Treatment groups were also not matched for the number of hours of clinician contact; therefore, results could reflect the nonspecific effects of increased clinician contact on outcome. In addition, clinicians making the assessments were not blind to the treatments to which patients were assigned.
As such, rater bias cannot be ruled out as a possible explanation for treatment effects. However, effects on performance-based measures of social cognition were as strong as clinician-rated measures; also, social adjustment effects were seen on an array of different measures, many of which leave little room for rater bias employment, for example, although employment data did rely largely on self-report.
Further, robust neurocognitive effects were also found on performance-based measures of cognition, arguing against a substantial rater bias. Increased familiarity with computerized testing associated with CET exposure may also explain some improvements in performance on computer-based neuropsychological tests.
However, CET effects on neurocognition were seen primarily on paper-and-pencil examinations that bear little resemblance to computerized training software, suggesting that although it is possible that CET influenced test-taking behavior in general, it is less likely that differential neurocognitive improvement favoring CET was the result of enhanced computer literacy or familiarity.
In addition, within-composite analyses need to be interpreted with caution; although a hierarchical approach was used to avoid excessively inflating type I error, multiple univariate tests were conducted on within-composite measures. However, to our knowledge this is the largest and longest early-course study of cognitive rehabilitation, and our results indicate that our a priori power analyses based on previous studies 17 guided us toward a sample size that was sufficient to reliably detect the medium to large CET effects observed in this study.
Consequently, it would appear that a sufficient number of individuals were included in the study to enable an adequate evaluation of the efficacy of CET in early schizophrenia. A one-year posttreatment follow-up study is being completed to ascertain the durability of these effects and to determine whether they are comparable with the sustained benefits achieved by patients with chronic schizophrenic illness CET is recovery-phase treatment for the remediation of social and nonsocial cognitive deficits among stable outpatients with schizophrenia.
International Journal of Computational Vision and Robotics
The results of this investigation suggest that the early application of CET may confer substantial benefits in cognitive functioning and broad domains of functional outcome for this population. Sufficient exposure to cognitive rehabilitation may be a vital, yet overlooked, component to early-intervention programs, ultimately providing the critical ingredients needed to help individuals recover from this disorder.
The authors are indebted to Gerard E. Hogarty, M. The authors also thank Konasale Prasad, M. In addition, they thank David Kupfer, M.
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Address correspondence to Dr. Professor Gerard E. Hogarty codirected and contributed to this study, but his death in April prevented his approving the final manuscript to meet criteria for authorship.
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Cognition and Actions Lab - Université Catholique Louvain - Neurosciences - Publications
Back to table of contents. Previous article. Other Articles Full Access. Shaun M. Eack Ph. Deborah P. Greenwald Ph. Susan S. Hogarty M. Susan J. Cooley M. Ann Louise DiBarry M. Debra M. Montrose Ph. Matcheri S.
Keshavan M. Add to favorites Download Citations Track Citations. Table 1Composite indexes and component measures of cognition and behavior for assessing persons with early-course schizophrenia. Table 1Composite indexes and component measures of cognition and behavior for assessing persons with early-course schizophrenia Enlarge table. Table 2Scores on composite indices of cognition and behavior for persons in the early course of schizophrenia who received cognitive enhancement therapy or enriched supportive therapy.
Table 2Scores on composite indices of cognition and behavior for persons in the early course of schizophrenia who received cognitive enhancement therapy or enriched supportive therapy Enlarge table. Table 3Univariate analysis of measures of cognition and behavior of persons in the early course of schizophrenia after two years of cognitive enhancement therapy or enriched supportive therapy.
Table 3Univariate analysis of measures of cognition and behavior of persons in the early course of schizophrenia after two years of cognitive enhancement therapy or enriched supportive therapy Enlarge table. References 1.