A pilot study of cognitive training in clinical high risk for psychosis: initial evidence of cognitive benefit.

Individuals at clinical high risk (CHR) for psychosis have cognitive deficits that are associated with functional impairment and psychosis conversion (Giuliano et al., 2012). Targeted cognitive training (TCT) (i.e., intense, progressively difficult practice of a cognitive skill) improves cognition and daily functioning in schizophrenia (Wykes et al., 2011). TCT has been proposed as a preventive intervention for CHR, but research is minimal and optimal training parameters, including dose, intensity, and setting, are unknown. Because prolonged duration of untreated CHR symptoms can compromise outcome, rapid treatment response is essential (Fusar-Poli et al., 2009). However, ambiguous risk status, psychosis-related stigma, and practical scheduling problems can reduce treatment motivation and compliance. Without pilot data to guide intervention development, the randomized-controlled trials necessary to show efficacy of cognitive training in CHRmay be unsuccessful. This study investigated the feasibility and potential behavioral benefits of 40 h/8 weeks of computer-based TCT in a single group of CHR participants. Cognitive and functional outcome were assessed with measures recommended for clinical trials, including the MATRICS Consensus Cognitive Battery (MCCB) and Global Functioning (GF): Role and Social scales (Cornblatt et al., 2007). Training performance was analyzed to: verify the relationship between training engagement and treatment outcome; identify an early predictor of treatment response; and evaluate intervention dose.