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From Theory to PrACTice: A Cognitive Remediation Program Based on a Neuropsychological Model of Schizophrenia.

Fabre D, Vehier A, Chesnoy-Servanin G, Gouiller N, D'Amato T, Saoud M - Front Psychiatry (2015)

Bottom Line: However, moderate improvement for patients who benefit from these therapies has been observed as described in Wykes et al. review (3).Interestingly, available cognitive remediation programs have not been influenced by these models.We describe the PrACTice program that is in the process of being validated.

View Article: PubMed Central - PubMed

Affiliation: EA 4615, Centre Hospitalier le Vinatier, Université de Lyon , Bron , France.

ABSTRACT
Cognitive dysfunction is one of the hallmark deficits of schizophrenia. A wide range of studies illustrate how it is strongly interconnected to clinical presentation and daily life functioning [see Ref. (1, 2)]. Hence, cognition is an important treatment target in schizophrenia. To address the challenge of cognitive enhancement in schizophrenia, a large number of cognitive remediation programs have been developed and evaluated over the past several decades. First, an overview of these programs is presented highlighting their specificity to cognitive deficit in schizophrenia using an integrated method. In this case, cognitive training focuses on enhancing several elementary cognitive functions considered as a prerequisite to social skills or vocational training modules. These programs are based on the neurodevelopmental hypothesis of schizophrenia. However, moderate improvement for patients who benefit from these therapies has been observed as described in Wykes et al. review (3). Next, neuropsychological models of schizophrenia are then presented. They highlight the critical role of the internally generated intentions in appropriate willful actions. The cognitive control mechanism deals with this ability. Interestingly, available cognitive remediation programs have not been influenced by these models. Hence, we propose another alternative to set up a specific cognitive remediation program for schizophrenia patients by targeting the cognitive control mechanism. We describe the PrACTice program that is in the process of being validated.

No MeSH data available.


Related in: MedlinePlus

Illustration from the active short-list, with the trial “To plan a route” as objective. The strategy is suggested in the speech bubble before to make the decision task. “Which tools would be useful to achieve the objective?” “How would you do it?” The target required a “useful” answer.
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Figure 3: Illustration from the active short-list, with the trial “To plan a route” as objective. The strategy is suggested in the speech bubble before to make the decision task. “Which tools would be useful to achieve the objective?” “How would you do it?” The target required a “useful” answer.

Mentions: During the training sessions, participants have to imagine performing the goal-directed action. Pictures with contextual information are displayed to help them: in a bubble speech, they have instructions such as “Which tools would be useful to achieve the objective?” and “How will you do it?” (see Figure 3). In levels 2 and 3, as there are several objectives, contextual information-guided participants to imagine achieving the right objective. In level 4, participants have to imagine the context and how they will achieve objectives. The accuracy and time of response are recorded as a measure of the effort made to produce a mental representation of the action. Indeed, decision times informed us on the process confronting the target that is displayed and the activated mental representations associated with the task to imagine the action and tools useful to achieve objectives. It allows a measure of the effort made to produce a mental representation of actions relative to the different objectives proposed. Furthermore, the PrACTice program includes 2 short-lists containing 10 trials (10 objectives) that are not used for training during the 24 sessions. These two lists include identical objectives, contexts, and targets but one list does not display the strategy to imagine how to achieve the objectives displayed by the program. These lists are used to introduce the training sessions with the program and is used as pre and post evaluation in the process of validation of the program.


From Theory to PrACTice: A Cognitive Remediation Program Based on a Neuropsychological Model of Schizophrenia.

Fabre D, Vehier A, Chesnoy-Servanin G, Gouiller N, D'Amato T, Saoud M - Front Psychiatry (2015)

Illustration from the active short-list, with the trial “To plan a route” as objective. The strategy is suggested in the speech bubble before to make the decision task. “Which tools would be useful to achieve the objective?” “How would you do it?” The target required a “useful” answer.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4664640&req=5

Figure 3: Illustration from the active short-list, with the trial “To plan a route” as objective. The strategy is suggested in the speech bubble before to make the decision task. “Which tools would be useful to achieve the objective?” “How would you do it?” The target required a “useful” answer.
Mentions: During the training sessions, participants have to imagine performing the goal-directed action. Pictures with contextual information are displayed to help them: in a bubble speech, they have instructions such as “Which tools would be useful to achieve the objective?” and “How will you do it?” (see Figure 3). In levels 2 and 3, as there are several objectives, contextual information-guided participants to imagine achieving the right objective. In level 4, participants have to imagine the context and how they will achieve objectives. The accuracy and time of response are recorded as a measure of the effort made to produce a mental representation of the action. Indeed, decision times informed us on the process confronting the target that is displayed and the activated mental representations associated with the task to imagine the action and tools useful to achieve objectives. It allows a measure of the effort made to produce a mental representation of actions relative to the different objectives proposed. Furthermore, the PrACTice program includes 2 short-lists containing 10 trials (10 objectives) that are not used for training during the 24 sessions. These two lists include identical objectives, contexts, and targets but one list does not display the strategy to imagine how to achieve the objectives displayed by the program. These lists are used to introduce the training sessions with the program and is used as pre and post evaluation in the process of validation of the program.

Bottom Line: However, moderate improvement for patients who benefit from these therapies has been observed as described in Wykes et al. review (3).Interestingly, available cognitive remediation programs have not been influenced by these models.We describe the PrACTice program that is in the process of being validated.

View Article: PubMed Central - PubMed

Affiliation: EA 4615, Centre Hospitalier le Vinatier, Université de Lyon , Bron , France.

ABSTRACT
Cognitive dysfunction is one of the hallmark deficits of schizophrenia. A wide range of studies illustrate how it is strongly interconnected to clinical presentation and daily life functioning [see Ref. (1, 2)]. Hence, cognition is an important treatment target in schizophrenia. To address the challenge of cognitive enhancement in schizophrenia, a large number of cognitive remediation programs have been developed and evaluated over the past several decades. First, an overview of these programs is presented highlighting their specificity to cognitive deficit in schizophrenia using an integrated method. In this case, cognitive training focuses on enhancing several elementary cognitive functions considered as a prerequisite to social skills or vocational training modules. These programs are based on the neurodevelopmental hypothesis of schizophrenia. However, moderate improvement for patients who benefit from these therapies has been observed as described in Wykes et al. review (3). Next, neuropsychological models of schizophrenia are then presented. They highlight the critical role of the internally generated intentions in appropriate willful actions. The cognitive control mechanism deals with this ability. Interestingly, available cognitive remediation programs have not been influenced by these models. Hence, we propose another alternative to set up a specific cognitive remediation program for schizophrenia patients by targeting the cognitive control mechanism. We describe the PrACTice program that is in the process of being validated.

No MeSH data available.


Related in: MedlinePlus