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A randomized controlled trial of working memory and processing speed training in schizophrenia

Published online by Cambridge University Press:  03 October 2018

B.D. Cassetta Open the ORCID record for B.D. Cassetta [Opens in a new window] ,
L.M. Tomfohr-Madsen  and
V.M. Goghari
B.D. Cassetta*
Affiliation:
Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada, T2N 1N4
L.M. Tomfohr-Madsen
Affiliation:
Department of Psychology, University of Calgary, 2500 University Drive NW, Calgary, AB, Canada, T2N 1N4
V.M. Goghari
Affiliation:
Department of Psychology and Graduate Department of Psychological Clinical Science, University of Toronto Scarborough, 1265 Military Trail, Toronto, ON, Canada, M1C 1A4
*
Author for correspondence: B. D. Cassetta, E-mail: [email protected]
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Abstract

Background

Although prior research has shown that cognitive training may improve cognition for schizophrenia patients, it is currently unclear which domains of cognition should be targeted in training. One suggestion is to target low- or mid-level cognitive processes. In particular, working memory (WM) and processing speed (PS) have been named as two key areas of impairment in schizophrenia, and two domains of cognition that are linked to higher-order cognition and daily functioning. This study aimed to investigate the near-transfer (transfer of gains to related contexts), far-transfer (transfer of gains to unrelated contexts), and real-world gains associated with WM and PS training in schizophrenia.

Methods

Eighty-three participants with schizophrenia were recruited and randomly assigned to computerized WM training, PS training, or a no-training control group. Outcome measures included WM, PS, fluid intelligence, executive functioning, social cognition, and daily functioning and symptoms.

Results

PS training led to significant gains in untrained PS tasks, as well as gains in far-transfer tasks that required speed of processing. WM training did not lead to gains in untrained WM tasks and showed inconsistent effects on some far-transfer tasks.

Conclusions

These results suggest some benefit of domain-specific cognitive training, specifically PS training, in schizophrenia. Far-transfer of gains to other cognitive domains and to real-world functioning may not occur after targeted WM or PS training, though non-specific effects (e.g. through behavioral activation, increased motivation) may lead to improvements in some tasks. Future studies should continue to investigate the mechanisms by which cognitive training may enhance cognition and functioning in schizophrenia.

Keywords

Cognitive remediationcognitive trainingprocessing speedprocessing speed trainingpsychosisschizophreniaworking memory trainingworking memory
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 12 , September 2019 , pp. 2009 - 2019
Copyright
Copyright © Cambridge University Press 2018 

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