Examining the durability of a hybrid, remote and computer-based cognitive remediation intervention for adolescents with 22q11.2 deletion syndrome.

Margaret A Mariano, Kerri Tang, Matthew Kurtz, Wendy R Kates
Author Information
  1. Margaret A Mariano: Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, New York, USA.
  2. Kerri Tang: Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, New York, USA.
  3. Matthew Kurtz: Department of Psychology, Wesleyan University, Middletown, Connecticut, USA.
  4. Wendy R Kates: Department of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, New York, USA.

Abstract

AIM: Schizophrenia and 22q11.2 deletion syndrome (22q11DS) share similar patterns of cognitive deficits. Up to 30% of those with 22q11DS develop schizophrenia during early adulthood. As cognitive decline has recently been found to predict onset of psychosis in adolescents with 22q11DS, early interventions such as cognitive remediation (CR) during adolescence are warranted. This paper investigates the durability of a remote, computerized, CR programme for youth with 22q11DS. Our aim was to determine if the positive effects of CR persisted 6 months beyond intervention completion.
METHODS: A longitudinal design with 21 participants serving as their own controls was used. Youth were seen for neurocognitive assessments at pre-treatment, after the targeted 8-month intervention, at post-treatment, and 6 months after for follow-up. During the intervention, cognitive coaches met remotely with participants for CR via video conferencing three times a week, and offered task-specific strategies. To determine if intervention improvements held across the 6-month follow-up period, neurocognitive measures were statistically examined with repeated measures analysis of variances from pre-treatment through follow-up.
RESULTS: Our CR intervention proved durable. Post-treatment improvements comprising cognitive flexibility, executive function, reaction time and working memory were maintained over the follow-up period.
CONCLUSIONS: Results confirm previous research regarding the durability of CR treatment and extend these findings to youth with 22q11DS. The present study may serve to inform early intervention efforts focused on cognitive and functionally relevant rehabilitation goals for youth with 22q11DS and suggests that 22q11DS can potentially serve as a suitable model for examining the trajectory preceding psychosis.

Keywords

References

  1. Schizophr Res. 2004 Oct 1;70(2-3):223-32 [PMID: 15329299]
  2. Psychiatr Serv. 2009 Nov;60(11):1468-76 [PMID: 19880464]
  3. Schizophr Bull. 2015 Jan;41(1):250-8 [PMID: 24444862]
  4. J Am Acad Child Adolesc Psychiatry. 2014 Sep;53(9):991-1000.e2 [PMID: 25151422]
  5. Schizophr Res. 2007 Aug;94(1-3):221-30 [PMID: 17524620]
  6. Arch Clin Neuropsychol. 2006 Oct;21(7):623-43 [PMID: 17014981]
  7. J Rehabil Res Dev. 2007;44(5):761-70 [PMID: 17943687]
  8. Br J Psychiatry. 2012 Jun;200(6):462-8 [PMID: 22661678]
  9. Behav Cogn Psychother. 2014 Jul;42(4):421-34 [PMID: 23631951]
  10. Schizophr Res. 2015 Feb;161(2-3):403-6 [PMID: 25533593]
  11. Medscape J Med. 2008 Apr 15;10(4):90 [PMID: 18504479]
  12. Schizophr Res. 2010 Jul;120(1-3):210-6 [PMID: 20472402]
  13. J Int Neuropsychol Soc. 2009 Jan;15(1):31-41 [PMID: 19128526]
  14. Am J Psychiatry. 2003 Sep;160(9):1580-6 [PMID: 12944331]
  15. Eur Child Adolesc Psychiatry. 2012 Jun;21(6):315-26 [PMID: 22354179]
  16. Curr Pharm Des. 2012;18(4):534-41 [PMID: 22239585]
  17. Am J Psychiatry. 2012 Jul;169(7):710-8 [PMID: 22581070]
  18. Schizophr Bull. 2011 May;37(3):524-30 [PMID: 21505119]
  19. Res Dev Disabil. 2013 Sep;34(9):2606-13 [PMID: 23751300]
  20. Psychiatry Res. 1995 Jan 31;56(1):45-51 [PMID: 7792341]
  21. Curr Psychiatry Rep. 2007 Apr;9(2):148-58 [PMID: 17389127]
  22. Arch Gen Psychiatry. 1999 Oct;56(10):940-5 [PMID: 10530637]
  23. Am J Psychiatry. 2011 May;168(5):472-85 [PMID: 21406461]
  24. Psychiatry Res. 2004 Jan 30;125(1):1-7 [PMID: 14967547]
  25. J Nerv Ment Dis. 2000 Aug;188(8):518-24 [PMID: 10972571]
  26. Acta Psychiatr Scand. 2003 Aug;108(2):101-9 [PMID: 12823166]
  27. Schizophr Res. 2003 Jun 1;61(2-3):163-74 [PMID: 12729868]
  28. Brain Inj. 1997 Mar;11(3):197-209 [PMID: 9058001]
  29. Biol Psychiatry. 2008 Mar 1;63(5):505-11 [PMID: 17662256]
  30. Schizophr Res. 2015 Aug;166(1-3):283-9 [PMID: 26044111]
  31. Arch Gen Psychiatry. 2004 Sep;61(9):866-76 [PMID: 15351765]
  32. Curr Opin Psychiatry. 2013 Mar;26(2):151-7 [PMID: 23318663]
  33. Acta Neuropsychiatr. 2012 Dec;24(6):328-35 [PMID: 25287174]
  34. Schizophr Res. 2007 Jan;89(1-3):251-60 [PMID: 17070671]
  35. Psychiatr Serv. 2006 Dec;57(12):1751-7 [PMID: 17158490]
  36. J Am Acad Child Adolesc Psychiatry. 2014 Aug;53(8):859-68 [PMID: 25062593]
  37. Schizophr Res. 2010 Jun;119(1-3):258-65 [PMID: 20347272]
  38. Genet Med. 2001 Jan-Feb;3(1):34-9 [PMID: 11339375]
  39. Acta Psychiatr Scand. 2005 Mar;111(3):193-201 [PMID: 15701103]
  40. JAMA Psychiatry. 2015 Apr;72(4):377-85 [PMID: 25715178]
  41. Schizophr Bull. 2000;26(1):119-36 [PMID: 10755673]
  42. J Am Acad Child Adolesc Psychiatry. 2012 May;51(5):464-6 [PMID: 22525952]
  43. Am J Med Genet B Neuropsychiatr Genet. 2007 Jan 5;144B(1):27-36 [PMID: 17034021]
  44. J Am Acad Child Adolesc Psychiatry. 2009 Nov;48(11):1060-8 [PMID: 19797984]
  45. J Am Acad Child Adolesc Psychiatry. 2010 Apr;49(4):333-44 [PMID: 20410726]
  46. Front Psychol. 2014 Jun 10;5:566 [PMID: 24959159]
  47. Epidemiol Psychiatr Sci. 2014 Mar;23(1):21-5 [PMID: 24131663]
  48. Psychiatry Res. 2015 Jan 30;225(1-2):93-98 [PMID: 25467705]

Grants

  1. R21 MH085901/NIMH NIH HHS
  2. R33 MH085901/NIMH NIH HHS

MeSH Term

Adolescent
Cognition
Cognitive Remediation
DiGeorge Syndrome
Female
Humans
Male
Therapy, Computer-Assisted
Videoconferencing

Word Cloud

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