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Case Reports in Psychiatry
Volume 2015, Article ID 242364, 10 pages
http://dx.doi.org/10.1155/2015/242364
Case Report

Top-Down Computerized Cognitive Remediation in Schizophrenia: A Case Study of an Individual with Impairment in Verbal Fluency

1École de Psychologie, Université Laval, Québec, QC, Canada G1V 0A6
2Institute of Psychiatry, King’s College London, London SE5 8AF, UK
3Centre de Recherche de l’Institut Universitaire en Santé Mentale de Québec, Québec, QC, Canada G1J 2G3
4Département de Psychiatrie, Faculté de Médecine, Université Laval, Québec, QC, Canada G1V 0A6

Received 18 January 2015; Accepted 29 March 2015

Academic Editor: Toshiya Inada

Copyright © 2015 Marjolaine Masson et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

The objective of this case study was to assess the specific effect of cognitive remediation for schizophrenia on the pattern of cognitive impairments. Case A is a 33-year-old man with a schizophrenia diagnosis and impairments in visual memory, inhibition, problem solving, and verbal fluency. He was provided with a therapist delivered cognitive remediation program involving practice and strategy which was designed to train attention, memory, executive functioning, visual-perceptual processing, and metacognitive skills. Neuropsychological and clinical assessments were administered at baseline and after three months of treatment. At posttest assessment, Case A had improved significantly on targeted (visual memory and problem solving) and nontargeted (verbal fluency) cognitive processes. The results of the current case study suggest that (1) it is possible to improve specific cognitive processes with targeted exercises, as seen by the improvement in visual memory due to training exercises targeting this cognitive domain; (2) cognitive remediation can produce improvements in cognitive processes not targeted during remediation since verbal fluency was improved while there was no training exercise on this specific cognitive process; and (3) including learning strategies in cognitive remediation increases the value of the approach and enhances participant improvement, possibly because strategies using verbalization can lead to improvement in verbal fluency even if it was not practiced.