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Schizophrenia Bulletin Advance Access originally published online on August 10, 2006
Schizophrenia Bulletin 2006 32(Supplement 1):S123-S131; doi:10.1093/schbul/sbl019
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© The Author 2006. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oxfordjournals.org.

Cognitive Predictors of Social Functioning Improvements Following Cognitive Remediation for Schizophrenia

Clare Reeder1,2, Nicola Smedley3, Kate Butt3,4, Diana Bogner5 and Til Wykes2
2 Department of Psychology, Institute of Psychiatry, Kings College, De Crespigny Park, London SE5 8AF, UK
3 Oxleas National Health Service Foundation Trust, UK
4 South Essex, National Health Service Foundation Trust
5 University College, London, UK

1 To whom correspondence should be addressed; tel: +44-20-7848-5040, fax: +44-20-7848-5006, e-mail: c.reeder{at}iop.kcl.ac.uk.

A greater understanding of the links between cognitive and social functioning changes is needed to refine cognitive treatments for schizophrenia. To date, studies have been cross-sectional, and few have investigated the impact of cognitive change. This single-blind randomized controlled trial explored the links between changes in executive/memory functions and social behavior, as well as the moderating effect of cognitive remediation therapy (CRT). A total of 85 participants with schizophrenia received 40 sessions of CRT (an individual psychological therapy aiming to improve attention, memory, and problem solving) or treatment-as-usual. At baseline, social functioning was significantly associated with "verbal working memory," "response inhibition," "verbal long-term memory," and "visuo-spatial long-term memory," but not "schema generation," factors. However, only improvement in "schema generation" predicted improved social functioning. This was true whether or not participants had received CRT. These results suggest that cross-sectional associations between cognitive functions and social functioning may not offer the best means for identifying good targets for intervention. Improvement in the ability to generate new schemas has a beneficial impact on social functioning.

Keywords: cognition / metacognition / psychological treatments / executive functioning / memory / cognitive remediation


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