Article Summary:
Previous research indicates that treatment intensity and regular attendance is an important characteristic that predicts a more favorable response to cognitive remediation (CR) in schizophrenia. Amanda's research is the first study to date to examine the neuropsychological, psychological, and clinical factors contributing to participants’ voluntary attendance for CR in a community-based clinic setting with a diverse clinical population. The results indicate that objective neuropsychological impairment (i.e., global neuropsychological functioning and attention/working memory in particular) and subjective awareness of having neuropsychological problems both significantly predict lower CR treatment utilization. These findings underscore previous findings suggesting that neuropsychological impairment is a rate-limiting factor with respect to psychiatric rehabilitation outcomes. Thus, although individuals may recognize their neuropsychological dysfunction, they simply may not have the cognitive skills necessary to manage their schedules and regularly attend their CR sessions.
The findings from this study have salient implications for clinical service providers because those clients who have been identified as having specific deficits in the domains of attention/working memory or processing speed may be at the highest risk for drop-out and poor treatment response, and may require extra attention from clinicians. The implications from these findings can be used as a way to provide ongoing guidance for service provision and can aid in the development of empirically informed strategies aimed at improving CR treatment utilization, and thus treatment effectiveness, in clinical settings.
Reference:
Gooding, A. L., Saperstein, A., Rivera Mindt, M., & Medalia, A. (2012). Predictors of treatment utilisation at cognitive remediation groups for schizophrenia: The roles of neuropsychological, psychological and clinical variables. Neuropsychological Rehabilitation: An International Journal, DOI:10.1080/09602011.2012.665583
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