Personalized and Scalable Cognitive Remediation Approaches

个性化且可扩展的认知矫正方法

• 批准号: 8729017
• 负责人: Alice Medalia
• 金额: $ 24.45万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-09-01 至 2016-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8729017
• 关键词: Address; Adult; Ambulatory Care Facilities; Area; Attention; Auditory; Clinic; Clinical; Cognition; Cognitive; Cognitive deficits; Cognitive remediation; Collection; Communities; Complex; Computers; Data; Development; Disease; Elements; Enrollment; Ensure; Evaluation; Exercise; Feedback; Functional disorder; Goals; Hour; Individual; Individual Differences; Intervention; Lead; Learning; Left; Link; Literature; Methodology; Methods; Motivation; National Institute of Mental Health; Neurocognition; Neurocognitive; Outcome; Participant; Patients; Perception; Phase; Pilot Projects; Population Study; Problem Solving; Procedures; Process; Psychological Factors; Randomized; Randomized Controlled Trials; Recovery; Recruitment Activity; Research; Sampling; Schizoaffective Disorders; Schizophrenia; Severities; System; Technology; Testing; Therapeutic Effect; Time; Training; Translations; Treatment Effectiveness; base; case-based; cognitive function; cognitive training; computerized; design; efficacy testing; experience; functional improvement; functional outcomes; meetings; practical application; programs; psychosocial rehabilitation; public health relevance; relating to nervous system; response; scaffold; skills; success; therapeutic target; treatment response; visual information

DESCRIPTION (provided by applicant): The extant literature on Cognitive Remediation (CR) for schizophrenia, an empirically based intervention, indicates that across treatment methods, CR has moderate effects on neurocognition and functional outcomes. However, substantial individual differences in response to CR interventions indicate a need to refine intervention strategies to better meet the specific neurocognitive and functional needs of treatment participants. Evidence that neurocognitive and psychological factors predict a strong response to CR has the potential to enable a personalization of the treatment process and to thereby match patients to appropriate treatment. Using the R34 mechanism we will lay the groundwork for a study that tests the efficacy and feasibility of delivering scalable and personalized CR in a community outpatient clinic setting. There are three phases of the proposed study. (1) During Development and Adaptation, we will assemble two personalized packages of restorative computer-based cognitive exercises which, based on prior research about predictors of a positive response to CR, will address the learning needs of people with different modal cognitive profiles. (2) During Open Trial and Refinement, we will pilot test the two cognitive interventions in a sample of 10 adults with schizophrenia and schizoaffective disorder attending a community psychosocial rehabilitation clinic. A 10-session open trial will allow for the collection of qualitative feedback from the subjects and quantitative cognitive assessment data to further refine assessment and treatment parameters. The goal of this phase is to the increase acceptability and feasibility of the CR interventions. (3) During the Pilot Feasibility Trial, we wll conduct a randomized controlled trial to see if baseline cognitive profile predicts response to the different treatment approaches. We will focus on the feasibility of recruiting, enrolling, randomizing, stratifying, retaining, and assessing outcomes in the participants. Consistent with the purpose of the R34 mechanism, this pilot study will lead to a R01, which will provide a more rigorous test of the impact of personalized intervention methodologies on cognitive and functional outcomes in schizophrenia.

描述（由申请人提供）：关于精神分裂症认知矫正（CR）的现有文献是一种基于经验的干预措施，表明在各种治疗方法中，CR 对神经认知和功能结果具有中等影响。然而，对 CR 干预措施反应的巨大个体差异表明需要完善干预策略，以更好地满足治疗参与者的特定神经认知和功能需求。神经认知和心理因素预测 CR 强烈反应的证据有可能实现治疗过程的个性化，从而使患者接受适当的治疗。使用 R34 机制，我们将为一项研究奠定基础，该研究测试以可扩展和个性化的 CR 提供的有效性和可行性。 社区门诊设置。拟议的研究分为三个阶段。 (1) 在发展和适应过程中，我们将组装两个个性化的基于计算机的认知练习恢复包，这些练习基于先前对 CR 积极反应的预测因素的研究，将满足具有不同模式认知特征的人的学习需求。 (2) 在公开试验和细化期间，我们将以 10 名在社区心理社会康复诊所就诊的精神分裂症和分裂情感障碍成人为样本，对这两种认知干预措施进行试点测试。为期 10 次的开放试验将允许收集受试者的定性反馈和定量认知评估数据，以进一步完善评估和治疗参数。此阶段的目标是提高 CR 干预措施的可接受性和可行性。 (3) 在试点可行性试验期间，我们将进行一项随机对照试验，看看基线认知特征是否可以预测对 不同的治疗方法。我们将重点关注招募、登记、随机化、分层、保留和评估参与者结果的可行性。与 R34 机制的目的一致，这项试点研究将导致 R01，它将为个性化干预方法对精神分裂症认知和功能结果的影响提供更严格的测试。