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Clinical Trial Details — Status: Completed

Administrative data

NCT number NCT03623477
Other study ID # 1505016194
Secondary ID UL1TR000457
Status Completed
Phase N/A
First received
Last updated
Start date August 16, 2016
Est. completion date October 25, 2019

Study information

Verified date February 2020
Source Weill Medical College of Cornell University
Contact n/a
Is FDA regulated No
Health authority
Study type Interventional

Clinical Trial Summary

The purpose of the study is to examine the effects of cognitive training on emotion regulation, impulse control, and aggression in people with schizophrenia. The study compares a combination of computerized cognitive remediation and social cognition training (CRT+SCT) to cognitive remediation alone (CRT). Study outcomes include multiple measures of aggression, emotion regulation, impulse control, cognition, and symptoms.


Description:

Neurocognitive and social cognitive impairments are contributors to negative emotionality and impulsive aggression in people with schizophrenia. Impulsive aggression poses several challenges to the care of people with schizophrenia. These include a greater risk of rehospitalization and longer hospital stays, involvement with the criminal justice system, and increased risk of recidivism. The investigators recently found that schizophrenia patients with aggression history experienced improvements in neurocognition as well as decreased hostility/agitation and incidents of verbal and physical aggression after participating in cognitive remediation training (CRT). Based on these findings, it is hypothesized that improving neurocognition through CRT may have enhanced the capacity of schizophrenia patients to inhibit aggression through improved emotion regulation capacity and impulse control. It is also postulated that the addition of Social Cognition Training (SCT) to CRT would provide greater benefits on emotion regulation and impulse control over CRT alone. To test the hypotheses, the investigators will conduct a clinical trial that compares two configurations of cognitive training--CRT plus SCT versus CRT plus control computer games. The goal of the study is to examine the comparative benefits of the two configurations of cognitive training on outcomes that include neurocognition, social cognition, emotion regulation, impulse control, and reactive aggression. Participants assigned to the CRT plus SCT group will complete 24 hours of CRT and 12 hours of SCT. Participants assigned to the CRT only group will complete 24 hours of CRT and 12 hours of control computer activities. Emotion regulation, impulse control, and reactive aggression will be indexed using laboratory-based challenges. The investigators will recruit and characterize 90 study participants on demographic and clinical variables including age, gender, education, aggression history, and medications. Study outcome measures will be administered at baseline and posttreatment to participants randomized to the study groups. In a subsample of 32 patients, the study investigators will further examine changes in the neural network of emotion regulation and impulsivity before and after cognitive training.


Recruitment information / eligibility

Status Completed
Enrollment 90
Est. completion date October 25, 2019
Est. primary completion date October 25, 2019
Accepts healthy volunteers No
Gender All
Age group 18 Years to 60 Years
Eligibility Inclusion Criteria:

- diagnosis of schizophrenia or schizo-affective disorder

- Age 18-60

- Mini Mental Status Exam score greater/equal to 24 at screening

- Auditory and visual acuity adequate to complete cognitive tests

- At least a score of 5 or more on the Life History of Aggression (LHA) aggression items or one confirmed assault in the past year

- Capacity and willingness to give consent

Exclusion Criteria:

- Inability to read or speak English

- Documented significant disease of the Central Nervous System (CNS)

- History of intellectual impairment predating psychosis (e.g., a diagnosis of developmental disability)

Study Design


Intervention

Behavioral:
Cognitive Remediation (CRT)
Study compares two configurations of cognitive training--computerized cognitive remediation versus a combination of computerized cognitive remediation and social cognition training. The cognitive remediation therapy group will complete computerized training activities in attention, memory, processing speed, problem solving, and executive functions.
CRT+ Social Cognition Training
Study compares two configurations of cognitive training--computerized cognitive remediation versus a combination of computerized cognitive remediation and social cognition training. The combined cognitive remediation and social cognition training group will complete computerized training that target neurocognitive functions, facial affect emotion recognition and mentalizing tasks.

Locations

Country Name City State
United States Manhattan Psychiatric Center New York New York
United States NewYork Presbyterian Hospital White Plains New York

Sponsors (4)

Lead Sponsor Collaborator
Weill Medical College of Cornell University Brain & Behavior Research Foundation, Nathan Kline Institute for Psychiatric Research, National Center for Advancing Translational Science (NCATS)

Country where clinical trial is conducted

United States, 

Outcome

Type Measure Description Time frame Safety issue
Other Change in psychotic symptoms Positive and Negative Syndrome Scale (PANSS). Scale total scores range from 30 to 210 with higher scores indicating greater symptom severity Change from baseline in psychotic symptom measure up to the end of intervention at 4 months
Primary Change in Aggression Overt Aggression Scale-Modified (OAS-M); Taylor Aggression Paradigm (TAP); Point Subtraction Aggression Paradigm (PSAP). Change from baseline in aggression measures up to the end of intervention at 4 months
Secondary Change in cognitive outcomes MATRICS Consensus Cognitive Battery (MCCB); Emotion Recognition-40 (ER-40); Reading the Mind in the Eyes (Eyes Task) Change from baseline in cognition measures up to the end of intervention at 4 months
Secondary Change in Emotionality Positive and Negative Affect Scale (PANAS); Toronto Alexithymia Scale (TAS); Observer Alexithymia Scale (OAS) Change from baseline in emotionality measures up to the end of intervention at 4 months
Secondary Change in Emotion Regulation Capacity Picture viewing task completed while peripheral psychophysiological response is obtained Change from baseline in measures up to the end of intervention at 4 months
Secondary Change in Impulse Control Behavioral Impulse control tasks including Go-NoGo Task and Emotional Stop Task Change from baseline in impulse control measures up to the end of intervention at 4 months
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