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Commentary| Volume 73, ISSUE 10, P935-937, May 15, 2013

Cognitive Training in Schizophrenia: Golden Age or Wild West?

  • Sophia Vinogradov
    Correspondence
    Address correspondence to Sophia Vinogradov, M.D., 116A–SFDVAMC, 4150 Clement Street, San Francisco, CA 94121
    Affiliations
    Department of Psychiatry, University of California, San Francisco, San Francisco, California

    San Francisco Department of Veterans Affairs Medical Center, San Francisco, California
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  • Melissa Fisher
    Affiliations
    Department of Psychiatry, University of California, San Francisco, San Francisco, California

    San Francisco Department of Veterans Affairs Medical Center, San Francisco, California
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  • Srikantan Nagarajan
    Affiliations
    Department of Psychiatry and Radiology and Biomedical Imaging, University of California, San Francisco, San Francisco, California
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      Six years ago, at the first Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia (CNTRICS) meeting, a neuroscientist questioned whether attention dysfunction was malleable in schizophrenia, despite a recent report that patients were 5 times more likely to work when cognitive remediation was combined with supported employment (
      • McGurk S.R.
      • Mueser K.T.
      • Feldman K.
      • Wolfe R.
      • Pascaris A.
      Cognitive training for supported employment: 2-3 year outcomes of a randomized controlled trial.
      ). The idea that impaired neural systems could demonstrate learning-induced plasticity was not part of the biological research lexicon at that point in time. Experimental neuroscientists were rightfully skeptical of a broad array of cognitive remediation interventions that were often studied under nonblinded and variously controlled conditions. Perplexing, also, was the homogeneity of effect sizes, despite widely varying treatment approaches, outcome measures, and length of intervention.
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