Training Executive Functioning in Psychosis: Effects on Neurophysiology, Neurocognition, and Functional Recovery.



M. Best, C. Bowie

Background: Cognitive remediation is a psychological intervention designed to improve neurocognition and functional recovery for individuals experiencing psychosis. Executive functioning is a domain of neurocognition that is most closely related to community functioning, however, few cognitive remediation interventions have directly trained executive functions.

Method: Two studies examining the efficacy of executive function training will be presented. Study 1 compared two weeks of executive function training to two weeks of sham training. Study 2 compared 6 weeks of executive function training (ET) to 6 weeks of perceptual training (PT) for individuals experiencing psychosis.

Results: In study 1, after only two weeks, individuals who received ET demonstrated significantly greater improvements in neurocognition (partial 2 = .25) and electrophysiology (EEG; partial 2 = .24). In study 2, immediately after the intervention, individuals who received PT demonstrated significantly greater improvements in the EEG mismatch negativity (related to perceptual processing; d = 0.64), however, this effect did not persist at 12-weeks post-treatment (d = 0.01). The groups did not differ in neurocognition or functioning immediately following treatment, however at 12-weeks post-treatment individuals who received ET demonstrated significantly greater improvements in EEG theta power (related to working memory; d = 1.01), neurocognition (d = 0.64), functional competence (d = 0.67), and case manager rated community functioning (d = 0.53).

Conclusion: Executive function training significantly improves neurophysiology, neurocognition, and functional recovery compared to both a control condition and to the most commonly used form of cognitive training. Additionally, training executive functioning primes further cognitive and functional improvements after the end of treatment. Executive function training is an efficient method for increasing functional recovery from psychosis.

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