Understanding Strategy Monitoring and Real-World Transfer in Cognitive Remediation Within the Context of Mood and Psychotic Disorders
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Authors
Haque, Mashal
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thesis
Language
eng
Keyword
Cognitive Remediation , Cognition , Functioning , Outcomes
Alternative Title
Abstract
Cognitive Remediation (CR) is a behavioural intervention designed to enhance cognitive abilities and improve functioning in several psychiatric disorders. CR programs involve cognitive training as well as therapist-facilitated procedures for strategy monitoring and the transfer of cognitive skills and strategies to real-world activities. Research focusing on strategy monitoring and real-world transfer treatment processes has been limited to date. Chapter 2 of this dissertation examined correlates of strategy monitoring and transfer skills development, and the relationships of these skills with treatment outcomes. Results showed that participants with less impaired baseline neurocognition produced higher quality strategies at session one. Over treatment, there was a significant improvement in strategy quality among more neurocognitively impaired individuals, but not among less neurocognitively impaired individuals. By the final session, participants with different levels of baseline neurocognitive impairment generated strategies of comparable quality. Additionally, participants at all levels of baseline real-world functioning showed improvements in transfer skills, however, individuals with higher baseline real-world functioning consistently produced higher quality transfer ideas from the beginning through the end of treatment. In terms of treatment outcomes, the development of strategy monitoring skills was associated with improvements in neurocognition, whereas the development of transfer skills was associated with improvements in real-world functioning. Chapter 3 examined the reliability and validity of a novel clinician-rated measure of strategy monitoring and real-world transfer skills. The strategy monitoring and transfer subscales showed evidence of good and moderate inter-rater reliability, respectively. Regarding validity, the strategy monitoring subscale showed evidence of convergent and discriminant validity, while the transfer subscale showed evidence of discriminant validity. Together, these studies support the notion that strategy monitoring and real-world transfer are active ingredients of CR, and build on existing research by developing a novel clinician-rated measure of these skills. Our studies represent a promising step toward developing a measure for use in empirical research and clinical settings implementing CR, however, further revision is needed.
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ProQuest PhD and Master's Theses International Dissemination Agreement
Intellectual Property Guidelines at Queen's University
Copying and Preserving Your Thesis
This publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.
Attribution 3.0 United States