title: Top-down computerized cognitive remediation in schizophrenia: a case study of an individual with impairment in verbal fluency.
abstract: The objective of this case study was to assess the specific effect of cognitive remediation for schizophrenia on the pattern of cognitive impairments. Case A is a 33-year-old man with a schizophrenia diagnosis and impairments in visual memory, inhibition, problem solving, and verbal fluency. He was provided with a therapist delivered cognitive remediation program involving practice and strategy which was designed to train attention, memory, executive functioning, visual-perceptual processing, and metacognitive skills. Neuropsychological and clinical assessments were administered at baseline and after three months of treatment. At posttest assessment, Case A had improved significantly on targeted (visual memory and problem solving) and nontargeted (verbal fluency) cognitive processes. The results of the current case study suggest that (1) it is possible to improve specific cognitive processes with targeted exercises, as seen by the improvement in visual memory due to training exercises targeting this cognitive domain; (2) cognitive remediation can produce improvements in cognitive processes not targeted during remediation since verbal fluency was improved while there was no training exercise on this specific cognitive process; and (3) including learning strategies in cognitive remediation increases the value of the approach and enhances participant improvement, possibly because strategies using verbalization can lead to improvement in verbal fluency even if it was not practiced.
authors.affiliation: École de Psychologie, Université Laval, Québec, QC, Canada G1V 0A6.
authors.forename: Marjolaine
authors.initials: M
authors.lastname: Masson
authors.affiliation: Institute of Psychiatry, King's College London, London SE5 8AF, UK.
authors.forename: Til
authors.initials: T
authors.lastname: Wykes
authors.affiliation: Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Québec, QC, Canada G1J 2G3 ; Département de Psychiatrie, Faculté de Médecine, Université Laval, Québec, QC, Canada G1V 0A6.
authors.forename: Michel
authors.initials: M
authors.lastname: Maziade
authors.affiliation: Institute of Psychiatry, King's College London, London SE5 8AF, UK.
authors.forename: Clare
authors.initials: C
authors.lastname: Reeder
authors.affiliation: École de Psychologie, Université Laval, Québec, QC, Canada G1V 0A6.
authors.forename: Marie-Anne
authors.initials: MA
authors.lastname: Gariépy
authors.affiliation: Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Québec, QC, Canada G1J 2G3 ; Département de Psychiatrie, Faculté de Médecine, Université Laval, Québec, QC, Canada G1V 0A6.
authors.forename: Marc-André
authors.initials: MA
authors.lastname: Roy
authors.affiliation: École de Psychologie, Université Laval, Québec, QC, Canada G1V 0A6.
authors.forename: Hans
authors.initials: H
authors.lastname: Ivers
authors.affiliation: École de Psychologie, Université Laval, Québec, QC, Canada G1V 0A6 ; Centre de Recherche de l'Institut Universitaire en Santé Mentale de Québec, Québec, QC, Canada G1J 2G3.
authors.forename: Caroline
authors.initials: C
authors.lastname: Cellard