a Department of Psychology , Queen's University , Kingston , ON , Canada.
Expert Rev Neurother. 2017 Jul;17(7):713-723. doi: 10.1080/14737175.2017.1331128. Epub 2017 May 24.
Individuals with psychotic disorders experience profound impairment in neurocognition, which is consistently found to be the best predictor of independent community functioning. Several diverse behavioural treatments designed to enhance neurocognitive abilities have been developed, with subtle to stark differences among them. Various approaches, to varying degrees, have demonstrated success across diffuse outcomes: improved brain structure and function, performance on neuropsychological tests, and community activities associated with daily living. Areas covered: This paper reviews the different approaches to cognitive remediation and the differential effects these approaches have on neurophysiological function, neurocognitive abilities, and real-world community functioning. Cognitive remediation approaches can be broadly classified along two dimensions: 1) treatment target, and 2) treatment modality. Some approaches target more basic perceptual skills, some target higher level executive processes, while some are non-targeted and seek to improve general cognitive ability. With regard to modality, approaches might have little/no therapist involvement and rely exclusively on computerized practice or they may include intensive therapist involvment to generalize neurocognitive change to community functioning. Expert commentary: Compared to other widely implemented treatments for schizophrenia, cognitive remediation produces better effects on outcome measures. It is time for cognitive remediation to be adopted as a best practice in the treatment of schizophrenia.
个体患有精神病障碍，其神经认知能力会受到严重损伤，而神经认知能力被一致认为是独立社区功能的最佳预测指标。目前已经开发出了几种不同的旨在增强神经认知能力的行为治疗方法，它们之间存在细微到明显的差异。各种方法在不同程度上都在弥散性结果上取得了成功：改善大脑结构和功能、神经心理学测试表现以及与日常生活相关的社区活动。涵盖领域：本文回顾了认知矫正的不同方法，以及这些方法对神经生理功能、神经认知能力和现实社区功能的不同影响。认知矫正方法可以大致分为两个维度：1）治疗目标，2）治疗方式。一些方法针对更基本的感知技能，一些方法针对更高层次的执行过程，而一些方法则是非靶向的，旨在提高一般认知能力。关于方式，方法可能几乎不需要或不需要治疗师的参与，仅依赖于计算机练习，或者可能包括强化治疗师的参与，将神经认知变化推广到社区功能。专家评论：与精神分裂症的其他广泛实施的治疗方法相比，认知矫正对结果测量的效果更好。认知矫正作为精神分裂症治疗的最佳实践，是时候被采用了。
