Conclusions
cognitive and motivational impairments, psychosis
This study aimed to identify and inform scalable remote interventions that address both cognitive and motivational impairments in psychosis using neuroscience-informed cognitive training exercises and a novel smartphone-based app. Our retention rate of 78% (78/100) and the national and international geography of participation in our study indicate that this approach is acceptable, feasible, tolerable, and scalable and that cognitive training and the PRIME app can induce improvements in emotion recognition, motivation, and symptoms that persist 6 months after the interventions. Future analyses will test models of the relationship between hours of cognitive training completed; PRIME use; and changes in cognition, motivation, symptoms, and functioning.This work was supported by the Stanley Medical Research Institute (grant 15T-010) and the National Center for Advancing Translational Sciences of the National Institutes of Health (award UL1-TR002494). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.Authors' Contributions: SV conceptualized and acquired funding for this study. Data curation and formal analysis were performed by MF. The investigation was conducted by MF, KE, AM, NG, KLC, and AC. The methodology was developed by MF, AM, AC, BB, and SV. NG was responsible for the primary administration of the study. RL provided resources, including the Personalized Real-Time Intervention for Motivational Enhancement (PRIME) app and data storage, along with overseeing PRIME coaches and assessment staff from the University of California, San Francisco. BB from Posit Science provided consultation and access to BrainHQ cognitive training exercises and computer games for the control group. DS provided the PRIME app. MF, AM, AC, KF, and SV supervised this study. IR provided validation of the cognitive training and control games completed. KE prepared visualizations of the PRIME app and locations of participants. MF, KE, and AM drafted the manuscript, and all authors were involved in reviewing and editing the manuscript.Conflicts of Interest: None declared.Cognitive and social cognitive training exercises.Commercially available computer games.Effect sizes (Cohen d) from baseline to posttraining and baseline to 6-month follow-up in measures showing statistically significant or trend-level, but not significant, main effects of time.CONSORT-eHEALTH (V 1.6.1).