Errorless learning and social problem solving ability in schizophrenia: An examination of the compensatory effects of training

Compensatory approaches to cognitive rehabilitation in schizophrenia aim to improve functioning by bypassing or compensating for impaired areas of cognition. At present, there is little empirical evidence that these approaches actually compensate for neurocognitive impairments in improving community functioning. This study examined the effects of errorless learning (EL), a compensatory cognitive rehabilitation approach, on social problem solving ability in schizophrenia. The study included 60 outpatients who met DSM-IV criteria for schizophrenia or schizoaffective disorder. Participants received a baseline battery to assess explicit and implicit memory functioning. Participants were stratified according to gender and level of memory functioning and then randomized to EL or symptom management training. Training was conducted over two days lasting a total of 6 h for each group. Assessment of social problem-solving ability, using the Assessment of Interpersonal Problem Solving Skills (AIPSS), was conducted after completion of training and at a 3-month follow-up without further intervention. Results from hierarchical multiple regression and analysis of covariance each supported the compensatory effects of training. These findings indicate that EL facilitates learning of new skills across varying levels of memory impairment. Future efforts may aim to explore the specific neurocognitive mechanisms involved in EL.