Cognitive rehabilitation of attentional deficits in schizophrenia

The purpose of the present study was to determine whether it is possible to rehabilitate attentional deficits in persons with schizophrenia using the Orientation Remedial Modules (ORM)--a commercially available attention remediation computer software package used to rehabilitate head-injured patients. The study also sought to determine if rehabilitating attention helps improve patients\u27 symptomatology. Measures used to determine whether change occurred included the Brief Psychiatric Rating Scale (BPRS) and the Continuous Performance Test (CPT). The sample consisted of 54 state hospital patients all with a diagnosis of schizophrenia. Twenty-seven subjects were in the experimental group and 27 in the placebo group. All subjects were seen for a six week period (three 20 minute sessions per week). Subjects in the experimental group underwent attention training with the ORM while those in the placebo group saw National Geographic Documentaries. All subjects were tested on BPRS and CPT prior to the treatment and at the end of training. The hypothesis that errors of omission would improve for the experimental group compared to the placebo group was confirmed. Patients in the experimental group also demonstrated significant decreases in psychiatric symptoms compared to the placebo group. Furthermore, all subjects showed significant decreases in errors of commission but no gains were seen in patients\u27 vigilance capacity. The significant results of the present study supported the notion that some attentional deficits in schizophrenia (distractibility) may be rehabilitated with focussed attention training used for head-injured patients. The ORM was not successful in rehabilitating other attentional problems like vigilance. Significant improvements in psychiatric status suggests that rehabilitating elementary functions such as distractibility may generalize to global functions as seen in improved BPRS scores for the experimental group. This latter finding points to the possibility of upward generalization which may occur when attention deficits are rehabilitated in schizophrenia