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Training attentional skills in patients with chronic schizophrenia: An examination of the efficacy of computer-assisted cognitive rehabilitation techniques
Abstract
Computer-assisted cognitive rehabilitation (CACR), a technique widely used in the rehabilitation of head injured patients, was examined for its potential usefulness in the remediation of attentional deficits in patients with chronic schizophrenia. The study was conducted in the comprehensive psychiatric rehabilitation program of a state psychiatric hospital. Subjects consisted of sixteen patients with chronic schizophrenia. In addition to their usual treatment regimen, half of these patients received twenty-four sessions of individual CACR over an eight-week period, and practiced several individually selected attentional tasks during each session. The remaining subjects were placed on a waiting list for CACR, and made up the control group. Subjects were assessed on several attentional measures pre- and post-CACR, and at three and eleven month follow-ups. Analysis of CACR task performance revealed that all but one subject demonstrated significant improvement on at least one task, and no subject demonstrated significant deterioration. A moderate amount of intrasubject variability on the tasks was observed. This variability was not found to be due to particular days being "good" or "bad" days for the subject, but instead appears to be due to each patient having an idiosyncratic constellation of cognitive deficits. Unfortunately, the improvements observed on the CACR tasks themselves did not generalize to other more clinically relevant measures. Repeated measures ANOVA of various laboratory attentional measures revealed only five group interaction effects, and four of these were in the wrong direction, with the Control group demonstrating relatively superior performance. Assessment of subject performance in Occupational Therapy classes revealed no significant differences between the CACR and Control groups, nor were there differences between the groups in overall clinical status. Finally, although the literature suggests that anticholinergic medication may have an adverse effect on attentional processes, anticholinergic dosage in these subjects was not found to be significantly correlated with performance on laboratory attentional measures. The implications of, and possible explanations for, these negative findings are discussed.
Subject Area
Psychotherapy|Educational psychology
Recommended Citation
Stuve, Paul, "Training attentional skills in patients with chronic schizophrenia: An examination of the efficacy of computer-assisted cognitive rehabilitation techniques" (1990). ETD collection for University of Nebraska-Lincoln. AAI9121938.
https://digitalcommons.unl.edu/dissertations/AAI9121938