전산화 주의 재활 훈련이 정신분열병 환자의 인지 기능에 미치는 효과 = The Effect of Computerized Attention Training on The Improvement of Cognitive Functions in Patients with Schizophrenia

다국어 초록 (Multilingual Abstract)

This study investigated the effect of computerized attention training on the improvement of cognitive functions in patients with schizophrenia. A total of 40 schizophrenic patients were randomly assigned to one of the three groups: the experimental(n=13), comparative(n=13) and control (n=14) groups. The attention training and Korean typing program were administered to the experimental and comparative groups, respectively. No training was given to the control group. The attention training consists of 10 sub-programs, which were developed to train sustained, selective and divided attention. Comprehensive neuropsychological tests such as the Rey-Osterrieth Complex Figure Test(ROCF), the Trail-Making Test, the Stroop test, the K-CVLT, the Wisconsin Card Sorting Test and the PANSS were administered before and after training. The three groups did not differ on the performances of any of the neuropsychological tests and for the PANSS scores administered prior to training. The experimental group showed significantly improved performances on the copy and delayed-recall conditions of the ROCF and the Stroop Color-Word Interference condition, which were administered after training, than did the comparative and control groups. In addition, the experimental group showed significantly reduced negative and general pathological symptoms after training, but the other two groups did not. These results indicate that attention rehabilitation training is effective for improving the cognitive functions of chronic schizophrenic patients. In addition, these results indicate the importance of cognitive rehabilitation for the treatment of schizophrenia.

참고문헌 (Reference)

1 김정기, "한국판-캘리포니아 언어학습검사(K-CVLT)" 도서출판 특수교육 1999

2 박윤정, "주의력 재활 훈련이 정신분열병 환자의 인지 기능에 미치는 효과" 한국임상심리학회 24 (24): 721-737, 2005

3 김명선, "시공간 재활 훈련이 정신분열병 환자의 인지 기능에 미치는 효과" 한국임상심리학회 27 (27): 51-68, 2008

4 박혜정, "만성 정신분열병 환자의 시지각과 주의의 관련성에 관한 연구" 성신여자대학교 2007

5 안석균, "만성 정신분열병 환자에서 전산화 인지재활 프로그램을 이용한 주의력 훈련의 효과" 36 (36): 72-79, 1997

6 Corrigan, P., "ecological validity of cognitive rehabilitation for schizophrenia" 11 : 14-21, 1993

7 Heaton,R.K, "Wisconsin Card Sorting Test Manual" Psychological Assessment Resources 1981

8 Green, M. F, "What are the functional consequences of neurocognitive deficits in schizophrenia" 153 : 321-330, 1996

9 Medalia, A., "The remediation of problem-solving skills in schizophrenia" 27 (27): 259-267, 2001

10 Kay, S. R., "The positive and negative syndrome scale(PANSS) for schizophrenia" 2 : 261-276, 1987

11 Nestor, P. G., "The mind adrift: attentional disregulations in schizophrenia. In The attentive brain" MIT Press 1998

12 Bark, N., "The impact of cognitive remediation on psychiatric symptoms of schizophrenia" 63 : 229-235, 2003

13 Velligan, D. I., "The functional significance of symptomatology and cognitive function in schizophrenia" 25 : 21-31, 1997

14 Breton, F., "The executive control of attention differentiates patients with schizophrenia, their first-degree relatives and healthy controls" 49 : 203-208, 2011

15 Wykes, T., "The effects of neurocognitive remediation on executive processing in patients with schizophrenia" 24 : 291-308, 1999

16 Prouteau, A., "The crucial role of sustained attention in community functioning in outpatients with schizophrenia" 129 : 171-177, 2004

17 Buchanan, R. W., "The comparative efficacy and long-term effect of clozapine treatment on neuropsychological test performance" 36 : 717-725, 1994

18 Dyer,F.N, "The Stroop phenomenon and its use in the study of perceptual, cognitive and response processes" 1 : 106-120, 1973

19 Watanabe, K., "The Rey-Osterrieht Complex Figure as a measure of executive function in childhood" 27 : 564-569, 2005

20 Stroop,J.R, "Studies of interference in serial verbal reactions" 18 : 643-662, 1935

21 Zajano, M. J., "Stroop interference as a function of percentage of congruent items" 63 : 1087-1096, 1986

22 Siverstein, S. M., "Stimulus configuration and context effects in perceptual organization in schizophrenia" 105 : 410-420, 1996

23 Green, M. F, "Should schizophrenia be treated as a neurocognitive disorder" 25 : 309-319, 1999

24 Filbey, F. M., "Selective attention deficits reflect increased genetic vulnerability to schizophrenia" 101 : 169-175, 2008

25 Meyers, J. E., "Rey complex figure test and recognition trial: Professional manual" Psychological Assessment Resources 1995

26 Benedict, K. H., "Remediation of attention deficits in chronic schizophrenic patients: a preliminary study" 28 : 187-188, 1989

27 Gianutsos, R., "Rehabilitating the verbal recall of brain-injured patients by mnemonic training: an experimental demonstration using single-case methodology" 2 : 117-135, 1979

28 Meltzer, H., "Recent advances in the pharmacotherapy of schizophrenia" 90 : 95-101, 1994

29 Eimon, M. C., "Performance of schizophrenic patients on a motor-free visual perception test" 37 : 327-332, 1983

30 Bracy,O.L, "PSS CogReHab attention manual" Psychological Software Services Inc 1994

31 Seltzer, J., "Neuropsychological rehabilitation in the treatment of schizophrenia" 61 (61): 597-608, 1997

32 Bozikas, V. P., "Neuropsychological profile of cognitively impaired patients with schizophrenia" 47 : 136-143, 2006

33 Saykin, A. J., "Neuropsychological functioning in schizophrenia: selective impairment in memory and learning" 48 : 618-624, 1991

34 Saykin, A. J., "Neuropsychological deficits in neuroleptic naive patients with first-episode schizophrenia" 51 : 124-131, 1994

35 Kim, M. S., "Neuropsychological correlates of P300 abnormalities in patients with schizophrenia and obsessive-compulsive disorder" 123 : 109-123, 2003

36 Groth-Marnat,G, "Neuropsychological assessment in clinical practice: a guide to test interpretation and integration" John Wiley & Sons 2000

37 Lezak, M. D, "Neuropsychological assesment (3rd ed.)" Oxford University Press 1995

38 Rattock, J., "Neuropsychiatry of traumatic brain injury" American Psychiatry Press 703-732, 1994

39 Mohr, F., "Neurological soft signs and neuropsychological performance in patients with first episode schizophrenia" 121 : 21-30, 2003

40 Ritter, I. M., "Neurocognitive measures of prefrontal cortical dysfunction in schizophrenia" 68 : 65-73, 2004

41 Bell, M. D., "Neurocognitive enhancement therapy with work therapy: effects on neurocognitive test performance" 58 : 763-768, 2001

42 Shorr, J. S., "Memory for the Rey-Osterrieth Figure: perceptual clustering, encoding and storage" 6 : 43-50, 1992

43 Bellgrove, M. A., "Local-global processing in early-onset schizophrenia: evidence for an impairment in shifting the spatial scale of attention" 51 : 48-65, 2003

44 염태호, "K-WAIS 실시요강" 한국가이던스 1992

45 Wykes, T., "Is it time to develop a new cognitive therapy for psychosis? Cognitive Remediation Therapy (CRT)" 21 : 1227-1256, 2001

46 Nuechterlein, K. H., "Information-processing abnormalities as neuropsychological vulnerability indicators for schizophrenia" 384 : 71-79, 1994

47 Nuechterlein, K. H., "Information processing and attentional functioning in the developmental course of schizophrenic disorders" 10 : 160-203, 1984

48 Braff,D.L, "Information processing and attention dysfunctions in schizophrenia" 19 : 233-259, 1993

49 Doniger, G. M., "Impaired visual object recognition and dorsal/ventral stream interaction in schizophrenia" 59 : 1011-1020, 2002

50 Chiulli, S. J., "Impact of age on drawing the Rey-Osterrieth figure" 9 : 219-224, 1995

51 Dollfus, S., "Executive/attentional cognitive functions in schizophrenic patients and their parents: a preliminary study" 53 : 93-99, 2002

52 Benedict, R., "Effects of attention training on information processing in schizophrenia" 20 : 537-546, 1994

53 Lopez-Luengo, B., "Effects of attention processing training on cognitive functioning of schizophrenic patients" 119 : 41-53, 2003

54 Medalia, A., "Effectiveness of attention training in schizophrenia" 24 : 147-152, 1998

55 Fiszdon, J. M., "Durability of cognitive remediation training in schizophrenia: performance on two memory tasks at 6-month and 12-month follow-up" 125 : 1-7, 2003

56 Weinberger, D., "Cortical maldevelopment, anti-psychotic drugs and schizophrenia: a search for common ground" 16 : 87-110, 1995

57 Massel, H. K., "Conversation skills training in thought-disordered schizophrenics through attention focusing" 38 : 51-61, 1991

58 Van den Bosch, R. J, "Context and cognition in schizophrenia. In Advances in the neurobiology of schizophrenia" John Wiley & Sons 1995

59 Bellucci, D. M., "Computer-assisted cognitive rehabilitation reduces negative symptoms in the severely mentally ill" 59 : 225-232, 2002

60 Burda, P. C., "Computer-assisted cognitive rehabilitation of chronic psychiatric inpatients" 10 : 359-368, 1994

61 Hermanutz, M., "Computer-assisted attention training in schizophrenics" 240 : 282-287, 1990

62 Poletti, S., "Computer-aided neurocognitive remediation in schizophrenia: durability of rehabilitation outcomes in a follow-up study" 20 : 659-674, 2010

63 Field, C. D., "Computer-aided cognitive rehabilitation: Possible application to the attentional deficit of schizophrenia, a report of negative results" 85 : 995-1002, 1997

64 Bradt, S., "Computer training for the young adult patients with chronic mental illness" 59 : 51-54, 1993

65 Ben-Yishay, Y., "Cognitive remediation in traumatic brain injury: updated and issues" 74 : 204-213, 1993

66 Bracy, O. L, "Cognitive rehabilitation: a process approach" 4 : 10-17, 1985

67 Sartory, G., "Cognitive rehabilitation in schizophrenia" 60 : 155-, 2003

68 Ballack,A.S, "Cognitive rehabilitation for schizophrenia: Is it possible? Is it necessary" 18 : 43-50, 1992

69 Silverstein, S. M., "Cognitive deficits and psychiatric outcomes in schizophrenia" 69 : 169-191, 1998

70 Siever, L. J., "Cognitive and brain function in schizotypal personality disorder" 54 : 157-167, 2002

71 Barkley,R.A, "Behavioral inhibition, sustained attention, and executive functions: Constructing a unifying theory of ADHD" 121 : 65-94, 1997

72 Braff,D.L, "Attention,habituation,and information processing in psychiatric disorders" Lippinott 1-13, 1985

73 Suslow, T., "Attention training in the cognitive rehabilitation of schizophrenic patients: A review of efficacy studies" 103 : 15-23, 2001

74 Bell, M. D., "Attention training in schizophrenia: differing responses to similar tasks" 43 : 490-496, 2009

75 Silverstein, A. B, "Agreement between a short-form and the full scale as a function of the correlation between them" 45 : 929-931, 1989

76 Twamley, E. W., "A review of cognitive training in schizophrenia" 29 : 359-382, 2003

77 McGurk, S. R., "A meta-analysis of cognitive remediation in schizophrenia" 164 : 1791-1802, 2007

78 Fioravanti, M., "A meta-analysis of cognitive deficits in adults with a diagnosis of schizophrenia" 15 : 73-95, 2005

79 Spreen, O., "A compendium of neuropsychological tests (2nd ed.)" Oxford University Press 1998