Rethinking the effects of working memory training on executive functions in schizophrenia: A machine learning approach.

Background: Executive dysfunction in schizophrenia profoundly impairs functional outcomes and remains insufficiently addressed by standard pharmacological treatments. While computerized cognitive training offers promise, traditional evaluation methods often fail to capture nuanced improvements along the psychosis-health continuum. This study aims to quantify executive function (EF) profile changes following working memory training and identify robust baseline predictors of treatment response. Methods: Ninety-four schizophrenia patients were randomized to adaptive Results: Adaptive training produced significant near-transfer effects on untrained working memory tasks and reduced general psychopathology ( Conclusions: Working memory training induces meaningful shifts in EF profiles in schizophrenia, promoting movement along the psychosis-health continuum toward neurotypical functioning. The classifier-based approach provides a more refined assessment compared to traditional binary measures, while the exploratory framework identifies specific EF domains predicting treatment response with potential causal relevance. These findings warrant validation through larger, multi-center trials with extended follow-up periods.