An integrated neurocognitive and social-cognitive treatment for youth at clinical high risk for psychosis: Cognition for Learning and for Understanding Everyday Social Situations (CLUES)

Schizophr Res. 2019 Jun;208:55-59. doi: 10.1016/j.schres.2019.01.029. Epub 2019 Feb 5.


Background: Cognitive deficits, a core feature contributing to disability in schizophrenia, are present in milder form in individuals at clinical high risk (CHR) for psychosis. This study investigated the feasibility of Cognition for Learning and Understanding Everyday Social Situations (CLUES), an integrated neurocognitive and social cognitive treatment for youth at CHR.

Method: This was an open, pilot feasibility trial. Seventeen individuals meeting CHR criteria were assessed prior to and following participation in CLUES for changes in symptoms, social and role functioning, and cognition. Participant attitudes towards CLUES were also examined.

Results: Participants significantly improved in social functioning [t(16) = -4.20, p = .001, d = 1.02], and trended for improvement in reaction time [t(15) = 2.09, p = .054, d = 0.52] from baseline to end of treatment. No other measures significantly changed. No participants transitioned to full psychosis during the treatment and follow up period. Participants reported they generally liked CLUES and found it helpful.

Conclusion: While limited by the small sample size and the open label design, our preliminary results indicate that CLUES is feasible and shows promise in improving social functioning. However, further investigation is warranted in order to determine its efficacy. Future directions should include conducting a randomized controlled trial in order to compare the efficacy of CLUES to another intervention.

Keywords: Attenuated psychosis; Clinical high risk for psychosis; Cognitive remediation, cognitive enhancement; Prevention; Treatment.

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Cognitive Dysfunction / etiology
  • Cognitive Dysfunction / rehabilitation*
  • Cognitive Remediation / methods*
  • Comprehension / physiology
  • Feasibility Studies
  • Female
  • Humans
  • Learning / physiology
  • Male
  • Pilot Projects
  • Psychotic Disorders / complications
  • Psychotic Disorders / rehabilitation*
  • Risk
  • Social Perception*
  • Social Skills*
  • Young Adult