Content area
Full Text
(ProQuest: ... denotes non-US-ASCII text omitted.)
Introduction
The term 'cognitive remediation' refers to a category of therapeutic interventions that were initially conceived for neurological patients and are being progressively extended to psychiatric settings. Wykes & van der Gaag (2001) describe cognitive remediation as a set of methods for teaching 'thinking' skills that focus on cognitive deficits, and that hold as a common characteristic the reliance on material having no personal relevance to the individual. Although there are various ways of categorizing cognitive remediation techniques, a straightforward distinction can be drawn between those relying on manual tasks and those that are computer assisted.
The aim of the present paper was to review computer-assisted cognitive remediation (CACR) in schizophrenia. CACR represents a relatively homogeneous subgroup of cognitive remediation interventions, typically consisting of weekly sessions of drill and practice meant to target cognitive functions such as attention, memory, and executive functions. Their common premise is that intense and regular practice on computerized tasks fosters improvement, even when the tasks involve deficient cognitive function. Several meta-analytical reviews (Kurtz et al. 2001; Pilling et al. 2002; Krabbendam & Aleman, 2003; Twamley et al. 2003; McGurk et al. 2007) have examined the efficacy of cognitive remediation as a whole, although, to our knowledge, none have yet been specifically devoted to the subset of computer-based methods.
The use of computer-based procedures for cognitive remediation is supported by a twofold argument. First, prolonged multimedia stimulation is considered to be a factor favouring neural plasticity (Hogarty et al. 2004). Second, computer activities are considered helpful in providing opportunities for acquiring new compensatory strategies, which is viewed as an important component of cognitive remediation (Kurtz et al. 2007). The literature emphasizes the strong potential of computers for designing cognitive training tasks, as they provide unlimited training possibilities and numerous forms of reinforcement (Hermanutz & Gestrich, 1991; Field et al. 1997), multisensory presentation (Medalia et al. 2001), the possibility of unlimited repetitions (Field et al. 1997), automatic adjustment of the difficulty level to the patient's progression (Field et al. 1997; Sartory et al. 2005), objective recording of performances (Field et al. 1997) and personalization of learning activities (Hermanutz & Gestrich, 1991; Medalia et al. 2001). Computers provide structured, flexible and standardized training tasks, in addition...