Neurocognition in psychosis
Cognitive deficits are core symptoms in schizophrenia and bipolar disorders. To fully understand the brain-behavior relation in psychotic disorders and to implement optimal treatment and remediation programs, correct identification and characterization of deficits in memory, attention, executive functioning and social cognition are needed.
Photo: Svein Harald Milde, UiO
Cognitive functioning may be regarded as the behavioral fingerprint of brain functioning. Strengths and weaknesses in thinking, feeling and responding provide a backdrop for how people manage their lives. Cognitive reserves are fueled by the person’s genetic make-up but the neurodevelopmental output is formed in a constant interplay with psychosocial demands. Our aim is to capture the variation in cognitive functioning in people with severe mental illness, and provide more valid diagnoses, better prognostic guidance and improved individualized intervention programs. We assess neurocognitive functions such as memory, attention, executive functioning, intellectual capacities, social cognition etc., using standard neuropsychological paper-and-pencil tests, computerized measures of attention and vigilance, and questionnaires and behavioral measures of social functioning. People with psychosis differ in their cognitive status. Not all individuals show impairments. Measures of structural and functional brain imaging add to the validity of neurocognitive characterization as do clinical ratings of symptoms and functional capacity. We collaborate closely with the clinical and the brain imaging groups in the logistics of data collection in order to validly answer our research questions.
The Neurocognitive Core Resource Unit (N-CRU) conducts neuropsychological assessment of all participants recruited to the study at all time-points (baseline and follow-ups). Cognitive data are essential for several clinical studies and are used to validate findings from gene and/or brain imaging studies. The group’s own research foci are several: a) we search to identify neurocognitive markers of subgroups within psychosis in order to improve precise diagnoses, outcome and treatment; b) we monitor change and stability in neurocognitive functioning to better predict illness trajectories; c) we develop cognitive remediation programs to improve behaviors not fully responding to medication and psychotherapy; d) we look for new measures of specific cognitive mechanisms (i.e. attention) governing more global functions (i.e. memory); and e) we search for measures of social cognition to better predict real-life functioning.
- Cognitive Remediation studies: The group is conducting several remediation studies, focusing on the effect of targeted training of neurocognitive and social cognitive functions in comparison to treatment as usual, and by including work-related as well as social functioning measures.
- The 10-year follow-up study: By comparing neurocognitive trajectories from baseline to follow-up in first episode psychosis we search for markers of different outcomes.
- The ecoval-study focuses on social processes across explanatory levels combining naturalistic observation of real-world functioning with laboratory assessments and functional brain measures (ERPs).
- The Genetics of attention and effort study explores the impact of the functional integrity of the brain’s effort network in schizophrenia, and the effect of psychosis susceptibility genes on cognitive mechanisms impaired in psychosis.
- The Neurocognitive Immune System study investigates how a broad range of immune markers, and their temporal pattern, associate with cognitive measures.
- The Neurocognitive web-based study: Tandem to the eNORMENT initiative, the group is looking for supplemental assessment tools suited for large-scale studies of cognitive functioning.