ABSTRACT
Cognitive adaptation training is a treatment approach designed to alter the physical environment of patients with schizophrenia to compensate for cognitive deficits and improve adaptive function. A wide range of environmental manipulations such as labels, signs, schedules, and rearrangement of objects are employed. In a preliminary study at a state hospital, outcomes for cognitive adaptation training were compared with outcomes for standard psychosocial treatment for two groups of patients with schizophrenia, matched on levels of functional impairment and symptoms. Both groups showed improvement in symptoms and adaptive function, but patients receiving the specialized training showed greater improvement in adaptive function than did the standard-treatment group.
Subject(s)
Adaptation, Psychological , Cognition Disorders/therapy , Cognitive Behavioral Therapy/methods , Schizophrenia/rehabilitation , Schizophrenic Psychology , Social Environment , Activities of Daily Living/classification , Activities of Daily Living/psychology , Adolescent , Adult , Cognition Disorders/diagnosis , Combined Modality Therapy , Female , Humans , Male , Middle Aged , Neuropsychological Tests , Occupational Therapy , Patient Admission , Patient Care Team , Pilot Projects , Psychiatric Status Rating Scales , Schizophrenia/diagnosis , Socioenvironmental TherapyABSTRACT
Schizophrenia is a mental illness which is characterized by severe cognitive deficits and impairments in adaptive functioning. The Allen Cognitive Levels (ACL) Assessment is a screening instrument designed to assess cognitive functioning and to aid clinicians in making judgments about how a patient will be able to perform basic activities of daily living. While the ACL has been widely used, the validity of ACL scores for predicting concurrent adaptive functioning has not been established empirically. The present study examined ACL scores in 110 schizophrenic patients. Scores on the ACL were found to be highly related to scores on the Functional Needs Assessment (r = 0.66), which measures a patient's ability to perform basic activities of daily living. Findings provided some of the first strong evidence that ACL scores reflect adaptive functioning. Correlations between the ACL and the Functional Needs Assessment were equally strong in non-Hispanic whites (n = 31, r = 0.67), Mexican-Americans (n = 58, r = 0.60), and African-Americans (n = 21, r = 0.46). Mean scores did not differ between patients from different ethnic groups. In addition, there was no relationship between ACL scores and level of acculturation within the Mexican-American group. Our data strongly support the hypothesis that the ACL provides a valid and culturally unbiased measure of cognitive functioning that can be helpful in determining how a patient is likely to perform activities of daily living.
