As we have noted previously, when the individuals are engaged in a highly salient, meaningful, enjoyable activity, such as planning for or participating in a party, they seem to be totally different from their previous states of withdrawal, often preoccupied with voices, etc. I had suggested that they were in an adaptive mode. This is surprising since our sample of individuals, like those in the hospital, showed that they were approximately 2 SDs below the norm on neurocognitive tests for attention, memory, and executive function. One individual, for example, was able to go through all of the routines in planning for a party, getting all of the essentials and inviting the other participants to the party. Another individual, who scored 2 SDs below the norm on the neurocognitive tests, reached the point in his improvement that he was able to drive a car in heavy traffic. These examples indicated that, clinically, the individuals all showed improvement in
Our current experimental work, showing improvement in self-concept, defeatist attitudes, and mood, following a guided success experience, was supported by collaboration and positive reinforcement by the experimenter. Since the individuals showed a significant improvement on card sorting (a behavioral or neurocognitive test), it would seem to indicate that, even though “neurocognitively impaired,” they were able to show significant improvement on a proxy task. The improved neurocognition, presumably, was based on enhanced motivation. Support for this notion is provided by a study in the literature, which showed that increased motivation resulted in increased performance on neurocognitive tasks (Foussias, 2015, attached).
The bottom line is: no matter how neurocognitively impaired an individual is on these other neurocognitive tests, it is possible to promote his recovery towards a much higher level of functioning. The improvement in positive self-concept, defeatist attitudes, and mood probably generated the motivation for the improvement.