Cognitive remediation therapy, narrative coherence, and the psychosocial functioning of persons with schizophrenia and other psychotic disorders: a case study.

• Online Access: http://hdl.handle.net/2047/d20000053

Schizophrenia is one of the most prominent forms of mental illness, and has a tremendously debilitating impact not only on the lives of persons with this disorder, but also society. In addition to the symptoms of schizophrenia and others psychotic disorders such as hallucinations and delusions, there are also associated cognitive, language, and functional deficits that exacerbate the debilitating nature of these conditions. This study explored the association between Cognitive Remediation Therapy (CRT) and the neurocognitive skills (such as attention and memory), narrative coherence (ability to speak in a logical, coherent manner) and psychosocial functioning (ability to engage in activities of daily living such as traveling independently on public transportation) of persons with schizophrenia and other psychotic disorders. This study also explored the benefits and barriers to conducting inpatient research regarding effective treatment for this population. The pre- and post-test performance on neuropsychological, narrative, and functional assessments of eight participants (in-patients at Westborough State Hospital, Westborough Massachusetts) with a psychotic disorder who completed fifty hours in a computer-based cognitive rehabilitation program were analyzed. Results did not show statistically significant differences from pre- to post-test performance; however, a case study of one of the participants highlighted the narrative and functional improvements this person experienced after receiving cognitive remediation. Additionally, the steps and challenges to conducting inpatient research with this particular population were illuminated. These outcomes highlight the possible benefits of using cognitive remediation therapy to treat the cognitive deficits of schizophrenia, and the organizational preconditions of institutions that compound the barriers to clear outcomes when studying this population.