Cognitive Training for Serious Mental Illness
Recruiting in Palo Alto (17 mi)
Age: 18+
Sex: Any
Travel: May be covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: VA Office of Research and Development
No Placebo Group
Trial Summary
What is the purpose of this trial?This study addresses the critical need for innovative therapeutic interventions in Veterans with serious mental illnesses (SMI) receiving care in VA Psychosocial Rehabilitation and Recovery Centers (PRRCs). The vast majority of individuals with SMI suffer from cognitive impairments, leading to chronic functional disability, and impaired outcomes, causing a significant strain on support networks and the VA healthcare system. This study aims to introduce an innovative mental health therapy, Targeted Cognitive Training (TCT), to Veterans struggling with serious mental illnesses (SMI). TCT works to improve basic sensory information processing and, ultimately, clinical, cognitive, and psychosocial functioning. By using EEG biomarkers to identify Veterans with SMI receiving care within VA Psychosocial Rehabilitation and Recovery Centers who are most likely to benefit from this treatment, and by understanding how best to implement this therapy, the investigators hope to enhance care and improve life quality for Veterans with SMI.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It is best to discuss this with the trial coordinators or your healthcare provider.
What data supports the effectiveness of the treatment Targeted Cognitive Training for Serious Mental Illness?
Research shows that cognitive training, including computer-assisted programs, can improve cognitive and functional performance in people with severe mental illness. Studies have found that such training can lead to significant improvements in cognitive abilities and social functioning, especially when patients are actively engaged in the training process.
12345Is cognitive training safe for people with serious mental illness?
The research does not report any safety concerns for cognitive training in people with serious mental illness, suggesting it is generally safe for use in humans.
56789How is Targeted Cognitive Training different from other treatments for serious mental illness?
Targeted Cognitive Training (TCT) is unique because it focuses on improving cognitive functions through structured exercises, often supplemented with social cognition exercises, which can lead to durable cognitive and social benefits. Unlike medication, TCT directly targets cognitive deficits and is delivered through computer-assisted sessions, making it a non-drug, interactive approach to treatment.
12348Eligibility Criteria
This trial is for Veterans with serious mental illnesses like schizophrenia, bipolar disorder, psychosis, or PTSD who are receiving care in VA Psychosocial Rehabilitation and Recovery Centers. It's designed to help those struggling with cognitive impairments due to their conditions.Inclusion Criteria
I can see clearly from 20 feet what should normally be seen at that distance.
I am between 18 and 75 years old.
Exclusion Criteria
I am able to understand and give informed consent.
Participant Groups
The study tests Targeted Cognitive Training (TCT), a new therapy aimed at improving sensory information processing and overall brain function which may lead to better clinical outcomes and quality of life for Veterans with serious mental illnesses.
2Treatment groups
Active Control
Group I: TCT + TAUActive Control1 Intervention
Subjects will complete 30 hours of Targeted Cognitive Training (TCT) in addition to their Treatment as Usual (TAU)
Group II: TAUActive Control1 Intervention
Subjects will participate in their standard Treatment as Usual (TAU) PRRC program
Find A Clinic Near You
Research locations nearbySelect from list below to view details:
VA San Diego Healthcare System, San Diego, CASan Diego, CA
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Who is running the clinical trial?
VA Office of Research and DevelopmentLead Sponsor
University of California, San DiegoCollaborator
References
Computer-Assisted Cognitive Training for Patients with Severe Mental Illness: a Retrospective Study. [2021]To investigate the effectiveness of eight 45-minute sessions of computer-assisted cognitive training programme (CCTP) on improving the cognitive and functional performance of patients with Severe Mental Illness (SMI).
Six month durability of targeted cognitive training supplemented with social cognition exercises in schizophrenia. [2022]Deficits in cognition, social cognition, and motivation are significant predictors of poor functional outcomes in schizophrenia. Evidence of durable benefit following social cognitive training is limited. We previously reported the effects of 70 h of targeted cognitive training supplemented with social cognitive exercises (TCT + SCT) verses targeted cognitive training alone (TCT). Here, we report the effects six months after training.
Motivation and engagement during cognitive training for schizophrenia spectrum disorders. [2022]Motivation and engagement are important factors associated with therapeutic outcomes in cognitive training for schizophrenia. The goals of the present report were to examine relations between objective treatment engagement (number of sessions attended, amount of homework completed) and self-reported motivation (intrinsic motivation and perceived competence to complete cognitive training) with neurocognitive and functional outcomes from cognitive training.
[Cognitive training in schizophrenic diseases]. [2006]The comparison of an experimental group of schizophrenic patients undergoing cognitive training with a control group was tested for significance over a total of 23 psychometric features, using the test known as t-distribution or "Students distribution". Cognitive training results in varying degrees of improvement in the various parameters. Uncharacteristic schizophrenic basic disorders remitted significantly, and there was improvement in activity of intention, BP/RS sum score, and the BP/RS factors of anxiety/depression, anergy, and activation. The NOSIE factors of manifest psychosis, irritability, and depression remitted, and social interest improved. From the psychological data it can be concluded that cognitive training can help improve, in particular, cognitive adjustment and adaptability, and the organisation of complex societal conditions.
Training engagement, baseline cognitive functioning, and cognitive gains with computerized cognitive training: A cross-diagnostic study. [2020]Computerized cognitive training (CCT) interventions are increasing in their use in outpatient mental health settings. These interventions have demonstrated efficacy for improving functional outcomes when combined with rehabilitation interventions. It has recently been suggested that patients with more cognitive impairment have a greater therapeutic response and that reduced engagement in training can identify cases who manifest low levels of benefit from treatment. Participants were psychiatric rehabilitation clients, with diagnoses of major depression, bipolar disorder and schizophrenia. Newly admitted cases received CCT, delivered via Brain HQ, with cognitive functioning divided into groups on the basis of a BACS t-score of 40 or less vs. more. Training engagement was indexed by the number of training levels achieved per day trained. Forty-nine cases trained on average for 17 days and completed a mean of 150 levels. Overall, patients improved by an average of 4.4 points (0.44 SD) in BACS t-scores (p < .001). Improvements were positively correlated with training engagement (r = 0.30, p < .05), but not with days trained (r = 0.09) or levels earned (r = 0.03) alone. Patients with higher levels of baseline cognitive performance had reduced cognitive gains (p < .003), but did not have less training engagement (p = .97). Diagnoses did not predict cognitive gains (p = .93) or target engagement (p = .74). Poorer performance at baseline and higher levels of training engagement accounted for >10% in independent variance in cognitive gains. The mean level of cognitive improvement far exceeded practice effects. The index of engagement, levels achieved per training day, is easily extracted from the training records of patients, which would allow for early and continuous monitoring of treatment engagement in CCT activities and therapist intervention as needed to improve engagement.
Addition of home-based cognitive retraining to treatment as usual in first episode schizophrenia patients: a randomized controlled study. [2021]We examined the effectiveness of a 2-month-long home-based cognitive retraining program together with treatment as usual (TAU; psychoeducation and drug therapy) on neuropsychological functions, psychopathology, and global functioning in patients with first episode schizophrenia (FES) as well as on psychological health and perception of level of family distress in their caregivers.
Neuroscience-informed Auditory Training in Schizophrenia: A Final Report of the Effects on Cognition and Serum Brain-Derived Neurotrophic Factor. [2020]We previously reported the interim effects in a per protocol analysis of a randomized controlled trial of an innovative neuroscience-informed computerized cognitive training approach in schizophrenia. Here we report the effects of training on behavioral outcome measures in our final sample using an intent-to-treat analysis. We also report the effects on serum brain-derived neurotrophic factor (BDNF).
Divergence of subjective and performance-based cognitive gains following cognitive training in schizophrenia. [2020]Cognitive training is effective for improving cognitive performance among people with schizophrenia. An individual's perception of their own cognition is dissociable from performance on objective cognitive tests. Since subjective cognitive benefit may impact engagement, motivation, and satisfaction with time-intensive cognitive interventions, this study aimed to determine whether subjective cognitive difficulties improve in conjunction with cognitive gains following 30 h of cognitive training.
Integrated Cognitive-Behavioral Social Skills Training and Compensatory Cognitive Training for Negative Symptoms of Psychosis: Effects in a Pilot Randomized Controlled Trial. [2022]Negative symptoms and cognitive impairment in schizophrenia (SZ) remain unmet treatment needs as they are highly prevalent, associated with poor functional outcomes, and resistant to pharmacologic treatment. The current pilot randomized controlled trial examined the efficacy of an integrated Cognitive-Behavioral Social Skills Training and Compensatory Cognitive Training (CBSST-CCT) intervention compared to Goal-focused Supportive Contact (SC) on negative symptoms and cognitive performance.