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PubMed1985

Personal and social skills training: cognitive-behavioral approaches to substance abuse prevention.

A total of nine evaluation studies have been conducted with four prevention models which focus on teaching generic personal and social skills. All of these approaches have produced demonstrable effects for one or more substance use behaviors, and the magnitude of these effects generally appears to be large. Although methodological problems may exist in some of these studies, the magnitude of the effects obtained and their consistency across studies provide strong support for the efficacy of these approaches. Finally, a major strength of the research conducted in this area is that all of these studies have assessed the impact of the prevention programs on presumed mediating variables, and have been able to demonstrate effects on a number of these variables consistent with the behavioral results. Thus, while these studies collectively provide evidence for the effectiveness of generic personal and social skills training substance abuse prevention models, only preliminary data are available concerning how and why these programs work.

Adolescent↗
PubMed1999

[Standard treatment of schizophrenia and legality of personnel equipment in psychiatric hospitals (German Psych-PV): possibilities and limitations].

BACKGROUND: Comprehensive insight regarding better treatment and social reintegration of patients with schizophrenia has been gained over the past decade. Implementation of this knowledge into everyday's practice should be a major aim prior to the research on new variants of rehabilitative measures. To which extent this takes place has been poorly discussed until now. METHOD: Our comprehensive treatment program includes psychoeducation for patients and relatives, cognitive training, social skills training, additional psychoeducation for patients with dual diagnosis and a variety of a traditional group therapies like work therapy. An intensive cooperation is practised with complementary psycho-social services. In n = 89 consecutive admissions lasting at least 2 weeks we examined which patients were reached by these treatment offers. RESULTS: 84% of the patients participated in group therapies, where they passed 6.9 hours weekly on average. Most patients were reached by occupation therapy (62%), followed by physical therapy (54%), unspecific conversation group (54%), psychoeducation (35%), cognitive training (30%), work therapy (26%) and social skills training (7%). The PANSS Positive Scale at admission was negatively correlated with participation in group therapies. DISCUSSION: The implementation of a variety of psychotherapeutic offers for psychotic patients adequate to the state of the art can be achieved under conditions of standard hospital care in Germany (Psych-PV-law). Required organizational measures therefore are programs offered for patients of several wards in union and participation of employees in education. However, even by such efforts a considerable part of patients is not reached. Strategies to improve treatment results should consider these problems.

Adolescent↗
PubMed2003

Item learning in cognitive skill training: effects of item difficulty.

Item difficulty effects in skill learning were examined by giving participants extensive training with repeated alphabet arithmetic problems that varied in addend size (e.g., C-D = ? is easy; C-J = ? is harder). Recognition memory for the items, as measured by interpolated recognition tests, was acquired early in training and was unaffected by item difficulty. Memory for the solutions to items, as measured by the participants' strategy reports that they had retrieved, rather than computed, the solution, was acquired later and was affected by item difficulty. Solutions to easier items were learned earlier in training for both young adults (18-24 years) and older adults (60-75 years), superimposed on an overall lower level of solution learning in older participants. The results suggest that the formation of associations between problems and their solutions is effortful and shares limited processing resources with the computational demands of the problem.

Adolescent↗
PubMed2000

Shifting from the perceptual brain to the logical brain: the neural impact of cognitive inhibition training.

What happens in the human brain when the mind has to inhibit a perceptual process in order to activate a logical reasoning process? Here, we use functional imaging to show the networks of brain areas involved in a deductive logic task performed twice by the same subjects, first with a perceptual bias and then with a logical response following bias-inhibition training. The main finding is a striking shift in the cortical anatomy of reasoning from the posterior part of the brain (the ventral and dorsal pathways) to a left-prefrontal network including the middle-frontal gyrus, Broca's area, the anterior insula, and the pre-SMA. This result indicates that such brain shifting is an essential element for human access to logical thinking.

Adult↗
PubMed1993

Effects of behavioral psychophysiological treatment on schoolchildren with migraine in a nonclinical setting: predictors and process variables.

Evaluated the outcome of a combined behavioral therapy, comprising relaxation training, temperature biofeedback, and cognitive training, administered in a school setting, at posttreatment, and 7-month follow-up, on a group of schoolchildren with migraine. Comparison between the experimental group (n = 32) and the waiting-list control group (n = 9) showed a treatment effect on headache frequency and duration but not on intensity. Using a 50% reduction in the headache activity as a criterion for clinical improvement, 45% of the children in the experimental group were clinically improved at the end of the treatment. The treated subjects were found to have maintained significant improvement at follow-up. Sex, headache history, age, and psychosomatic complaints before the training emerged as predictors of outcome. A decrease in state anxiety and an increase in the ability to relax during the sessions contributed to headache improvement. Finally, the acquired capacity to raise one's finger temperature during the biofeedback sessions was related to headache reduction after the training.

Adolescent↗
PubMed1996

A controlled field trial of group versus individual cognitive-behavioural training for relapse prevention.

Results are presented of a randomized field trial comparing two aftercare regimes, namely individual versus group delivery of a structured relapse prevention approach. Two addictions treatment programs (one a 12-Step 26-day residential program, the other an evening group counselling program) implemented structured relapse prevention in either group or individual format as part of the first three months of aftercare. Process measures (e.g. attendance, client satisfaction) indicated that both group and individual formats were delivered very successfully at both sites. Follow-up rate at 12 months across both programs was 74%, and drinking and drug use at the 12-month follow-up was substantially less than use at entry into treatment. However, there were no significant differences in outcomes between individual and group delivery on any of the alcohol or drug use measures. Only one psychosocial outcome measure (social support from friends at 12-month follow-up) showed a significant difference for format and it favored the group format. These findings suggest some important directions for future research.

Adult↗
PubMed2006

Competence assessment of laparoscopic operative and cognitive skills: Objective Structured Clinical Examination (OSCE) or Observational Clinical Human Reliability Assessment (OCHRA).

BACKGROUND: There is no agreed system that is acknowledged as the ideal assessment of laparoscopic operative and cognitive skills. A new approach that combines Objective Structured Clinical Examination (OSCE) and Observational Clinical Human Reliability Assessment (OCHRA) was developed and used to assess trainees' operative and cognitive skills during laparoscopic training courses. METHODS: Performance of 60 trainees participating in 3-day essential laparoscopic skills training (cognitive and psychomotor) courses were assessed and scored using both OSCE and OCHRA. RESULTS: The study showed significant inverse correlations between the number of technical errors identified by OCHRA and the scores obtained by OSCE for individual tasks performed either by electro-surgical hook or laparoscopic scissors (r = -0.864 and r = -0.808, respectively). Significant differences between trainees were observed in relation to both overall OSCE scores and OCHRA parameters: execution time, total errors, and consequential errors (P < 0.001). CONCLUSIONS: OCHRA provides a discriminative feedback assessment of laparoscopic operative skills. OCHRA and OSCE are best regarded as complementary assessment tools for operative and cognitive skills. The present study has documented significant variance between surgical trainees in the acquisition of both cognitive and operative skills.

Cholecystectomy, Laparoscopic↗
PubMed2003

Intensive group training versus cognitive intervention in sub-acute low back pain: short-term results of a single-blind randomized controlled trial.

OBJECTIVE: To evaluate the short-term effect of physical exercise and a cognitive intervention in low back pain. DESIGN: Randomized controlled trial. SUBJECTS: Ninety-three patients sick-listed for 8-12 weeks for sub-acute low back pain were randomized to an exercise regime (n = 30), a cognitive intervention (n = 34) or a control group (n = 29). METHODS: Primary outcome measures were pain, disability, sick-listing and satisfaction with care. Secondary outcome measures were self-efficacy for pain and for function, fear-avoidance beliefs, emotional distress, generic health status and life satisfaction. RESULTS: Eighteen percent of subjects dropped out. Drop-out was most frequent in the exercise group. At 18 weeks after inclusion fear-avoidance beliefs were reduced in both intervention groups. The cognitive group demonstrated significant improvement in disability, self-efficacy for pain, emotional distress, general health and life satisfaction. Patients in the exercise group were significantly more satisfied with the treatment, and patients following the exercise protocol reduced pain significantly. No effect on sick-listing was seen. CONCLUSION: Cognitive intervention improved disability and may be feasible for most patients sick-listed in the sub-acute phase. Physical exercise reduced patients' symptoms, but requires high motivation by patients. Despite positive effects in intervention groups on variables considered as negative prognostic factors for long-term disability and sickness absence, interventions had no effect on sick-listing.

Adult↗
PubMed1986

The elephant on the fence: approaches to the psychotherapy of attention deficit disorder.

Attention Deficit Disorder (ADD) is understood in terms of a complex interaction between neurophysiological growth, environmental demand, and ego-development. Various therapeutic approaches have been recommended, including cognitive training and psychodynamic psychotherapy. Cognitive impairments demand modifications in the usual psychotherapeutic techniques to develop an effective integrated approach to treatment.

Attention Deficit Disorder with Hyperactivity↗
PubMed1986

[Behavior therapy of cardiac phobia--a clinical report of experiences in the training of cognitive anxiety management].

We report about a psychotherapeutic approach of intervention with patients suffering of severe cardiac neurosis. The patients treated had panic attacks almost every night. The patients learned cognitive strategies in combination with a self-controlled stimulus exposition. In addition an analysis of the individual learning history was made. We found an anxious, dominant mother in 8 of 10 cases. Two patients had a foster-mother. Six married patients had a tendency of separation and a fear of separation as well. In these cases we recommended a marital therapy or an individual therapy after our hospital treatment. All treated patients lost the panic attacks; agoraphobic tendencies were reduced as well--no longer impairing their every day life. In five cases all clinical symptoms had disappeared completely. In all cases we found the improvements persisting 6 months after treatment.

Adaptation, Psychological↗
PubMed1998

[Computer-assisted neuropsychological training in neurological rehabilitation].

Using computer-assisted cognitive training to treat patients with cognitive disorders has proved a useful tool in neurological rehabilitation. This has been shown by positive experience in many rehabilitation clinics but also in numerous control studies investigating the efficiency of such training. Patients with attention deficits show the most pronounced improvements as the computer with its technical possibilities is an ideal training instrument because of stimulus representation and reaction time measures. In other areas, computer training has become an essential therapeutic means complementing other therapies. In a clinical environment it seems that computer training is essential because it enables attaining the necessary therapeutic density. However, training must be integrated and become part of a global therapeutic framework.

Brain Damage, Chronic↗
PubMed2006

Training attention-switching ability in adults with ADHD.

OBJECTIVE: Children with ADHD show attention-switching impairment. The present study assessed attention-switching ability in adults with ADHD, the extent to which this ability can be improved via targeted training, and the degree to which training extends to novel tasks of attention-switching. METHOD: Adults with ADHD (n = 16) and adults without ADHD (n = 18) were divided into training and non-training groups. Training groups performed six blocks of four different attention-switching tasks, while non-training groups completed non-switching, "filler" tasks. Lastly, the four groups were tested on two novel attention-switching tasks. RESULTS: Adults with ADHD showed impaired attention-switching, relative to non-ADHD adults, but training significantly improved attention-switching in both ADHD and non-ADHD training groups. Finally, training effects transferred to new tasks of attention-switching. CONCLUSION: Adults with ADHD show attention-switching impairments, but deficits may be ameliorated with short-term, targeted training. Research has implications for cognitive training in ADHD.

Adult↗