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Dassing R, Offerlin-Meyer I, Cugnot A, Danion JM, Krasny-Pacini A, Berna F. Improving autobiographical memory in schizophrenia using wearable cameras: A single-case experimental study. Neuropsychol Rehabil 2024; 34:103-132. [PMID: 36520673 DOI: 10.1080/09602011.2022.2155668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
Autobiographical memory (AM) impairments influence both sense of identity and social functioning of patients with schizophrenia. However, cognitive remediation methods addressing these difficulties do not sufficiently consider the heterogeneity of this disorder and frequently face methodological limitations. The aim of the present study was to evaluate the efficacy of a method using a wearable camera (NarrativeClip®), through an alternating treatments design across two types of AM training. In parallel, repeated measures were used to appreciate the efficacy, specificity, and generalizability of the programme's benefits. Three patients were invited to wear the camera during 24 personal events. Ten of these events memories were trained by visual cueing (wearable camera condition), 10 others by verbal cueing (written diary condition) and 4 were not trained (control condition). Using pictures collected by the wearable camera seemed particularly relevant, since it promoted more detailed recalls than the diary method, from the first training session and until the end of a one-year follow-up. In addition, the repeated measures performed revealed (1) the efficacy (improvement in AM capacities after participating in the programme), (2) specificity (persistence of working memory deficits), and (3) generalizability (improvement in measures of episodic memory) of our cognitive remediation programme's effects.
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Affiliation(s)
- Romane Dassing
- INSERM U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France
- Psychiatry Department, University Hospital of Strasbourg, Strasbourg, France
- University of Strasbourg, Strasbourg, France
| | - Isabelle Offerlin-Meyer
- INSERM U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France
- Psychiatry Department, University Hospital of Strasbourg, Strasbourg, France
- University of Strasbourg, Strasbourg, France
| | - Alice Cugnot
- INSERM U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France
- University of Strasbourg, Strasbourg, France
| | - Jean-Marie Danion
- INSERM U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France
- Psychiatry Department, University Hospital of Strasbourg, Strasbourg, France
- University of Strasbourg, Strasbourg, France
| | - Agata Krasny-Pacini
- INSERM U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France
- University of Strasbourg, Strasbourg, France
- University Rehabilitation Institute Clemenceau, Strasbourg, France
| | - Fabrice Berna
- INSERM U1114 - Cognitive Neuropsychology and Pathophysiology of Schizophrenia, Strasbourg, France
- Psychiatry Department, University Hospital of Strasbourg, Strasbourg, France
- University of Strasbourg, Strasbourg, France
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Lindamer L, Almklov E, Pittman JOE, Shi S, Maye J, Jak A, Twamley E, Rabin B. Multi-method study of the implementation of Cognitive Symptom Management and Rehabilitation Training (CogSMART) in real-world settings. BMC Health Serv Res 2022; 22:1542. [PMID: 36528588 PMCID: PMC9758865 DOI: 10.1186/s12913-022-08941-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Cognitive Symptom Management and Rehabilitation Training (CogSMART) and Compensatory Cognitive Training (CCT) are evidence-based compensatory cognitive training interventions that improve cognition in persons with a history of traumatic brain injury or other neuropsychiatric disorders. Despite demonstrated efficacy, use and effectiveness of CogSMART/CCT in real-world settings is not known.We used a multi-method design to collect and analyze quantitative and qualitative survey data from several domains of the Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework to gather information about use of CogSMART/CCT in real-world settings from provider and patient perspectives. Surveys were sent to email addresses from persons who registered on the CogSMART website seeking access to training manuals and other resources. Descriptive statistics were generated, and we used Natural Language Processing methods to study the self-report free responses. Using n-gram analysis, we identified the most frequently reported responses.We found CogSMART/CCT was broadly used in real-world settings and delivered by a variety of providers for several patient groups with high attendance and overall high satisfaction. CogSMART/CCT seemed to be offered in VA- or university-related clinics more than in private practice or rehabilitation centers. The diversity of providers and variety of formats by which to deliver CogSMART/CCT (i.e., individual, group, telehealth) seemed to play a role in its widespread implementation, as did its adaptability. Most providers made adaptations to the intervention that reduced the length or number of sessions. These changes were most likely to be based on client characteristics. The low rates of formal training, however, may have contributed to lower levels of perceived helpfulness among patients.Reach and Adoption of a cognitive rehabilitation intervention improved by increasing access to the manuals. Attention to characteristics of dissemination and implementation in the design of an intervention may enhance its use in real-world settings. The relevant outcomes, easy access to training manuals, and adaptability of CogSMART/CCT seem to have been important factors in its use in a variety of settings and for several disorders with cognitive impairment. The adoption of CogSMART/CCT by a variety of providers other than neuropsychologists suggests its use may be broadened to other healthcare providers, if adequately trained, to increase access to an intervention with demonstrated efficacy for cognitive rehabilitation for several neuropsychiatric disorders.
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Affiliation(s)
- Laurie Lindamer
- VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161 USA ,grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
| | - Erin Almklov
- VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161 USA
| | - James O. E. Pittman
- VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161 USA ,grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
| | - Shuyuan Shi
- grid.17091.3e0000 0001 2288 9830Department of Psychology, University of British Columbia, 2136 West Mall, Vancouver, BC V6T 1Z4 Canada
| | - Jacqueline Maye
- VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161 USA ,grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
| | - Amy Jak
- VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161 USA ,grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
| | - Elizabeth Twamley
- VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161 USA ,grid.266100.30000 0001 2107 4242Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
| | - Borsika Rabin
- VA Center of Excellence for Stress and Mental Health, 3350 La Jolla Village Dr., San Diego, CA 92161 USA ,grid.266100.30000 0001 2107 4242Department of Family Medicine and Public Health, University of California San Diego, 9500 Gilman Dr., La Jolla, CA 92093 USA
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Saperstein AM, Medalia A, Malinovsky I, Bello I, Dixon LB. Toolkit for assessing and addressing cognitive health in early psychosis: Evaluation of feasibility and utility in a coordinated specialty care setting. Early Interv Psychiatry 2021; 15:1376-1381. [PMID: 33185025 PMCID: PMC8272079 DOI: 10.1111/eip.13070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 10/21/2020] [Accepted: 10/30/2020] [Indexed: 11/27/2022]
Abstract
AIM Methods to identify and harness individual cognitive strengths while addressing relative weaknesses have the potential to complement recovery services for first-episode psychosis but systematic implementation is needed. We developed a cognitive health toolkit, trained teams from OnTrackNY, a network of coordinated specialty care (CSC) programs and examined toolkit feasibility and clinical utility during the first year of roll-out. METHODS The toolkit includes a clinician manual, assessment and decision-making tools, and a menu of cognitive health service options. Assessment uses the WRAT5-Reading subtest and a new Self-Assessment of Cognitive Functioning which, together, determine participant- and clinician-perceived cognitive health need. Program-level data were analysed for rates of assessment, identification of cognitive health needs and cognitive health service provision. RESULTS Data from 18 OnTrackNY teams included 933 participants, including 310 new admissions. Across teams, 43.9% of newly admitted participants received a WRAT5-Reading and 41.3% received a self-assessment. Of all assessments completed in the study period, 50.7% were at or within 3-months of admission and 69.1% were within the first year of program participation. Cognitive health need was identified by self-report (57.6%) and clinician-report (69.9%) and led to provision of specific services, including psychoeducation, compensatory skills training and in some cases restorative cognitive training. CONCLUSIONS Preliminary feasibility data are encouraging but barriers to assessment need to be identified and addressed. Rates of identified cognitive health need warrant further study of the implementation process and outcomes so that cognitive health assessment and treatment practices may ultimately be disseminated to CSC programs more broadly.
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Affiliation(s)
- Alice M. Saperstein
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
| | - Alice Medalia
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
- Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York, New York
| | - Igor Malinovsky
- Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York, New York
| | - Iruma Bello
- Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York, New York
| | - Lisa B. Dixon
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, New York, New York
- Behavioral Health Services and Policy Research, New York State Psychiatric Institute, New York, New York
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Chong NIM, Maniam Y, Chua YC, Tang C. The Implementation and Review of Cognitive Remediation Training for First Episode Psychosis in Singapore. Front Psychiatry 2021; 12:784935. [PMID: 34916979 PMCID: PMC8669156 DOI: 10.3389/fpsyt.2021.784935] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 11/08/2021] [Indexed: 11/22/2022] Open
Abstract
Objective: Early intervention in patients with first episode psychosis (FEP) can improve cognitive abilities, with both short- and long-term benefits. In this paper, we describe the implementation and review of cognitive remediation training (CRT) in an Asian FEP population. The outcomes of the training are also evaluated and discussed. Methods: This naturalistic paper describes in detail the real-life implementation and conduct of CRT in an early psychosis intervention service. One hundred and nine patients with FEP underwent a 24-session CRT programme, using Cogpack and Neuropsychological Educational Approach to Remediation. The program is evaluated with pre- and post-CRT assessment scores which included Montreal Cognitive Assessment and Brief Assessment of Cognition in Schizophrenia. The rates of improvement on these cognitive assessments were evaluated using paired t-tests, with statistical significance set at p ≤ 0.05. Results: Of the 109 patients who underwent CRT, a total of 92 (84.4%) completed all 24 sessions. Paired t-tests between pre- and post-CRT assessments scores revealed that participants significantly improved on majority of the measures, including verbal memory, digit sequencing, and symbol coding. Conclusion: As with other cognitive remediation programmes, CRT has shown to improve cognitive functioning in patients with FEP. The results support the use of CRT in an Asian context and may serve as guidance for the implementation of similar training programmes in other Asian early psychosis intervention services.
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Affiliation(s)
- Nigel Ian Ming Chong
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yogeswary Maniam
- Early Psychosis Intervention Program, Institute of Mental Health, Singapore, Singapore
| | - Yi Chian Chua
- Early Psychosis Intervention Program, Institute of Mental Health, Singapore, Singapore
| | - Charmaine Tang
- Early Psychosis Intervention Program, Institute of Mental Health, Singapore, Singapore
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Vidarsdottir OG, Roberts DL, Twamley EW, Gudmundsdottir B, Sigurdsson E, Magnusdottir BB. Case Report: Successful Implementation of Integrative Cognitive Remediation for Early Psychosis. Front Psychiatry 2020; 11:624091. [PMID: 33519563 PMCID: PMC7840956 DOI: 10.3389/fpsyt.2020.624091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 12/16/2020] [Indexed: 11/13/2022] Open
Abstract
Many individuals demonstrate functionally relevant impairment in neurocognition as well as social cognition early on in the course of their psychotic disorder. There is robust evidence supporting cognitive remediation as an effective treatment of cognitive dysfunction in schizophrenia. Increasingly it is accepted that earlier treatment is associated with better outcome and that it is important to systematically assess and treat cognitive dysfunction before the cognitive and functional disabilities are fully realized. However, the clinical availability of these interventions remains sparse. As we move forward with implementing evidence-based interventions into multi-component treatment for early psychosis, it is important to reflect on experience as well as evidence. This case report aims to describe the implementation of an integrative cognitive remediation program in coordinated specialty care (CSC) for early psychosis in Iceland and investigate whether the intervention is sustainable in a CSC setting. Data on the number of patients treated, facilitators trained, groups conducted, and funding was used to assess the sustainability. The results show that since initial implementation in 2016, the intervention has been routinely available as part of standard care, with over 100 patients having received the treatment. The report discusses key factors in the successful implementation of the program.
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Affiliation(s)
- Olina G Vidarsdottir
- Department of Psychiatry, Landspitali-The National University Hospital, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - David L Roberts
- Division of Community Recovery, Research and Training, Department of Psychiatry, University of Texas Health Science Center, San Antonio, TX, United States
| | - Elizabeth W Twamley
- Department of Psychiatry, University of California, La Jolla, CA, United States.,Center of Excellence for Stress and Mental Health and Research Service, VA San Diego Healthcare System, San Diego, CA, United States
| | - Berglind Gudmundsdottir
- Department of Psychiatry, Landspitali-The National University Hospital, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Engilbert Sigurdsson
- Department of Psychiatry, Landspitali-The National University Hospital, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Brynja B Magnusdottir
- Department of Psychiatry, Landspitali-The National University Hospital, Reykjavik, Iceland.,Department of Psychology, Reykjavik University, Reykjavik, Iceland
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