Effects of cognitive remediation on negative symptoms dimensions: exploring the role of working memory.

Published online

Journal Article

BACKGROUND: Recent theories suggest that poor working memory (WM) may be the cognitive underpinning of negative symptoms in people with schizophrenia. In this study, we first explore the effect of cognitive remediation (CR) on two clusters of negative symptoms (i.e. expressive and social amotivation), and then assess the relevance of WM gains as a possible mediator of symptom improvement. METHOD: Data were accessed for 309 people with schizophrenia from the NIMH Database of Cognitive Training and Remediation Studies and a separate study. Approximately half the participants received CR and the rest were allocated to a control condition. All participants were assessed before and after therapy and at follow-up. Expressive negative symptoms and social amotivation symptoms scores were calculated from the Positive and Negative Syndrome Scale. WM was assessed with digit span and letter-number span tests. RESULTS: Participants who received CR had a significant improvement in WM scores (d = 0.27) compared with those in the control condition. Improvements in social amotivation levels approached statistical significance (d = -0.19), but change in expressive negative symptoms did not differ between groups. WM change did not mediate the effect of CR on social amotivation. CONCLUSIONS: The results suggest that a course of CR may benefit behavioural negative symptoms. Despite hypotheses linking memory problems with negative symptoms, the current findings do not support the role of this cognitive domain as a significant mediator. The results indicate that WM improves independently from negative symptoms reduction.

Full Text

Duke Authors

Cited Authors

  • Cella, M; Stahl, D; Morris, S; Keefe, RSE; Bell, MD; Wykes, T

Published Date

  • September 4, 2017

Published In

Start / End Page

  • 1 - 9

PubMed ID

  • 28866985

Pubmed Central ID

  • 28866985

Electronic International Standard Serial Number (EISSN)

  • 1469-8978

Digital Object Identifier (DOI)

  • 10.1017/S0033291717000757

Language

  • eng

Conference Location

  • England