Young adults with psychotic-spectrum disorder have lower odds of attaining educational goals, partly due to cognitive problems. Cognitive remediation (CR) could improve cognitive- and potentially academic functioning. The current study examined an adapted CR-intervention ‘Mindset’ aimed at academic functioning for people with a psychotic-spectrum disorder in secondary education. Pilot-feasibility study of Mindset including the experience of nine participants with psychotic-spectrum disorder who received Mindset and six CR trainers. Post-CR interviews with participants and trainers were subjected to qualitative evaluation. Furthermore, preliminary results from pre- to post-CR changes on the College Self-Efficacy Inventory (CSEI), Cognitive Problems and Strategies Assessment (CPSA) and Multidimensional Students’ Life Satisfaction Scale (MSLSS) are presented using Reliable Change Index (RCI) and effect-sizes (Cohen’s d). Qualitative evaluation showed that overall experience with Mindset was positive for participants and trainers. Mindset was not experienced as too difficult and aligned well with education. However, tailoring to the individual is required. Effect sizes in change from pre- to post-CR were small for school satisfaction (d = 0.25) and self-reported cognitive problems (d = 0.12), small to medium for increases in self-efficacy (d = 0.49) and large for increases in strategy use (d = 3.58). Feasibility of Mindset was good in terms of adaptation and expansion, implementation and limited efficacy. However, concerning acceptability, drop-out prior to Mindset was high and Mindset needs adjustment in terms of individual tailoring and language. Future studies have to attest to its efficacy.
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Most severe mental disorders have their onset between the age of 17 and 27, a time when many young adults begin participating in secondary or post-secondary education. The cognitive deficits typically associated with psychiatric disorders, especially psychotic disorders, increase the risk of leaving school early, which can lead to a reduction in employment opportunities later on in life and, in turn, a poorer long-term prognosis. Therefore, specific interventions aiming to improve these cognitive functions are needed. Cognitive remediation (CR) aims to improve cognitive functioning and may increase real-world functioning in educational performance. This study aims to examine the feasibility and applicability of a CR training named Mindset for students with psychotic disorders in the Netherlands.
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This study provides an illustration of a research design complementary to randomized controlled trial to evaluate program effects, namely, participatory peer research (PPR). The PPR described in current study was carried out in a small sample (N = 10) of young adults with mild intellectual disabilities (MID) and severe behavioral problems. During the PPR intervention, control and feedback to individuals is restored by training them to become participant-researchers, who collaborate in a small group of people with MID. Their research is aimed at the problems the young adults perceive and/or specific subjects of their interest. The study was designed as a multiple case study with an experimental and comparison group. Questionnaires and a semistructured interview were administered before and after the PPR project. Results of Reliable Change Index (RCI) analyses showed a decrease in self-serving cognitive distortions in the PPR group, but not in the comparison group. These results indicate that PPR helps to compensate for a lack of adequate feedback and control, and in turn may decrease distorted thinking and thereby possibly later challenging behavior.
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