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Psychiatric conditions are each defined by different set of symptoms, however, they often share common characteristics such as impairments in cognitive and social functioning. These impairments can cause significant distress and disrupt daily functioning by preventing individuals from actively participating in school or work, maintaining healthy relationships with others, and engaging in everyday activities independently. The goal of this clinical trial is to examine if action-based cognitive remediation (ABCR) therapy, a type of cognitive training program, works to treat cognitive impairments in participants with psychiatric disorders.
The main questions it aims to answer are:
Researchers will compare how much the thinking skills of participants change during an 8-week waiting period (where they get no treatment) to how much they change during the 8-week training program to see if the training makes a bigger difference in helping them think and live better.
Participants will :
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Action-Based Cognitive Remediation (ABCR) with Waitlist Control Period | Experimental |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Action-Based Cognitive Remediation | Behavioral | Action-Based Cognitive Remediation (ABCR) is a type of cognitive remediation therapy, an intervention that focuses on mitigating cognitive deficits to enhance everyday functioning through behavioural learning strategies. The goal of ABCR is to increase real-world transferability of cognitive skills onto daily functioning through group discussions and computerized exercises. ABCR programs typically last 10 weeks with 2-hour sessions usually twice per week. Participants get placed into groups of 4-6 people with two therapists. Each session involves computer-based exercises and group discussion of cognitive strategies related to the theme of the day. Participants then role-play everyday functional tasks (e.g., meal planning, scheduling appointments) that reflect the focus of the session. Sessions conclude by linking content to individual goals and identifying cognitively challenging daily activities to practice between sessions. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from Baseline in neurocognitive performance from baseline to post-intervention, relative to change observed during the 8-week wait-list period (Screen for Cognitive Impairment in Psychiatry) | Investigators will assess cognitive functioning using the Screen for Cognitive Impairment in Psychiatry, from which a composite score will be calculated to represent overall cognitive performance. The test is comprised of five subscales: the Verbal Learning Test scores range from 0-30, the Working Memory Test scores range from 0-24, the Verbal Fluency scores represent number of correct responses with no fixed maximum score, the Verbal Learning Test-Delayed scores range from 0-10, the Processing Speed Test scores range from 0-30. | Participants complete the Screen for Cognitive Impairment in Psychiatry at baseline, 1 week post-waiting period, 1 week post-intervention, and 3-months post-intervention |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Social Cognition from Baseline to Post-Intervention Relative to the 8-Week Wait-List Period (Brief Social Cognition and Emotional Processing) | Investigators will assess social cognition using the Brief Social Cognition and Emotional Processing assessment. The Brief Social Cognition and Emotional Processing includes tasks assessing emotional processing and social cognitive abilities. Scores are calculated based on participant performance on the assessment tasks, with higher scores indicating better social cognitive performance. Scores below 60 suggest impaired social cognition and functional impairment, whereas scores of 60 or above suggest intact social cognitive functioning. |
| Measure | Description | Time Frame |
|---|---|---|
| Change from Baseline in Negative Symptom Severity from Baseline to Post-Intervention, Relative to Change Observed During the 8-Week Wait-List Period (Positive and Negative Severity Scale) | The investigators will measure symptom severity through the brief version of the brief version of the Positive and Negative Severity Scale (PANSS-6). Each of the 6 items of the PANSS-6 is rated on a scale of 7 points and the total score ranges from 6 to 42 with higher scores indicating more severe symptoms of a psychotic disorder. |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Yasmine Tiraoui-Elkhoumri, BA | Contact | 613-722-6521 | 6599 | ytiraoui@theroyal.ca |
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| Participants complete the BSCOPE at baseline, 1 week post-waiting period, 1 week post-intervention, and 3-months post-intervention. |
| Change from Baseline in Community Functioning from Baseline to Post-Intervention, Relative to Change Observed During the 8-Week Wait-List Period (Role Functioning Scale) | The investigators will measure community functioning through the Role Functioning Scale. Each of the 4 items of the Role Functioning Scale is scored on a scale of 1 to 7. The total score is from 4 to 28 with a higher score indicating greater community functioning. | Participants complete the Role Functioning Scale at baseline, 1 week post-waiting period, 1 week post-intervention, and 3-months post-intervention. |
| Change from Baseline in Goal Attainment from Baseline to Post-Intervention, Relative to Change Observed During the 8-Week Wait-List Period (Goal Attainment Scaling) | The investigators will measure individualized goal achievement using Goal Attainment Scaling. Participants identify personal goals at baseline, and attainment of each goal is scored on a standardized scale ranging from -2 to +2, where higher scores indicate greater goal attainment. | Participants complete Goal Attainment Scaling at baseline, 1 week post-waiting period, 1 week post-intervention, and 3-months post-intervention. |
| Change from Baseline in Social and Occupational Functioning from Baseline to Post-Intervention, Relative to Change Observed During the 8-Week Wait-List Period (Social and Occupational Functioning Assessment Scale) | The investigators will measure social and occupational functioning using the Social and Occupational Functioning Assessment Scale (SOFAS). The SOFAS is scored on a scale from 0 to 100, with higher scores indicating better social and occupational functioning. | Participants complete the Social and Occupational Functioning Assessment Scale at baseline, 1 week post-waiting period, 1 week post-intervention, and 3-months post-intervention. |
| Feasibility of the intervention | The investigators will measure the feasibility of the intervention through a structured interview with participants using the RE-AIM dimensions and CFIR Hybrid Framework | Participants will conduct a structured interview 1 week-post intervention |
| Acceptability of the intervention | The investigators will measure the acceptability of the intervention through a structured interview with participants using the RE-AIM dimensions and CFIR Hybrid Framework | Participants will conduct a structured interview 1 week post-intervention |
| Participants complete the brief version of the Positive and Negative Severity Scale at baseline, 1 week post-waiting period, 1 week post-intervention, and 3-months post-intervention. |
| Change from Baseline in Symptom Severity from Baseline to Post-Intervention, Relative to Change Observed During the 8-Week Wait-List Period (Hamilton Anxiety Rating Scale) | The investigators will measure anxiety symptom severity using the Hamilton Anxiety Rating Scale (HAM-A). The HAM-A consists of 14 items rated on a scale from 0 to 4. The total score ranges from 0 to 56, with higher scores indicating greater anxiety symptom severity. | Participants complete the Hamilton Anxiety Rating Scale at baseline, 1 week post-waiting period, 1 week post-intervention, and 3-months post-intervention. |
| Change from Baseline in Symptom Severity from Baseline to Post-Intervention, Relative to Change Observed During the 8-Week Wait-List Period (Patient Health Questionnaire-9) | The investigators will measure depressive symptom severity using the Patient Health Questionnaire-9 (PHQ-9). The PHQ-9 consists of nine items rated on a scale from 0 to 3. The total score ranges from 0 to 27, with higher scores indicating greater depressive symptom severity. | Participants complete the Patient Health Questionnaire-9 at baseline, 1 week post-waiting period, 1 week post-intervention, and 3-months post-intervention. |
| Change from Baseline in Cognitive Motivation from Baseline to Post-Intervention, Relative to Change Observed During the 8-Week Wait-List Period (Cognitive Motivation Scale) | The investigators will measure cognitive motivation using the Cognitive Motivation Scale. The scale produces a total score representing the participant's level of motivation for cognitive engagement, with higher scores indicating greater cognitive motivation. | Participants complete the Cognitive Motivation Scale at baseline, 1 week post-waiting period, 1 week post-intervention, and 3-months post-intervention. |
| Change from Baseline in Self-Esteem from Baseline to Post-Intervention, Relative to Change Observed During the 8-Week Wait-List Period (Self-Esteem Rating Scale) | The investigators will measure self-esteem using the short form Self-Esteem Rating Scale. The scale produces a total score representing the participant's level of self-esteem, with higher scores indicating greater self-esteem. | Participants complete the Self-Esteem Rating Scale at baseline, 1 week post-waiting period, 1 week post-intervention, and 3-months post-intervention. |
| ID | Term |
|---|---|
| D001523 | Mental Disorders |
| D012559 | Schizophrenia |
| D001008 | Anxiety Disorders |
| D019964 | Mood Disorders |
| D000068105 | Bipolar and Related Disorders |
| D003130 | Combat Disorders |
| D000067877 | Autism Spectrum Disorder |
| D060825 | Cognitive Dysfunction |
| D003072 | Cognition Disorders |
| ID | Term |
|---|---|
| D019967 | Schizophrenia Spectrum and Other Psychotic Disorders |
| D040921 | Stress Disorders, Traumatic |
| D000068099 | Trauma and Stressor Related Disorders |
| D002659 | Child Development Disorders, Pervasive |
| D065886 | Neurodevelopmental Disorders |
| D019965 | Neurocognitive Disorders |
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