Schizophrenia has resisted traditional forms of social and vocational rehabilitation. While behavioral cognitive interventions have recently shown effects on resistant symptoms or selected aspects of neurocognition and problem solving ability, there has been little evidence of broad generalization to community life. In contrast, Cognitive Enhancement Therapy (CET), a developmental approach to facilitating social cognitive capacities, is demonstrating extensive effects on social cognition, social and vocational adjustment, neuropsychological performance and residual symptoms. This proposal first seeks to undertake and publish extensive analyses of the two year outcomes among 121 patients randomized to CET or Enriched Supportive Therapy. Second, we propose to complete and publish a provocative third year, post-treatment assessment that indicates a maintenance of effects. Third, we shall prepare training materials for dissemination to the public sector. Post-hoc analyses have suggested a therapeutic potential of our recently tested Personal Therapy (PT) for schizophrenia patients who abuse alcohol and/or cannabis, and selected CET principles appear uniquely relevant to the cognitive deficits of this population. Thus, a fourth objective is to develop a modified CET/PT intervention targeted toward the cognitive deficits and the dysregulating temperament of these patients. Improved efficacy might ultimately result by addressing the shared pathoetiologies of schizophrenia and substance use disorder in a single treatment. In order to determine the feasibility, relevance, acceptance and preliminary evidence of efficacy for the new intervention, a progressive series of treatment development pilot studies are proposed that will include 30 schizophrenia patients with a substance use disorder involving alcohol and/or cannabis. These pilot studies continue the process that has historically characterized this program's mission to first develop and later test novel interventions that respond to the needs of underserved schizophrenia patients. If successful, a Treatment Manual will be made available to researchers interested in testing the new approach.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Research Project (R01)
Project #
5R01MH030750-26
Application #
6603357
Study Section
Special Emphasis Panel (ZMH1-ITV-D (01))
Program Officer
Heinssen, Robert K
Project Start
1978-04-01
Project End
2005-06-30
Budget Start
2003-07-01
Budget End
2005-06-30
Support Year
26
Fiscal Year
2003
Total Cost
$538,261
Indirect Cost
Name
University of Pittsburgh
Department
Psychiatry
Type
Schools of Medicine
DUNS #
004514360
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
Hogarty, Gerard E; Greenwald, Deborah P; Eack, Shaun M (2006) Durability and mechanism of effects of cognitive enhancement therapy. Psychiatr Serv 57:1751-7
Hogarty, Gerard E; Flesher, Samuel; Ulrich, Richard et al. (2004) Cognitive enhancement therapy for schizophrenia: effects of a 2-year randomized trial on cognition and behavior. Arch Gen Psychiatry 61:866-76
Keshavan, M S; Hogarty, G E (1999) Brain maturational processes and delayed onset in schizophrenia. Dev Psychopathol 11:525-43
Hogarty, G E; Flesher, S (1999) Practice principles of cognitive enhancement therapy for schizophrenia. Schizophr Bull 25:693-708
Hogarty, G E; Flesher, S (1999) Developmental theory for a cognitive enhancement therapy of schizophrenia. Schizophr Bull 25:677-92
Hogarty, G E; Greenwald, D; Ulrich, R F et al. (1997) Three-year trials of personal therapy among schizophrenic patients living with or independent of family, II: Effects on adjustment of patients. Am J Psychiatry 154:1514-24
Hogarty, G E; Kornblith, S J; Greenwald, D et al. (1997) Three-year trials of personal therapy among schizophrenic patients living with or independent of family, I: Description of study and effects on relapse rates. Am J Psychiatry 154:1504-13
Carter, M; Flesher, S (1995) The neurosociology of schizophrenia: vulnerability and functional disability. Psychiatry 58:209-24
Hogarty, G E; Anderson, C M; Reiss, D J et al. (1991) Family psychoeducation, social skills training, and maintenance chemotherapy in the aftercare treatment of schizophrenia. II. Two-year effects of a controlled study on relapse and adjustment. Environmental-Personal Indicators in the Course of Schizophreni Arch Gen Psychiatry 48:340-7
Munetz, M R; Toenniessen, L; Scala, C et al. (1989) Onset and course of tardive dyskinesia. Psychosomatics 30:346-8

Showing the most recent 10 out of 14 publications