Katie M. Lavigne – PhD Progress Report – Assessing CRT and MCT for Schizophrenia

Katie M. Lavigne February 24, 2014
PhD Progress Report
Project Summary

Schizophrenia is a debilitating disorder that can severely impact the lives of patients and their families. Despite improvements in medications used to treat schizophrenia, they are not always effective at improving symptoms, cognition (e.g., memory, attention) and social functioning. For these reasons, health professionals are actively searching for complementary treatment options that can be used alongside conventional medications. Cognitive training is one of the most common and effective types of these alternative treatments; however, different types of cognitive training target different aspects of schizophrenia, and the distinct effects of these treatments on symptoms, cognition, social functioning, and brain activity are still unclear. The goal of my PhD research is to examine brain activity associated with changes in symptoms, cognition, and social functioning in schizophrenia patients undergoing one of two popular cognitive therapies, cognitive remediation therapy (CRT) and metacognitive training (MCT). CRT uses training and practice to improve memory and attention whereas MCT focuses on teaching patients to counteract biases in thinking that contribute to delusions. Groups of 6-10 schizophrenia patients will take part in either CRT or MCT over an 8-week period, and symptoms, cognition, social functioning, and brain activity will be assessed pre- and post-treatment. This research will be the first direct comparison of brain changes underlying two popular cognitive therapies for schizophrenia, and could lead to more individualized treatment options for patients by determining which features of schizophrenia are impacted most through CRT vs. MCT. Future research combining CRT and MCT would serve as the first steps in the development of a comprehensive treatment program involving treatment with medications in conjunction with cognitive training.

Procedure

Each group of participants will complete a two-day pre-assessment, an 8-week treatment program, and a two-day post-assessment. A brief assessment of symptoms, cognition, and social functioning will also take place at midpoint (4 weeks into treatment). Pre- and post-assessments will occur approximately one week prior to and one week after treatment, respectively, leading to 10 to 12 weeks for data collection per group, depending on patients’ availability. Groups will be run consecutively and will involve multiple sites; therefore, we expect to collect data on approximately 4 to 5 groups per year, or 40 to 50 participants per year.

Progress

Pre-, midpoint, and post-assessment batteries have been finalized for the assessment of symptoms, cognition, and social functioning. We are currently in the process of finalizing the cognitive tasks that patients will complete during measurement of brain activity pre- and post-assessment, and expect to begin data collection within 2 to 3 weeks.

We are currently recruiting and running treatment groups at two inpatient sites (BC Psychosis Program, UBC Hospital & Willow Pavilion, Vancouver General Hospital). Recruitment of outpatients is beginning this week and will be carried out through VCH Outpatient Mental Health Teams, with outpatients’ assessments to begin within 2 to 3 weeks, and outpatient treatment groups to begin in approximately one month.


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