A Comparison of Cognitive Training Approaches in Psychotic Disorders

Study Overview
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Brief Summary
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Cognitive remediation (CR) is the best treatment to improve neurocognitive abilities for individuals with psychosis, however, there is no gold standard method of cognitive remediation available. Cognitive training refers to the training component of CR in which people practice computerized exercises that train specific cognitive abilities. There is no agreed upon approach within the field as to the type of training that is most effective with some studies, training higher level cognitive abilities, some training perceptual abilities, and others training general cognitive skills. This study will directly compare two competing methods of cognitive training on measures of neurophysiology, neurocognition, functional competence, and real-world functional performance.

Official Title
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A Comparison of Cognitive Training Approaches in Psychotic Disorders

Conditions
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Psychotic Disorders

Intervention / Treatment
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* Behavioral: Cognitive Remediation - Executive Training
* Behavioral: Cognitive Remediation - Perceptual Training


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: psychotic disorder No previous cognitive remediation in past 6 months Exclusion Criteria: Brain injury Substance abuse Neurocognitive disorder Developmental Disability

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Double


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Executive Training<br>Executive Training (ET) involves training on computerized cognitive exercises that have graded increases in difficulty so that the participant is always challenged. A therapist will be in the room with participants to address any difficulties with the program and facilitate generation of strategies. ET will be delivered in both individual and group settings. | Behavioral: Cognitive Remediation - Executive Training<br>* Cognitive remediation is a cognitive and behavioural therapy designed to improve cognitive skills such as memory, and problem solving ability.<br>|
| Experimental: Perceptual Training<br>Perceptual Training (PT) involves training on computerized cognitive exercises that have graded increases in difficulty so that the participant is always challenged. A therapist will be in the room with participants to address any difficulties with the program and facilitate generation of strategies. PT will be delivered in both individual and group settings. | Behavioral: Cognitive Remediation - Perceptual Training<br>* Cognitive remediation is a cognitive and behavioural therapy designed to improve cognitive skills such as attention, and processing speed.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Functional Performance - Specific Levels of Functioning (SLOF) from Baseline | Rating scale completed by participants' case managers that rates their ability to perform different everyday tasks | Post-treatment (within 2 weeks following the end of treatment) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Neurocognition - MATRICS Cognitive Consensus Battery (MCCB) from Baseline | The MCCB is the gold standard cognitive assessment for schizophrenia research | Post-treatment (within 2 weeks following the end of treatment) | 
| Change in Neurophysiology - EEG from Baseline | Alpha and Theta band synchronization, p300, mismatch negativity | Post-treatment (within 2 weeks following the end of treatment) | 
| Functional Competence - Canadian Objective Assessment of Life Skills Brief (COALS-B) from Baseline | Performance based measure of real life functional skills using role-play | Post-treatment (within 2 weeks following the end of treatment) | 
| Change in Functional Performance - Specific Levels of Functioning (SLOF) from Baseline | Rating scale completed by participants' case managers that rates their ability to perform different everyday tasks | Follow-Up (3 months after the end of treatment) | 
| Change in Neurocognition - MATRICS Cognitive Consensus Battery (MCCB) from Baseline | The MCCB is the gold standard cognitive assessment for schizophrenia research | Follow-Up (3 months after the end of treatment) | 
| Change in Neurophysiology - EEG from Baseline | Alpha and Theta band synchronization, p300, mismatch negativity | Follow-Up (3 months after the end of treatment) | 
| Functional Competence - Canadian Objective Assessment of Life Skills Brief (COALS-B) from Baseline | Performance based measure of real life functional skills using role-play | Follow-Up (3 months after the end of treatment) |