ABSTRACT
OBJECTIVE: This study analyzed attentional performance in patients with schizophrenia during a continuous performance task requiring a high response rate. METHOD: The Conners' Continuous Performance Test-II (CPT-II) was administered to 64 patients with schizophrenia and 64 healthy comparison subjects. A cross-sectional design was used in order to allow analysis of the means between patients and healthy subjects. Differences in performance were assessed for significance using ANCOVA. Percentiles were also analyzed in order to determine whether a participant showed normal or pathological performance. Pearson's correlation was used to detect possible relationships between attentional performance and psychopathology. RESULTS: Of the 12 CPT-II measures, response style and slowing of reaction time (RT) between targets increased to similar extents between patients and healthy comparison subjects. Patients performed significantly less well than non-patient group on all other measures. Nevertheless, patient's performance on four of these measures remained within the normal range, and patient's performance on the remaining measures qualified as pathological only in the case of variability in hit RT. No significant correlations between attention performance and symptoms were found. CONCLUSIONS: These results suggest that although patients may show lower attentional functioning than non-patients on tasks requiring a high response rate, their attentional performance remains within the normal range on most dimensions.
ABSTRACT
Este trabajo tiene por objetivos analizar la relación entre autoestima, sintomatología, funcionamiento cognitivo y percepción subjetiva de déficit cognitivos en pacientes con esquizofrenia y evaluar la eficacia del Programa «Mind Training», diseñado específicamente para trabajar la autoestima mediante ejercicios cognitivos, en estos pacientes. Participaron 83 pacientes con esquizofrenia a los que se les evaluó con la «Escala de síndrome positivo y negativo», la «Escala de autoestima de Rosenberg» y la «Batería MATRICS». Posteriormente, 40 de estos pacientes fueron asignados aleatoriamente a uno de los dos grupos experimentales: uno que fue entrenado durante 10 semanas con el «Programa Mind Training» y otro que no recibió entrenamiento. Los resultados encontrados indican la existencia de una correlación negativa entre autoestima y percepción de déficit cognitivos, de forma que aquellos pacientes con mayor autoestima tienen una menor percepción de sus déficit cognitivos. Por otro lado, el programa Mind Training no fue eficaz para mejorar los síntomas, la cognición ni la autoestima de estos pacientes
The purpose of this paper is to analyze the relationship between selfesteem, symptomatology, cognitive functioning and self-reported cognitive deficits in patients with schizophrenia, and evaluate the effectiveness of a Mind Training Program specifically designed to work self-esteem through cognitive exercises in these patients. The 83 patients with schizophrenia who participated were assessed with the Scale of Positive and Negative Syndrome, the Rosenberg Self-Esteem Scale and the «MATRICS Battery». Subsequently, 40 of these patients were randomized to one of two experimental groups: one that was trained for 10 weeks with a «Mind Training Program» and another that received no training. The results indicate the existence of a negative correlation between self-esteem and self-reported cognitive deficits, so that patients with higher self-esteem have a lower perception of their cognitive deficits. On the other hand, the Mind Training program was not effective in improving symptoms, cognition and selfesteem of these patients
Subject(s)
Humans , Self Concept , Schizophrenia/epidemiology , Cognition , Psychometrics/instrumentation , Schizophrenic Psychology , Cognition Disorders/epidemiology , Cognitive Behavioral Therapy/methods , Psychotherapeutic Processes , Self EfficacyABSTRACT
INTRODUCTION: Despite the effectiveness of pharmacological treatment, residual hallucinations do not completely resolve in some medicated patients. The aim of this study was to investigate the efficacy of attention training for reducing hallucinations in individuals with psychosis. METHODS: A randomised controlled trial was performed in which 20 individuals suffering auditory hallucinations received auditory stimulation similar to their internal voices, which was integrated into the RehaCom program of attention training. An equal number of individuals suffering auditory hallucinations did not receive this training. Cognitive and symptomatological variables were evaluated before and after the intervention period in both groups. RESULTS: Only data of 16 subjects were analysed. Auditory hallucinations no longer occurred by the end of the training program in five of eight individuals, whereas their frequency, intensity and negative content and associated anxiety were significantly reduced in the remaining three. No changes in hallucinations were observed in the control group. Attentional processes and executive functions were significantly better in patients who underwent the training than in those who did not at the end of the intervention period. CONCLUSIONS: Attention training can help people with auditory hallucinations develop an ability to ignore them, which can reduce or eliminate them entirely.
Subject(s)
Acoustic Stimulation/methods , Attention/physiology , Cognitive Behavioral Therapy/methods , Hallucinations/rehabilitation , Hearing Disorders/psychology , Psychotic Disorders/complications , Adult , Case-Control Studies , Female , Hallucinations/psychology , Humans , Male , Middle Aged , Psychotic Disorders/rehabilitation , Therapy, Computer-Assisted/methods , Young AdultABSTRACT
A pesar de la eficacia de la medicación antipsicótica, algunos pacientes medicados presentan alucinaciones auditivas residuales, que parecen mejorar complementando el tratamiento con intervenciones psicológicas, tales como el entrenamiento en estrategias de afrontamiento. A pesar de los resultados obtenidos, este entrenamiento presenta algunos problemas como son la corta duración de sus efectos, la falta de generalización de resultados a otras situaciones, la subjetividad del síntoma tratado o el poco control que sobre él tiene el terapeuta. En el presente estudio se diseñó un entorno controlado en el que los pacientes con alucinaciones reciben estimulación auditiva semejante a las voces que oyen mientras realizan una tarea atencional informatizada. La labor del paciente consiste en centrar su atención en la tarea obviando los distractores auditivos para, de esta forma, intentar reducir o eliminar sus alucinaciones auditivas. En este estudio piloto participaron tres personas con alucinaciones auditivas persistentes durante los últimos seis meses, obteniéndose una mejoría significativa en la mayoría de los parámetros que evalúan las alucinaciones tras recibir el entrenamiento (AU)
Despite the effectiveness of anti-psychotic pharmacotherapy, residual hallucinations do not vanish completely in some medicated patients. Additional psychological therapies such as training in coping strategies seem to improve the management of auditory hallucinations, nevertheless, despite the promising results, training in coping strategies has some problems like the short duration of their effects, the lack of generalization of results to other situations, the subjective nature of the symptom and the scarce control exerted by the therapist. In this study a controlled environment was designed. Subjects who suffered hallucinations received auditory stimulation similar to their voices and at the same time they performed an attention computerized task. The participants had to focus their attention on the task ignoring the auditory information and, in this way, try to reduce or eliminate their hallucinations. Three patients suffering persistent auditory hallucinations during the last six months participated in this pilot study obtaining a significant improvement in the majority of the parameters assessed about the hallucination after the treatment
Subject(s)
Humans , Hallucinations/therapy , Cognitive Behavioral Therapy/methods , Attention , Psychotic Disorders/therapy , Antipsychotic Agents/therapeutic useABSTRACT
Cognitive and neuropsychological deficits have long been recognised as part of the schizophrenic syndrome. As these deficits persist after acute psychosis subsides and contribute to the social and occupational difficulties often experienced by individuals with schizophrenia, researchers have begun to consider the applicability of neuropsychological rehabilitation techniques to the treatment of schizophrenic neuropsychological deficits. Although the effectiveness of cognitive rehabilitation programmes in schizophrenia has been addressed, no attention has been afforded to whether the trained patient perceives improvement of the cognitive processes instructed. The present study utilised a treatment versus control group comparison design to evaluate the effect of a neuropsychological rehabilitation programme on the perception of improvement both in schizophrenic patients and their therapists. Twenty-four participants diagnosed with schizophrenia participated in the study. One half of the sample was trained by means of Attention Process Training (APT) and the rest of the patients comprised the control group. No significant differences in perception of improvement were found between treatment and control group, and trained patients found the APT more useful than did their therapists.
Subject(s)
Cognitive Behavioral Therapy/methods , Perception/physiology , Schizophrenia/rehabilitation , Schizophrenic Psychology , Treatment Outcome , Adult , Analysis of Variance , Attention/physiology , Brief Psychiatric Rating Scale , Case-Control Studies , Cognition Disorders/physiopathology , Cognition Disorders/rehabilitation , Female , Humans , Male , Neuropsychological Tests/statistics & numerical dataABSTRACT
The goal of this study was to investigate the impact of Attention Process Training (APT) on cognitive functioning in schizophrenia. Twenty-four patients with schizophrenia were randomly assigned to one of the two following conditions: training by means of APT or no training. The dependent variables included measures of attention, memory and executive functions derived from a cancellation task, dichotic listening, dual task, Trail Making Test, Paced Auditory Serial Addition Task, Everyday Attention Questionnaire, Spain-Complutense Verbal Learning Test and Wisconsin Card Sorting Test (WCST). All participants were also rated on measures of positive and negative symptoms. The tasks were administrated to all participants at baseline. Participants in the training group received individual intensive APT twice a week, whereas the control group did not receive training. All participants were subsequently retested on the same tests. Although, contrary to expectations, neither group improved on clinical and information-processing measures of attention and memory, patients in the trained group had a significantly higher performance on executive function (as measured by the WCST) than did the control group. We conclude that it is feasible to use practice in attention to remediate executive function deficits in schizophrenia.
Subject(s)
Attention/physiology , Cognition Disorders/etiology , Cognition Disorders/therapy , Schizophrenia/complications , Schizophrenia/physiopathology , Teaching/methods , Adult , Brief Psychiatric Rating Scale , Cognition Disorders/diagnosis , Diagnostic and Statistical Manual of Mental Disorders , Dichotic Listening Tests , Female , Humans , Male , Memory , Neuropsychological Tests , Schizophrenia/diagnosis , Severity of Illness Index , Surveys and QuestionnairesABSTRACT
Desde la década de los sesenta son numerosos las investigaciones que ponen de manifiesto la existencia de déficit cognitivos en la esquizofrenia. Sin embargo, los estudios longitudinales sobre el curso de estos déficit son escasos. El objetivo de este estudio es averiguar si existen diferencias en el rendimiento cognitivo de pacientes diagnosticados de esquizofrenia en diferentes momentos temporales. Para ello se analizaron los datos obtenidos en una muestra de ocho pacientes que fueron evaluados dos veces, en el intervalo de un año, con pruebas de atención, memoria y funciones ejecutivas. Los resultados encontrados muestran una mejoría del rendimiento en la prueba de cancelación en condición simple y dividida, en la parte B del test de trazado y en algunos valores del TAVEC, así como una estabilidad del funcionamiento en el resto de las pruebas. Se concluye que en la muestra de pacientes analizada la atención sostenida y alternante mejoran en el transcurso de un año mientras que el resto de funciones analizadas (atención selectiva y dividida, memoria y funciones ejecutivas) se mantendrían estables (AU)
Subject(s)
Adult , Female , Male , Middle Aged , Humans , Random and Systematic Sampling , Cognitive Science/methods , Schizophrenia/diagnosis , Schizophrenia/therapy , Cognition Disorders/diagnosis , Cognition Disorders/psychology , Cognition Disorders/therapy , Longitudinal Studies , Learning , Memory , Attention/physiologyABSTRACT
El objetivo de este trabajo es analizar el efecto de un programa diseñado para mejorar problemas atencionales, en la percepción subjetiva de mejora atencional de veinticuatro pacientes esquizofrénicos (AU)
