Abstract
Background: Early psychosocial interventions targeting cognitive and functional outcomes in individuals at clinical high risk for psychosis are a research priority. An even greater need is the identification of effective interventions in underserved populations. Compensatory Cognitive Training (CCT) is a psychosocial intervention with demonstrated efficacy in chronic schizophrenia and first episode psychosis, but remains to be evaluated in pre-illness phases. The aim of this study was to describe the development and implementation of an ongoing pilot randomized controlled trial investigating the efficacy of group-based, manualized CCT, as compared to recreational therapy (RT), for Latino participants at clinical high risk for psychosis (CHR) in both the United States and Mexico. It is hypothesized that, in comparison to those receiving RT, participants receiving CCT will show significant improvements in neurocognitive performance and functional capacity (co-primary outcomes) and self-rated functioning and clinical symptoms (secondary outcomes).Methods: Latino CHR participants aged 12–30 years will be included in the study. Both CCT and RT will be delivered in either Spanish or English, depending on group preference. Additionally, all assessments will be administered in participants’ preferred language. A comprehensive assessment of neurocognitive and functional performance and clinical symptomatology will be performed at baseline, mid-intervention (4 weeks, 8 weeks), post-intervention (12 weeks) and 3-month follow-up. The primary outcome measures are neurocognition and functional capacity, as assessed by the MATRICS (Measurement and Treatment Research in Cognition in Schizophrenia) Consensus Cognitive Battery and the University of California, San Diego Performance-Based Skills Assessment-Brief, respectively. Furthermore, secondary outcomes measures will be used to examine change in clinical symptoms and self-reported functioning in response to CCT versus RT.Discussion: The evaluation of a novel treatment such as CCT in CHR youth will provide empirical support for a low risk, comprehensive cognitive intervention that could have important implications for public health if it improves neurocognition and functioning.
Highlights
Recent efforts to extend medical prevention models to the field of schizophrenia have resulted in systematic, reliable identification of individuals who are at clinical high risk (CHR) for imminent onset of psychosis [1, 2]
The aim of this paper is to describe the development and implementation of an ongoing pilot randomized controlled trial investigating the efficacy of Compensatory Cognitive Training (CCT), as compared to recreational therapy (RT), for CHR Latino participants in both the United States and Mexico
CCT is a psychosocial intervention with demonstrated efficacy in first episode and chronic schizophrenia [35, 36], but remains to be evaluated in preillness phases
Summary
Recent efforts to extend medical prevention models to the field of schizophrenia have resulted in systematic, reliable identification of individuals who are at clinical high risk (CHR) for imminent onset of psychosis (i.e., putative prodromal psychosis) [1, 2]. Diagnosis of a psychosis-risk syndrome requires that symptoms are associated with functional impairment and/or distress and of recent onset or worsening. Psychosocial interventions targeting cognitive and functional outcomes in individuals at clinical high risk for psychosis are a research priority. The aim of this study was to describe the development and implementation of an ongoing pilot randomized controlled trial investigating the efficacy of group-based, manualized CCT, as compared to recreational therapy (RT), for Latino participants at clinical high risk for psychosis (CHR) in both the United States and Mexico. In comparison to those receiving RT, participants receiving CCT will show significant improvements in neurocognitive performance and functional capacity (co-primary outcomes) and self-rated functioning and clinical symptoms (secondary outcomes)
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