Examinando por Autor "Sampedro, Agurne"
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Ítem Analyzing structural and functional brain changes related to an integrative cognitive remediation program for schizophrenia: a randomized controlled trial(Elsevier B.V., 2023-05) Sampedro, Agurne; Ibarretxe Bilbao, Naroa ; Peña Lasa, Javier ; Cabrera Zubizarreta, Alberto; Sánchez Gómez, Pedro Manuel ; Gómez Gastiasoro, Ainara; Iriarte Yoller, Nagore ; Pavón, Cristóbal ; Tous Espelosín, Mikel ; Ojeda del Pozo, NataliaCognitive remediation has been shown to improve cognition in schizophrenia, but little is known about the specific functional and structural brain changes related to the implementation of an integrative cognitive remediation program. This study analyzed the functional and structural brain changes identified after implementing an integrative cognitive remediation program, REHACOP, in schizophrenia. The program combined cognitive remediation, social cognitive training, and functional and social skills training. The sample included 59 patients that were assigned to either the REHACOP group or an active control group for 20 weeks. In addition to a clinical and neuropsychological assessment, T1-weighted, diffusion-weighted and functional magnetic resonance images were acquired during a resting-state and during a memory paradigm, both at baseline and follow-up. Voxel-based morphometry, tract-based spatial statistics, resting-state functional connectivity, and brain activation analyses during the memory paradigm were performed. Brain changes were assessed with a 2 × 2 repeated-measure analysis of covariance for group x time interaction. Intragroup paired t-tests were also carried out. Repeated-measure analyses revealed improvements in cognition and functional outcome, but no significant brain changes associated with the integrative cognitive remediation program. Intragroup analyses showed greater gray matter volume and cortical thickness in right temporal regions at post-treatment in the REHACOP group. The absence of significant brain-level results associated with cognitive remediation may be partly due to the small sample size, which limited the statistical power of the study. Therefore, further research is needed to clarify whether the temporal lobe may be a key area involved in cognitive improvements following cognitive remediation.Ítem As we were and as we should be, combined exercise training in adults with schizophrenia: CORTEX-SP study part II(John Wiley and Sons Inc, 2024-08) Tous Espelosín, Mikel; Pavón, Cristóbal; Elizagarate Zabala, Edorta; Sampedro, Agurne; Maldonado Martín, SaraObjective: To determine the changes in health-related quality of life (HRQoL) and sleep quality following a supervised combined exercise (EX) program compared to a Treatment-As-Usual (TAU) and to analyze the relationship between the differences in cardiorespiratory fitness (CRF) and HRQoL domains in people with schizophrenia (SZ). Methods: The SZ (n = 112, 41.3 ± 10.4 year) was randomly assigned into a TAU control group (n = 53) or EX-group (n = 59, 3 days/week). The 36-item Short-Form Health Survey questionnaire assessed HRQoL and the sleep quality analysis (accelerometry). Results: After the intervention (20 weeks), physical functioning (∆ = 12.9%), general health (∆ = 15.3%), mental health (∆ = 8.3%), physical component summary (PCS) (∆ = 5.1%), and sleep efficiency (∆ = 1.9%) increased (p < 0.05) in the EX, with no significant changes in the TAU for any domains studied. There were significant differences between groups whose EX showed improvements (p < 0.05) compared to TAU in physical functioning, general health, PCS, and sleep efficiency. A greater CRF was associated with better values in physical functioning, role-physical, bodily pain, general health, vitality, and PCS after the exercise program in SZ. Conclusions: A 20-week supervised combined exercise intervention program for SZ increased sleep efficiency and physical functioning, general and mental health, and PCS scores. This could lead to a critical HRQoL change from how they were to how they should be. Trial Registration: ClinicalTrials.gov identifier: NCT03509597.Ítem Brain white matter correlates of creativity in schizophrenia: a diffusion tensor imaging study(Frontiers Media S.A., 2020-06-23) Sampedro, Agurne; Peña Lasa, Javier; Ibarretxe Bilbao, Naroa; Cabrera Zubizarreta, Alberto; Sánchez Gómez, Pedro Manuel; Gómez Gastiasoro, Ainara; Iriarte Yoller, Nagore; Pavón, Cristóbal; Ojeda del Pozo, NataliaThe relationship between creativity and psychopathology has been a controversial research topic for decades. Specifically, it has been shown that people with schizophrenia have an impairment in creative performance. However, little is known about the brain correlates underlying this impairment. Therefore, the aim of this study was to analyze whole brain white matter (WM) correlates of several creativity dimensions in people with schizophrenia. Fifty-five patients with schizophrenia underwent diffusion-weighted imaging on a 3T magnetic resonance imaging machine as well as a clinical and a creativity assessment, including verbal and figural creativity measures. Tract-based spatial statistic, implemented in FMRIB Software Library (FSL), was used to assess whole brain WM correlates with different creativity dimensions, controlling for sex, age, premorbid IQ, and medication. Mean fractional anisotropy (FA) in frontal, temporal, subcortical, brain stem, and interhemispheric regions correlated positively with figural originality. The most significant clusters included the right corticospinal tract (cerebral peduncle part) and the right body of the corpus callosum. Verbal creativity did not show any significant correlation. As a whole, these findings suggest that widespread WM integrity is involved in creative performance of patients with schizophrenia. Many of these areas have also been related to creativity in healthy people. In addition, some of these regions have shown to be particularly impaired in schizophrenia, suggesting that these WM alterations could be underlying the worse creative performance found in this pathology.Ítem Cognitive, creative, functional, and clinical symptom improvements in schizophrenia after an integrative cognitive remediation program: a randomized controlled trial(Nature Research, 2021-12) Sampedro, Agurne; Peña Lasa, Javier; Sánchez Gómez, Pedro Manuel; Ibarretxe Bilbao, Naroa; Gómez Gastiasoro, Ainara; Iriarte Yoller, Nagore; Pavón, Cristóbal; Tous Espelosín, Mikel; Ojeda del Pozo, NataliaThis study analyzed the effectiveness of an integrative cognitive remediation program (REHACOP) in improving neurocognition, social cognition, creativity, functional outcome, and clinical symptoms in patients with schizophrenia. In addition, possible mediators predicting improvement in functional outcomes were explored. The program combined cognitive remediation with social cognitive training and social and functional skill training over 20 weeks. The sample included 94 patients, 47 in the REHACOP group and 47 in the active control group (occupational activities). Significant differences were found between the two groups in change scores of processing speed, working memory, verbal memory (VM), inhibition, theory of mind, emotion processing (EP), figural creative strengths, functional competence, disorganization, excitement, and primary negative symptoms. A mediational analysis revealed that changes in VM, inhibition, and EP partially explained the effect of cognitive remediation on functional competence improvement. This study provides initial evidence of the effect of integrative cognitive remediation on primary negative symptoms and creativity.Ítem Comparing transcranial direct current stimulation and transcranial random noise stimulation over left dorsolateral prefrontal cortex and left inferior frontal gyrus: effects on divergent and convergent thinking(Frontiers Media S.A., 2022-11-03) Peña Lasa, Javier ; Sampedro, Agurne; Balboa Bandeira, Yolanda ; Ibarretxe Bilbao, Naroa; Zubiaurre Elorza, Leire; García Guerrero, Acebo ; Ojeda del Pozo, NataliaThe essential role of creativity has been highlighted in several human knowledge areas. Regarding the neural underpinnings of creativity, there is evidence about the role of left dorsolateral prefrontal cortex (DLPFC) and left inferior frontal gyrus (IFG) on divergent thinking (DT) and convergent thinking (CT). Transcranial stimulation studies suggest that the left DLPFC is associated with both DT and CT, whereas left IFG is more related to DT. However, none of the previous studies have targeted both hubs simultaneously and compared transcranial direct current stimulation (tDCS) and random noise stimulation (tRNS). Additionally, given the relationship between cognitive flexibility and creativity, we included it in order to check if the improvement in creativity may be mediated by cognitive flexibility. In this double-blind, between-subjects study, 66 healthy participants were randomly assigned to one of three groups (N = 22) that received a transcranial direct current stimulation (tDCS), transcranial random noise stimulation (tRNS), or sham for 20 min. The tDCS group received 1.5 mA with the anode over the left DLPFC and cathode over the left IFG. Locations in tRNS group were the same and they received 1.5 mA of high frequency tRNS (100–500 Hz). Divergent thinking was assessed before (baseline) and during stimulation with unusual uses (UU) and picture completion (PC) subtests from Torrance Creative thinking Test, whereas convergent thinking was evaluated with the remote association test (RAT). Stroop test was included to assess cognitive flexibility. ANCOVA results of performance under stimulation (controlling for baseline performance) showed that there were significant differences in PC (F = 3.35, p = 0.042, (Formula presented.) = 0.10) but not in UU (F = 0.61, p = 0.546) and RAT (F = 2.65, p = 0.079) scores. Post-hoc analyses showed that tRNS group had significantly higher scores compared to sham (p = 0.004) in PC. More specifically, tRNS showed higher performance in fluency (p = 0.012) and originality (p = 0.021) dimensions of PC compared to sham. Regarding cognitive flexibility, we did not find any significant effect of any of the stimulation groups (F = 0.34, p = 0.711). Therefore, no further mediation analyses were performed. Finally, the group that received tDCS reported more adverse effects than sham group (F = 3.46, p = 0.035). Altogether, these results suggest that tRNS may have some advantages over tDCS in DT.Ítem Correlates of creativity and effects of integrative cognitive remediation in schizophrenia: a multimodal neuroimaging study(Universidad de Deusto, 2021-12-10) Sampedro, Agurne; Peña Lasa, Javier; Ojeda del Pozo, Natalia; Facultad de Psicología y Educación; Programa de Doctorado en Psicología por la Universidad de DeustoThe idea that there is a relationship between creativity and schizophrenia has been a research topic of great interest for centuries. It is now suggested that people with schizophrenia show an impaired creative capacity. Nevertheless, the cognitive, clinical and brain underpinnings of the relationship between creativity and schizophrenia, and the possible role of creativity in functional outcome remain almost unknown. Being one of the most disabling disorders in the world, the improvement of functional outcome is considered the main treatment target in this disease. Cognitive remediation has shown to be an effective intervention in improving functional outcome as well as cognition and clinical symptoms in schizophrenia. However, results among studies are still heterogeneous and little is known about the effectiveness of the combination of cognitive remediation with other trainings in improving creativity, primary negative symptoms, and brain structure and function in schizophrenia. Moreover, it is unclear which domains predict the improvement in functional outcome. The present thesis is composed by six scientific contributions. The first study (Psychiatry and Clinical Neurosciences) aimed to analyze differences in creativity between patients with schizophrenia and healthy controls as well as the mediating role of cognitive flexibility, working memory, and theory of mind in the relationship between schizophrenia and creativity. The second study (Journal of Psychiatric Research) investigated simultaneously the specific contribution of multiple neurocognitive, social cognitive and clinical variables to creativity in schizophrenia. The third study (npj Schizophrenia) assessed the predictive role of creativity on functional outcome through a mediational model including sociodemographic, clinical, neurocognitive, and social cognitive variables among patients with schizophrenia. The fourth study (Frontiers in Neuroscience) analyzed whole brain white matter correlates of different creativity dimensions in schizophrenia. The fifth study (npj Schizophrenia) evaluated the effectiveness of an integrative cognitive remediation program (REHACOP) that combined training in neurocognition, social cognition, as well as social and functional skills among patients with schizophrenia in multiple domains: creativity, neurocognition, social cognition, functional outcome, and clinical symptoms. An additional aim of the fifth study was to explore the mediators predicting improvement in functional outcome after the integrative cognitive remediation. Finally, the sixth study (under review) explored the structural and functional brain changes induced by the REHACOP program in patients with schizophrenia. Results showed that patients with schizophrenia obtained lower scores in creativity compared to healthy controls and that this lower performance was partly due to an impairment in cognitive flexibility, working memory, and theory of mind. Moreover, creative performance of patients with schizophrenia was explained by multiple neurocognitive, social cognitive and clinical variables. In addition, creativity mediated the relationship between neurocognition and functional outcome as well as the relationship between negative symptoms and functional outcome in patients with schizophrenia. White matter mean fractional anisotropy adjacent to multiple brain regions, including frontal, temporal, subcortical, brain stem, and interhemispheric regions, correlated positively with creativity and specifically, with figural originality, among patients with schizophrenia. Furthermore, the integrative cognitive remediation was effective in producing significant changes in neurocognition, social cognition, creativity, functional outcome, and clinical symptoms. Besides, changes in verbal memory, inhibition, and emotion processing partially explained the effect of cognitive remediation on functional competence. Finally, the integrative cognitive remediation failed to produce structural and functional brain changes in patients with schizophrenia. However, the REHACOP group showed greater grey matter volume and cortical thickness in right temporal regions at post-treatment. In conclusion, the present thesis provides on the one hand, a better understanding of the role of creativity on schizophrenia, through the interaction of multiple neurocognitive, social cognitive, clinical, functional outcome, and brain characteristics. On the other hand, this thesis reinforces the effectiveness of integrative cognitive remediation in multiple cognitive and functional outcome domains, and provides initial evidence of the effect of cognitive remediation in creativity and primary negative symptoms among patients with schizophrenia. Moreover, this thesis attempts to better understand the effects of integrative cognitive remediation in brain structure and function, suggesting that further research should clarify whether the temporal lobe may be a key area involved in neuroprotective processes of cognitive remediation.Ítem Cross-validation of predictive equation for cardiorespiratory fitness by modified shuttle walk test in adults with schizophrenia: a secondary analysis of the cortex-sp study(MDPI, 2021-10-29) Tous Espelosín, Mikel; Ruiz de Azúa García, Sonia; Iriarte Yoller, Nagore; Sánchez Gómez, Pedro Manuel; Elizagarate Zabala, Edorta; Sampedro, Agurne; Maldonado Martín, SaraCardiorespiratory fitness (CRF) can be direct or estimated from different field tests. The Modified Shuttle Walk Test (MSWT) is suitable for all levels of function, allowing a peak response to be elicited. Therefore, we aimed (1) to validate the equation presented in the original study by Singh et al. for evaluating the relationship between MSWT with peak oxygen uptake (VO2peak) in adults with schizophrenia (SZ), (2) to develop a new equation for the MSWT to predict VO2peak, and (3) to validate the new equation. Participants (N = 144, 41.3 ± 10.2 years old) with SZ performed a direct measurement of VO2peak through a cardiopulmonary exercise test and the MSWT. A new equation incorporating resting heart rate, body mass index, and distance from MSWT (R2 = 0.617; adjusted R2 = 0.60; p < 0.001) performs better than the Singh et al. equation (R2 = 0.57; adjusted R2 = 0.57; p < 0.001) to estimate VO2peak for the studied population. The posteriori cross-validation method confirmed the model’s stability (R2 = 0.617 vs. 0.626). The findings of the current study support the validity of the new regression equation incorporating resting heart rate, body mass index, and distance from MSWT to predict VO2peak for assessment of CRF in people with SZ.Ítem The effect of changing the balance between right and left dorsolateral prefrontal cortex on different creativity tasks: a transcranial random noise stimulation study(Creative Education Foudation, 2021-12) Peña Lasa, Javier; Sampedro, Agurne; Gómez-Gastiasoro, Ainara; Ibarretxe Bilbao, Naroa; Zubiaurre Elorza, Leire; Aguiar, Covadonga; Ojeda del Pozo, NataliaTranscranial random noise stimulation (tRNS) increases performance in some perceptual tasks. However, little is known about its effect on creativity. Although dorsolateral prefrontal cortex (DLPFC) has been postulated as an important cortical area related to creativity, the relative role of left and right DLPFC is still unclear. We aimed to compare the effect of anodal left/cathodal right (L + R−) and cathodal left/anodal right (L − R+) tRNS over the DLPFC. Eighty-four participants were randomly assigned to L + R−, L−R+ or sham group. Current was set at 2 mA (100–500 Hz) with a 1 mA direct current offset (20 min). Creativity was assessed before and during tRNS with the Remotes Associates Test (RAT), Unusual Uses (UU) and Picture Completion (PC) from Torrance Test of Creative Thinking, nine-dot problem and matchstick arithmetic problems. Bootstrapped analysis of covariance (under-stimulation scores controlling for baseline) showed that L + R− and L − R+ groups had higher scores than sham in UU whereas only L + R− improved in RAT compared to sham. The L − R+ group performed significantly better than L + R− and sham groups in PC, nine-dot problem and matchstick arithmetic problems. L + R− DLPFC may help verbal creative thinking whereas the L − R + seems to produce a “releasing effect” through insight problem solving and originality.Ítem The effect of transcranial random noise stimulation (tRNS) over bilateral posterior parietal cortex on divergent and convergent thinking(Nature Research, 2020-09-23) Peña Lasa, Javier; Sampedro, Agurne; Ibarretxe Bilbao, Naroa; Zubiaurre Elorza, Leire; Aizpurua Gordillo, Aralar; Ojeda del Pozo, NataliaCreativity pervades many areas of everyday life and is considered highly relevant in several human living domains. Previous literature suggests that the posterior parietal cortex (PPC) is related to creativity. However, none of previous studies have compared the effect of transcranial random noise stimulation (tRNS) over bilateral PPC on both verbal and visual divergent thinking (DT) and Remote Associates Test (RAT) in the same experimental design. Forty healthy participants were randomly assigned to tRNS (100–500 Hz) over bilateral PPC or sham group, for 15 min and current was set at 1.5 mA. Participants’ creativity skills were assessed before and after brain stimulation with the Unusual Uses and the Picture Completion subtests from the Torrance Test of Creative Thinking and the RAT. ANCOVA (baseline scores as covariate) results indicated that tRNS group had significantly higher scores at post-test in RAT and visual originality compared to sham group. Unusual Uses, on the other hand, was not significant. Improvement in RAT suggests the involvement of PPC during via insight solution which may reflect internally directed attention that helps the recombination of remotely associated information. The improvement in visual originality dimension from DT may be due to a higher internally directed attention while reducing externally oriented attention.Ítem Enhancement of divergent creative thinking after transcranial near-infrared photobiomodulation over the default mode network(Routledge, 2024) Peña Lasa, Javier; Muthalib, Makii; Beaty, Roger E.; Sampedro, Agurne; Ibarretxe Bilbao, Naroa; Zubiaurre Elorza, Leire; García Guerrero, Acebo; Cortazar, Ibon; Niso, Mikel; Ojeda del Pozo, NataliaTranscranial photobiomodulation (tPBM) has been used for cognitive enhancement in healthy people. However, its effect on creativity has not been investigated. The default mode network (DMN) is associated with divergent thinking (DT; but not convergent thinking, CT), and also with anxiety, which in turn has been negatively related to creativity. We aimed to use tPBM over the DMN to assess the effect on DT compared to sham. Additionally, we assessed the possible mediating effect of anxiety between tPBM and DT. In this single-blind, between-subjects study, 58 healthy participants were randomly assigned to tPBM or sham group. tPBM was applied using near-infrared light (810 nm, 40 Hz; 50% duty cycle), through light-emitting diode devices combining transcranial plus intranasal PBM over the cortical nodes of the DMN for 20 min (240 J/cm2 in total). DT and CT were assessed before (baseline) and after tPBM with the Unusual Uses (UU), Picture Completion (PC) and Remote Associates test (RAT). ANCOVA (post-stimulation controlling for baseline) results showed that tPBM group had significantly higher scores compared to sham in total UU, PC, and total DT. tPBM may be effective for DT enhancement. The lack of effect on CT reveals a specific link between DMN and DT.Ítem Enhancing creativity with combined transcranial direct current and random noise stimulation of the left dorsolateral prefrontal cortex and inferior frontal gyrus(John Wiley and Sons Inc, 2023-03) Peña Lasa, Javier; Muthalib, Makii; Sampedro, Agurne; Cardoso-Botelho, Mafalda; Zabala Gómez, Oihana; Ibarretxe Bilbao, Naroa; García Guerrero, Acebo; Zubiaurre Elorza, Leire; Ojeda del Pozo, NataliaCreativity is a fundamental human accomplishment from scientific advances to composing music. The left dorsolateral prefrontal cortex (DLPFC) and inferior frontal gyrus (IFG) are important metacontrol hubs in flexibility and persistence brain states, respectively. Those hubs are related to divergent thinking, insight problem-solving, and convergent thinking. In this double-blind, between-subjects study, 81 healthy participants were randomly assigned to one of three groups (n = 27) that received a combined transcranial direct current stimulation–transcranial random noise stimulation (tDCS-tRNS) protocol with the anode over the left DLPFC and cathode over the left IFG (+DLPFC−IFG), the opposite montage (−DLPFC+IFG), and a sham group (+DLPFC−IFG). Both active tDCS-tRNS groups received 20 min of 1 mA tDCS with 1 mA (100–500 Hz) tRNS. Creativity was assessed before (baseline) and during stimulation with the Unusual Uses, Picture Completion (PC), Remote Association test (RAT), Matchstick Arithmetic (MA), and Nine-dot (ND) problems. Only the +DLPFC−IFG group had significantly higher scores compared with sham in the RAT (p =.009), PC fluency (p =.018), PC originality (p =.007), ND (p =.007), and MA (p =.032). Overall, −DLPFC+IFG had greater scores in all creativity tests compared with sham. Implications from the metacontrol theory are discussed.Ítem The impact of creativity on functional outcome in schizophrenia: a mediational model(Nature Research, 2021-02-26) Sampedro, Agurne ; Peña Lasa, Javier; Sánchez Gómez, Pedro Manuel; Ibarretxe Bilbao, Naroa; Iriarte Yoller, Nagore; Pavón, Cristóbal; Hervella Garcés, Isabel; Tous Espelosín, Mikel; Ojeda del Pozo, NataliaFunctional impairment remains one of the most challenging issues for treatment in schizophrenia. However, previous studies have mainly focused on the negative impact of symptoms excluding variables that could positively impact functional outcome, such as creativity, which is considered an adaptive capacity for real-life problem-solving. This study analyzed the predictive role of creativity on functional outcome in 96 patients with schizophrenia through a mediational model, including sociodemographic, clinical, neurocognitive, and social cognitive variables. Path analysis revealed that creativity significantly mediated the relationship between neurocognition and functional outcome, and that creativity mediated between negative symptoms and functional outcome. Additionally, neurocognition was directly associated with functional outcome and social functioning was associated with creativity. The involvement of creativity in functional outcome could have relevant implications for the development of new interventions. These findings open up a new field of research on additional personal resources as possible factors of functional outcome in schizophrenia and other diseasesÍtem Improvement in creativity after transcranial random noise stimulation (tRNS) over the left dorsolateral prefrontal cortex(Nature Publishing Group, 2019-12) Peña Lasa, Javier; Sampedro, Agurne; Ibarretxe Bilbao, Naroa; Zubiaurre Elorza, Leire; Ojeda del Pozo, NataliaCreativity has previously been shown to improve after the application of direct and alternating current transcranial stimulation over the dorsolateral prefrontal cortex (DLPFC). However, previous studies have not tested whether transcranial random noise stimulation (tRNS) was efficient for this purpose. The aim of this randomized, double-blind, placebo-controlled study was to investigate the effect of tRNS on both verbal convergent and (verbal and visual) divergent thinking during left DLPFC tRNS stimulation. Thirty healthy participants were randomly allocated to either a tRNS active group or a sham group. Each session lasted 20 min and the current was set to 1.5 mA (100–500 Hz). Participants’ verbal convergent thinking was assessed with the Remote Associates Test (RAT). Verbal and visual divergent thinking were respectively measured by using the Unusual Uses and Picture Completion subtests from the Torrance Tests of Creative Thinking. Bootstrapped analysis of variance showed significant differences in the mean change scores between the active tRNS group and the sham group in RAT scores (d = 1.68); unusual uses: fluency (d = 2.29) and originality (d = 1.43); and general creativity (d = 1.45). Visual divergent thinking, in contrast, did not show any significant improvement. Our results suggested that tRNS over the left DLPFC is effective for increasing verbal divergent and convergent thinking.Ítem Mediating role of cognition and social cognition on creativity among patients with schizophrenia and healthy controls: revisiting the Shared Vulnerability Model(Blackwell Publishing, 2020-02) Sampedro, Agurne; Peña Lasa, Javier; Ibarretxe Bilbao, Naroa; Sánchez Gómez, Pedro Manuel; Iriarte Yoller, Nagore; Ledesma González, Sara; Tous Espelosín, Mikel; Ojeda del Pozo, NataliaAim: As suggested by the Shared Vulnerability Model, impairment in executive functions could lead to worse creative performance among individuals with schizophrenia. Another impaired function in schizophrenia, previously related to creativity in healthy people, is theory of mind. However, little is known about the effect of theory of mind in creativity in schizophrenia. Therefore, the aim of this study was to analyze differences in creativity among patients with schizophrenia compared to healthy controls (HC) and to explore the potential role of executive functions and theory of mind as mediators of this relation. Methods: Forty-five patients with schizophrenia and 45 HC underwent a neuropsychological assessment, including executive functions (cognitive flexibility and working memory), theory of mind, and verbal and figural creativity. Results: As expected, patients with schizophrenia obtained lower scores in creativity, cognitive flexibility, working memory, and theory of mind compared to HC. Path analysis showed that theory of mind mediated the relation between group (schizophrenia or HC) and both figural (Z = 2.075, P = 0.037) and verbal creativity (Z = 2.570, P = 0.010). Working memory mediated the relation between group and figural creativity (Z = 2.034, P = 0.041) and was marginally significant for verbal creativity (Z = 1.930, P = 0.053). Finally, cognitive flexibility mediated between group and figural creativity (Z = 2.454, P = 0.014). Conclusion: Results suggest that the lower performance in creativity among patients with schizophrenia was partly due to an impairment in executive functions and theory of mind. The involvement of theory of mind opens up a new field of research as a possible risk factor in the Shared Vulnerability Model.Ítem Moderators of functional improvement after integrative cognitive remediation in schizophrenia: toward a personalized treatment approach(Elsevier Ireland Ltd, 2023-11) Sampedro, Agurne; Peña Lasa, Javier; Sánchez Gómez, Pedro Manuel; Ibarretxe Bilbao, Naroa; Iriarte Yoller, Nagore; Pavón, Cristóbal; Ojeda del Pozo, NataliaCognitive remediation is an effective intervention for improving functional outcome in schizophrenia. However, the factors that moderate this improvement are still poorly understood. The study aimed to identify moderators of functional outcome improvement after integrative cognitive remediation (REHACOP) in schizophrenia. This was a secondary analysis of data from two randomized controlled trials, which included 182 patients (REHACOP group=94; active control group=88). Hierarchical regression analyses were conducted to identify moderators of functional outcome improvement. Two baseline level groups (low-level and high-level) were created to analyze the moderating role of this baseline level cluster using repeated measures ANCOVA. The REHACOP was effective regardless of participants’ baseline level, but regression analyses indicated that the effectiveness on functional outcome was higher among those who were older, had fewer years in education, lower scores in baseline cognition and functional outcome, and more negative symptoms. Repeated measures ANOVA showed that the baseline level cluster influenced the improvement in functional outcome, with the low-level group showing greater improvements. The results reinforced the need to implement cognitive remediation programs more broadly as a treatment for schizophrenia in healthcare services. Furthermore, they provided evidence for the development of personalized cognitive remediation plans to improve benefits in different schizophrenia profiles.Ítem Neurocognitive, social cognitive, and clinical predictors of creativity in schizophrenia(Elsevier Ltd, 2020-07-20) Sampedro, Agurne; Peña Lasa, Javier; Ibarretxe Bilbao, Naroa; Sánchez Gómez, Pedro Manuel; Iriarte Yoller, Nagore; Pavón, Cristóbal; Hervella Garcés, Isabel; Tous Espelosín, Mikel; Ojeda del Pozo, NataliaBackground: Creativity is considered an essential human accomplishment and a key component for daily life problem solving. It has been suggested that impairment in working memory, cognitive flexibility, and theory of mind could lead to lower creativity in schizophrenia. Additionally, other neurocognitive and social cognitive domains, as well as clinical symptoms could play a role in this relationship. However, the extent to which each of these domains influences creativity in schizophrenia remains unknown. Therefore, the aim of this study was to simultaneously investigate the specific contribution of neurocognitive, social cognitive, and clinical variables to creativity in schizophrenia. Methods: One hundred and one patients with schizophrenia were assessed in terms of sociodemographic, clinical, neurocognitive, social cognitive, and creativity variables. Results: After controlling for sociodemographic variables, regression analyses showed that higher social perception (β = 0.286, p = .004) and processing speed (β = 0.219, p = .023) predicted creativity total score. Higher social perception (β = 0.298, p = .002) and processing speed (β = 0.277, p = .004) explained figural creativity. Finally, lower negative symptoms (β = −0.302, p = .002) and higher social perception (β = 0.210, p = .029) predicted verbal creativity. Conclusions: Results suggest that neurocognitive, social cognitive, as well as clinical symptoms influence creativity of patients with schizophrenia. Moreover, these findings point out the prominent role of social cognition in creativity in schizophrenia.