State Representation in Early Psychosis (STEP)
Psychosis, Schizophrenia, Schizophrenia Spectrum and Other Psychotic Disorders
About this trial
This is an interventional basic science trial for Psychosis
Eligibility Criteria
Inclusion Criteria:
- English proficiency, as determined by staff observation and participant self-report
- Estimated IQ at or above 70, as estimated by the cognitive assessments
Additional Inclusion Criteria for Early Psychosis Participants:
- Clinical diagnosis of schizophrenia, schizoaffective disorder, schizophreniform disorder, psychosis NOS, bipolar disorder with psychosis, or major depressive disorder with psychosis, with onset of psychotic symptoms within the previous 5 years
- Achieved clinical stability, defined as outpatient status for at least one month prior to study participation plus clinically stable doses of psychiatry medications for at least one month prior to study participation
Exclusion Criteria:
- Unable or unwilling to provide informed consent
- The participant is unable to demonstrate adequate decisional capacity, in the judgment of the consenting study staff member, to make a choice about participating in the research study
- Participant is pregnant
- Participant is illiterate
- Cannot pass the CMRR Subject Safety Screen due to MRI contraindications
- Presence of a major neurological disorder
- Previous clinically significant head injury or prolonged unconsciousness, as determined by the PI/Co-Is
- Meets criteria for substance or alcohol dependence within 3 months of enrollment
- The presence of any major medical condition that, in the opinion of the PI/Co-Is, would impede participation in the study or would put the participant at additional risk by participating
Additional Exclusion Criteria for Early Psychosis Participants:
- Has participated in significant formal cognitive training programs, as determined by the PI/Co-Is
- Meets criteria for clinical risk of suicidal behavior, as defined by:
- Clinician judgement
- A suicide attempt within 6 months of enrollment
- Active suicidal ideation at screening or baseline, as indicated by the C-SSRS
- Previous intent to act on suicidal ideation with a specific plan and/or preparatory acts within 6 months of enrollment, as indicated by the C-SSRS
Additional Exclusion Criteria for Control Participants:
- Meets DSM-5 criteria for psychotic, bipolar, or autism spectrum disorder
- Has a family history (1st degree relative) of psychotic, bipolar, or autism spectrum disorder
Sites / Locations
- University of MinnesotaRecruiting
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
Perceptual Discrimination Training
Cognitive Control Training
Training will involve Gabor patch and other visual stimuli discrimination exercises that focus on improving signal-to-noise resolution and attentional control with minimal working memory/cognitive control effects. On each training trial, participants are required to distinguish a target stimulus among a set of distractor stimuli. The similarity between target and distractors increases in level of difficulty based on an adaptive perceptual processing staircase function. Consecutive correct responses lead to increased modulation of the distractors to be more similar to the target, while 1 incorrect response drops the user to an easier level. Difficulty is adapted to maintain an 80% correct response rate. Each session will consist of 4 exercises requiring ~45 minutes. with 40 trials for each exercise.
Training will involve maintaining accurate representations of cognitive context (the "rule") in working memory during response selection. On each training trial, participants must observe stimuli, and hold the correct response context "on-line" in order to select the correct response from among the stimuli. Training is adaptive using a staircase function, such that two consecutive correct responses increases either the speed of stimuli presentation or the working memory load via an increased number of stimuli that are presented; one incorrect response reduces the cognitive load. Each session will consist of 45 exercises requiring ~45 minutes.