Alice M Saperstein1, David A Lynch2, Min Qian3, Alice Medalia4. 1. Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, United States. Electronic address: Alice.Saperstein@nyspi.columbia.edu. 2. Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, 1051 Riverside Drive, New York, NY 10032, United States. Electronic address: dal2151@cumc.columbia.edu. 3. Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY 10032, United States. Electronic address: mq2158@cumc.columbia.edu. 4. New York State Psychiatric Institute, Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York-Presbyterian, 1051 Riverside Drive, New York, NY 10032, United States. Electronic address: am2938@cumc.columbia.edu.
Abstract
BACKGROUND: There is concern that awareness of cognitive deficit among people with schizophrenia receiving Cognitive Remediation (CR) might undermine motivation, engagement, and CR outcomes. We therefore examined the relationship of subjective awareness of cognitive deficit to aspects of motivation and cognitive learning during an efficacious CR program. METHODS: Individuals with schizophrenia/schizoaffective disorder who completed 30 sessions of CR (N = 67) were evaluated on cognitive performance, self-reported cognitive difficulties, intrinsic motivation and perceived competency for cognitive training tasks at the beginning and end of treatment. RESULTS: We found no relationship between actual and perceived cognitive functioning when measured cross-sectionally or as difference scores, pre/post treatment. Greater awareness of cognitive problems was associated with lower perceived competency for cognitive tasks at treatment beginning and end-point (p-values < .05). The significant relationship between awareness of cognitive problems and perceived value of the treatment at end-point was fully mediated by perceived competency. While greater perceived competency was associated with shorter time to treatment completion (p = .0025), it was intrinsic motivation measured at end-point that was associated with cognitive change (p = .02). DISCUSSION: While awareness of cognitive problems may not be a prerequisite for cognitive improvement during CR, it could impact engagement in, and how one values treatment via its effect on perceived competency. Results also highlighted the importance of intrinsic motivation for doing cognitive learning activities, given its relationship to cognitive gain. Further study is needed to understand how best to assess and address awareness of cognitive abilities within the CR setting.
BACKGROUND: There is concern that awareness of cognitive deficit among people with schizophrenia receiving Cognitive Remediation (CR) might undermine motivation, engagement, and CR outcomes. We therefore examined the relationship of subjective awareness of cognitive deficit to aspects of motivation and cognitive learning during an efficacious CR program. METHODS: Individuals with schizophrenia/schizoaffective disorder who completed 30 sessions of CR (N = 67) were evaluated on cognitive performance, self-reported cognitive difficulties, intrinsic motivation and perceived competency for cognitive training tasks at the beginning and end of treatment. RESULTS: We found no relationship between actual and perceived cognitive functioning when measured cross-sectionally or as difference scores, pre/post treatment. Greater awareness of cognitive problems was associated with lower perceived competency for cognitive tasks at treatment beginning and end-point (p-values < .05). The significant relationship between awareness of cognitive problems and perceived value of the treatment at end-point was fully mediated by perceived competency. While greater perceived competency was associated with shorter time to treatment completion (p = .0025), it was intrinsic motivation measured at end-point that was associated with cognitive change (p = .02). DISCUSSION: While awareness of cognitive problems may not be a prerequisite for cognitive improvement during CR, it could impact engagement in, and how one values treatment via its effect on perceived competency. Results also highlighted the importance of intrinsic motivation for doing cognitive learning activities, given its relationship to cognitive gain. Further study is needed to understand how best to assess and address awareness of cognitive abilities within the CR setting.
Authors: Peter F Buckley; Donna A Wirshing; Prameet Bhushan; Joseph M Pierre; Seth A Resnick; William C Wirshing Journal: CNS Drugs Date: 2007 Impact factor: 5.749
Authors: Christopher R Bowie; Elizabeth W Twamley; Hannah Anderson; Brooke Halpern; Thomas L Patterson; Philip D Harvey Journal: J Psychiatr Res Date: 2006-10-02 Impact factor: 4.791
Authors: Emily B H Treichler; Michael L Thomas; Andrew W Bismark; William C Hochberger; Melissa Tarasenko; John Nungaray; Lauren Cardoso; Yash B Joshi; Wen Zhang; Joyce Sprock; Neal Swerdlow; Amy N Cohen; Gregory A Light Journal: Schizophr Res Date: 2019-01-16 Impact factor: 4.939
Authors: Louise Birkedal Glenthøj; Lise Mariegaard; Tina Dam Kristensen; Christina Wenneberg; Alice Medalia; Merete Nordentoft Journal: NPJ Schizophr Date: 2020-11-13