Predictors of treatment utilisation at cognitive remediation groups for schizophrenia: The roles of neuropsychological, psychological and clinical variables

Abstract

The present study highlights the importance of carefully assessing neuropsychological functioning at the outset of cognitive remediation (CR) treatment. The effects of neuropsychological, psychological, and clinical variables on treatment utilisation (TU) in CR groups for individuals with schizophrenia were examined. Data included neuropsychological and psychosocial assessments conducted with 39 adult clients enrolled in CR as part of their ongoing outpatient therapy. TU was calculated using the percentage of sessions attended over a three-month period. Better global neuropsychological functioning (r = .46, p = .007), attention/working memory (r = .39, p = .03), and processing speed (r = .44, p = .01) were each associated with greater TU. Trend-level associations with TU were observed with executive functioning (r = .33, p = .06) and verbal learning (r = .23; p = .07). Higher rates of self-reported cognitive complaints were associated with lower TU (r = –.45, p = .01). Hierarchical regression analyses revealed that both objective and subjective indicators of neuropsychological functioning independently contributed to the prediction of TU. This information can serve to help providers develop empirically informed strategies to support their clients' CR treatment utilisation. The implications from these findings can be used as a way to provide ongoing guidance for service provision and can aid in improving CR treatment utilisation, and thus treatment effectiveness, in clinical settings.

Keywords:

• Schizophrenia
• Neuropsychological impairment
• Cognitive remediation
• Treatment utilisation

Acknowledgement

The authors would like to thank Dr Jimmy Choi, who provided helpful comments on the methodology and measures for this study, and Genna Santorelli for assistance with the scoring and entering of study data. The study was supported by grant K23MH079718 (to MRM).

Results from this paper were presented as posters at the 43^rd Annual Conference of the Association for Behavioral and Cognitive Therapies in November 2009, in New York, NY, and at the 2^nd Biennial Schizophrenia International Research Conference: Bridging Research to Clinic, in April 2010, in Florence, Italy.