Neuropsychology; Psychiatry; Schizophrenia; Veterans
"Exploring Ways to Restore Cognitive and Work Capacity" is our mission. Our goal is to restore functional capacity to people with disabling psychiatric conditions. We are particularly interested in vocational rehabilitation and neurocognitive rehabilitation and have tested interventions that can augment current best practices. Our work suggests that providing patients with on-going, specific feedback about their cognitive and work performance can improve vocational outcomes. Based on models of neuroplasticity, we have tested the use of computer-based cognitive exercises of attention, memory, language and executive functioning. We have found that such training can result in normal levels of task performance, improved neuropsychological test performance, and better functioning on the job. We have found that cognitive training combined with work therapy leads to greater productivity and when combined with supported employment leads to higher rates of competitive employment, especially for those with the poorest initial community functioning.
Evidence linking cognitive training to neuroplastic changes comes from pre-post fMRI studies that show improved cognitive efficiency on working memory tasks. Other methods being explored include social information processing groups, a CBT approach to negative cognitions regarding return to work, using D'serine as a cognitive enhancer to boost new learning in conjunction with cognitive training, and using motivation enhancing strategies. While most of our work has been with schizophrenia, we are now applying cognitive remediation approaches to patients in initial stages of substance abuse treatment and early stage Alzheimer's disease. Under development are new cognitive training software, simulated job interview training, and psychophysiological approaches.
Specialized Terms: Cognitive Remediation; Neuropsychology; Neuropsychology of Schizophrenia; Psychiatric Rehabilitation; Schizophrenia; Supported Employment
Extensive Research Description
NIDA Cognitive Remediation and Work Therapy in the Early Phase of Substance Abuse Treatment. Pilot study to determine whether these interventions improve substance abuse outcomes.
NIMH SBIR “Vocational Rehabilitation Training Simulation for the Psychiatrically Disabled, Phase 1.- Development of computer-based job interview role-play training.
VA Rehabilitation R&D “Cognitive Training to Enhance Work Program
NIMH "Cognitive Training and Enhanced Supported Employment.” - RCT of Positscience cognitive training with CMHC based Supported Employment
VA Rehabilitation R&D (Lysaker PI, Bell Co-PI). Effects of CBT and Cognitive Remediation on Work in Schizophrenia.” - RCT of CBT and Positscience cognitive training with VA work therapy.
Benefits of Cognitive Remediation and Supported Employment for Schizophrenia Patients with Poor Community Functioning
Bell MD, Choi KH, Dyer C, Wexler BE. Benefits of Cognitive Remediation and Supported Employment for Schizophrenia Patients with Poor Community Functioning. Psychiatr Serv. 2014 Jan 2. doi: 0.1176/appi.ps.201200505. [Epub ahead of print] PMID:24382594
Virtual Reality Job Interview Training For Individuals with Psychiatric Disabilities
Smith MJ, Ginger EM, Wright K, Wright M, Olsen D, Bell MD, Fleming MF. Virtual Reality Job Interview Training For Individuals with Psychiatric Disabilities. Journal of Nervous and Mental Disorders 2014;202: 659–667 PMID: 25099298
The social attribution task – multiple choice (SAT-MC): A psychometric and equivalence study of an alternate form
Johannesen, J.K., Lurie, J.B., Fiszdon, J.F., & Bell, M.D. (2013). The social attribution task – multiple choice (SAT-MC): A psychometric and equivalence study of an alternate form. ISRN Psychiatry, Volume 2013, Article ID 830825, http://dx.doi.org/10.1155/2013/830825
Social Cognitive Impairments and Negative Symptoms in Schizophrenia: Are there Subtypes with Distinct Functional Correlates?
Bell MD, Corbera S, Johannesen JK, Fiszdon JM, Wexler BE. Social Cognitive Impairments and Negative Symptoms in Schizophrenia: Are there Subtypes with Distinct Functional Correlates? Schiz Bull, 2013, 39, 186-196.
Simulated job interview skill training for people with psychiatric disability: feasibility and tolerability of virtual reality training
Bell MD, Weinstein A, Simulated Job Interview Skill Training for People With Psychiatric Disability: Feasibility and Tolerability of Virtual Reality Training, Schiz Bull 2011, 37: S91-S97.
Social Attribution Test-Multiple Choice (SAT-MC) in schizophrenia: Comparison with a community sample and relationship to neurocognitive, social cognitive and symptom measures
Bell MD, Fiszdon JF, Greig TC, Wexler BW. Social Attribution Test-Multiple Choice (SAT-MC) in schizophrenia: Comparison with a community sample and relationship to neurocognitive, social cognitive and symptom measures. Schiz Research, 2010, 122:164-171.
Memory profiles in schizophrenia: categorization validity and stability
Bell MD, Johannesen JK, Greig TC, Wexler BE. Memory profiles in schizophrenia: categorization validity and stability. Schiz Research, 2010, 118:26-33.
Neurocognition, social cognition, perceived social discomfort and vocational outcomes in schizophrenia
Bell MD, Tsang HWH, Greig TC, Bryson GJ. Neurocognition, social cognition, perceived social discomfort and vocational outcomes in schizophrenia. Schizophrenia Bulletin, 2009, 35(4), 738-747.
Neurocognitive Enhancement Therapy with Vocational Services in Schizophrenia: Work Outcomes at Two Year Follow-Up
Bell MD, Zito W, Greig T, Wexler BE. Neurocognitive Enhancement Therapy with Vocational Services in Schizophrenia: Work Outcomes at Two Year Follow-Up. Schizophrenia Research, 2008, 105:18-29.
Full List of PubMed Publications
- Smith MJ, Smith JD, Fleming MF, Jordan N, Brown CH, Humm L, Olsen D, Bell MD: Mechanism of Action for Obtaining Job Offers With Virtual Reality Job Interview Training. Psychiatr Serv. 2017 Mar 15; 2017 Mar 15. PMID: 28292223
- Bell MD, Laws HB, Petrakis IB: A randomized controlled trial of cognitive remediation and work therapy in the early phase of substance use disorder recovery for older veterans: Neurocognitive and substance use outcomes. Psychiatr Rehabil J. 2017 Mar; 2016 Oct 10. PMID: 27732034
- Fiszdon JM, Roberts DL, Penn DL, Choi KH, Tek C, Choi J, Bell MD: Understanding Social Situations (USS): A proof-of-concept social-cognitive intervention targeting theory of mind and attributional bias in individuals with psychosis. Psychiatr Rehabil J. 2017 Mar; 2016 Jun 9. PMID: 27281040
- Smith MJ, Bell MD: Response: Importance of Virtual Reality Job Interview Training in Today's World. J Nerv Ment Dis. 2016 Oct. PMID: 27748698
- Gooding AL, Choi J, Fiszdon JM, Wilkins K, Kirwin PD, van Dyck CH, Devanand D, Bell MD, Rivera Mindt M: Comparing three methods of computerised cognitive training for older adults with subclinical cognitive decline. Neuropsychol Rehabil. 2016 Oct; 2015 Dec 16. PMID: 26674122
- Mervis JE, Lysaker PH, Fiszdon JM, Bell MD, Chue AE, Pauls C, Bisoglio J, Choi J: Addressing defeatist beliefs in work rehabilitation. J Ment Health. 2016 Aug; 2016 Feb 1. PMID: 26828824
- Fiszdon JM, Kurtz MM, Choi J, Bell MD, Martino S: Motivational Interviewing to Increase Cognitive Rehabilitation Adherence in Schizophrenia. Schizophr Bull. 2016 Mar; 2015 Sep 29. PMID: 26420905
- Bell MD, Vissicchio NA, Weinstein AJ: Visual and verbal learning deficits in Veterans with alcohol and substance use disorders. Drug Alcohol Depend. 2016 Feb 1; 2015 Dec 2. PMID: 26684868
- Bell MD, Vissicchio NA, Weinstein AJ: Cognitive Training and Work Therapy for the Treatment of Verbal Learning and Memory Deficits in Veterans With Alcohol Use Disorders. J Dual Diagn. 2016. PMID: 26828571
- Lystad JU, Falkum E, Haaland VØ, Bull H, Evensen S, Bell MD, Ueland T: Neurocognition and occupational functioning in schizophrenia spectrum disorders: The MATRICS Consensus Cognitive Battery (MCCB) and workplace assessments. Schizophr Res. 2016 Jan; 2015 Dec 11. PMID: 26692347
- Smith MJ, Fleming MF, Wright MA, Jordan N, Humm LB, Olsen D, Bell MD: Job Offers to Individuals With Severe Mental Illness After Participation in Virtual Reality Job Interview Training. Psychiatr Serv. 2015 Nov; 2015 Jul 1. PMID: 26130002
- Smith MJ, Fleming MF, Wright MA, Losh M, Humm LB, Olsen D, Bell MD: Brief report: vocational outcomes for young adults with autism spectrum disorders at six months after virtual reality job interview training. J Autism Dev Disord. 2015 Oct. PMID: 25986176
- Au DW, Tsang HW, So WW, Bell MD, Cheung V, Yiu MG, Tam KL, Lee GT: Effects of integrated supported employment plus cognitive remediation training for people with schizophrenia and schizoaffective disorders. Schizophr Res. 2015 Aug; 2015 Jun 1. PMID: 26044114
- Smith MJ, Fleming MF, Wright MA, Roberts AG, Humm LB, Olsen D, Bell MD: Virtual reality job interview training and 6-month employment outcomes for individuals with schizophrenia seeking employment. Schizophr Res. 2015 Aug; 2015 May 29. PMID: 26032567
- Smith MJ, Humm LB, Fleming MF, Jordan N, Wright MA, Ginger EJ, Wright K, Olsen D, Bell MD: Virtual Reality Job Interview Training for Veterans with Posttraumatic Stress Disorder. J Vocat Rehabil. 2015. PMID: 27721645
- Smith MJ, Ginger EJ, Wright M, Wright K, Boteler Humm L, Olsen D, Bell MD, Fleming MF: Virtual reality job interview training for individuals with psychiatric disabilities. J Nerv Ment Dis. 2014 Sep. PMID: 25099298
- Nuechterlein KH, Ventura J, Subotnik KL, Hayata JN, Medalia A, Bell MD: Developing a Cognitive Training Strategy for First-Episode Schizophrenia: Integrating Bottom-Up and Top-Down Approaches. Am J Psychiatr Rehabil. 2014 Jul. PMID: 25489275
- Johannesen JK, Lurie JB, Fiszdon JM, Bell MD: The Social Attribution Task-Multiple Choice (SAT-MC): A Psychometric and Equivalence Study of an Alternate Form. ISRN Psychiatry. 2013; 2013 Jun 20. PMID: 23864984
- Fiszdon JM, Fanning JR, Johannesen JK, Bell MD: Social cognitive deficits in schizophrenia and their relationship to clinical and functional status. Psychiatry Res. 2013 Jan 30; 2012 Sep 25. PMID: 23017655
- Bell MD, Corbera S, Johannesen JK, Fiszdon JM, Wexler BE: Social cognitive impairments and negative symptoms in schizophrenia: are there subtypes with distinct functional correlates? Schizophr Bull. 2013 Jan; 2011 Oct 5. PMID: 21976710
- Corbera S, Wexler BE, Ikezawa S, Bell MD: Factor structure of social cognition in schizophrenia: is empathy preserved? Schizophr Res Treatment. 2013; 2013 Dec 15. PMID: 24455254
- Surti TS, Corbera S, Bell MD, Wexler BE: Successful computer-based visual training specifically predicts visual memory enhancement over verbal memory improvement in schizophrenia. Schizophr Res. 2011 Nov; 2011 Jul 27. PMID: 21795025
- Bell MD, Weinstein A: Simulated job interview skill training for people with psychiatric disability: feasibility and tolerability of virtual reality training. Schizophr Bull. 2011 Sep. PMID: 21860052
- Mercado CL, Johannesen JK, Bell MD: Thought disorder severity in compromised, deteriorated, and preserved intellectual course of schizophrenia. J Nerv Ment Dis. 2011 Feb. PMID: 21278540
- Sewell RA, Perry EB Jr, Karper LP, Bell MD, Lysaker P, Goulet JL, Brenner L, Erdos J, d'Souza DC, Seibyl JP, Krystal JH: Clinical significance of neurological soft signs in schizophrenia: factor analysis of the Neurological Evaluation Scale. Schizophr Res. 2010 Dec; 2010 Sep 19. PMID: 20855185
- Bell MD, Fiszdon JM, Greig TC, Wexler BE: Social attribution test--multiple choice (SAT-MC) in schizophrenia: comparison with community sample and relationship to neurocognitive, social cognitive and symptom measures. Schizophr Res. 2010 Sep; 2010 Apr 18. PMID: 20400268
- Bell MD, Johannesen JK, Greig TC, Wexler BE: Memory profiles in schizophrenia: categorization validity and stability. Schizophr Res. 2010 May; 2010 Jan 20. PMID: 20085855
- Fiszdon JM, Bell MD: Effects of presentation modality and valence on affect recognition performance in schizophrenia and healthy controls. Psychiatry Res. 2009 Dec 30; 2009 Nov 8. PMID: 19900721
- Wexler BE, Zhu H, Bell MD, Nicholls SS, Fulbright RK, Gore JC, Colibazzi T, Amat J, Bansal R, Peterson BS: Neuropsychological near normality and brain structure abnormality in schizophrenia. Am J Psychiatry. 2009 Feb; 2008 Sep 2. PMID: 18765481
- Bell MD, Zito W, Greig T, Wexler BE: Neurocognitive enhancement therapy with vocational services: work outcomes at two-year follow-up. Schizophr Res. 2008 Oct; 2008 Aug 19. PMID: 18715755
- Fiszdon JM, Choi J, Goulet J, Bell MD: Temporal relationship between change in cognition and change in functioning in schizophrenia. Schizophr Res. 2008 Oct; 2008 Jul 25. PMID: 18657398
- Bell MD, Tsang HW, Greig T, Bryson G: Cognitive predictors of symptom change for participants in vocational rehabilitation. Schizophr Res. 2007 Nov; 2007 Sep 4. PMID: 17766090
- Greig TC, Zito W, Wexler BE, Fiszdon J, Bell MD: Improved cognitive function in schizophrenia after one year of cognitive training and vocational services. Schizophr Res. 2007 Nov; 2007 Jul 31. PMID: 17669629
- Zito W, Greig TC, Wexler BE, Bell MD: Predictors of on-site vocational support for people with schizophrenia in supported employment. Schizophr Res. 2007 Aug; 2007 May 23. PMID: 17512172
- Fiszdon JM, Richardson R, Greig T, Bell MD: A comparison of basic and social cognition between schizophrenia and schizoaffective disorder. Schizophr Res. 2007 Mar; 2007 Jan 26. PMID: 17258431
- Fiszdon JM, McClough JF, Silverstein SM, Bell MD, Jaramillo JR, Smith TE: Learning potential as a predictor of readiness for psychosocial rehabilitation in schizophrenia. Psychiatry Res. 2006 Aug 30; 2006 Jul 24. PMID: 16860881
- Bell MD, Mishara AL: Does negative symptom change relate to neurocognitive change in schizophrenia? Implications for targeted treatments. Schizophr Res. 2006 Jan 1; 2005 Nov 16. PMID: 16297601
- Bell MD, Bryson GJ, Greig TC, Fiszdon JM, Wexler BE: Neurocognitive enhancement therapy with work therapy: Productivity outcomes at 6- and 12-month follow-ups. J Rehabil Res Dev. 2005 Nov-Dec. PMID: 16680620
- Wexler BE, Bell MD: Cognitive remediation and vocational rehabilitation for schizophrenia. Schizophr Bull. 2005 Oct; 2005 Aug 3. PMID: 16079390
- Bell MD, Zito W: Integrated versus sealed-over recovery in schizophrenia: BORRTI and executive function. J Nerv Ment Dis. 2005 Jan. PMID: 15674128
- Conway Greig T, Nicholls SS, Wexler BE, Bell MD: Test-retest stability of neuropsychological testing and individual differences in variability in schizophrenia outpatients. Psychiatry Res. 2004 Dec 30. PMID: 15661317
- Fiszdon JM, Bell MD: [Cognitive remediation and work therapy in the outpatient treatment of patients with schizophrenia]. Sante Ment Que. 2004 Autumn. PMID: 15928790
- Bell MD, Fiszdon J, Bryson G, Wexler BE: Effects of neurocognitive enhancement therapy in schizophrenia: normalisation of memory performance. Cogn Neuropsychiatry. 2004 Aug. PMID: 16571581
- Greig T, Zito W, Bell MD: Rehab rounds: A hybrid transitional and supported employment program. Psychiatr Serv. 2004 Mar. PMID: 15001722
- Fiszdon JM, Bryson GJ, Wexler BE, Bell MD: Durability of cognitive remediation training in schizophrenia: performance on two memory tasks at 6-month and 12-month follow-up. Psychiatry Res. 2004 Jan 30. PMID: 14967547
- Greig TC, Bryson GJ, Bell MD: Theory of mind performance in schizophrenia: diagnostic, symptom, and neuropsychological correlates. J Nerv Ment Dis. 2004 Jan. PMID: 14718771