A Study of the Effectiveness of Cognitive Adaptation Training in Early Intervention for Psychosis
Overview
- Phase
- Not Applicable
- Intervention
- Not specified
- Conditions
- Psychosis
- Sponsor
- Centre for Addiction and Mental Health
- Enrollment
- 67
- Locations
- 1
- Primary Endpoint
- Change in Adaptive Functioning (SOFAS)
- Status
- Completed
- Last Updated
- 7 years ago
Overview
Brief Summary
The proposed study will involve a randomized trial of Cognitive Adaptation Training (CAT) for early intervention as compared against an active control in which Action Based Cognitive Remediation (ABCR) will be applied.
Detailed Description
The proposed project will expand knowledge of the role of compensatory and restorative cognitive interventions for early intervention population individuals with schizophrenia. The investigators will conduct a two arm randomized trial comparing the impacts of CAT and Action Based Cognitive Remediation (ABCR) for individuals with schizophrenia who are under the age of 30. The model would mirror the investigators' preliminary work at CAMH (Kidd et al., 2014) in which there will be 4 months of specialist-delivered treatment followed by 5 months of maintenance by case managers with pre, 4 month, and 9 month evaluations conducted. This study will be among the most rigorous examinations of such interventions to date, would be among the first to examine integrative approaches, and would make a substantial contribution to the early intervention literature. The questions for the purposes of this project are: 1. Is CAT effective among individuals with schizophrenia under the age of 30? and 2. Does integrating cognitive remediation with CAT enhance outcomes as compared with CAT alone?
Investigators
Sean Kidd
Clinician Scientist
Centre for Addiction and Mental Health
Eligibility Criteria
Inclusion Criteria
- •Participants must be CAMH clients, have an assigned caseworker, be between the ages of 16-34 and have a psychosis such as schizophrenia or schizoaffective disorder.
Exclusion Criteria
- •not currently experiencing high level of paranoia.
Outcomes
Primary Outcomes
Change in Adaptive Functioning (SOFAS)
Time Frame: Change from baseline to 4 months and 9 months
A global level of social and occupational functioning will be obtained using the Social and Occupational Functioning Scale from the DSM-IV (American Psychiatric Association, 2000). The SOFAS rates global functioning on a scale from 0 to 100. The rating does not take into account level of symptomatology.
Change in Adaptive Functioning (SFS)
Time Frame: Change from baseline to 4 months and 9 months
The Social Functioning Scale (SFS; Birchwood et al., 1990) will be administered. This is a self-report measure that details the frequency and intensity with which the person engages in functional activities. A total score and domain scores for social withdrawal, relationships, social activity, recreational activity, independence (competence), independence (performance) and employment are generated.
change in Adaptive Functioning (MCAS)
Time Frame: Change from baseline to 4 months and 9 months
Both client and clinician versions of 17-item The Multnomah Community Ability Scale (MCAS, Barker et al., 1994) will be used to assess functionality.
Secondary Outcomes
- Medication Adherence(Throughout the 9 months of participation.)
- Hospitalization(Throughout the 9 months of participation.)
- Change in Goal Attainment (GAS)(Change from baseline to 4 months and 9 months)
- Change in Caregiver Burden (IEQ)(Change from baseline to 4 months and 9 months)
- Change in Cognition (WRAT-III)(Change from baseline to 4 months and 9 months)
- Change in Cognition (Trail Making test part A)(Change from baseline to 4 months and 9 months)
- Change in Cognition (Digit Span Subtest of the Weschler Adult Intelligence Scale - III )(Change from baseline to 4 months and 9 months)
- Change in Cognition (CVLT)(Change from baseline to 4 months and 9 months)
- Change in Cognition (Trail Making Test, Part B, and the Wisconsin Card Sorting Test)(Change from baseline to 4 months and 9 months)
- Change in Positive symptoms (BPRS-E)(Change from baseline to 4 months and 9 months)
- Change in Negative symptoms (NSA)(Change from baseline to 4 months and 9 months)