Cognitive remediation is designed to improve

neurocognitive Neurocognitive functions are cognitive functions closely linked to the function of particular areas, neural pathways, or cortical networks in the brain, ultimately served by the substrate of the brain's neurological matrix (i.e. at the cellular ...

abilities such as

attention Attention is the behavioral and cognitive process of selectively concentrating on a discrete aspect of information, whether considered subjective or objective, while ignoring other perceivable information. William James (1890) wrote that "Att ...

working memory Working memory is a cognitive system with a limited capacity that can 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 memory, ...

cognitive flexibility Cognitive flexibility is an intrinsic property of a cognitive system often associated with the mental ability to adjust its activity and content, switch between different task rules and corresponding behavioral responses, maintain multiple con ...

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. The evolution of forethought, the capacity to think ahead, is c ...

, 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 TBI/concussionto severe traumatic br ...

and

schizophrenia Schizophrenia is a mental disorder characterized by continuous or relapsing episodes of psychosis. Major symptoms include hallucinations (typically hearing voices), delusions, and disorganized thinking. Other symptoms include social w ...

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 Effects on cognitive skill performance in schizophrenia are durable for months after the therapies are withdrawn, particularly in terms of executive functioning, working memory, and verbal memory.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,

gains have been linked to improvements in obtaining and working in competitive jobs.

In practice

Narrowly defined, CR is a set of cognitive drills or compensatory interventions designed to enhance cognitive functioning. However, from the vantage point of the rehabilitation field, CR engages the participant in a learning activity to enhance the neurocognitive skills relevant to overall recovery goals. CR 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 Social cognition is a sub-topic of various branches of psychology that focuses on how people process, store, and apply information about other people and social situations. It focuses on the role that cognitive processes play in social interacti ...

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'', meaning "beyond", or "on top of".Metcalfe, J., & Shimamura, A. P. (1994). ''Metacognition: knowi ...

, such as social cognition and intervention training and metacognitiive training.

For anorexia nervosa

For individuals with

anorexia nervosa Anorexia nervosa, often referred to simply as anorexia, is an eating disorder characterized by low weight, food restriction, body image disturbance, fear of gaining weight, and an overpowering desire to be thin. ''Anorexia'' is a term of Gre ...

(AN), CRT 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 Kate Tchanturia (born 1960) is a British psychologist who is a professor of psychology in eating disorders at the Institute of Psychiatry, Psychology and Neuroscience, King’s College London. She is also Consultant Psychologist at the South Londo ...

and colleagues at the

Institute of Psychiatry, Psychology and Neuroscience The Institute of Psychiatry, Psychology and Neuroscience (IoPPN) is a research institution dedicated to discovering what causes mental illness and diseases of the brain. In addition, its aim is to help identify new treatments for them and way ...

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 chronic AN 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