Targeted Cognitive Training in Clinical High Risk (CHR) for Psychosis
Condition: Clinical High Risk for Psychosis
MeSH terms: Psychotic Disorders; Mental Disorders
Study type: Interventional

Summary: 
      This project is a randomized-controlled trial to test the efficacy of computer-based targeted
      cognitive training (TCT) versus a placebo intervention of commercial computer games in
      adolescent/young adults at clinical high risk (CHR) for psychosis. TCT is designed to
      optimize learning-induced neuroplasticity in vulnerable neurocognitive systems. A main aim is
      to test the hypothesis that this neuroscience-guided TCT intervention will improve neural
      function, and that these neural improvements will improve cognition and functional outcome.
      CHR participants will be randomly assigned to 40 hours of TCT or placebo computer games
      completed within 10 weeks. TCT consists of 20 hours of training in cognition, including
      processing speed, memory, attention, and cognitive control followed by 20 hours of training
      in social cognition including affect recognition and theory of mind. Neuroimaging, cognition,
      social cognition, clinical symptoms, and functional status will be assessed at baseline,
      after 20 hours/5 weeks of cognitive training (mid-intervention), and after 20 hours/5 weeks
      of social-cognitive training (post-intervention). Cognition, social cognition, symptoms, and
      functioning will also be assessed at a 9 month follow-up (i.e. 9 months after intervention
      completion). We predict that TCT will lead to improvements in neurocognitive function and
      functional status. The results of this study will provide important information about a
      benign, non-pharmacological intervention for improving cognition and functional outcome in
      CHR individuals.
    


Intervention name(s): Targeted Cognitive Training; Computer Games
Intervention type(s): Behavioral; Behavioral
Intervention description(s): Targeted Cognitive Training is performed on the computer through Posit Science. Games are modern and engaging modifications of classic neuropsychological tests, such as set-shifting games modeled on the Wisconsin Card Sort Test, and cognitive control games modeled on Stroop-like interference tasks. Games will target two sets of skills: Targeted cognitive skills include: processing speed, memory, attention, flexibility/cognitive-control, and problem-solving. After 20 hours of training on these skills, participants will complete 20 hours of training on core social cognitive skills, including facial affect recognition, gaze direction perception, and face identity recognition, and theory of mind.; The comparison intervention consists of 40 hours of commercially available and cognitively non-specific computer games. These computer games - such as checkers, solitaire, crossword puzzles - are entertaining and engaging but do not target specific neurocognitive skills.
Other intervention name(s): Posit Science
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: Triple (Participant, Investigator, Outcomes Assessor)
Primary purpose: Treatment
Keywords: schizophrenia; psychosis; at risk; prodrome; attenuated psychosis syndrome