年龄作为重度精神疾病患者进行代偿性认知训练后变化的调节因素。
Age as a moderator of change following compensatory cognitive training in individuals with severe mental illnesses.
作者信息
Thomas Kelsey R, Puig Olga, Twamley Elizabeth W
机构信息
Department of Clinical and Health Psychology, University of Florida.
Department of Psychiatry, University of California, San Diego.
出版信息
Psychiatr Rehabil J. 2017 Mar;40(1):70-78. doi: 10.1037/prj0000206. Epub 2016 Aug 22.
OBJECTIVE
This study explored whether age moderated cognitive, symptom, and functional changes over a 12-week compensatory cognitive training (CCT) intervention for participants with severe mental illnesses. CCT focused on the cognitive domains of attention, learning, prospective memory, and executive functioning, often impaired in this population.
METHOD
Seventy-seven unemployed individuals (46 participants with severe mood disorders and 31 participants with schizophrenia/schizoaffective disorder; mean age = 44 years) received CCT for 12 weeks in the context of a supported employment program. Participants were administered cognitive, symptom severity, and functional measures at baseline and 3-, 6-, and 12-month follow-ups, as well as at 18 and 24 months for symptom/functional measures. Mixed effects models, controlling for diagnosis, examined whether age impacted the trajectories of change following CCT.
RESULTS
Analyses showed several significant time by age interactions; younger participants improved more over time on category fluency, β = -.280, t(42.10) = -2.76, p = .008, and financial capacity (UCSD Performance-Based Skills Assessment), β = -.194, t(54.02) = -2.21, p = .031, whereas older participants showed greater reduction in positive symptom severity (Positive and Negative Syndrome Scale), β = -.109, t(78.35) = -2.34, p = .022, and less functional decline on the Independent Living Skills Survey, β = .118, t(109.77) = 2.05, p = .043.
CONCLUSIONS AND IMPLICATIONS FOR PRACTICE
Age moderated the effects of CCT over time on measures of cognition, symptom severity, and functioning. Younger participants improved on objective measures of verbal processing speed and financial capacity, whereas older participants showed reduced positive symptom severity and less decline in self-reported daily functioning. These findings suggest that CCT may differentially benefit persons with severe mental illnesses depending on age. (PsycINFO Database Record
目的
本研究探讨了年龄是否会调节重度精神疾病患者在为期12周的代偿性认知训练（CCT）干预过程中的认知、症状和功能变化。CCT聚焦于注意力、学习、前瞻性记忆和执行功能等认知领域，这些领域在该人群中常受损。
方法
77名失业个体（46名患有重度情绪障碍的参与者和31名患有精神分裂症/分裂情感性障碍的参与者；平均年龄 = 44岁）在支持性就业项目的背景下接受了12周的CCT。参与者在基线、3个月、6个月和12个月随访时接受认知、症状严重程度和功能测量，症状/功能测量在18个月和24个月时也进行。控制诊断的混合效应模型检验了年龄是否影响CCT后的变化轨迹。
结果
分析显示了几个显著的年龄与时间交互作用；较年轻的参与者在类别流畅性（β = -.280，t(42.10) = -2.76，p = .008）和财务能力（基于加州大学圣地亚哥分校表现的技能评估）（β = -.194，t(54.02) = -2.21，p = .031）方面随时间改善更多，而较年长的参与者在阳性症状严重程度（阳性和阴性症状量表）方面有更大程度的降低（β = -.109，t(78.35) = -2.34，p = .022），并且在独立生活技能调查中功能下降较少（β = .118，t(109.77) = 2.05，p = .043）。
结论及对实践的启示
年龄调节了CCT随时间对认知、症状严重程度和功能测量的影响。较年轻的参与者在言语加工速度和财务能力的客观测量方面有所改善，而较年长的参与者阳性症状严重程度降低，自我报告的日常功能下降较少。这些发现表明，CCT可能因年龄不同而对重度精神疾病患者有不同程度的益处。（PsycINFO数据库记录
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