Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, USA.
Schizophr Bull. 2024 Aug 27;50(5):1028-1038. doi: 10.1093/schbul/sbae108.
Decades of research have firmly established that cognitive health and cognitive treatment services are a key need for people living with psychosis. However, many current clinical programs do not address this need, despite the essential role that an individual's cognitive and social cognitive capacities play in determining their real-world functioning. Preliminary practice-based research in the Early Psychosis Intervention Network early psychosis intervention network shows that it is possible to develop and implement tools that delineate an individuals' cognitive health profile and that help engage the client and the clinician in shared decision-making and treatment planning that includes cognitive treatments. These findings signify a promising shift toward personalized cognitive health.
Extending upon this early progress, we review the concept of interindividual variability in cognitive domains/processes in psychosis as the basis for offering personalized treatment plans. We present evidence from studies that have used traditional neuropsychological measures as well as findings from emerging computational studies that leverage trial-by-trial behavior data to illuminate the different latent strategies that individuals employ.
We posit that these computational techniques, when combined with traditional cognitive assessments, can enrich our understanding of individual differences in treatment needs, which in turn can guide evermore personalized interventions.
As we find clinically relevant ways to decompose maladaptive behaviors into separate latent cognitive elements captured by model parameters, the ultimate goal is to develop and implement approaches that empower clients and their clinical providers to leverage individual's existing learning capacities to improve their cognitive health and well-being.
数十年来的研究已经明确,认知健康和认知治疗服务是精神病患者的一项关键需求。然而,尽管个体的认知和社会认知能力在决定其现实生活功能方面起着至关重要的作用,但许多当前的临床项目并未满足这一需求。早期精神病干预网络的初步基于实践的研究表明,开发和实施能够描绘个体认知健康状况的工具,并帮助患者和临床医生共同决策和制定包含认知治疗的治疗计划是可行的。这些发现标志着向个性化认知健康的可喜转变。
在这一早期进展的基础上,我们回顾了精神病患者认知领域/过程个体间变异性的概念,作为提供个性化治疗计划的基础。我们展示了使用传统神经心理学测量以及新兴计算研究的发现的证据,这些研究利用逐试行为数据来阐明个体采用的不同潜在策略。
我们假设,这些计算技术与传统认知评估相结合,可以丰富我们对治疗需求个体差异的理解,从而进一步指导更具个性化的干预措施。
随着我们找到临床上有意义的方法将适应不良行为分解为模型参数捕获的单独潜在认知元素,最终目标是开发和实施使患者及其临床提供者能够利用个体现有学习能力来改善认知健康和幸福感的方法。