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Adapting Basic Cognitive Measures for Clinical Assessment of Schizophrenia

NAMHC Concept Clearance

Presenter

Robert K. Heinssen, Ph.D., ABPP
Program Chief, Schizophrenia Spectrum Disorders Research Program
Adult Psychopathology and Psychosocial Intervention Research Branch
Division of Adult Translational Research and Treatment Development

Goal

This initiative will support the development of new cognitive assessment measures for schizophrenia that are based on experimental cognitive science paradigms, in contrast to traditional clinical neuropsychological methods.

Rationale

Cognitive deficits are a core feature of schizophrenia and a major determinant of poor functional outcome, yet no drug has been approved for cognitive enhancement purposes. In 2002, NIMH established the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative to stimulate the development of drugs to treat cognitive deficits in schizophrenia. As part of this initiative, the MATRICS Neurocognition Committee developed a consensus cognitive battery for assessing cognitive change in clinical trials. However, many of the neuropsychological measures included in the MATRICS battery were complex and tended to engage multiple cognitive functions simultaneously.

To meet the need for more precise assessment instruments for measuring cognitive deficits in treatment studies, a paradigm shift is proposed that replaces clinical neuropsychological approaches with experimental cognitive science methods. Cognitive science tasks offer several advantages: (1) highly refined laboratory tasks that probe specific cognitive systems; (2) construct validity; and (3) flexibility to design tasks that distinguish specific cognitive deficits from generalized performance problems. Furthermore, introducing cognitive science tasks into clinical assessment will foster translational approaches to intervention development by bringing together animal modelers, human cognitive neuroscientists, and clinical schizophrenia researchers.

This initiative will support projects in the following areas: (1) standardization of task design and administration; (2) evaluation of measurement properties; (3) issues related to subject burden; and (4) training, administration, and scoring difficulties. Results from these studies will provide invaluable guidance to subsequent larger-scale efforts to create cognitive science-based assessment tools for use in treatment studies of cognitive deficits in schizophrenia.

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