Acceptability, engagement, and efficacy of cognitive remediation for cognitive outcomes in young adults with first-episode psychosis and social anxiety: A randomized-controlled trial
Bibliographic record
Abstract
• Cognitive remediation leads to significant improvements in executive functions. • Cognitive remediation leads to significant improvements in visual memory. • Engagement in group cognitive remediation remains a challenge in this population. • Perceived competency and enjoyment influences engagement in cognitive remediation. Social anxiety disorder (SAD) is a frequent comorbidity in first-episode psychosis (FEP) and may increase cognitive impairments. Cognitive remediation (CR) is an effective treatment for cognition, particularly in a group format. This study aims to assess the efficacy, acceptability and engagement of group CR on cognitive outcomes in FEP+SAD compared to group cognitive-behavioral therapy (CBT). Participants with FEP+SAD were randomized to group CR ( n = 45) or CBT-SAD ( n = 51). They were assessed for cognition at baseline, post-therapy and 3- and 6-month follow-up. The CR group additionally completed scale to assess perceived competency and enjoyment in CR. Linear mixed models for repeated measures were used for cognitive scores. Descriptive statistics and t -tests were used to summarize acceptability, perceived competency, and enjoyment, for CR completers and non-completers. The CR group performed significantly better than CBT on executive functions and visual memory at post-therapy compared to baseline. Twenty participants completed CR (44 %; mean 5.5 sessions). At week 1, CR non-completers presented higher levels of perceived competency. Completers reported higher enjoyment scores at the last session compared to the first session. Group CR is effective for cognitive outcomes in FEP+SAD, but acceptability and engagement present a challenge. Future studies are necessary to explore approaches promoting engagement.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.005 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.003 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.002 | 0.003 |
| Insufficient payload (model declined to judge) | 0.007 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".