Search

Individuals with psychotic disorders have deficits in metacognition. Thirty-four adults with schizophrenia were randomized to 2 months of metacognitive training (MCT) or a healthy living skills control group. All participants were enrolled in a work therapy program, followed by a supported employment program. Assessments were conducted at baseline, at the end of the 2-month active intervention, and at 4- and 12-month follow-ups. At the end of active intervention, the MCT group demonstrated greater improvement and better work behavior relative to controls. At follow-up, the MCT group demonstrated significantly greater insight and fewer positive symptoms and a greater percentage were employed in the community. We speculate that being better able to think about one's thoughts, recognize biases in thinking, and correct those thoughts may aid in responding to workplace challenges and hence improve work outcomes.

Virtual Reality Job Interview Training (VR-JIT) is a computerized interview simulator with efficacy at enhancing interview skills and employment outcomes. A randomized controlled trial assessed VR-JIT effectiveness for participants in individual placement and support (IPS), in which approximately 55% of individuals with serious mental illness obtain employment.Ninety participants with serious mental illness were randomly assigned to IPS+VR-JIT (N=54) or IPS as usual (N=36), completing pretest-posttest assessments and an employment evaluation at 9 months. Intent-to-treat chi-square analysis, multivariable logistic regression, Cox proportional hazards models, and mixed-effects linear regressions were conducted. Fifty-one percent were IPS nonresponders (i.e., no employment within the first 90 days of IPS).IPS+VR-JIT participants did not have significantly higher employment rates, compared with IPS-as-usual participants (43% versus 28%). IPS nonresponders (N=46) in the IPS+VR-JIT group had greater odds of obtaining employment (odds ratio [OR]=5.82, p=0.014) and shorter time to employment (hazard ratio=2.70, p=0.044) compared with IPS nonresponders in the IPS-as-usual group. Intent-to-treat mixed-effects linear analyses indicated that IPS+VR-JIT, compared with IPS as usual, significantly improved interview skills (p=0.006), interview confidence (p=0.013), and interview anxiety (p=0.019).VR-JIT's potential benefits (increased employment in a shorter time) appeared to be specific to IPS nonresponders, whereas employment outcomes for recent IPS enrollees were not affected. VR-JIT could be a valuable resource for employment specialists to support IPS nonresponders, because 47% of participants engaged in mock interview training with their specialist. Future research should focus on evaluating the effectiveness and implementation of VR-JIT among IPS nonresponders.

Returning citizens struggle to obtain employment after release from prison and navigating job interviews is a critical barrier they encounter. Implementing evidence-based interview training is a major gap in prison-based vocational services. We conducted a randomized controlled trial (RCT) to evaluate the feasibility and initial effectiveness of Virtual Reality Job Interview Training (VR-JIT) within two prisons. Forty-four male returning citizens were randomized to receive service-as-usual (SAU) with VR-JIT (SAU + VR-JIT, n = 28) or SAU ( n = 16). Participants reported VR-JIT was highly acceptable and usable. SAU + VR-JIT, compared with SAU, had significant improvements (with large effect sizes) in interview skills, interview training motivation, and interview anxiety (all p < .05; [Formula: see text] > .15), and greater employment by 6-month follow-up (odds ratio [OR] = 7.4, p = .045). VR-JIT can potentially help fill a major gap in prison-based services. Future research is needed to validate VR-JIT effectiveness and evaluate VR-JIT implementation strategies within prisons.

Background Pharmacological and psychosocial interventions have only modest efficacy for Alcohol Use Disorder (AUD), and continued alcohol use has brain effects on neurocognition, which place heavy drinkers at increased risk of early onset dementia. The most common neurocognitive deficits are in the domains of executive function and memory, and these deficits may impact AUD treatment outcomes. AUD related Mild Cognitive Impairment (AUD-MCI) is a diagnosis in DSM-V and ICD-10. Donepezil, a cholinesterase inhibitor, is currently FDA approved for treatment of dementia, and recent preclinical research suggests anticholinesterase agents may treat alcoholism. Another approach to cognitive recovery is Cognitive Remediation Therapy (CRT). Recent research supports CRT efficacy in schizophrenia and related disorders, and some research suggests that CRT could improve neurocognition in substance abuse disorders (SUDs). This is the first report of an open-label clinical trial that combined donepezil with CRT to improve neurocognitive and clinical outcomes in the early phase of AUD recovery. Methods Eleven older male US Veterans with AUD-MCI as determined by Level II neurocognitive criteria and who had recently relapsed participated in an open-label trial of 13 weeks of donepezil combined with CRT. They were compared with matched historical control samples on neurocognitive and clinical outcomes. Results Participants had excellent adherence to donepezil and CRT. Neurocognitive improvements were highly significant on a composite score of learning and memory and executive function measures ( p < .0001) and was significantly better than historical matched controls ( p < .001). On a Clinical Global Impression scale, 90.9% of participants had a good clinical recovery compared with 59.5% of historical matched controls ( p Conclusions AUD-MCI has not received much research attention but is of considerable public health importance. Findings in this open-label trial of donepezil + CRT should encourage further investigation into the clinical benefit of this combined treatment for AUD-MCI.

See Whyte and Turkstra (doi:10.1093/brain/awab210) for a scientific commentary on this article. In a randomized controlled trial, Mahncke et al. show that a self-administered computerized cognitive training program drove significant and enduring improvements in cognitive function in people with a history of mild traumatic brain injury and cognitive impairment, compared to an active control (computer games)., Clinical practice guidelines support cognitive rehabilitation for people with a history of mild traumatic brain injury (mTBI) and cognitive impairment, but no class I randomized clinical trials have evaluated the efficacy of self-administered computerized cognitive training. The goal of this study was to evaluate the efficacy of a self-administered computerized plasticity-based cognitive training programmes in primarily military/veteran participants with a history of mTBI and cognitive impairment. A multisite randomized double-blind clinical trial of a behavioural intervention with an active control was conducted from September 2013 to February 2017 including assessments at baseline, post-training, and after a 3-month follow-up period. Participants self-administered cognitive training (experimental and active control) programmes at home, remotely supervised by a healthcare coach, with an intended training schedule of 5 days per week, 1 h per day, for 13 weeks. Participants (149 contacted, 83 intent-to-treat) were confirmed to have a history of mTBI (mean of 7.2 years post-injury) through medical history/clinician interview and persistent cognitive impairment through neuropsychological testing and/or quantitative participant reported measure. The experimental intervention was a brain plasticity-based computerized cognitive training programme targeting speed/accuracy of information processing, and the active control was composed of computer games. The primary cognitive function measure was a composite of nine standardized neuropsychological assessments, and the primary directly observed functional measure a timed instrumental activities of daily living assessment. Secondary outcome measures included participant-reported assessments of cognitive and mental health. The treatment group showed an improvement in the composite cognitive measure significantly larger than that of the active control group at both the post-training [+6.9 points, confidence interval (CI) +1.0 to +12.7, P = 0.025, d = 0.555] and the follow-up visit (+7.4 points, CI +0.6 to +14.3, P = 0.039, d = 0.591). Both large and small cognitive function improvements were seen twice as frequently in the treatment group than in the active control group. No significant between-group effects were seen on other measures, including the directly-observed functional and symptom measures. Statistically equivalent improvements in both groups were seen in depressive and cognitive symptoms.

Embodied cognition assessment may be more closely related to how children function than standard measures of executive functioning (EF) that require little body movement. Activate Test of Embodied Cognition (ATEC) measures cognitive functioning based on cognitively demanding physical tasks assessed using an automated administration with motion capture technology. This study evaluated the psychometrics of ATEC.Children ages 5-11 years were recruited from the community (N = 55). ATEC was performed twice for a subsample, approximately 2 weeks apart. Motion capture data were collected and converted into ATEC Total Score. Concurrent measures included scores from NIH Toolbox for EF (Flanker, Working Memory, Go/No-Go task, Balloon Analogue Risk Task (BART)), and parent reports (Child Behavior Checklist (CBCL), Behavioral Rating Inventory of Executive Function (BRIEF-2) and Swanson, Nolan, and Pelham Rating Scale (SNAP-IV) for ADHD).ATEC Total Score was significantly correlated with concurrent measures of EF and showed significant discriminant validity between At-Risk children and Normal Range children on CBCL Competency, CBCL ADHD Combined score, BRIEF-2 Global Executive Composite, BRIEF-2 Cognitive Regulation Index and SNAP-IV ADHD Combined Score. Regression analyses showed that ATEC Total score was a better predictor of CBCL Competency than any of the standard EF assessments. ATEC Total Score had excellent test-retest reliability, (ICC = .945, df = 27, p < .001) with a small practice effect (Cohen's d = 0.33). ATEC Total Score correlated with age (r = .42, p < .003) suggesting improvement with normal development. ATEC produces reliable scores that may identify children at risk for EF impairments.

OBJECTIVE: In a previous report on a randomized clinical trial of a 3-month program of Cognitive Remediation Therapy (CRT) augmented by work therapy (WT) compared with WT alone for older Veterans with substance use disorder (SUD), we reported significantly greater improvements at six- month follow-up on neurocognitive outcomes of working memory and executive functions for the CRT+WT condition. However, no difference was found between conditions on substance use disorder (SUD) outcomes, with both groups showing unusually high levels of abstinence. In the present study, we extended follow-up to 12 months to test whether there was an SUD outcome “sleeper effect” from CRT+WT. To better understand the effects of WT, we added a treatment-as-usual (TAU) comparison sample. METHOD: 48 Veterans with SUD receiving standard outpatient VA care were randomized into CRT+WT or WT. Clinical Global Impression (CGI) ratings were performed on 43/48 participants with up-to-date medical records. TAU comparison group (n = 44) with similar demographic and illness characteristics was added to the analysis. RESULTS: Treatment groups did not differ significantly at 12 months on CGI (p=.27), with 77% receiving CRT+WT showing favorable SUD outcomes compared to 62% in WT. Both groups had better CGI outcomes (p

While there is increasing support for the efficacy of psychosocial interventions for people with SMI, the real-world effectiveness of such treatments is diminished by lack of motivation for treatment, leading to poor treatment engagement/dropout. We sought to evaluate the efficacy of motivational interviewing (MI) in improving attendance in a full course of cognitive training, examine motivation level as a potential mechanism of action, and examine variables associated with initial engagement in the training.One hundred fourteen participants with SMI were randomized to MI or sham control interview (CI), both of which were followed by a 4-month active phase during which participants could attend up to 50 unpaid cognitive training sessions.Fidelity to the MI intervention was high, and MI condition was associated with increases in perceived value of training tasks and, to a lesser extent, how enjoyable/interesting they were rated. Twenty-nine percent of the full sample did not attend any training sessions. In ITT analyses, there was no significant between-group impact of MI on treatment attendance, though one emerged when participants who did not attend any sessions were excluded. Treatment attendance was predicted by the level of motivation achieved after the MI/CI intervention. Those who attended at least one training session (regardless of randomization) were more likely to believe they had cognitive impairments, had higher IQ and had less severe general psychiatric symptoms.MI showed some promise and may be a worthwhile addition to more comprehensive, robust efforts to promote initial treatment engagement and subsequent adherence.

Autism spectrum disorder (ASD) and schizophrenia (SZ) are separate clinical entities but share deficits in social–emotional processing and static neural functional connectivity patterns. We compared patients’ dynamic functional network connectivity (dFNC) state engagement with typically developed (TD) individuals during social–emotional processing after initially characterizing such dynamics in TD. Young adults diagnosed with ASD (n = 42), SZ (n = 41), or TD (n = 55) completed three functional MRI runs, viewing social–emotional videos with happy, sad, or neutral content. We examined dFNC of 53 spatially independent networks extracted using independent component analysis and applied k-means clustering to windowed dFNC matrices, identifying four unique whole-brain dFNC states. TD showed differential engagement (fractional time, mean dwell time) in three states as a function of emotion. During Happy videos, patients spent less time than TD in a happy-associated state and instead spent more time in the most weakly connected state. During Sad videos, only ASD spent more time than TD in a sad-associated state. Additionally, only ASD showed a significant relationship between dFNC measures and alexithymia and social–emotional recognition task scores, potentially indicating different neural processing of emotions in ASD and SZ. Our results highlight the importance of examining temporal whole-brain reconfiguration of FNC, indicating engagement in unique emotion-specific dFNC states.

Aim: Determine whether effects of poverty on academic achievement are mediated by effects of poverty on executive cognitive functions. Methods: Web-based classroom-administered tests assessed executive function in 5717 children grades k-8 in 40 schools, and poverty level and academic achievement for each school were drawn from US Department of Education data. Boot-strapping procedures were used to evaluate mediation by executive function of the association between poverty and academic proficiency. Results: Executive function and academic achievement were both related to school poverty (pearson r -0.50 to -0.65, p = 0.0009 to 0.0001). Estimated indirect effects of poverty on reading (-0.26, 95% CI: -0.47, -0.07) and math (-0.23, 95% CI: -0.44, -0.06) through effects on executive function were significant. Controlling for executive function, effects of poverty on reading (-0.58 to -0.31) and math (-0.59 to -0.35) were diminished, indicating partial mediation of effects of poverty on reading and math via effects on executive function. Conclusion: Interventions that enhance executive function in children in impoverished and/or violent environments could mitigate damaging effects of these environments on neurocognitive and associated life and health outcomes. Without intervention, many young adults in troubled areas of the world will be ill-prepared for productive function in society.

Importance: The International Classification of Functioning, Disability and Health (ICF) Core Sets (CSs) for schizophrenia are sets of ICF categories that are relevant specifically to the functioning and disability of people with schizophrenia. Objective: To identify the problems occupational therapists commonly encounter when treating people with schizophrenia and to validate the ICF–CSs for schizophrenia from their perspective. Design: Three-round Delphi study using online surveys distributed to occupational therapists worldwide. Participants were asked which problems with functioning they considered most relevant when treating people with schizophrenia. Participants: Occupational therapists experienced in the treatment of people with schizophrenia. Measures: Responses were linked to the ICF categories by two trained health professionals, and a statistical measure of agreement and κ coefficient were calculated. Results: Ninety-two occupational therapists from 29 countries in all six World Health Organization regions named 2,527 meaningful concepts. After the linking process, 121 ICF categories and 31 Personal Factors were presented to the expert panel, who reached consensus (agreement of ≥75%) on 97 ICF categories and 27 Personal Factors. Consensus was reached on the 25 categories in the Brief ICF–CS for schizophrenia and 89 of the 97 categories in the Comprehensive ICF–CS for schizophrenia. Conclusions and Relevance: The ICF Core Sets for schizophrenia were validated from the perspective of occupational therapists and are potentially useful tools for clinical practice because they cover a wide variety of problems that occupational therapists deal with in interventions with people with schizophrenia. What This Article Adds: The ICF–CSs for schizophrenia are useful guides for describing and classifying functioning, disability, and health to aid occupational therapy intervention with people with schizophrenia. Occupational therapists are essential in the rehabilitation of this client population, and their perspective has contributed to the development and enrichment of the ICF–CSs for schizophrenia.

Background IQ and IQ decline are considered risk factors for poor prognosis in people with a diagnosis of schizophrenia. However, it is still not clear if, at least in part, IQ and IQ decline influence long-term outcomes via a negative effect on interventions. Aim To identify whether current IQ, estimated premorbid IQ, or IQ decline moderate the response to cognitive remediation (CR). Method Individual participant data from twelve randomised controlled trials of CR were considered. Hierarchical and k-means analyses were carried out to identify different IQ clusters. The moderating effect of estimated premorbid IQ, current IQ, and different IQ clusters (preserved, deteriorated and compromised trajectories) on cognitive outcomes at post-therapy and follow-up were evaluated using multiple linear regression. Results Data from 984 participants (CR = 544, control = 440) with schizophrenia and schizoaffective disorders were considered. The sample had a mean current IQ of 84.16 (SD 15.61) and estimated premorbid IQ of 95.82 (SD 10.63). Current IQ moderated working memory outcomes: people with higher IQ had larger working memory gains after therapy compared to those with a lower IQ. Those with a preserved IQ had better cognitive outcomes compared to either the deteriorated or compromised IQ groups, and those with a deteriorated IQ had better outcomes compared to those in the compromised IQ group. Conclusion Current IQ is a significant moderator of cognitive gains after CR. These findings highlight the need to evaluate whether therapy adaptations (e.g. offering more sessions) can attenuate this effect so that those with lower IQ may derive benefit similar to those with higher IQ.

Job interviewing is often the first big hurdle for people seeking employment and may be especially difficult for someone with a psychiatric disorder or disability. Performing well in a job interview often requires coping with the emotional demands of the interaction and having the necessary social skills to establish rapport with the interviewer in order to present oneself in a favorable way. Virtual Reality Job Interview Training (VR-JIT) was created specifically for people with severe and persistent mental illness (SPMI) and other potential employment handicaps (e.g., physical disability, felony convictions, first job) to help them overcome their fears, learn the necessary skills, and develop self-confidence to do well during a job interview. The chapter begins by reviewing vocational rehabilitation services for individuals with SPMI, explains the scientific foundations of the VR-JIT training program, describes the special features of the online tool, and presents research findings on its acceptability and efficacy among individuals with SPMI and other disabilities. The authors observed that trainees largely adhered to VR-JIT and could master the skills and earn excellent scores by the end of training. VR-JIT had a moderate to large effect on improving job interview skills in live role-play interviews and increasing self-confidence for job interviews. Moreover, 6-month follow-up survey results suggest that VR-JIT increased access to employment or other competitive volunteer positions as well as reduced the number of weeks to obtaining their employment goal

BackgroundCognitive deficits at the first episode of schizophrenia are predictive of functional outcome. Interventions that improve cognitive functioning early in schizophrenia are critical if we hope to prevent or limit long-term disability in this disorder.MethodsWe completed a 12-month randomized controlled trial of cognitive remediation and of long-acting injectable (LAI) risperidone with 60 patients with a recent first episode of schizophrenia. Cognitive remediation involved programs focused on basic cognitive processes as well as more complex, life-like situations. Healthy behavior training of equal treatment time was the comparison group for cognitive remediation, while oral risperidone was the comparator for LAI risperidone in a 2 × 2 design. All patients were provided supported employment/education to encourage return to work or school.ResultsBoth antipsychotic medication adherence and cognitive remediation contributed to cognitive improvement. Cognitive remediation was superior to healthy behavior training in the LAI medication condition but not the oral medication condition. Cognitive remediation was also superior when medication adherence and protocol completion were covaried. Both LAI antipsychotic medication and cognitive remediation led to significantly greater improvement in work/school functioning. Effect sizes were larger than in most prior studies of first-episode patients. In addition, cognitive improvement was significantly correlated with work/school functional improvement.ConclusionsThese results indicate that consistent antipsychotic medication adherence and cognitive remediation can significantly improve core cognitive deficits in the initial period of schizophrenia. When combined with supported employment/education, cognitive remediation and LAI antipsychotic medication show separate significant impact on improving work/school functioning.

The Michigan Department of Corrections operates the Vocational Villages, which are skilled trades training programs set within prisons that include an immersive educational community using virtual reality, robotics, and other technologies to develop employable trades. An enhancement to the Vocational Villages could be an evidence-based job interview training component. Recently, we conducted a series of randomized controlled trials funded by the National Institute of Mental Health to evaluate the efficacy of virtual reality job interview training (VR-JIT). The results suggested that the use of VR-JIT was associated with improved job interview skills and a greater likelihood of receiving job offers within 6 months. The primary goal of this study is to report on the protocol we developed to evaluate the effectiveness of VR-JIT at improving interview skills, increasing job offers, and reducing recidivism when delivered within two Vocational Villages via a randomized controlled trial and process evaluation. Our aims are to: (1) evaluate whether services-as-usual in combination with VR-JIT, compared to services-as-usual alone, enhances employment outcomes and reduces recidivism among returning citizens enrolled in the Vocational Villages; (2) evaluate mechanisms of employment outcomes and explore mechanisms of recidivism; and (3) conduct a multilevel, mixed-method process evaluation of VR-JIT implementation to assess the adoptability, acceptability, scalability, feasibility, and implementation costs of VR-JIT.

Highlights • Autism spectrum disorder (ASD) & schizophrenia (SZ) have mentalizing deficits. • Spatially constrained ICA reveals shared deficits in mentalizing default mode activity. • Mentalizing-related temporoparietal junction activity correlated with ADOS scores in ASD. • Mentalizing-related precuneus activity correlated with tendency to fantasize in SZ. • Both categorical and RDoC approaches to study neural deficits in SZ & ASD are supported., Schizophrenia and autism spectrum disorder (ASD) are nosologically distinct neurodevelopmental disorders with similar deficits in social cognition, including the ability to form mental representations of others (i.e., mentalizing). However, the extent of patient deficit overlap in underlying neural mechanisms is unclear. Our goal was to examine deficits in mentalizing task-related (MTR) activity modulation in schizophrenia and ASD and the relationship of such deficits with social functioning and psychotic symptoms in patients. Adults, ages 18–34, diagnosed with either ASD or schizophrenia, and typically developed controls (n = 30/group), performed an interactive functional MRI Domino task. Using independent component analysis, we analyzed game intervals known to stimulate mentalizing in the default mode network (DMN), i.e., medial prefrontal cortex (MPFC), posterior cingulate cortex (PCC), precuneus, and temporoparietal junction (TPJ), for group differences in MTR activity and associations between MTR activity and social and psychosis measures. Compared to controls, both schizophrenia and ASD groups showed MTR activity deficits in PCC and TPJ. In TPJ and MPFC, MTR activity modulation was associated with social communication impairments only in ASD. In precuneus, MTR activity was associated with increased self-reported fantasizing only in schizophrenia. In schizophrenia, we found no indication of over-mentalizing activity or an association between MTR activity and psychotic symptoms. Results suggest shared neural deficits between ASD and schizophrenia in mentalizing-associated DMN regions; however, neural organization might correspond to different dimensional social deficits. Our results therefore indicate the importance of examining both categorical-clinical diagnosis and social functioning dimensional constructs when examining neural deficits in schizophrenia and ASD.

BACKGROUND: Meta-analyses have reported that the effects of cognitive remediation might go beyond improvement in cognition to include unexpected benefits for schizophrenia patients such as negative symptom reduction and improvements in functioning. In addition, some evidence indicated that these potentially beneficial effects are also present in the initial course of schizophrenia, but work in this area is still developing. METHOD: A RCT compared Cognitive Remediation (CR) to Healthy Behaviors Training (HBT) in 80 patients (78% male) with a mean age of 21.9 years and mean education of 12.3 years who had a first psychotic episode within two years of study entry. Participants were trained using CR programs or received HBT involving 50 sessions over 6 months and then booster sessions over the next 6 months. The SANS and BPRS were used to assess symptoms. The UCLA Social Attainment Survey assessed social functioning. RESULTS: Using GLMM, improvements over 12 months were found favoring CR for SANS Expressive Symptoms (p

Schizophrenia (SZ) and Autism Spectrum Disorder (ASD) show overlap in social cognitive and functioning impairments. Proposed predictors of social functioning (SF) and quality of life (QL) have been symptom severity, IQ and social cognition. Empathy has rarely been compared between ASD and SZ and its predictive power on functional outcomes is unclear. We investigated general, affective, and cognitive empathy in 46 SZ, 30 ASD and 51 healthy controls (HC) and examined their relationship to SF and QL in addition to IQ and symptoms. SZ and ASD shared deficits in general and cognitive empathy, and personal distress, but only SZ showed deficits in affective empathy. Both groups showed lower performance-based empathy scores and only ASD showed slower responses compared to HC. Negative symptoms predicted QL in both groups, the more negative symptoms the worse QL (ASD t=-3.22; SZ t= -3.43; p0.01), and only in ASD, IQ predicted QL, the higher the IQ the higher QL (t = 2.1; p0.05). In ASD only, negative symptoms predicted SF, the greater negative symptoms the worse SF (t=-3.45; p0.01), and communication deficits predicted SF, the higher deficits, the higher SF (t = 2.9; p0.01). Negative symptoms but not empathy were the shared predictors of functioning across ASD and SZ.

BackgroundRecent theories suggest that poor working memory (WM) may be the cognitive underpinning of negative symptoms in people with schizophrenia. In this study, we first explore the effect of cognitive remediation (CR) on two clusters of negative symptoms (i.e. expressive and social amotivation), and then assess the relevance of WM gains as a possible mediator of symptom improvement.MethodData were accessed for 309 people with schizophrenia from the NIMH Database of Cognitive Training and Remediation Studies and a separate study. Approximately half the participants received CR and the rest were allocated to a control condition. All participants were assessed before and after therapy and at follow-up. Expressive negative symptoms and social amotivation symptoms scores were calculated from the Positive and Negative Syndrome Scale. WM was assessed with digit span and letter-number span tests.ResultsParticipants who received CR had a significant improvement in WM scores (d = 0.27) compared with those in the control condition. Improvements in social amotivation levels approached statistical significance (d = −0.19), but change in expressive negative symptoms did not differ between groups. WM change did not mediate the effect of CR on social amotivation.ConclusionsThe results suggest that a course of CR may benefit behavioural negative symptoms. Despite hypotheses linking memory problems with negative symptoms, the current findings do not support the role of this cognitive domain as a significant mediator. The results indicate that WM improves independently from negative symptoms reduction.

Background Heterogeneity in work outcomes is common among individuals with serious mental illness (SMI). Objective In 2 studies, we sought to examine the efficacy of adding errorless learning, a behavioral training intervention, to evidence-based supported employment to improve SMI work outcomes. Work behavior problems were targeted for intervention. We also explored associations between early work behavior and job tenure. Methods For both studies (VA: n = 71; community mental health center: n = 91), randomization occurred at the time of job obtainment with participants randomized (1:1) to either errorless learning plus ongoing supported employment or ongoing supported employment alone and then followed for 12 months. Dependent variables included job tenure, work behavior, and hours worked and wages earned per week. For the primary intent-to-treat analyses, data were combined across studies. Results Findings revealed that participants in the errorless learning plus supported employment group stayed on their jobs significantly longer than those in the supported employment alone group (32.8 vs 25.6 wk). In addition, differential treatment effects favoring errorless learning were found on targeted work behavior problems (50.5% vs 27.4% improvement from baseline to follow-up assessment). There were no other differential treatment effects. For the prediction analyses involving work behavior, social skills explained an additional 18.3% of the variance in job tenure beyond levels of cognition, symptom severity, and past work history. Conclusions These data support errorless learning as an adjunctive intervention to enhance supported employment outcomes and implicate the relevance of workplace social difficulties as a key impediment to prolonged job tenure.

Objective Cognitive remediation therapy (CRT) is reported to improve neurocognitive and substance use disorder (SUD) outcomes in residential treatments. This National Institute of Drug Abuse funded pilot study reports on CRT as an augmentation to outpatient treatment for SUD. Method Recovering outpatient veterans were randomized into CRT + Work Therapy (n = 24) or work therapy (n = 24) with treatment-as-usual. Blind assessments of neurocognition and substance use were performed at baseline, 3 months (end of treatment), and 6-month follow-up. Results Baseline assessments revealed high rates of cognitive impairment with 87.5% showing significant decline from premorbid IQ on at least 1 measure (median = 3/14 measures). Adherence to treatment was excellent. Follow-up rates were 95.7% at 3 months and 87.5% at 6 months. Mixed effects models of cognitive change over time revealed significant differences favoring CRT + Work Therapy on working memory (WM) and executive function indices. Global index of cognition showed a nonsignificant trend (effect size [ES] = .37) favoring CRT + Work Therapy. SUD outcomes were excellent for both conditions. CRT + Work Therapy had a mean of 97% days of abstinence at 3 months, 94% in the 30 days prior to 6-month follow-up, and 24/26 weeks of total abstinence; differences between conditions were not significant. Conclusions and implications for practice CRT was well accepted by outpatient veterans with SUDs and led to significant improvements in WM and executive functions beyond that of normal cognitive recovery. No difference between conditions was found for SUD outcomes, perhaps because work therapy obscured the benefits of CRT. (PsycINFO Database Record

As mobile technologies have become ubiquitous in recent years, computer-based cognitive tests have become more popular and efficient. In this work, we focus on assessing motor function in children by analyzing their gait movements. Although there has been a lot of research on designing automated assessment systems for gait analysis, most of these efforts use obtrusive wearable sensors for measuring body movements. We have devised a computer vision-based assessment system that only requires a camera which makes it easier to employ in school or home environments. A dataset has been created with 27 children performing the test. Furthermore, in order to improve the accuracy of the system, a deep learning based model was pre-trained on NTU-RGB+D 120 dataset and then it was fine-tuned on our gait dataset. The results highlight the efficacy of proposed work for automating the assessment of children’s performances by achieving 76.61% classification accuracy.

Over the recent years there has been a growing debate regarding the extent and nature of the overlap in neuropathology between schizophrenia (SZ) and autism spectrum disorder (ASD). Dynamic functional network connectivity (dFNC) is a recent analysis method that explores temporal patterns of functional connectivity (FC). We compared resting-state dFNC in SZ, ASD and healthy controls (HC), characterized the associations between temporal patterns and symptoms, and performed a three-way classification analysis based on dFNC indices.Resting-state fMRI was collected from 100 young adults: 33 SZ, 33 ASD, 34 HC. Independent component analysis (ICA) was performed, followed by dFNC analysis (window = 33 s, step = 1TR, k-means clustering). Temporal patterns were compared between groups, correlated with symptoms, and classified via cross-validated three-way discriminant analysis.Both clinical groups displayed an increased fraction of time (FT) spent in a state of weak, intra-network connectivity [p .001] and decreased FT in a highly-connected state [p .001]. SZ further showed decreased number of transitions between states [p .001], decreased FT in a widely-connected state [p .001], increased dwell time (DT) in the weakly-connected state [p .001], and decreased DT in the highly-connected state [p = .001]. Social behavior scores correlated with DT in the widely-connected state in SZ [r = 0.416, p = .043], but not ASD. Classification correctly identified SZ at high rates (81.8%), while ASD and HC at lower rates.Results indicate a severe and pervasive pattern of temporal aberrations in SZ (specifically, being "stuck" in a state of weak connectivity), that distinguishes SZ participants from both ASD and HC, and is associated with clinical symptoms.

This paper focuses on creating video-based human activity recognition methods towards an automated cognitive assessment system for children. We present the Activate Test for Embodied Cognition (ATEC), which assesses executive functioning in children through physical/cognitive tasks. Detecting activities for children is challenging due to high amount of random motion and variability. This paper focuses on creating a ubiquitous and non-intrusive activity recognition system for upper-body movements. Our proposed methods are evaluated on real-world data from children performing the Cross-your-Body task. The dataset includes 15 children performing 8 types of activities, resulting to 1900 annotated video samples.

Cognitive remediation is now widely recognized as an effective treatment for cognitive deficits in schizophrenia. Its effects are meaningful, durable, and related to improvements in everyday functional outcomes. As with many therapies, the evolution of cognitive remediation has resulted in treatment programs that use a variety of specific techniques, yet share common core principles. This paper is the product of a cognitive remediation expert working group consensus meeting to identify core features of the treatment and produce recommendations for its design, conduct, reporting, and implementation. Four techniques were identified as core features of cognitive remediation: facilitation by a therapist, cognitive exercise, procedures to develop problem-solving strategies, and procedures to facilitate transfer to real world functioning. Treatment techniques within each of these core features are presented to facilitate decisions for clinical trials and implementation in clinical settings.

In this paper, we present our preliminary data analysis towards an automated assessment system for the Sailor Step task. The Sailor Step task is an embodied cognition task designed to assess attention, working memory, response inhibition, rhythm and coordination in children. Children must remember instructions and coordinate their movements following visual cues presented during a themed video clip. Skeleton data were collected through the Kinect camera. This paper presents an overview of the assessment task, the data collection and annotation with a preliminary analysis towards an automated scoring system through motion capture analysis methods.

BACKGROUND: The observation that individuals with schizophrenia tend to misinterpret subtle social cues is often attributed to deficit in Theory of Mind (ToM). While ToM is commonly assessed using videos portraying interaction between actors, recent work in vision science shows that stimuli with no innate animate features can also convey similar social information through motion alone. These simplified stimuli are advantageous for experimental purposes and may provide further insights into perceptual mechanisms supporting social cognitive function. The Social Attribution Task-Multiple Choice (SAT-MC), based on the classic Hieder and Simmel (1944) stimuli, tells a story using three geometric shapes moving about a centrally fixed figure, followed by questions about what the viewer observed. Although there are no explicit social cues, viewers typically detect actions suggestive of relationships between objects, their intentions, and emotions. This talk will present findings from three studies examining psychometric, functional, and neurophysiological aspects on SAT -MC performance in schizophrenia. METHODS: Study 1 examined psychometric properties of two forms of the SAT-MC in comparison to video-based social cognitive tests using human actors in 32 schizophrenia (SZ) and 30 substance use disorder (SUD) participants. Study 2 examined functional relationships of the SAT-MC and affect recognition (BLERT) performance across neurocognitive, metacognitive, ToM, and symptom domains in 72 adults with SZ. Study 3 is an in-progress investigation of neurophysiological mechanisms of social cognition using test versions adapted for EEG recording. Chronic SZ, clinical high-risk (CHR), and healthy age-matched community samples are being collected. RESULTS: SZ scored significantly lower than SUD on two versions of the SAT-MC, each classifying ~60% of SZ as impaired, compared with ~30% of SUD. The two SAT-MC forms demonstrated good test-retest and parallel form reliability, minimal practice effect, high internal consistency, similar patterns of correlation with social cognitive test performance, and compared favorably to social cognitive tests across psychometric features. When examining functional correlates of SAT -MC performance, impairment is found to co-occur with deficits in affect recognition in the majority of cases but relates uniquely to reductions in verbal memory and emotional intelligence measures. Finally, a preliminary analysis (n=8 SZ, n=2 CHR) of EEG collected during SAT-MC video presentation finds significant correlations (r=.66-.72) between occipito-parietal gamma desynchronization and task performance. Additional analyses find task-related EEG during SAT to be predictive of affect recognition (BLERT) and ToM (TASIT) performance, with correlates including alpha desynchronization in frontal, occipital, and temporal regions, and synchronization of temporal theta and occipital gamma (all r > .5). CONCLUSIONS: SAT-MC performance is found to be reliable using different stimuli, related to affect recognition and ToM in three independent samples, and shows high diagnostic specificity in classifying SZ against a SUD sample. Functional correlates also involve encoding and emotional intelligence abilities tested outside the visual modality. Analysis of neural oscillatory activity related SAT-MC performance to visual and attention processes, as well as engagement of a broader social cognitive network applied to affect recognition and ToM tasks. Impairment in visual motion processing appears integral to schizophrenia pathophysiology and a critical factor influencing social cognitive abilities attributed to higher-order ToM ability.

BackgroundThe popularity of cognitive remediation (CR) interventions for individuals with psychosis is in part based on the well-established link between cognition and functioning and the assumption that by targeting cognition, function can improve. While numerous trials have reported CR's efficacy, it is still not considered an evidence-based treatment. Importantly, little is known about the mechanisms through which it may affect functioning.MethodIn this study, we evaluated CR's proximal and distal effects, and examined potential mechanisms. A total of 75 individuals with psychotic disorders were randomized to a combination of strategy-based and drill-and-practice CR or wait-list control, with assessments of training task performance, neurocognition, functional capacity, symptoms and functioning conducted at baseline, end of the 2-month intervention, and 2-month follow-up.ResultsCompared with treatment as usual, CR was associated with large post-training improvements on training tasks targeting attention, visuospatial memory, and verbal learning and memory, with persisting group differences at the 2-month follow-up. These generalized to mostly large improvements on neuropsychological measures targeting visuospatial memory, verbal learning and memory, delayed verbal memory and verbal working memory. While there were no CR-associated improvements on measures of functional capacity, symptoms, or a self-report measure of independent living skills, there was an effect on an interviewer-rated measure of functioning (Quality of Life Scale), which appeared primarily driven by the Intrapsychic Foundations subscale. Finally, for those randomized to CR, there were significant, medium-sized correlations between training task improvement, neuropsychological improvement and functioning measures.ConclusionsThis suggests a complex, multifactorial relationship between CR, and cognitive and functional change.

BACKGROUND: Individuals with substance use disorders (SUDs) have low employment rates and job interviewing is a critical barrier to employment for them. Virtual reality training is efficacious at improving interview skills and vocational outcomes for several clinical populations. OBJECTIVE: This study evaluated the acceptability and efficacy of virtual reality job interview training (VR-JIT) at improving interview skills and vocational outcomes among individuals with SUDs via a small randomized controlled trial (n = 14 VR-JIT trainees, n = 11 treatment-as-usual (TAU) controls). METHODS: Trainees completed up to 10 hours of virtual interviews, while controls received services as usual. Primary outcome measures included two pre-test and two post-test video-recorded role-play interviews and vocational outcomes at six-month follow-up. RESULTS: Trainees reported that the intervention was easy-to-use and helped prepared them for future interviews. While co-varying for pre-test role-play performance, trainees had higher post-test role-play scores than controls at the trend level (p < 0.10). At 6-month follow-up, trainees were more likely than controls to attain a competitive position (78.6% vs. 44.4%, p < 0.05, respectively). Trainees had greater odds of attaining a competitive position by 6 month follow-up compared to controls (OR: 5.67, p < 0.05). VR-JIT participation was associated with fewer weeks searching for a position (r = –0.36, p < 0.05). CONCLUSION: There is preliminary evidence that VR-JIT is acceptable to trainees with SUDs. Moreover, VR-JIT led to better vocational outcomes with trainees having greater odds of attaining a competitive position by 6-month follow-up. Future studies could evaluate the effectiveness of VR-JIT within community-based services.

Background: Millions of children raised in unstable, impoverished or violent environments fall behind more fortunate peers in brain development, executive cognitive functions (EF), and academic achievement, general health and employment outcomes. It is important to empirically demonstrate the relation between environment-related compromised EF and compromised functional life outcomes in order to establish that interventions to enhance EF in high-risk children could mitigate life-long effects of adverse rearing environments. Methods: EF was assessed in 5717 children grades k-8 in 40 schools across the United States with web-based classroom-administered tests, and poverty level and academic achievement for each school drawn from US Department of Education data. A regression-based EF factor score was used to evaluate the degree of mediation by EF of the association between poverty and academic proficiency. Findings: EF and academic achievement were both related to school poverty (pearson r -.50 to - .65, p =.0009 to

Individual Placement and Support (IPS) is the evidence-based model of supported employment that increases employment rates in adults with severe mental illness (SMI). Although IPS is largely successful, over 80% of adults with SMI remain unemployed. An enhancement to high fidelity IPS could be an evidence-based job interview training component. To meet this training need, our group recently completed a series of randomized controlled efficacy trials funded by the National Institute of Mental Health to develop and test virtual reality job interview training (VR-JIT) in a lab setting. The results demonstrated that the intervention was efficacious at helping trainees improve their job interview skills and receive job offers within six months of completing VR-JIT compared to non-trainees. The overarching goal of this study is to evaluate the effectiveness of VR-JIT as an enhancement to IPS when delivered in a large community-based mental health service provider via a randomized controlled trial and initial process evaluation. Our aims are to: evaluate whether IPS services-as-usual in combination with VR-JIT, compared to IPS services-as-usual alone, enhances IPS outcomes for adults with SMI; evaluate mechanisms of employment outcomes and psychological distress; and conduct a multilevel, multidisciplinary, and mixed-method process evaluation of VR-JIT adoption and implementation to assess the acceptability, scalability, generalizability, and affordability of VR-JIT.

Risk-taking, when unregulated by good executive function, may predispose youth to potentially dangerous behaviors such as substance abuse, unsafe sex practices, and criminal activity. The computer-based Balloon Analogue Risk Task (BART) has been widely used to study risk-taking propensity and predict real-world risky behaviors. We administered the youth version BART-Y to 6,929 children between grades K-8 and hypothesize that executive function, a cognitive skillset for self-regulation controlled by the frontal lobe, improves risk tolerance. Our preliminary results show that BART Total Points increased across grades and also significantly improved (p

Recent research has shown that hundreds of millions of workers worldwide may lose their jobs to robots and automation by 2030, impacting over 40 developed and emerging countries and affecting more than 800 types of jobs. While automation promises to increase productivity and relieve workers from tedious or heavy-duty tasks, it can also widen the gap, leaving behind workers who lack automation training. In this project, we propose to build a technologically based, personalized vocational cyberlearning training system, where the user is assessed while immersed in a simulated workplace/factory task environment, and the system collecting and analyzing multisensory cognitive, behavioral and physiological data. Such a system, will produce recommendations to support targeted vocational training decision-making. The focus is on collecting and analyzing specific neurocognitive functions that include, working memory, attention, cognitive overload and cognitive flexibility. Collected data are analyzed to reveal, in iterative fashion, relationships between physiological and cognitive performance metrics, and how these relate to work-related behavioral patterns that require special vocational training.

This study focused on the efficacy of cognitive training for verbal learning and memory deficits in a population of older veterans with alcohol use disorders.Veterans with alcohol use disorders, who were in outpatient treatment at VA facilities and in early-phase recovery (N = 31), were randomized to receive a three-month trial of daily cognitive training plus work therapy (n = 15) or work therapy alone (n = 16), along with treatment as usual. Participants completed assessments at baseline and at three- and six-month follow-ups; the Hopkins Verbal Learning Task (HVLT) was the primary outcome measure.Participants were primarily male (97%) and in their mid-50s (M = 55.16, SD = 5.16) and had been sober for 1.64 (SD = 2.81) months. Study retention was excellent (91% at three-month follow-up) and adherence to treatment in both conditions was very good. On average, participants in the cognitive training condition had more than 41 hours of cognitive training, and both conditions had more than 230 hours of productive activity. HVLT results at three-month follow-up revealed significant condition effects favoring cognitive training for verbal learning (HVLT Trial-3 T-score, p.005, Cohen's d = 1.3) and verbal memory (HVLT Total T-score, p.01, Cohen's d = 1.1). Condition effects were sustained at six-month follow-up. At baseline, 55.9% of participants showed a significant deficit in verbal memory and 58.8% showed a deficit in verbal learning compared with a premorbid estimate of verbal IQ. At three-month follow-up there was a significant reduction in the number of participants in the cognitive training condition with clinically significant verbal memory deficits (p.01, number needed to treat = 3.0) compared with the work therapy alone condition and a trend toward significance for verbal learning deficits, which was not sustained at six-month follow-up.This National Institute on Drug Abuse-funded pilot study demonstrates that cognitive training within the context of another activating intervention (work therapy) may have efficacy in remediating verbal learning and memory deficits in patients with alcohol use disorder. Findings indicate a large effect for cognitive training in this pilot study, which suggests that further research is warranted. This study is registered on ClinicalTrials.gov (NCT 01410110).

The MCCB is widely used in clinical trials of schizophrenia, but its relationship to occupational functioning still needs further elaboration. While previous research has indicated that various domains of neurocognition assessed by individual tests are related to work functioning, these reports preceded the development of the MCCB as the standard neurocognitive test battery in the field. In the current study, the vocational functioning of 131 Norwegian participants with schizophrenia spectrum disorders who were enrolled in a vocational rehabilitation program were assessed on the Vocational Cognitive Rating Scale (VCRS), the Work Behavior Inventory (WBI), and the Complexity Scale (CS) as well as on the MCCB. Significant correlations were found between most MCCB domains and VCRS Total Score. MCCB processing speed and attention were most powerfully related to and predictive of WBI scores. When participants were divided into "low complexity" or "higher complexity" work categories, participants in the "low-complexity" group performed significantly worse than participants in the "higher-complexity" group regarding processing speed, working memory, visual learning and the composite score. The same pattern emerged for participants working sheltered compared to competitive jobs. The VCRS, WBI and CS may be useful in vocational rehabilitation. They bridge an important gap between test- and occupational-setting, providing valuable information about impairments related to occupational functioning. We found the MCCB to be sensitive to occupational functioning as measured by VCRS, WBI and CS, with neurocognition accounting for a small but significant proportion of the variance in these different measures of occupational functioning.

Adherence to treatment in psychiatric populations is notoriously low. In this randomized, controlled, proof-of-concept study, we sought to examine whether motivational interviewing (MI) could be used to enhance motivation for, adherence to, and benefit obtained from cognitive rehabilitation. Dual diagnosis MI, developed specifically for individuals with psychotic symptoms and disorganization, was further adapted to focus on cognitive impairments and their impact. Sixty-four outpatients diagnosed with schizophrenia spectrum disorders completed baseline assessments and were randomized to receive either the 2-session MI focused on cognitive functioning or a 2-session sham control interview focused on assessment and feedback about preferred learning styles. Next, all participants were given 4 weeks during which they could attend up to 10 sessions of a computer-based math training program, which served as a brief analog for a full course of cognitive rehabilitation. As hypothesized, MI condition was associated with greater increases in task-specific motivation along with greater training program session attendance. Moreover, postinterview motivation level predicted session attendance. There were no significant differences in improvement on a measure of cognitive training content, which may have been due to the abbreviated nature of the training. While the literature on the efficacy of MI for individuals with psychosis has been mixed, we speculate that our positive findings may have been influenced by the adaptations made to MI as well as the focus on a nonpharmacological intervention.

Objectives The present study aims to investigate the synergistic effects of cognitive remediation training (CRT) on Integrated Supported Employment (ISE). ISE blends individual placement support service with work-related social skills training for Chinese people suffering from schizophrenia or schizoaffective disorder. Method Ninety participants with schizophrenia or schizoaffective disorders were recruited from two psychiatric outpatient services in Hong Kong. They were randomly assigned into the ISE + CRT (n = 45) and ISE (n = 45) conditions. Blinded assessments on vocational, clinical, psychological, and neurocognitive outcomes were conducted by independent assessors. The two groups were followed up at 7 and 11 months. Results Both groups yielded similar improvements across several outcome domains assessed immediately after the interventions and at 7 and 11 month follow-ups, but no significant group differences were found. Significant positive trends over time in vocational, clinical and cognitive outcomes consistently favored the ISE + CRT condition. Conclusion While both the ISE + CRT and ISE groups demonstrated improvement in vocational, clinical, psychological, and neurocognitive outcomes, there was no evidence to show that cognitive remediation facilitated further improvement in these domains beyond gains associated with ISE alone. Further investigation is needed to fully exploit the synergistic potential of ISE combined with CRT, and to better understand which individuals experience a maximal benefit from the specific rehabilitation program components.

Young adults with high-functioning autism spectrum disorder (ASD) have low employment rates and job interviewing presents a critical barrier to employment for them. Results from a prior randomized controlled efficacy trial suggested virtual reality job interview training (VR-JIT) improved interviewing skills among trainees with ASD, but not controls with ASD. We conducted a brief survey with 23 of 26 participants from this study to evaluate their vocational outcomes at 6-month follow-up with a focus on whether or not they attained a competitive position (employment or competitive volunteering). Logistic regression indicated VR-JIT trainees had greater odds of attaining a competitive position than controls (OR 7.82, p < 0.05). Initial evidence suggests VR-JIT is a promising intervention that enhances vocational outcomes among young adults with high-functioning ASD.

Cognitive remediation performed in a cognitive laboratory was compared with a sham control using portable brain games to study effects on vocational, neurocognitive, and functional outcomes for participants with psychotic disorders in vocational rehabilitation (VR). Seventy-seven participants (61% schizophrenia, 39% other psychosis) in transitional (45.5%) or supported employment (54.5%) were randomly assigned to 6 months of portable cognitive-games (CG) or cognitive remediation (CR) plus a weekly goal-setting group, and evaluated during training, post-training and at 12 months. Overall rates of employment did not differ significantly at 12-month follow-up; however, VR + CG attained employment more rapidly during training. A significant time by condition interaction favored VR + CR on Quality of Life Total Score and Instrumental Functioning over 12 months. Neurocognitive outcomes favored VR + CR, particularly on attention. Training hours related significantly to neurocognitive improvement regardless of condition. No differences were found in training adherence despite portability for VR + CG. Results indicate that VR + CR had significantly greater effect than VR + CG on neurocognition and community functioning, but not on employment outcome. Job attainment rates during the training period revealed a potential advantage for portable training raising new questions concerning how cognitive remediation can be most effectively integrated with VR.

This study introduces a computerized clinical decision-support tool, the Fluid Outpatient Rehabilitation Treatment (FORT), that incorporates individual and ever-evolving patient needs to guide clinicians in developing and updating treatment decisions in real-time. In this proof-of-concept feasibility pilot, FORT was compared against traditional treatment planning using similar behavioral therapies in 52 adults with severe mental illness attending community-based day treatment. At posttreatment and follow-up, group differences and moderate-to-large effect sizes favoring FORT were detected in social function, work readiness, self-esteem, working memory, processing speed, and mental flexibility. Of participants who identified obtaining a General Education Diploma as their goal, 73% in FORT passed the examination compared with 18% in traditional treatment planning. FORT was also associated with higher agency cost-effectiveness and a better average benefit-cost ratio, even when considering diagnosis, baseline symptoms, and education. Although the comparison groups were not completely equivalent, the findings suggest computerized decision support systems that collaborate with human decision-makers to personalize psychiatric rehabilitation and address critical decisions may have a role in improving treatment effectiveness and efficiency.

Theory of mind (ToM) is the ability to understand mental states of others and it is crucial for building sensitivity to other persons or events. Measuring ToM is important for understanding and rehabilitating social cognitive impairments in persons with schizophrenia. The Social Attribution Task-Multiple Choice (SAT-MC) has been successfully employed to measure ToM between individuals with schizophrenia (SZ) and healthy controls (HC) in North America. Given that the SAT-MC uses geometric shapes, is nonverbal and less culturally loaded than other social cognition measures, it may serve for measuring ToM in schizophrenia across cultures. A total of 120 participants (30 per group; Korean SZ; Korean HC; North American SZ; North American HC) were selected from existing databases to examine the reliability and validity of the SAT-MC. Internal consistency, factor structure, measurement invariance, discriminant validity, and convergent/divergent validity were examined. The SAT-MC had good internal consistency regardless of the clinical and cultural group as evidence by Cronbach's α ≥ 0.78 in all groups. Confirmatory factor analysis confirmed the one-factor model with a good model fit (χ2 = 188.122, TLI = 0.958, CFI = 0.963, RMSEA = 0.045). The SAT-MC was sensitive to detect individual differences in ToM of SZ and HC, regardless of culture (p The SAT-MC is a reliable measure for evaluating ToM in both Koreans and North Americans with or without schizophrenia, supporting its potential utility in diverse language and cultures for schizophrenia research.

The Social Attribution Task-Multiple Choice (SAT-MC) tests the ability to extract social themes from viewed object motion. This form of animacy perception is thought to aid the development of social inference, but appears impaired in schizophrenia. The current study was undertaken to examine psychometric equivalence of two forms of the SAT-MC and to compare their performance against social cognitive tests recommended for schizophrenia research. Thirty-two schizophrenia (SZ) and 30 substance use disorder (SUD) participants completed both SAT-MC forms, the Bell-Lysaker Emotion Recognition Task (BLERT), Hinting Task, The Awareness of Social Inference Test (TASIT), Ambiguous Intentions and Hostility Questionnaire (AIHQ) and questionnaire measures of interpersonal function. Test sensitivity, construct and external validity, test-retest reliability, and internal consistency were evaluated. SZ scored significantly lower than SUD on both SAT-MC forms, each classifying ~60% of SZ as impaired, compared with ~30% of SUD. SAT-MC forms demonstrated good test-retest and parallel form reliability, minimal practice effect, high internal consistency, and similar patterns of correlation with social cognitive and external validity measures. The SAT-MC compared favorably to recommended social cognitive tests across psychometric features and, with exception of TASIT, was most sensitive to impairment in schizophrenia when compared to a chronic substance use sample.

There is a recent trend of research and applications of Cyber-Physical Systems (CPS) in manufacturing to enhance human-robot collaboration and production. In this paper, we propose a CPS framework for personalized Human-Robot Collaboration and Training to promote safe human-robot collaboration in manufacturing environments. We propose a human-centric CPS approach that focuses on multimodal human behavior monitoring and assessment, to promote human worker safety and enable human training in Human-Robot Collaboration tasks. We present the architecture of our proposed system, our experimental testbed and our proposed methods for multimodal physiological sensing, human state monitoring and interactive robot adaptation, to enable personalized interaction.