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Arnautovska U, Milton A, Trott M, Soole R, Siskind D. The role of human involvement and support in digital mental health interventions for people with schizophrenia spectrum disorders: a critical review. Curr Opin Psychiatry 2024; 37:356-362. [PMID: 38994811 DOI: 10.1097/yco.0000000000000957] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/13/2024]
Abstract
PURPOSE OF REVIEW Schizophrenia spectrum disorders (SDD) are characterized by a complex array of psychosis symptoms, and typically require ongoing and long-term support, including pharmacological and nonpharmacological management. Digital mental health interventions (DMHIs) have been suggested as a novel therapeutic approach to enable low-cost, scalable improvements in quality of care for adults living with SSD. However, the types and role of human involvement and support within DMHIs is currently unknown. RECENT FINDINGS Several recent systematic reviews and meta-analyses have investigated the potential efficacy of DMHIs for people with SSD, with scant yet emerging systematic evidence on the effects of human support within DMHIs on mental health outcomes. Further, several recent individual studies examined the efficacy of DMHIs with human support among people with SSD and provided valuable insights into the potential key elements of such support on outcomes relevant to this population. SUMMARY The current critical review provides the first narrative synthesis of available evidence to guide clinicians and intervention develops in designing DMHIs with adequate human support that may enhance long-term outcomes of people living with SSD.
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Affiliation(s)
- Urska Arnautovska
- Faculty of Medicine, The University of Queensland
- Metro South Addiction and Mental Health Service, Brisbane
- Queensland Centre for Mental Health Research, Wacol, Queensland
| | - Alyssa Milton
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales
- Australian Research Council (ARC) Centre of Excellence for Children and Families over the Life Course, Australia
| | - Mike Trott
- Faculty of Medicine, The University of Queensland
- Queensland Centre for Mental Health Research, Wacol, Queensland
| | - Rebecca Soole
- Faculty of Medicine, The University of Queensland
- Queensland Centre for Mental Health Research, Wacol, Queensland
| | - Dan Siskind
- Faculty of Medicine, The University of Queensland
- Metro South Addiction and Mental Health Service, Brisbane
- Queensland Centre for Mental Health Research, Wacol, Queensland
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2
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Nuechterlein KH, Nasrallah H, Velligan D. Measuring Cognitive Impairments Associated With Schizophrenia in Clinical Practice: Overview of Current Challenges and Future Opportunities. Schizophr Bull 2024:sbae051. [PMID: 39088730 DOI: 10.1093/schbul/sbae051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/03/2024]
Abstract
BACKGROUND Cognitive impairment associated with schizophrenia (CIAS) negatively impacts daily functioning, quality of life, and recovery, yet effective pharmacotherapies and practical assessments for clinical practice are lacking. Despite the pivotal progress made with establishment of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) Consensus Cognitive Battery (MCCB) for clinical research, implementation of the full MCCB is too time-consuming and cost-ineffective for most clinicians in clinical practice. STUDY DESIGN Here we discuss current assessments in relation to delivery format (interview-based and performance-based), validity, ease of use for clinicians and patients, reliability/reproducibility, cost-effectiveness, and suitability for clinical implementation. Key challenges and future opportunities for improving cognitive assessments are also presented. STUDY RESULTS Current assessments that require 30 min to complete would have value in clinical settings, but the associated staff training and time required might preclude their application in most clinical settings. Initial profiling of cognitive deficits may require about 30 min to assist in the selection of evidence-based treatments; follow-up monitoring with brief assessments (10-15 min in duration) to detect treatment-related effects on global cognition may complement this approach. Guidance on validated brief cognitive tests for the strategic monitoring of treatment effects on CIAS is necessary. CONCLUSIONS With increased advancements in technology-based and remote assessments, development of validated formats of remote and in-person assessment, and the necessary training models and infrastructure required for implementation, are likely to be of increasing clinical relevance for future clinical practice.
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Affiliation(s)
- Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA
| | - Henry Nasrallah
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati School of Medicine, Cincinnati, OH
| | - Dawn Velligan
- Division of Schizophrenia and Related Disorders, Department of Psychiatry and Behavioral Sciences, University of Texas Health Science Center, San Antonio, TX
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3
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Zainal NH, Newman MG. Mindfulness enhances cognitive functioning: a meta-analysis of 111 randomized controlled trials. Health Psychol Rev 2024; 18:369-395. [PMID: 37578065 PMCID: PMC10902202 DOI: 10.1080/17437199.2023.2248222] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 08/09/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Currently no comprehensive meta-analysis of MBI efficacy on global and unique cognitive subdomains exist. METHOD Examined the effects of MBIs on global cognition and 15 cognitive subdomains. Inclusion criteria: meditation naïve participants; randomized controlled trial; outcome included one objective or subjective cognitive functioning measure; primary focus was teaching mindfulness skills. Exclusion criteria: inadequate data; one-session ; control condition contained any MBI component. Robust variance estimation and moderator analyses controlling for presence of treatment fidelity were conducted. RESULTS One-hundred-and-eleven RCTs (n = 9,538) met eligibility criteria. MBIs had small-to-moderate significant effects on global cognition, executive attention, working memory accuracy, inhibition accuracy, shifting accuracy, sustained attention, and subjective cognitive functioning (vs. waitlist/no-treatment, g = 0.257-0.643; vs. active controls, g = 0.192-0.394). MBIs did not impact executive functioning (EF) latency indices, verbal fluency, processing speed, episodic memory, and cognitive error. Treatment effects were stronger for those with elevated psychiatric symptoms vs. healthy controls, and medical samples, studies with complete-case (vs. intention-to-treat) analysis, face-to-face (vs. self-guided) delivery, and non-standard (vs. standard MBI). CONCLUSION MBIs consistently yielded small-to-moderate yet practically meaningful effect sizes on global cognition and six cognitive subdomains that captured accuracy vs. latency-based indices of EF and sustained accuracy.
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Affiliation(s)
- Nur Hani Zainal
- Department of Health Care Policy, Harvard Medical School, Boston, MA, USA
- Department of Psychology, National University of Singapore, Singapore
| | - Michelle G Newman
- Department of Psychology, The Pennsylvania State University, University Park, PA, USA
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4
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Attarha M, Mahncke H, Merzenich M. The Real-World Usability, Feasibility, and Performance Distributions of Deploying a Digital Toolbox of Computerized Assessments to Remotely Evaluate Brain Health: Development and Usability Study. JMIR Form Res 2024; 8:e53623. [PMID: 38739916 PMCID: PMC11130778 DOI: 10.2196/53623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Revised: 03/15/2024] [Accepted: 04/11/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND An ongoing global challenge is managing brain health and understanding how performance changes across the lifespan. OBJECTIVE We developed and deployed a set of self-administrable, computerized assessments designed to measure key indexes of brain health across the visual and auditory sensory modalities. In this pilot study, we evaluated the usability, feasibility, and performance distributions of the assessments in a home-based, real-world setting without supervision. METHODS Potential participants were untrained users who self-registered on an existing brain training app called BrainHQ. Participants were contacted via a recruitment email and registered remotely to complete a demographics questionnaire and 29 unique assessments on their personal devices. We examined participant engagement, descriptive and psychometric properties of the assessments, associations between performance and self-reported demographic variables, cognitive profiles, and factor loadings. RESULTS Of the 365,782 potential participants contacted via a recruitment email, 414 (0.11%) registered, of whom 367 (88.6%) completed at least one assessment and 104 (25.1%) completed all 29 assessments. Registered participants were, on average, aged 63.6 (SD 14.8; range 13-107) years, mostly female (265/414, 64%), educated (329/414, 79.5% with a degree), and White (349/414, 84.3% White and 48/414, 11.6% people of color). A total of 72% (21/29) of the assessments showed no ceiling or floor effects or had easily modifiable score bounds to eliminate these effects. When correlating performance with self-reported demographic variables, 72% (21/29) of the assessments were sensitive to age, 72% (21/29) of the assessments were insensitive to gender, 93% (27/29) of the assessments were insensitive to race and ethnicity, and 93% (27/29) of the assessments were insensitive to education-based differences. Assessments were brief, with a mean duration of 3 (SD 1.0) minutes per task. The pattern of performance across the assessments revealed distinctive cognitive profiles and loaded onto 4 independent factors. CONCLUSIONS The assessments were both usable and feasible and warrant a full normative study. A digital toolbox of scalable and self-administrable assessments that can evaluate brain health at a glance (and longitudinally) may lead to novel future applications across clinical trials, diagnostics, and performance optimization.
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Brown MI, Heck PR, Chabris CF. The Social Shapes Test as a Self-Administered, Online Measure of Social Intelligence: Two Studies with Typically Developing Adults and Adults with Autism Spectrum Disorder. J Autism Dev Disord 2024; 54:1804-1819. [PMID: 36757539 PMCID: PMC9909157 DOI: 10.1007/s10803-023-05901-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/11/2023] [Indexed: 02/10/2023]
Abstract
The Social Shapes Test (SST) is a measure of social intelligence which does not use human faces or rely on extensive verbal ability. The SST has shown promising validity among adults without autism spectrum disorder (ASD), but it is uncertain whether it is suitable for adults with ASD. We find measurement invariance between adults with (n = 229) or without ASD (n = 1,049) on the 23-item SST. We also find that adults without ASD score higher on the SST than adults with ASD (d = 0.21). We also provide two, 14-item versions which demonstrated good parallel test-retest reliability and are positively related to scores on the Frith-Happé task. The SST is suitable for remote, online research studies.
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Affiliation(s)
- Matt I Brown
- Geisinger Health System, Lewisburg, PA, USA.
- Human Resources Research Organization, 66 Canal Center Plaza, Suite 700, 22314, Alexandria, VA, USA.
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Larrauri CA, Harvey PD, Kane JM. A Patient-Clinician Discussion of Current Challenges in Schizophrenia Part 1: Addressing Daily Functioning and Cognitive Impairments Associated with Schizophrenia [Podcast]. Neuropsychiatr Dis Treat 2023; 19:1331-1338. [PMID: 37292181 PMCID: PMC10244615 DOI: 10.2147/ndt.s419177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 04/28/2023] [Indexed: 06/10/2023] Open
Abstract
Dr John M. Kane discusses cognitive impairments in schizophrenia with fellow expert Dr Philip D. Harvey and patient advocate and mental health clinician, Mr Carlos A. Larrauri, who was diagnosed with schizophrenia. The podcast aims to raise awareness of the unmet need to address cognitive impairments associated with schizophrenia (CIAS) as well as the challenges/opportunities faced by patients and clinicians regarding assessments and treatments. The authors emphasize the importance of a treatment focus on daily functioning, in parallel with cognitive symptoms, to mitigate impairments and improve overall outcomes. Mr Larrauri presents the patient perspective and shares his experiences of how psychosocial support and cognitive training can benefit recovery and help patients achieve their goals.
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Affiliation(s)
| | | | - John M Kane
- Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
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Remote cognitive assessment in severe mental illness: a scoping review. SCHIZOPHRENIA 2022; 8:14. [PMID: 35249112 PMCID: PMC8897553 DOI: 10.1038/s41537-022-00219-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 12/16/2021] [Indexed: 11/16/2022]
Abstract
Many individuals living with severe mental illness, such as schizophrenia, present cognitive deficits and reasoning biases negatively impacting clinical and functional trajectories. Remote cognitive assessment presents many opportunities for advancing research and treatment but has yet to be widely used in psychiatric populations. We conducted a scoping review of remote cognitive assessment in severe mental illness to provide an overview of available measures and guide best practices. Overall, 34 studies (n = 20,813 clinical participants) were reviewed and remote measures, psychometrics, facilitators, barriers, and future directions were synthesized using a logic model. We identified 82 measures assessing cognition in severe mental illness across 11 cognitive domains and four device platforms. Remote measures were generally comparable to traditional versions, though psychometric properties were infrequently reported. Facilitators included standardized procedures and wider recruitment, whereas barriers included imprecise measure adaptations, technology inaccessibility, low patient engagement, and poor digital literacy. Our review identified several remote cognitive measures in psychiatry across all cognitive domains. However, there is a need for more rigorous validation of these measures and consideration of potentially influential factors, such as sex and gender. We provide recommendations for conducting remote cognitive assessment in psychiatry and fostering high-quality research using digital technologies.
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8
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Ben-gal Dahan A, Koren D. Basic learning functions among young adults coping with schizophrenia. INTERNATIONAL JOURNAL OF MENTAL HEALTH 2022. [DOI: 10.1080/00207411.2022.2108988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Affiliation(s)
| | - Dan Koren
- Department of Psychology, University of Haifa, Haifa, Israel
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9
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Miller ML, Raugh IM, Strauss GP, Harvey PD. Remote digital phenotyping in serious mental illness: Focus on negative symptoms, mood symptoms, and self-awareness. Biomark Neuropsychiatry 2022. [DOI: 10.1016/j.bionps.2022.100047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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10
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Launes J, Uurainen H, Virta M, Hokkanen L. Self-administered online test of memory functions. NORDIC PSYCHOLOGY 2022. [DOI: 10.1080/19012276.2022.2074525] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Jyrki Launes
- Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Hanna Uurainen
- Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Maarit Virta
- Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Laura Hokkanen
- Faculty of Medicine, Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
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11
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Russell MT, Funsch KM, Springfield CR, Ackerman RA, Depp CA, Harvey PD, Moore RC, Pinkham AE. Validity of remote administration of the MATRICS Consensus Cognitive Battery for individuals with severe mental illness. Schizophr Res Cogn 2022; 27:100226. [PMID: 34934639 PMCID: PMC8655110 DOI: 10.1016/j.scog.2021.100226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/17/2021] [Accepted: 11/17/2021] [Indexed: 10/25/2022]
Abstract
The MATRICS Consensus Cognitive Battery (MCCB) is a gold-standard tool for assessing cognitive functioning in individuals with severe mental illness. This study is an initial examination of the validity of remote administration of 4 MCCB tests measuring processing speed (Trail Making Test: Part A, Animal Fluency), working memory (Letter-Number Span), and verbal learning and memory (Hopkins Verbal Learning Test-Revised). We conducted analyses on individuals with bipolar disorder (BD) and schizophrenia-spectrum disorders (SCZ), as well as healthy volunteers, who were assessed in-person (BD = 80, SCZ = 116, HV = 14) vs. remotely (BD = 93, SCZ = 43, HV = 30) to determine if there were significant differences in performance based on administration format. Additional analyses tested whether remote and in-person assessment performance was similarly correlated with symptom severity, cognitive and social cognitive performance, and functional outcomes. Individuals with BD performed significantly better than those with SCZ on all MCCB subtests across administration format. Animal Fluency did not differ by administration format, but remote participants performed significantly worse on Trail Making and HVLT-R. On the Letter-Number Span task, individuals with bipolar disorder performed significantly better when participating remotely. Finally, patterns of correlations with related constructs were largely similar between administration formats. Thus, results suggest that remote administration of some of the MCCB subtests may be a valid alternative to in-person testing, but more research is necessary to determine why some tasks were affected by administration format.
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Affiliation(s)
- Madisen T Russell
- Department of Psychology, University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX 75080, United States of America
| | - Kensie M Funsch
- Department of Psychology, University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX 75080, United States of America
| | - Cassi R Springfield
- Department of Psychology, University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX 75080, United States of America
| | - Robert A Ackerman
- Department of Psychology, University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX 75080, United States of America
| | - Colin A Depp
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, United States of America
| | - Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1120 NW 14th Street, Miami, FL 33136, United States of America.,Research Service, Bruce W. Carter VA Medical Center, Miami, FL 33136, United States of America
| | - Raeanne C Moore
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093, United States of America
| | - Amy E Pinkham
- Department of Psychology, University of Texas at Dallas, 800 W. Campbell Rd., Richardson, TX 75080, United States of America
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12
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Capizzi R, Fisher M, Biagianti B, Ghiasi N, Currie A, Fitzpatrick K, Albertini N, Vinogradov S. Testing a Novel Web-Based Neurocognitive Battery in the General Community: Validation and Usability Study. J Med Internet Res 2021; 23:e25082. [PMID: 33955839 PMCID: PMC8138705 DOI: 10.2196/25082] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 01/04/2021] [Accepted: 03/16/2021] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND In recent years, there has been increased interest in the development of remote psychological assessments. These platforms increase accessibility and allow clinicians to monitor important health metrics, thereby informing patient-centered treatment. OBJECTIVE In this study, we report the properties and usability of a new web-based neurocognitive assessment battery and present a normative data set for future use. METHODS A total of 781 participants completed a portion of 8 tasks that captured performance in auditory processing, visual-spatial working memory, visual-spatial learning, cognitive flexibility, and emotional processing. A subset of individuals (n=195) completed a 5-question survey measuring the acceptability of the tasks. RESULTS Between 252 and 426 participants completed each task. Younger individuals outperformed their older counterparts in 6 of the 8 tasks. Therefore, central tendency data metrics were presented using 7 different age bins. The broad majority of participants found the tasks interesting and enjoyable and endorsed some interest in playing them at home. Only 1 of 195 individuals endorsed not at all for the statement, "I understood the instructions." Older individuals were less likely to understand the instructions; however, 72% (49/68) of individuals over the age of 60 years still felt that they mostly or very much understood the instructions. CONCLUSIONS Overall, the tasks were found to be widely acceptable to the participants. The use of web-based neurocognitive tasks such as these may increase the ability to deploy precise data-informed interventions to a wider population.
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Affiliation(s)
- Riley Capizzi
- Department of Psychology, Temple University, Philadelphia, PA, United States
| | - Melissa Fisher
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Bruno Biagianti
- Department of Research and Development, Posit Science Corporation, San Francisco, CA, United States
| | - Neelufaer Ghiasi
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Ariel Currie
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Karrie Fitzpatrick
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Nicholas Albertini
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
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13
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Biagianti B, Fisher M, Loewy R, Brandrett B, Ordorica C, LaCross K, Schermitzler B, McDonald M, Ramsay I, Vinogradov S. Specificity and Durability of Changes in Auditory Processing Efficiency After Targeted Cognitive Training in Individuals With Recent-Onset Psychosis. Front Psychiatry 2020; 11:857. [PMID: 33005156 PMCID: PMC7484996 DOI: 10.3389/fpsyt.2020.00857] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 08/06/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND We previously demonstrated that the high heterogeneity of response to computerized Auditory Training (AT) in psychosis can be ascribed to individual differences in sensory processing efficiency and neural plasticity. In particular, we showed that Auditory Processing Speed (APS) serves as a behavioral measure of target engagement, with faster speed predicting greater transfer effects to untrained cognitive domains. Here, we investigate whether the ability of APS to function as a proxy for target engagement is unique to AT, or if it applies to other training interventions, such as Executive Functioning Training (EFT). Additionally, we examine whether changes in APS are durable after these two forms of training. METHODS One hundred and twenty-five participants with Recent Onset Psychosis (ROP) were randomized to AT (n = 66) and EFT (n = 59), respectively. APS was captured at baseline, after treatment, and at 6-month follow-up. Mixed models repeated measures analysis with restricted maximum likelihood was used to examine whether training condition differentiated APS trajectories. Within-group correlational analyses were used to study the relationship between APS and performance improvements in each of the training exercises. RESULTS The two groups were matched for age, gender, education, and baseline APS. Participants showed high inter-individual variability in APS at each time point. The mixed model showed a significant effect of time (F = 5.99, p = .003) but not a significant group-by-time effect (F = .73, p = .48). This was driven by significant APS improvements AT patients after treatment (d = .75) that were maintained after 6 months (d = .63). Conversely, in EFT patients, APS improvements did not reach statistical significance after treatment (p = .33) or after 6 months (p = .24). In AT patients, baseline APS (but not APS change) highly predicted peak performance for each training exercise (all r's >.42). CONCLUSIONS Participant-specific speed in processing basic auditory stimuli greatly varies in ROP, and strongly influences the magnitude of response to auditory but not executive functioning training. Importantly, enhanced auditory processing efficiency persists 6 months after AT, suggesting the durability of neuroplasticity processes induced by this form of training. Future studies should aim to identify markers of target engagement and durability for cognitive training interventions that target sensory modalities beyond the auditory domain.
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Affiliation(s)
- Bruno Biagianti
- Department of R&D, Posit Science Corporation, San Francisco, CA, United States.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Melissa Fisher
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Rachel Loewy
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | | | - Catalina Ordorica
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Kristin LaCross
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, United States
| | - Brandon Schermitzler
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Michelle McDonald
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Ian Ramsay
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
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14
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Ramsay IS, Schallmo MP, Biagianti B, Fisher M, Vinogradov S, Sponheim SR. Deficits in Auditory and Visual Sensory Discrimination Reflect a Genetic Liability for Psychosis and Predict Disruptions in Global Cognitive Functioning. Front Psychiatry 2020; 11:638. [PMID: 32733293 PMCID: PMC7358403 DOI: 10.3389/fpsyt.2020.00638] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Accepted: 06/19/2020] [Indexed: 11/29/2022] Open
Abstract
Sensory discrimination thresholds (i.e., the briefest stimulus that can be accurately perceived) can be measured using tablet-based auditory and visual sweep paradigms. These basic sensory functions have been found to be diminished in patients with psychosis. However, the extent to which worse sensory discrimination characterizes genetic liability for psychosis, and whether it is related to clinical symptomatology and community functioning remains unknown. In the current study we compared patients with psychosis (PSY; N=76), their first-degree biological relatives (REL; N=44), and groups of healthy controls (CON; N=13 auditory and visual/N=275 auditory/N=267 visual) on measures of auditory and visual sensory discrimination, and examined relationships with a battery of symptom, cognitive, and functioning measures. Sound sweep thresholds differed among the PSY, REL, and CON groups, driven by higher thresholds in the PSY compared to CON group, with the REL group showing intermediate thresholds. Visual thresholds also differed among the three groups, driven by higher thresholds in the REL versus CON group, and no significant differences between the REL and PSY groups. Across groups and among patients, higher thresholds (poorer discrimination) for both sound and visual sweeps strongly correlated with lower global cognitive scores. We conclude that low-level auditory and visual sensory discrimination deficits in psychosis may reflect genetic liability for psychotic illness. Critically, these deficits relate to global cognitive disruptions that are a hallmark of psychotic illnesses such as schizophrenia.
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Affiliation(s)
- Ian S Ramsay
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Michael-Paul Schallmo
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Bruno Biagianti
- Department of R&D, Posit Science Corporation, San Francisco, CA, United States
| | - Melissa Fisher
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States
| | - Scott R Sponheim
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, United States.,Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, United States
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15
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Reilly T, Mechelli A, McGuire P, Fusar-Poli P, Uhlhaas PJ. E-Clinical High Risk for Psychosis: Viewpoint on Potential of Digital Innovations for Preventive Psychiatry. JMIR Ment Health 2019; 6:e14581. [PMID: 31584006 PMCID: PMC6915798 DOI: 10.2196/14581] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2019] [Revised: 06/28/2019] [Accepted: 06/28/2019] [Indexed: 12/12/2022] Open
Abstract
E-mental health is an emerging area of research that has the potential to overcome some of the current barriers to progress in working with people at clinical high risk for psychosis (CHR-P). This article provides an overview of how e-mental health could be used in the detection, prediction, and treatment in the CHR-P population. Specifically, we evaluate e-detection, e-prediction, and e-therapeutics for this clinical population. E-mental health holds great promise to improve current management of CHR-P individuals.
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Affiliation(s)
- Thomas Reilly
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Andrea Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.,Early Psychosis: Interventions and Clinical-Detection Lab, Department of Psychosis Studies, King's College London, London, United Kingdom.,OASIS Service, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom.,Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.,National Institute for Health Research, Maudsley Biomedical Research Centre, South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Peter J Uhlhaas
- Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, United Kingdom
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