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精神分裂症认知矫正的实证研究现状。

Current trends in the empirical study of cognitive remediation for schizophrenia.

机构信息

Department of Psychiatry, Columbia University Medical Center, New York, NY, USA.

出版信息

Can J Psychiatry. 2013 Jun;58(6):311-8. doi: 10.1177/070674371305800602.

Abstract

Cognitive remediation (CR) for schizophrenia is a learning-based behavioural skills training intervention designed to enhance neuro and (or) social cognitive skills, with the ultimate goal of generalization to improve psychosocial outcomes. This review summarizes conceptual approaches to CR for schizophrenia and the evidence for efficacy in clinical research settings. Four issues are at the forefront of ongoing research: the identification of techniques that produce the largest cognitive change, delineation of techniques that enhance transfer of cognitive skills to functional skills, the identification of CR methods that can be personalized to meet the specific cognitive and functional needs of each individual, and, all the while, ensuring that when CR methods are developed in a research setting, they remain scalable for delivery in the larger clinical community. In response to these issues, 3 prominent research trends have emerged: the rise of a new generation of computerized restorative cognitive training, the integration of CR with skills training to promote generalization, and the application of techniques to enhance motivation and learning during CR. As data on the neural basis of learning in people with schizophrenia become available, new technologies that harness the ability of the brain to make sustainable, functional changes may be integrated within a therapeutic context that promotes a personalized approach to learning. The development of transportable and scalable methods of CR that maximize the ability of people with schizophrenia to improve cognition will help them achieve personal goals for recovery.

摘要

认知矫正(CR)治疗精神分裂症是一种基于学习的行为技能训练干预措施,旨在增强神经和(或)社会认知技能,最终目标是推广以改善心理社会结局。本文综述了精神分裂症认知矫正的概念方法和临床研究中的疗效证据。目前,有四个问题是研究的重点:确定可产生最大认知改变的技术,确定可增强认知技能向功能技能转移的技术,确定可根据每个人的具体认知和功能需求进行个性化的 CR 方法,同时确保在研究环境中开发 CR 方法时,它们仍然可以在更大的临床环境中进行扩展。针对这些问题,出现了 3 个突出的研究趋势:新一代计算机化的恢复性认知训练的兴起,CR 与技能训练的整合以促进推广,以及应用技术来增强 CR 期间的动机和学习。随着关于精神分裂症患者学习的神经基础的数据的出现,利用大脑进行可持续、功能性改变的新技术可能会整合到促进个性化学习的治疗环境中。开发可运输和可扩展的 CR 方法,可以最大限度地提高精神分裂症患者改善认知的能力,帮助他们实现个人康复目标。

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