# The feasibility of culturally adapted computerised cognitive remediation for first-episode psychosis

## TL;DR

This study adapts a computer-based cognitive training program for British South Asians with early psychosis, finding it culturally acceptable and effective in improving cognition.

## Contribution

The first culturally adapted computerised cognitive remediation program for British South Asians with first-episode psychosis is developed and tested.

## Key findings

- Culturally adapted CIRCuiTS was acceptable and well-engaged by participants.
- Participants showed improved cognition and mental state after the intervention.
- High retention and satisfaction rates were observed in the feasibility study.

## Abstract

British South Asians have a greater incidence of psychotic illness, which is associated with cognitive deficits. Computerised cognitive remediation aims to improve cognition.

We aimed to culturally adapt computerised cognitive remediation for British South Asians with first-episode psychosis, and assess its feasibility.

Qualitative interviews were analysed using thematic analysis to guide cultural adaptation of cognitive remediation, followed by a case series to determine feasibility. Our sample comprised 20 participants: ten in the qualitative interviews and ten in the feasibility evaluation. The sample was generated via purposive sampling from early intervention services in England, and was an entirely Muslim cohort, who were mainly Pakistani and born in the UK. Our intervention was computerised interactive remediation of cognition training for schizophrenia (CIRCuiTS), which was culturally adapted based on formative qualitative interviews and using an established framework. Participants engaged with 40 h of tasks over 12 weeks, with the aim of improving attention, memory and executive functioning. Feasibility was explored by assessing acceptability, engagement and retention in the study, and a range of measures were used to assess impact on cognition and mental state.

The cultural adaptation of CIRCuiTS was found to be acceptable, with high levels of engagement and satisfaction. Despite the small sample, the intervention led to improved cognition and mental state.

This is the first study to culturally adapt computerised cognitive remediation for British South Asians who are Muslim, and it had high acceptability with good retention, engagement and satisfaction. Future effectiveness testing is recommended.