Section of Experimental Psychopathology and Neurophysiology, Department of Psychiatry, University Hospital Heidelberg, Vossstr. 4, 69115 Heidelberg, Germany.
Psychiatry Res. 2013 Oct 30;209(3):375-80. doi: 10.1016/j.psychres.2013.04.015. Epub 2013 Jun 28.
Cognitive impairment is regarded a core feature of schizophrenia and is associated with low psychosocial functioning. There is rich evidence that cognitive remediation can improve cognitive functions in patients with schizophrenia. However, little is known about what predicts individual remediation success. Some studies suggest that baseline cognitive impairment might be a limiting factor for training response. Aim of the current study was to further examine the role of cognitive and symptom variables as predictors of remediation success. We studied a total sample of 32 patients with schizophrenia and schizoaffective disorder who were engaged in a computer-based cognitive training program (CogPack). A pre-training test battery provided cognitive measures of selective attention, executive functioning, processing speed, verbal memory, and verbal intelligence along with measures for positive and negative symptoms. Training response was defined as improvement on training tasks. Correlation analyses revealed no significant relationship between any of the baseline cognitive or symptom measures and improvement rates. However, better baseline cognition was associated with a higher percentage of tasks with initial ceiling effects. We conclude that not carefully tailoring task difficulty to patients' cognitive abilities constitutes a much more severe threat to cognitive remediation success than cognitive impairment itself.
认知障碍被认为是精神分裂症的核心特征，与较低的社会心理功能有关。有丰富的证据表明认知矫正可以改善精神分裂症患者的认知功能。然而，对于什么因素可以预测个体矫正成功，我们知之甚少。一些研究表明，基线认知障碍可能是训练反应的限制因素。本研究的目的是进一步探讨认知和症状变量作为矫正成功预测因子的作用。我们研究了总共 32 名患有精神分裂症和分裂情感障碍的患者，他们参与了基于计算机的认知训练计划（CogPack）。在培训前的测试中，我们提供了选择性注意力、执行功能、处理速度、言语记忆和言语智力的认知测量，以及阳性和阴性症状的测量。训练反应定义为训练任务的改善。相关分析显示，基线认知或症状测量与改善率之间没有显著关系。然而，更好的基线认知与初始上限效应的任务比例更高有关。我们的结论是，不根据患者的认知能力仔细调整任务难度，对认知矫正成功构成的威胁比认知障碍本身更为严重。
