Department of Psychology and Program in Neuroscience and Behavior, Wesleyan University, Judd Hall, 207 High Street, Middletown, CT 06459, United States.
Department of Psychology and Program in Neuroscience and Behavior, Wesleyan University, Judd Hall, 207 High Street, Middletown, CT 06459, United States.
Schizophr Res. 2024 Oct;272:20-25. doi: 10.1016/j.schres.2024.08.009. Epub 2024 Aug 23.
Racial disparities in diagnosis, treatment, and outcome have been well-established for people with schizophrenia. While cognitive remediation treatments have been shown to produce mild to moderate improvements in cognition for people with schizophrenia, few studies have examined racial/ethnic differences in treatment response. This study employed a secondary analysis of data from two randomized, single-blind controlled trials (N = 119) investigating the efficacy of two forms of cognitive training, to explore potential racial/ethnic differences in targeted outcomes. Given the extant literature, we predicted that racial/ethnic minorities would (1) drop out of the study at higher rates, (2) display greater levels of functional and cognitive impairment prior to treatment, and (3) display lower levels of improvement in cognitive and functioning outcomes following treatment. Our study revealed largely negative findings: white vs. non-white groups showed similar treatment drop-out rates, similar levels of cognitive impairment and symptom severity at study baseline and showed similar responses to cognitive training, with the exception of working memory in which participants' racial/ethnic minority status predicted significantly greater improvement in response to cognitive training. These findings suggest that cognitive remediation treatments are effective at addressing cognitive deficits in racial/ethnic minorities and supports cognitive remediation as a treatment which may help address racial/ethnic disparities in cognition. Given the scant research literature, future analyses should look at race as a potential mediator of treatment in a variety of evidence-based psychosocial treatments.
种族差异在精神分裂症患者的诊断、治疗和预后方面已经得到了充分证实。虽然认知矫正治疗已被证明能轻度至中度改善精神分裂症患者的认知能力，但很少有研究探讨治疗反应的种族/民族差异。本研究对两项随机、单盲对照试验（N=119）的数据进行了二次分析，以探讨两种认知训练形式的针对性结果的潜在种族/民族差异。鉴于现有文献，我们预测少数民族/族裔群体将：（1）更高的退出研究率；（2）在治疗前表现出更大程度的功能和认知障碍；（3）在认知和功能结果治疗后表现出较低的改善水平。我们的研究结果揭示了大部分负面发现：白人组与非白人组的治疗退出率相似，治疗前的认知障碍和症状严重程度相似，对认知训练的反应也相似，但工作记忆除外，参与者的种族/民族少数群体地位预测对认知训练的反应有显著更大的改善。这些发现表明，认知矫正治疗在解决少数民族的认知缺陷方面是有效的，并支持认知矫正作为一种治疗方法，可能有助于解决认知方面的种族/民族差异。鉴于研究文献匮乏，未来的分析应该将种族视为各种基于证据的心理社会治疗中治疗的潜在中介因素。
