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Am J Psychiatry 1993; 150:178-187
Copyright © 1993 by American Psychiatric Association
Cognitive remediation in schizophrenia: is it time yet?
MF Green
Camarillo-Neuropsychiatric Institute Research Program, UCLA.
Considerable effort has been directed toward identifying and
conceptualizing information-processing deficits in schizophrenia and other
psychotic disorders. The impressive gains in this field have made
meaningful contributions to our understanding of the etiology and course of
these disorders. This article considers whether the time is ripe to move
beyond identification of these deficits to remediation of them. This move
is far from a simple matter; it requires careful attention to theoretical
frameworks and to the criteria for selecting certain cognitive deficits,
among many, for remediation. A sparse and somewhat dated literature
suggests that certain types of cognitive remediation, at least when defined
in a narrow sense, are feasible with schizophrenic patients. This
literature can reasonably justify continuing investigations on a modest
scale. Specific questions for further studies include the following. 1)
Which cognitive models provide a framework to guide cognitive
interventions? 2) Which specific functions or levels of information
processing should be targeted by cognitive interventions? 3) Are cognitive
interventions effective? 4) Does the remediation of basic cognitive
deficits generalize? A major strength of this area of investigation is the
testability of the questions. Several research designs are tentatively
suggested.
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