Abstract
In people with schizophrenia, cognitive deficits have a negative prognostic influence on functioning. There is evidence that psychological therapies targeting cognitive problems, Cognitive Remediation (CR), are moderately effective in improving cognition and functioning in this population, but there is still a limited understanding of the mechanisms responsible for the variability in individual response. To date, there is little rigorous evidence on the predictors of CR outcomes. This thesis addresses this gap by identifying and evaluating, the impact of factors that could alter CR response.A systematic review identified factors potentially important in defining the outcome of cognitive remediation. Four empirical studies were conducted to clarify the role of some individual and therapy characteristics on CR response. The investigated factors were age, intelligence, symptom severity, and total number of CR sessions completed. The results demonstrated that younger people, individuals with higher current IQ, and those who attended more sessions deriving more benefits from CR. Finally, a case study tested a personalised form of CR (pCR), which adapted therapy elements according to the participants’ initial cognitive profile, and assessed its feasibility and acceptability.
The results of this thesis indicate that further attempts should be made to consolidate knowledge on the predictors of CR response in people with schizophrenia. These studies will help to inform how to appropriately tailor this therapy to different individuals with schizophrenia, and ultimately optimise and maximise the benefits of CR.
| Date of Award | 1 Sept 2021 |
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| Original language | English |
| Awarding Institution |
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| Supervisor | Matteo Cella (Supervisor) & Til Wykes (Supervisor) |