- Title
- Computerised cognitive remediation of everyday memory in individuals with schizophrenia
- Creator
- Anderson, Loraine
- Resource Type
- thesis
- Date
- 2015
- Description
- Professional Doctorate - Doctor of Clinical Psychology (DClinPsych)
- Description
- Cognitive deficits, and in particular memory problems, are well documented in people with schizophrenia. Cognitive remediation programs have been found to be successful in remediating these cognitive deficits including memory. Mnemonics and other strategies have been found to assist with memory but it has also been found that people with schizophrenia trained in these strategies don’t utilise them to improve memory performance. Recent research in cognitive remediation has focused on motivation as a factor in engagement with mnemonic and other cognitive strategies. It is not known what motivational factors and program length improves cognition. In addition access to programs in rural and remote areas of Australia is limited yet it is unknown if people with schizophrenia would utilise online cognitive remediation programs. The purpose of this study was to establish whether online cognitive remediation therapy programs are feasible for use with people with schizophrenia. This thesis will focus on the second of two studies which examines whether Cognitive Remediation Therapy (CRT) can improve memory using specific learning and motivational techniques. In this study, two purpose-built online CRT programs were developed, both identical except that one had no specific strategies (control) and one had mnemonic strategies and instructions (experimental). Participants were recruited from Newcastle and Lake Macquarie Mental Health services with a confirmed diagnosis of schizophrenia. Participants were randomly allocated to four different conditions: paid control, paid experimental, unpaid control or unpaid experimental. Initial assessments were completed with all participants that included two subtests of the WASI, the WTAR, SANS and SAPS, EMQ, GAF, and CVLT-II as well as the initial assessment on the online CRT program. The CRT program was made of several memory tasks in which participants paired a cue word or face with a response word. Different cues and response pairs were used in initial test, final test and in two training modules. The two training modules comprised of six training levels each. Participants completed the same learning, cued recall and two-alternative forced-choice recognition tasks during the pre and post-test as well training modules. After the initial assessment, participants were asked to complete two hours a week of the CRT training program over six weeks (or two levels a week). At the end of six weeks all participants completed a final assessment which included the EMQ, GAF, and CVLT-II in addition to a final assessment on the online CRT program. Results: In total 40 participants completed the study, 19 in the experimental condition and 21 in the control group with approximately equal numbers in the paid and unpaid conditions. There were few significant differences in between the different performances conditions on the memory focused CRT program, or on the other assessments employed. Payment had little effect, with only marginally more training being completed on average for the paid group than unpaid. There was little evidence for an association between symptoms and training levels completed. Given that a large number of participants did not complete any training only results from the pre and post CRT assessments were analysed. However, these analyses were supplemented by examining correlations between changes in performance from pre to post memory sessions with number of training levels completed. For learning tasks, word cues required significantly fewer tries than face cues. Approximately half the participants completed six or more training levels. Overall, all participants’ GAF and EMQ scores improved, but there were no significant differences between experimental and control groups. In the CVLT-II there were only two tasks which showed significant differences between conditions; the total number correct in four recall attempts was significantly greater post-test overall, but this improvement did not differ between instruction groups and the same was the case for the short (30 second) delay recall test.
- Subject
- schizophrenia; cognitive remediation; web-based program
- Identifier
- http://hdl.handle.net/1959.13/1309872
- Identifier
- uon:21963
- Rights
- Copyright 2015 Loraine Anderson
- Language
- eng
- Full Text
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