Cognitive and clinical correlates of early-stage psychosis: Associations with functioning and the feasibility of a cognitive training intervention

Haining, Kate (2022) Cognitive and clinical correlates of early-stage psychosis: Associations with functioning and the feasibility of a cognitive training intervention. PhD thesis, University of Glasgow.

Abstract

Schizophrenia is associated with a broad range of adverse outcomes - including suicidality and self-harm and impairments in cognitive performance and functioning - that are already present during early stages, including in the clinical high-risk for psychosis (CHR-P) state and first-episode psychosis (FEP). This thesis sought to target several key gaps in existing research literature which limit our current understanding of early-stage psychosis. To this end, the overarching aim of this thesis was to investigate cognitive and clinical correlates of early-stage psychosis including associations with functioning and the feasibility of a computerised cognitive training intervention.

This thesis presents four studies which provide insights with regard to early detection and intervention in the early stages of psychosis. Chapter 2 investigates the prevalence of suicidality and non-suicidal self-harm among community-recruited CHR-P and FEP participants as well as factors associated with current suicidal ideation in the CHR-P group. Meanwhile, Chapters 3 and 4 harness machine learning methods to study cognition in a sample of CHR-P participants primarily recruited from the community. Specifically, Chapter 3 leverages supervised machine learning methods to examine the relationship between cognitive impairment and functioning while Chapter 4 employs unsupervised machine learning methods to examine cognitive heterogeneity and its association with both clinical and functional outcome. Finally, Chapter 5 investigates whether neuroplasticity-based computerised cognitive training can improve cognition and enhance gamma-band activity in a small sample of CHR-P and FEP participants.

Overall, these studies indicate that a considerable proportion of CHR-P and FEP participants experience adverse outcomes, emphasising the need for novel early detection and intervention strategies in the community. Findings are discussed in relation to the feasibility of digital detection and intervention strategies; the need for more tailored and personalised approaches to treatment; the need to develop more accurate models for effective clinical decision-making; and the importance of including psychiatric controls as a reference point. In sum, this thesis builds upon the existing literature and provides insights which have implications for both research and clinical practice.

• Item Type: Thesis (PhD)
• Qualification Level: Doctoral
• Subjects: R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry
• Colleges/Schools: College of Medical Veterinary and Life Sciences > School of Psychology & Neuroscience
• Supervisor's Name: Uhlhaas, Professor Peter and Fracasso, Dr. Alessio
• Date of Award: 2022
• Depositing User: Theses Team
• Unique ID: glathesis:2022-83178
• Copyright: Copyright of this thesis is held by the author.
• Date Deposited: 10 Oct 2022 09:46
• Last Modified: 10 Oct 2022 09:49
• Thesis DOI: 10.5525/gla.thesis.83178
• URI: https://theses.gla.ac.uk/id/eprint/83178

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