Targeted Cognitive Training's Effects on Real-World Cognition in Individuals at High Risk for Psychosis

Individuals at clinical high risk for psychosis (CHRp) often experience cognitive and social cognitive impairments, leading to functional difficulties that affect their quality of life. Although interventions have been developed to address these issues, current functioning measures have not been successful in capturing the global and social functioning abilities of CHRp participants. This research study aims to investigate whether Targeted Cognitive Training (TCT) can improve the daily reports of cognitive difficulties and social cognitive abilities of individuals at clinical high risk for psychosis, as compared to a control condition. The study had 64 participants, 32 in the treatment group and 32 in the control group. They were required to complete daily diaries before, during, and after a cognitive training program (TCT) and during a 9-month follow-up. The training sessions were accessed using the PositScience IOS app, and the participants completed them in 8-12 weeks. An exploratory factor analysis was conducted to determine the dimensionality of the scales from the daily diary data. A Structural Equation Model (SEM) was run to understand the differences in real-world cognition and real-world social cognition reported in the daily diaries at four different time points between the two groups (Training and Control). The study found no significant differences in self-report real-world cognition and real-world social cognition between the treatment and control groups during or after TCT. Therefore, the EMS approach used in this study was not sufficiently sensitive to measure a change in functioning in CHRp. In the Discussion, we provide some suggestions for improving these measures.