Cognitive remediation is designed to improve neurocognitive abilities such as

attention Attention or focus, is the concentration of awareness on some phenomenon to the exclusion of other stimuli. It is the selective concentration on discrete information, either subjectively or objectively. William James (1890) wrote that "Atte ...

working memory Working memory is a cognitive system with a limited capacity that can Memory, hold information temporarily. It is important for reasoning and the guidance of decision-making and behavior. Working memory is often used synonymously with short-term m ...

, cognitive flexibility and

planning Planning is the process of thinking regarding the activities required to achieve a desired goal. Planning is based on foresight, the fundamental capacity for mental time travel. Some researchers regard the evolution of forethought - the cap ...

, and executive functioning which leads to improved

psychosocial The psychosocial approach looks at individuals in the context of the combined influence that psychological factors and the surrounding social environment have on their physical and mental wellness and their ability to function. This approach is ...

functioning.

Empirical support

Empirical support for cognitive remediation in

traumatic brain injury A traumatic brain injury (TBI), also known as an intracranial injury, is an injury to the brain caused by an external force. TBI can be classified based on severity ranging from mild traumatic brain injury (mTBI/concussion) to severe traumati ...

and

schizophrenia Schizophrenia () is a mental disorder characterized variously by hallucinations (typically, Auditory hallucination#Schizophrenia, hearing voices), delusions, thought disorder, disorganized thinking and behavior, and Reduced affect display, f ...

is documented by published randomized controlled trials and meta-analyses. Effects on cognitive skill performance in schizophrenia are durable for months after the therapies are withdrawn, particularly in terms of executive functioning, working memory, and verbal memory. Importantly, neurocognitive gains have been linked to improvements in obtaining and working in competitive jobs.

In practice

Narrowly defined, cognitive remediation is a set of cognitive drills or compensatory interventions designed to enhance cognitive functioning. However, from the vantage point of the rehabilitation field, cognitive remediation engages the participant in a learning activity to enhance the neurocognitive skills relevant to overall recovery goals. Cognitive remediation programs vary in the extent to which they reflect these narrow or broader perspectives, and there is ongoing research to identify the active ingredients that result in a positive response to treatment. Data suggests that when cognitive remediation is provided to people with schizophrenia, it is most effective when given in the broader context of psychosocial rehabilitation. Recent attention has turned to incorporating motivational enhancements into the treatment of cognitive dysfunction for psychological disorders. Meta-analyses on cognitive remediation usually also consider interventions targeting social cognition and

metacognition Metacognition is an awareness of one's thought processes and an understanding of the patterns behind them. The term comes from the root word ''Meta (prefix), meta'', meaning "beyond", or "on top of".Metcalfe, J., & Shimamura, A. P. (1994). ''Metac ...

, such as social cognition and intervention training and metacognitive training. Cognitive remediation can be delivered in 1-to-1 or groups sessions for early psychosis.

For anorexia nervosa

For individuals with

anorexia nervosa Anorexia nervosa (AN), often referred to simply as anorexia, is an eating disorder characterized by Calorie restriction, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. Individuals wit ...

, cognitive remediation therapy is an interactive treatment which combines practical exercises with discussions about their relevance to the patient’s everyday life. Cognitive remediation therapy was adapted for

by Professor Kate Tchanturia and colleagues at the Institute of Psychiatry, Psychology and Neuroscience to address the process rather than the content of thinking, thus helping patients to develop a metacognitive awareness of their own thinking style. The treatment is hypothesized to work by strengthening and refining neural circuits, and by learning and transferring new cognitive strategies to appropriate situations. The aim is to identify and target the cognitive impairments specific to each patient, and to motivate the patient to engage in meta-cognitive processes i.e. to consider their cognitive/thinking styles and to explore alternative strategies, which in turn might lead to behavioral changes. By becoming aware of problematic cognitive styles, the patient can reflect on how these affect everyday life and learn to develop new strategies. The intervention was originally developed for adults with anorexia nervosa but it has been explored for younger patients as well.

References

External links

Handbook of Cognitive Dysfunction ManagementCognitive Remediation to Improve Functional Outcome
{{Medical resources , ICD10 = , ICD10CM = , ICD9 = , ICDO = , OMIM = , DiseasesDB = , MedlinePlus = , eMedicineSubj = , eMedicineTopic = , PatientUK = , MeshID = D000072466 , GeneReviewsNBK = , GeneReviewsName = , NORD = , GARDNum = , GARDName = , Orphanet = , AO = , RP = , WO = , OrthoInfo = , NCI = , Scholia = , SNOMED CT = Neuropsychology

Empirical support

In practice

For anorexia nervosa

See also

References

External links