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Training engagement, baseline cognitive functioning, and cognitive gains with computerized cognitive training: A cross-diagnostic study

机译:通过计算机化认知训练来训练参与度,基线认知功能和认知增益:交叉诊断研究

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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?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.
机译:在门诊心理健康环境中,计算机认知训练(CCT)干预的使用正在增加。这些干预措施与康复干预措施相结合,已显示出改善功能结局的功效。最近有人提出,认知功能障碍较多的患者具有更大的治疗反应,而参与培训的减少可以识别出治疗获益较低的病例。参加者为精神病康复患者,诊断为重度抑郁症,躁郁症和精神分裂症。新入院的患者接受了通过脑部总部提供的CCT,认知功能根据BACS t得分小于或等于40或更高分为几组。培训参与度以每天达到的培训级别数为索引。平均对49个案例进行了17天的培训,平均完成了150个级别的培训。总体而言,患者的BACS t评分平均提高了4.4点(0.44 SD)(p <0.001)。改善与培训投入呈正相关(r = 0.30,p <0.05),但与受训天数(r = 0.09)或单独获得的水平(r = 0.03)则没有正相关。基线认知水平较高的患者的认知增益降低(p 。003),但没有较少的训练参与(p?= ?. 97)。诊断不能预测认知能力的提高(p = 0.93)或目标参与度(p = 0.74)。在基线时表现较差和较高的培训参与度导致认知增益的独立差异大于10%。认知改善的平均水平远远超过了实践效果。参与度指数(每个培训日达到的水平)可以轻松地从患者的培训记录中提取,这将有助于及早监测持续参与CCT活动的治疗参与度,并根据需要改善治疗师的治疗师干预。

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