# Systematic Evaluation of the Effects of Cognitive Remediation across Affective and Non-Affective Psychosis

> **NIH NIH R03** · MCLEAN HOSPITAL · 2020 · $164,000

## Abstract

PROJECT SUMMARY
Psychotic disorders including schizophrenia [SZ] and bipolar disorder [BD] are among the most costly and
debilitating psychiatric diseases worldwide. Both SZ and BD are associated with marked cognitive deficits,
which are among the strongest predictors of poor community functioning, disability, and reduced quality of life
(1-3). Cognitive remediation (CR) is one of the few available interventions to target cognitive symptoms
directly. Growing evidence indicates that CR improves cognition in patients with these illnesses at the group
level (e.g. 4-6). However, a number of critical knowledge gaps limit our ability to develop robust, individualized
CR interventions and provide access to patients who are most likely to benefit: first, CR outcomes are highly
heterogeneous and predictors of treatment response have not been identified; and second, the underlying
neurobiological mechanisms that mediate cognitive and functional enhancement remain largely undetermined.
CR trials are challenging, as interventions are often lengthy and intensive, and ascertainment and retention of
patients with psychotic disorders is difficult. As a result, the majority of CR studies are underpowered to clearly
identify predictors of response, compare treatment effects by diagnosis, examine the ability of CR to drive rapid
neural change, and determine the extent to which neural change is associated with cognitive or functional
outcomes. These knowledge gaps have limited our ability to develop robust, targeted CR programs and deliver
them to patients most likely to benefit.
The aims of this project are twofold: 1) identification of patient characteristics associated with cognitive
treatment response including baseline demographic, clinical, and cognitive variables, and multivariate models;
and 2) examination of CR's ability to drive rapid, EEG-measured neural change in key information processing
systems, and the associations of this change with primary cognitive outcomes. Over the last eight years our
group has completed two separate randomized controlled trials of a 70-hour CR program in patients with SZ
and BD with funding from NIMH and the Brain and Behavior Research Foundation. These studies employed
identical CR paradigms, active control conditions, primary (cognitive) and secondary (clinical, functional)
outcome measures taken at the same timepoints (baseline, midpoint, and post-treatment), and EEG protocols.
We will systematically examine moderator of CR response across the sample including demographic, clinical
and cognitive variables; we will then use principal components analysis (PCA) with regression to evaluate
factors predictive of CR response, compare univariate predictors with our multivariate models, and explore
clustering behavior in responders vs. non-responders. Finally, we will examine early effects of CR training on
EEG-measured neurophysiology, and the relationship of neural modulation to cognitive response. This project
is uniquely posit...

## Key facts

- **NIH application ID:** 9977312
- **Project number:** 1R03MH120442-01A1
- **Recipient organization:** MCLEAN HOSPITAL
- **Principal Investigator:** KATHRYN Eve LEWANDOWSKI
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $164,000
- **Award type:** 1
- **Project period:** 2020-04-01 → 2022-03-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9977312

## Citation

> US National Institutes of Health, RePORTER application 9977312, Systematic Evaluation of the Effects of Cognitive Remediation across Affective and Non-Affective Psychosis (1R03MH120442-01A1). Retrieved via AI Analytics 2026-06-12 from https://api.ai-analytics.org/grant/nih/9977312. Licensed CC0.

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