Improving Thinking Through Everyday Self-Assessment Training (iTEST): Results of the Initial Open Trial to Improve Introspective Accuracy in Schizophrenia
AI Summary
iTEST was feasible with 86.7% retention and 87% average daily mobile training completion over 16 weeks.
Statistically significant improvements in introspective accuracy occurred on both trained tasks and two of three untrained tasks (Cohen's d 0.5 to 1.28).
Significant gains in real-world functioning, positive symptoms, and depression; first evidence introspective accuracy can be improved and blueprint for blended digital interventions.
STUDY DESIGN: Improving Thinking through Everyday Self-Assessment Training combines 16 weeks of daily mobile task-based training in IA with weekly individual coaching in applying IA to everyday behaviors. Sixty individuals with diagnoses of schizophrenia or schizoaffective disorder participated in an open trial of iTEST with assessments at baseline, 8, 12, and 16 weeks. Primary outcomes included IA on 2 trained tasks (mobile verbal learning and facial emotion recognition tests) and 3 untrained tasks (verbal memory, emotion recognition, and executive functioning).
STUDY RESULTS: Improving Thinking through Everyday Self-Assessment Training showed strong feasibility, retaining 86.7% of participants, and strong adherence with an average daily mobile-training completion rate of 87%. In linear-mixed models with intent-to-treat data, statistically significant IA improvements were observed over time in both trained tasks and in 2 of the 3 untrained tasks (Cohen’s d’s = 0.5-1.28). Significant improvements were also observed in secondary outcomes of real-world function, positive symptoms, and depression.
CONCLUSIONS: This project provides the first data, to our knowledge, to demonstrate that IA in schizophrenia can be improved. Improving Thinking through Everyday Self-Assessment Training also represents one of just a few blended digital health interventions, including remote cognitive training, and may therefore serve as a blueprint for future intervention development.
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