务）有选择性的益处，而需要更简单的单一认知功能的任务（视觉扫描和运动速度任务）的表现则受到不利影响。言语化对精神分裂症患者认知任务表现的影响取决于任务的性质。在执行技能测试中可以看到益处，但在单一成分认知任务中的表现会恶化。在为精神分裂症患者开发认知矫正策略时，在推荐言语化策略之前，应该考虑每个任务的性质和认知要求。
