Neuropsychology Review

, 19:353 | Cite as

Cognitive Remediation in Schizophrenia

Review

Abstract

Cognitive deficits are routinely evident in schizophrenia, and are of sufficient magnitude to influence functional outcomes in work, social functioning and illness management. Cognitive remediation is an evidenced-based non-pharmacological treatment for the neurocognitive deficits seen in schizophrenia. Narrowly defined, cognitive remediation is a set of cognitive drills or compensatory interventions designed to enhance cognitive functioning, but from the vantage of the psychiatric rehabilitation field, cognitive remediation is a therapy which engages the patient in learning activities that enhance the neurocognitive skills relevant to their chosen recovery goals. Cognitive remediation programs vary in the extent to which they reflect these narrow or broader perspectives but six meta-analytic studies report moderate range effect sizes on cognitive test performance, and daily functioning. Reciprocal interactions between baseline ability level, the type of instructional techniques used, and motivation provide some explanatory power for the heterogeneity in patient response to cognitive remediation.

Keywords

Cognitive remediation Cognition Psychiatric rehabilitation Schizophrenia Cognitive dysfunction 

References

  1. Anthony, W. A. (2008). Cognitive remediation and psychiatric rehabilitation. Journal of Psychiatric Rehabilitation, 32, 87–88. doi:10.2975/32.2.2008.87.88.CrossRefGoogle Scholar
  2. Anthony, W. A., Cohen, M. R., Farkas, M. D., & Gagne, C. (2002). Psychiatric rehabilitation (2nd ed.). Boston: Boston University, Center for Psychiatric Rehabilitation.Google Scholar
  3. Barch, D. M. (2005). The relationships among cognition, motivation, and emotion in schizophrenia: how much and how little we know. Schizophrenia Bulletin, 31, 875–881. doi:10.1093/schbul/sbi040.PubMedCrossRefGoogle Scholar
  4. Bell, M. D., Choi, J., & Lysaker, P. (2007a). Psychological interventions to improve work outcomes for people with psychiatric disabilities. Tidsskrift for Norsk Psykologforening, 44, 606–617.Google Scholar
  5. Bell, M. D., Fiszdon, J. M., Greig, T., Wexler, B. W., & Bryson, G. (2007b). Neurocognitive enhancement therapy with work therapy in schizophrenia: a six month follow-up of neuropsychological performance. Journal of Rehabilitation Research and Development, 44, 761–770. doi:10.1682/JRRD.2007.02.0032.CrossRefGoogle Scholar
  6. Bellack, A. S., Weinhardt, L. S., Gold, J. M., & Gearon, J. S. (2001). Generalization of training effects in schizophrenia. Schizophrenia Research, 48, 255–262. doi:10.1016/S0920-9964(00)00066-9.PubMedCrossRefGoogle Scholar
  7. Bellucci, D. M., Glaberman, K., & Haslam, N. (2003). Computer-assisted cognitive rehabilitation reduces negative symptoms in the severely mentally ill. Schizophrenia Research, 59, 225–232. doi:10.1016/S0920-9964(01)00402-9.PubMedCrossRefGoogle Scholar
  8. Berger, H. J., van Spaendonck, K. P., Horstink, M. W., Buytenhuijs, E. L., Lammers, P. W., & Cools, A. R. (1993). Cognitive shifting as a predictor of progress in social understanding in high-functioning adolescents with autism: a prospective study. Journal of Autism and Developmental Disorders, 23, 341–359. doi:10.1007/BF01046224.PubMedCrossRefGoogle Scholar
  9. Berridge, K. C. (2004). Motivation concepts in behavioral neuroscience. Physiology & Behavior, 81, 179–209. doi:10.1016/j.physbeh.2004.02.004.CrossRefGoogle Scholar
  10. Black, A., & Deci, E. (2000). The effects of instructors’ autonomy support and students’ autonomous motivation on learning organic chemistry: a self-determination theory-perspective. Science Education, 84, 740–756. doi:10.1002/1098-237X(200011)84:6<740::AID-SCE4>3.0.CO;2-3.CrossRefGoogle Scholar
  11. Bryson, G., & Bell, M. D. (2003). Initial and final work performance in schizophrenia: cognitive and symptom predictors. The Journal of Nervous and Mental Disease, 191, 87–92.PubMedCrossRefGoogle Scholar
  12. Carter, D. E., & Werner, T. J. (1978). Complex learning and information processing by pigeons: a critical analysis. Journal of the Experimental Analysis of Behavior, 29, 565–601. doi:10.1901/jeab.1978.29-565.PubMedCrossRefGoogle Scholar
  13. Choi, J., & Kurtz, M. M. (2009). A comparison of remediation techniques on the Wisconsin Card Sorting Test in schizophrenia. Schizophrenia Research, 107, 76–82. doi:10.1016/j.schres.2008.09.017.PubMedCrossRefGoogle Scholar
  14. Choi, J., & Medalia, A. (2005). Factors associated with a positive response to cognitive remediation in a community psychiatric sample. Psychiatric Services (Washington, D.C.), 56, 602–604. doi:10.1176/appi.ps.56.5.602.Google Scholar
  15. Choi, J., & Medalia, A. (2009). How to enhance intrinsic motivation within the setting of a cognitive remediation program. Schizophrenia Bulletin, 35(sup 1), 284.Google Scholar
  16. Choi, J., Mogami, T., & Medalia, A. (2009). Intrinsic Motivation Inventory (IMI): An adapted scale for schizophrenia research. Schizophrenia Bulletin, doi:10.1093/schbul/sbp030.
  17. Cicerone, K. D., Dahlberg, C., Malec, J. F., Langenbahn, D. M., Felicetti, T., Kneipp, S., et al. (2005). Evidence-based cognitive rehabilitation: updated review of the literature from 1998 through 2002. Archives of Physical Medicine and Rehabilitation, 86, 1681–1692. doi:10.1016/j.apmr.2005.03.024. see comment.PubMedCrossRefGoogle Scholar
  18. Cordova, D. I., & Lepper, M. R. (1996). Intrinsic motivation and the process of learning: beneficial effects of contextualization, personalization, and choice. Journal of Educational Psychology, 88, 715–730. doi:10.1037/0022-0663.88.4.715.CrossRefGoogle Scholar
  19. Cronbach, L. J., & Snow, R. E. (1977). Aptitudes and instructional methods. New York: Irvington/Naiburg.Google Scholar
  20. Deci, E. L., & Ryan, R. M. (2008). Facilitating optimal motivation and psychological well-being across life’s domains. Canadian Psychology/Psychologie canadienne, 49, 14–23.CrossRefGoogle Scholar
  21. Delahunty, A., Morice, R., & Frost, B. (1993). Specific cognitive flexibility rehabilitation in schizophrenia. Psychological Medicine, 23, 221–227.PubMedCrossRefGoogle Scholar
  22. Deng, Y., Booth, J. R., Chou, T.-L., Ding, G.-S., & Peng, D.-L. (2008). Item-specific and generalization effects on brain activation when learning Chinese characters. Neuropsychologia, 46, 1864–1876. doi:10.1016/j.neuropsychologia.2007.09.010.PubMedCrossRefGoogle Scholar
  23. Dweck, C. S. (1986). Motivational processes affecting learning. The American Psychologist, 41, 1040–1048. doi:10.1037/0003-066X.41.10.1040.CrossRefGoogle Scholar
  24. Dweck, C. S., Mangels, J. A., & Good, C. (2004). Motivational effects on attention, cognition, and performance. In D. Y. Dai & R. J. Sternberg (Eds.), Motivation, emotion, and cognition: Integrative perspectives on intellectual functioning and development (pp. 41–56). New Jersey: Erlbaum.Google Scholar
  25. Eccles, J. S., & Wigfield, A. (2002). Motivational beliefs, values, and goals. Annual Review of Psychology, 53, 109–132. doi:10.1146/annurev.psych.53.100901.135153.PubMedCrossRefGoogle Scholar
  26. Elliot, A. J., & Dweck, C. S. (2005). Handbook of competence and motivation. New York: Guilford.Google Scholar
  27. Fiszdon, J. M., Bryson, G. J., Wexler, B. E., & Bell, M. D. (2004). Durability of cognitive remediation training in schizophrenia: performance on two memory tasks at 6-month and 12-month follow-up. Psychiatry Research, 125, 1–7. doi:10.1016/j.psychres.2003.10.004.PubMedCrossRefGoogle Scholar
  28. Fiszdon, J. M., Whelahan, H., Bryson, G. J., Wexler, B. E., & Bell, M. D. (2005). Cognitive training of verbal memory using a dichotic listening paradigm: impact on symptoms and cognition. Acta Psychiatrica Scandinavica, 112, 187–193. doi:10.1111/j.1600-0447.2005.00565.x.PubMedCrossRefGoogle Scholar
  29. Fiszdon, J. M., Choi, J., Bryson, G. J., & Bell, M. D. (2006). Impact of intellectual status on response to cognitive task training in patients with schizophrenia. Schizophrenia Research, 87, 261–269. doi:10.1016/j.schres.2006.04.011.PubMedCrossRefGoogle Scholar
  30. Gold, J. M. (2008). Is cognitive impairment in schizophrenia ready for diagnostic prime time? World Psychiatry; Official Journal of the World Psychiatric Association (WPA), 7, 32–33.Google Scholar
  31. Gopal, V. Y., & Variend, H. (2005). First-episode schizophrenia: review of cognitive deficits and cognitive remediation. Advances in Psychiatric Treatment, 11, 38–44. doi:10.1192/apt.11.1.38.CrossRefGoogle Scholar
  32. Green, M. F., Kern, R. S., & Heaton, R. K. (2004). Longitudinal studies of cognition and functional outcome in schizophrenia: implications for MATRICS. Schizophrenia Research, 72, 41–51.CrossRefGoogle Scholar
  33. Green, M. F., Satz, P., Ganzell, S., & Vaclav, J. F. (1992). Wisconsin Card Sorting Test performance in schizophrenia: remediation of a stubborn deficit. The American Journal of Psychiatry, 149, 62–67.PubMedGoogle Scholar
  34. Greig, T. C., Zito, W., Wexler, B. E., Fiszdon, J., & Bell, M. D. (2007). Improved cognitive function in schizophrenia after one year of cognitive training and vocational services. Schizophrenia Research, 96, 156–161. doi:10.1016/j.schres.2007.07.003.PubMedCrossRefGoogle Scholar
  35. Grolnick, W., & Ryan, R. (1987). Autonomy in children’s learning: an experimental and individual difference investigation. Journal of Personality and Social Psychology, 52, 890–898. doi:10.1037/0022-3514.52.5.890.PubMedCrossRefGoogle Scholar
  36. Heinrichs, R. W., & Zakzanis, K. K. (1998). Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology, 12, 426–445. doi:10.1037/0894-4105.12.3.426.PubMedCrossRefGoogle Scholar
  37. Hodge, H. R., Siciliano, D., Whithey, P., Moss, B., Judd, G., Shores, E. A., et al. (2008). A randomized controlled trial of cognitive remediation in schizophrenia. Schizophrenia Bulletin., . doi:10.1093/schbul/sbn102.Google Scholar
  38. Hogarty, G. E., Greenwald, D. P., & Eack, S. M. (2006). Durability and mechanism of effects of cognitive enhancement therapy. Psychiatric Services (Washington, D.C.), 57, 1751–1757. doi:10.1176/appi.ps.57.12.1751.Google Scholar
  39. Joanisse, M. F., & Seidenberg, M. S. (1999). Impairments in verb morphology after brain injury: a connectionist model. Proceedings of the National Academy of Sciences of the United States of America, 96, 7592–7597. doi:10.1073/pnas.96.13.7592.PubMedCrossRefGoogle Scholar
  40. Kern, R. S., Wallace, C. J., Hellman, S. G., Womack, L. M., & Green, M. F. (1996). A training procedure for remediating WCST deficits in chronic psychotic patients: an adaptation of errorless learning principles. Journal of Psychiatric Research, 30, 283–294. doi:10.1016/0022-3956(96)00028-3.PubMedCrossRefGoogle Scholar
  41. King, R., Lloyd, C., & Meehan, T. (2007). Handbook of Psychosocial Rehabilitation. Oxford: Blackwell.Google Scholar
  42. Krabbendam, L., & Aleman, A. (2003). Cognitive rehabilitation in schizophrenia: a quantitative analysis of controlled studies. Psychopharmacology, 169, 376–382. doi:10.1007/s00213-002-1326-5.PubMedCrossRefGoogle Scholar
  43. Kurtz, M. M., Moberg, P. J., Gur, R. C., & Gur, R. E. (2001). Approaches to cognitive remediation of neuropsychological deficits in schizophrenia: a review and meta-analysis. Neuropsychology Review, 11, 197–210. doi:10.1023/A:1012953108158.PubMedCrossRefGoogle Scholar
  44. Kurtz, M. M., Moberg, P. J., Gur, R. C., & Gur, R. E. (2004). Results from randomized, controlled trials of the effects of cognitive remediation on neurocognitive deficits in patients with schizophrenia. Psychological Medicine, 34, 569–570. doi:10.1017/S0033291704002016. comment.PubMedCrossRefGoogle Scholar
  45. Kurtz, M. M., Seltzer, J. C., Shagan, D. S., Thime, W. R., & Wexler, B. E. (2007). Computer-assisted cognitive remediation in schizophrenia: what is the active ingredient? Schizophrenia Research, 89, 251–260. doi:10.1016/j.schres.2006.09.001.PubMedCrossRefGoogle Scholar
  46. Kurtz, M. M., Seltzer, J. C., Fujimoto, M., Shagan, D. S., & Wexler, B. E. (2008a). Predictors of change in life skills in schizophrenia after cognitive remediation. Schizophrenia Research., . doi:10.1016/j.schres.2008.10.014.Google Scholar
  47. Kurtz, M. M., Wexler, B. E., Fujimoto, M., Shagan, D. S., & Seltzer, J. C. (2008b). Symptoms versus neurocognition as predictors of change in life skills in schizophrenia after outpatient rehabilitation. Schizophrenia Research, 102, 303–311. doi:10.1016/j.schres.2008.03.023.CrossRefGoogle Scholar
  48. Lindenmayer, J., Kaushik, S., Branch, C., McGurk, S., Khan, A., Li, H., et al. (2008). Does computerized cognitive remediation change brain activation patterns in schizophrenia: fMRI pilot data. European Psychiatry, 23, S127–S128. doi:10.1016/j.eurpsy.2008.01.827.CrossRefGoogle Scholar
  49. Maples, N. J., & Velligan, D. I. (2008). Cognitive adaptation training: establishing environmental supports to bypass cognitive deficits and improve functional outcomes. American Journal of Psychiatric Rehabilitation, 11, 164–180. doi:10.1080/15487760801963686.CrossRefGoogle Scholar
  50. McGurk, S. R., Mueser, K. T., & Pascaris, A. (2005). Cognitive training and supported employment for persons with severe mental illness: one-year results from a randomized controlled trial. Schizophrenia Bulletin, 31, 898–909. doi:10.1093/schbul/sbi037.PubMedCrossRefGoogle Scholar
  51. McGurk, S. R., Mueser, K. T., Feldman, K., Wolfe, R., & Pascaris, A. (2007a). Cognitive training for supported employment: 2–3 year outcomes of a randomized controlled trial. The American Journal of Psychiatry, 164, 437–441. doi:10.1176/appi.ajp.164.3.437.CrossRefGoogle Scholar
  52. McGurk, S. R., Twamley, E. W., Sitzer, D. I., McHugo, G. J., & Mueser, K. T. (2007b). A meta-analysis of cognitive remediation in schizophrenia. The American Journal of Psychiatry, 164, 1791–1802. doi:10.1176/appi.ajp.2007.07060906.CrossRefGoogle Scholar
  53. Medalia, A., & Choi, J. (2009). The role of motivation and engagement in successful cognitive training with schizophrenia patients. Schizophrenia Bulletin, 35(sup 1), 355.Google Scholar
  54. Medalia, A., & Lim, R. (2004). Treatment of cognitive dysfunction in psychiatric disorders. Journal of Psychiatric Practice, 10, 17–25. doi:10.1097/00131746-200401000-00003.PubMedCrossRefGoogle Scholar
  55. Medalia, A., & Richardson, R. (2005). What predicts a good response to cognitive remediation interventions? Schizophrenia Bulletin, 31, 942–953. doi:10.1093/schbul/sbi045.PubMedCrossRefGoogle Scholar
  56. Medalia, A., Dorn, H., & Watras-Gans, S. (2000). Treating problem-solving deficits on an acute care psychiatric inpatient unit. Psychiatry Research, 97, 79–88. doi:10.1016/S0165-1781(00)00214-6.PubMedCrossRefGoogle Scholar
  57. Medalia, A., Revheim, N., & Casey, M. (2001). The remediation of problem-solving skills in schizophrenia. Schizophrenia Bulletin, 27, 259–267.PubMedGoogle Scholar
  58. Medalia, A., Revheim, N., & Casey, M. (2002). Remediation of problem-solving skills in schizophrenia: evidence of a persistent effect. Schizophrenia Research, 57, 165–171. doi:10.1016/S0920-9964(01)00293-6.PubMedCrossRefGoogle Scholar
  59. Medalia, A., Herlands, T., & Baginsky, C. (2003). Rehab rounds: cognitive remediation in the supportive housing setting. Psychiatric Services (Washington, D.C.), 54, 1219–1220. doi:10.1176/appi.ps.54.9.1219.Google Scholar
  60. Medalia, A., Revheim, N., & Herlands, T. (2009). Cognitive remediation for psychological disorders, therapist guide. New York: Oxford University Press.Google Scholar
  61. Nakagami, E., Xie, B., Hoe, M., & Brekke, J. S. (2008). Intrinsic motivation, neurocognition, and psychosocial functioning in schizophrenia: testing mediator and moderator effects. Schizophrenia Research, 105, 95–104. doi:10.1016/j.schres.2008.06.015.PubMedCrossRefGoogle Scholar
  62. Olie, J.-P., Spina, E., Murray, S., & Yang, R. (2006). Ziprasidone and amisulpride effectively treat negative symptoms of schizophrenia: results of a 12-week, double-blind study. International Clinical Psychopharmacology, 21, 143–151. doi:10.1097/01.yic.0000182121.59296.70.PubMedCrossRefGoogle Scholar
  63. Pilling, S., Bebbington, P., Kuipers, E., Garety, P., Geddes, J., Martindale, B., et al. (2002). Psychological treatments in schizophrenia: II. Meta-analyses of randomized controlled trials of social skills training and cognitive remediation. Psychological Medicine, 32, 783–791. see comment.PubMedGoogle Scholar
  64. Prior, M. R. (1979). Cognitive abilities and disabilities in infantile autism: a review. Journal of Abnormal Child Psychology, 7, 357–380. doi:10.1007/BF00917609.PubMedCrossRefGoogle Scholar
  65. Revheim, N., & Marcopulos, B. A. (2006). Group treatment approaches to address cognitive deficits. Psychiatric Rehabilitation Journal, 30, 38–45. doi:10.2975/30.2006.38.45.PubMedCrossRefGoogle Scholar
  66. Roder, V., Muelle, D. R., Mueser, K. T., & Brenner, H. D. (2006). Integrated Psychological Therapy (IPT) for schizophrenia: is it effective? Schizophrenia Bulletin, 32, S81–S93. doi:10.1093/schbul/sbl021.PubMedCrossRefGoogle Scholar
  67. Rohling, M. L., Faust, M. E., Beverly, B., & Demakis, G. (2009). Effectiveness of cognitive rehabilitation following acquired brain injury: a meta-analytic re-examination of Cicerone et al.’s (2000, 2005) systematic reviews. Neuropsychology, 23, 20–39. doi:10.1037/a0013659.PubMedCrossRefGoogle Scholar
  68. Rund, B. R., & Borg, N. E. (1999). Cognitive deficits and cognitive training in schizophrenic patients: a review. Acta Psychiatrica Scandinavica, 100, 85–95. doi:10.1111/j.1600-0447.1999.tb10829.x.PubMedCrossRefGoogle Scholar
  69. Ryan, R. M., & Deci, E. L. (2000). Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. The American Psychologist, 55, 68–78. doi:10.1037/0003-066X.55.1.68.PubMedCrossRefGoogle Scholar
  70. Schunk, D. H. (2000). Self-theories and achievement motivation. In PsycCRITIQUES, pp. 554–556.Google Scholar
  71. Schunk, D. H. (2001). Social cognitive theory and self-regulated learning. New Jersey: Erlbaum.Google Scholar
  72. Schunk, D. H. (2004). Continuing the controversy about reward and intrinsic motivation. In PsycCRITIQUES, pp. 532–534.Google Scholar
  73. Schunk, D. H., & Pajares, F. (2005). Competence perceptions and academic functioning. New York: Guilford.Google Scholar
  74. Schunk, D. H., & Zimmerman, B. J. (2008). Motivation and self-regulated learning: Theory, research, and applications. New Jersey: Erlbaum.Google Scholar
  75. Shuell, T. J. (1986). Cognitive conceptions of learning. Review of Educational Research, 56, 411–436.Google Scholar
  76. Silverstein, S. M., & Wilkniss, S. (2004). The future of cognitive rehabilitation of schizophrenia. Schizophrenia Bulletin, 30, 679–692.PubMedGoogle Scholar
  77. Silverstein, S. M., Menditto, A. A., & Stuve, P. (2001). Shaping attention span: an operant conditioning procedure to improve neurocognition and functioning in schizophrenia. Schizophrenia Bulletin, 27, 247–257.PubMedGoogle Scholar
  78. Sitzer, D. I., Twamley, E. W., Patterson, T. L., & Jeste, D. V. (2008). Multivariate predictors of social skills performance in middle-aged and older out-patients with schizophrenia spectrum disorders. Psychological Medicine, 38, 755–763. doi:10.1017/S0033291707001304.PubMedCrossRefGoogle Scholar
  79. Spaulding, W. D., Reed, D., Sullivan, M., Richardson, C., & Weiler, M. (1999). Effects of cognitive treatment in psychiatric rehabilitation. Schizophrenia Bulletin, 25, 657–676.PubMedGoogle Scholar
  80. Suslow, T., Schonauer, K., & Arolt, V. (2001). Attention training in the cognitive rehabilitation of schizophrenic patients: a review of efficacy studies. Acta Psychiatrica Scandinavica, 103, 15–23. doi:10.1034/j.1600-0447.2001.00016.x.PubMedCrossRefGoogle Scholar
  81. Twamley, E. W., Jeste, D. V., & Bellack, A. S. (2003). A review of cognitive training in schizophrenia. Schizophrenia Bulletin, 29, 359–382.PubMedGoogle Scholar
  82. Twamley, E. W., Savla, G. N., Zurhellen, C. H., Heaton, R. K., & Jeste, D. V. (2008). Development and pilot testing of a novel compensatory cognitive training intervention for people with psychosis. American Journal of Psychiatric Rehabilitation, 11, 144–163. doi:10.1080/15487760801963678.PubMedCrossRefGoogle Scholar
  83. Vansteenkiste, M., Simons, J., Lens, W., Sheldon, K., & Deci, E. (2004). Motivating learning, performance, and persistence: the synergistic effects of intrinsic goal contents and autonomy-supportive contexts. Journal of Personality and Social Psychology, 87, 246–260. doi:10.1037/0022-3514.87.2.246.PubMedCrossRefGoogle Scholar
  84. Velligan, D. I., & Gonzalez, J. M. (2007). Rehabilitation and recovery in schizophrenia. The Psychiatric Clinics of North America, 30, 535–548. doi:10.1016/j.psc.2007.05.001.PubMedCrossRefGoogle Scholar
  85. Velligan, D. I., Bow-Thomas, C. C., Huntzinger, C., Ritch, J., Ledbetter, N., Prihoda, T. J., et al. (2000). Randomized controlled trial of the use of compensatory strategies to enhance adaptive functioning in outpatients with schizophrenia. The American Journal of Psychiatry, 157, 1317–1323. doi:10.1176/appi.ajp.157.8.1317.PubMedCrossRefGoogle Scholar
  86. Velligan, D. I., Kern, R. S., & Gold, J. M. (2006). Cognitive rehabilitation for schizophrenia and the putative role of motivation and expectancies. Schizophrenia Bulletin, 32, 474–485. doi:10.1093/schbul/sbj071.PubMedCrossRefGoogle Scholar
  87. Wexler, B. E., & Bell, M. D. (2005). Cognitive remediation and vocational rehabilitation for schizophrenia. Schizophrenia Bulletin, 31, 931–941. doi:10.1093/schbul/sbi038.PubMedCrossRefGoogle Scholar
  88. Wexler, B. E., Anderson, M., Fulbright, R. K., & Gore, J. C. (2000). Preliminary evidence of improved verbal working memory performance and normalization of task-related frontal lobe activation in schizophrenia following cognitive exercises. The American Journal of Psychiatry, 157, 1694–1697. doi:10.1176/appi.ajp. 157.10.1694.PubMedCrossRefGoogle Scholar
  89. Wilk, C. M., Gold, J. M., Humber, K., Dickerson, F., Fenton, W. S., & Buchanan, R. W. (2004). Brief cognitive assessment in schizophrenia: normative data for the repeatable battery for the assessment of neuropsychological status. Schizophrenia Research, 70, 175–186. doi:10.1016/j.schres.2003.10.009.PubMedCrossRefGoogle Scholar
  90. Wykes, T., Brammer, M., Mellers, J., Bray, P., Reeder, C., Williams, C., et al. (2002). Effects on the brain of a psychological treatment: cognitive remediation therapy: Functional magnetic resonance imaging in schizophrenia. The British Journal of Psychiatry, 181, 144–152.PubMedGoogle Scholar
  91. Wykes, T., Reeder, C., Williams, C., Corner, J., Rice, C., & Everitt, B. (2003). Are the effects of cognitive remediation therapy (CRT) durable? Results from an exploratory trial in schizophrenia. Schizophrenia Research, 61, 163–174. doi:10.1016/S0920-9964(02)00239-6.PubMedCrossRefGoogle Scholar
  92. Wykes, T., Newton, E., Landau, S., Rice, C., Thompson, N., & Frangou, S. (2007a). Cognitive remediation therapy (CRT) for young early onset patients with schizophrenia: an exploratory randomized controlled trial. Schizophrenia Research, 94, 221–230. doi:10.1016/j.schres.2007.03.030.CrossRefGoogle Scholar
  93. Wykes, T., Reeder, C., Landau, S., Everitt, B., Knapp, M., Patel, A., et al. (2007b). Cognitive remediation therapy in schizophrenia: randomised controlled trial. The British Journal of Psychiatry, 190, 421–427. doi:10.1192/bjp.bp.106.026575.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  1. 1.Department of PsychiatryColumbia University College of Physicians and SurgeonsNew YorkUSA

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