SEARCH · PubMed Health

Results for “Cognitive Training”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 289 records · Page 16Linked to original sources

PubMed2005

Impact of long-term HPN on daily life in adults.

BACKGROUND AND AIMS: Home parenteral nutrition (HPN) is a therapy that changes life radically and often means lifelong dependence on parenteral feeding. The aim of this study was to gain insight into problems experienced by adult patients who were dependent on long-term HPN. METHODS: A survey was performed on all patients at the ambulatory care clinics of two university centres. We used two techniques: written questionnaires and interviews. The questionnaires addressed fatigue (CIS), quality of sleep, anxiety, depression (BDI), social impairment (subscale SIP68), and sexual functioning. Data were analysed descriptively. Structured interviews inquired about the negative influence of HPN dependence on daily life. These data were quantified by content analysis. RESULTS: The response rate was 76% (n = 48). Questionnaire results: all the respondents had multiple physical symptoms, which they attributed to the underlying disease. Furthermore, severe fatigue (63%), sleeping disorders, (severe) depression (65%), social impairment (55%), and sexual disorders (33%) were present. Quality of life (QoL) correlated with fatigue, sleeping disorders, anxiety, depression, and social impairment (P<0.02). Interview results: psychosocial problems were the main complaints in daily life due to HPN dependence, e.g. negative changes in moods and feelings (including anxiety), lack of freedom, limitations in social life and being dependent. CONCLUSIONS: Although many somatic symptoms were present, HPN-dependent patients reported primarily psychosocial problems in daily life. To improve QoL, HPN teams should assess somatic as well as psychosocial aspects standard. Given the large proportion of patients with depressive disorders, therapies such as anti-depressant medication, psychosocial support and cognitive training, should be offered.

Ambulatory Care Facilities↗

PubMed2004

Preserved neural correlates of priming in old age and dementia.

Implicit memory, including priming, can be preserved in aging and dementia despite impairment of explicit memory. To explore the neural correlates of preserved memory ability, whole-brain functional MRI (fMRI) was used during a repetition priming paradigm to study 34 young adults, 33 older adults without dementia, and 24 older adults in the early stages of dementia of the Alzheimer type (DAT). Both older adult groups showed repetition-based response time benefits (priming) and changes in activation along inferior frontal gyrus similar to those shown by young adults. Across all three groups, repetition-related response time reductions correlated with prefrontal activity reductions, demonstrating a direct relation between priming and fMRI-measured activity change. These results suggest that despite difficulties with deliberate memory, both older adults without dementia and those with early-stage DAT can modify behavior mediated by prefrontal contributions, making these preserved abilities an attractive target for cognitive training and rehabilitation.

Adolescent↗

PubMed2007

Contribution of divergent thinking to community functioning in schizophrenia.

Fluency deficits have been associated with poor community functioning in patients with schizophrenia. In our previous study we demonstrated that the ability to generate higher-quality responses on tasks of divergent thinking as measured by several fluency tests was impaired in patients with schizophrenia. The purpose of the present study was to investigate the contribution of the deficits in divergent thinking to community dysfunction in schizophrenia. Forty Japanese outpatients with schizophrenia and 32 healthy control subjects were recruited for this study and assessed over a broad spectrum of the neurocognitive domain. Their capacity for divergent thinking was assessed by idea, design, and word fluency tests. Community functioning was assessed by using the Global Assessment of Functioning (GAF), the Life Assessment Scale for the Mentally Ill (LASMI), and the Social Functioning Scale (SFS). The results confirmed the qualitative deficits of divergent thinking in schizophrenia. Stepwise multiple regressions using neurocognitive and demographic/clinical variables as predictors revealed that the higher-quality response scores on the tasks of divergent thinking significantly contributed to community functioning. Moreover, the deficit on the verbal task of divergent thinking significantly contributed to impairment in the area of daily living, and the deficit on the nonverbal task of divergent thinking significantly contributed to impairment in the area of interpersonal relations. The results of this study reveal the importance and the possibility of cognitive remediation and cognitive training with strategies that target capacity for divergent thinking to improve community functioning in patients with schizophrenia.

Adult↗

PubMed1998

Insomnia.

This article reviews issues involved in the diagnosis of insomnia and discusses treatment options, including pharmacologic treatment, which is indicated mainly in acute insomnia. Sleep hygiene is then discussed. Finally, the various behavioral treatments are reviewed, including light therapy, relaxation training, cognitive therapy, sleep curtailment, and stimulus control therapy.

Acute Disease↗

PubMed2001

Exposure therapy in the treatment of PTSD among cocaine-dependent individuals: description of procedures.

An estimated 30% to 50% of cocaine-dependent individuals meet criteria for lifetime PTSD. This comorbidity has detrimental effects on clinical presentation, and treatment course and outcome. Cocaine dependence is associated with increased rates of exposure to trauma, more severe symptoms, higher rates of treatment attrition and retraumatization, and greater vulnerability to PTSD when compared to other substance use disorders. These associations underscore the need for effective treatments that address issues particular to PTSD in a manner tolerable to cocaine-dependent individuals. This article describes a manualized psychotherapy developed specifically for individuals with PTSD and cocaine dependence. Concurrent Treatment of PTSD and Cocaine Dependence (CTPCD) provides coping skills training, cognitive restructuring techniques, and relapse prevention strategies to reduce cocaine use. In-vivo and imaginal exposure therapy techniques are incorporated to reduce PTSD symptom severity. Primary treatment goals include psychoeducation specific to the interrelationship between PTSD and cocaine dependence, and clinically meaningful reductions in cocaine use and PTSD symptomatology. Secondary goals include a reduction in HIV high-risk behaviors and improved functioning in associated areas, such as anger and negative affect management.

Cocaine-Related Disorders↗

PubMed1995

Chronic nonprogressive headaches in children and adolescents.

Chronic nonprogressive headaches are common in adolescents. The features of this syndrome are distinct from those of migraine. Chronic nonprogressive headaches have received less attention and study than migraine headaches. The prevalence of this syndrome is not clear. A structured psychological interview with the patient and the parents of the patient coupled with psychological testing of the patient will usually identify factors playing a role in the continuing headache. Counseling, biofeedback, and cognitive training, combined with judicious use of medication, will frequently lead to resolution of the headache.

Adolescent↗

PubMed2001

Four paradigms to study visual--spatial attention of myopic subjects.

We describe four protocols for evaluating the attentional skills of myopic and control subjects in target stimulus detection tasks; simple reaction times (RT) are recorded. Two protocols are designed to study both automatic and voluntary orienting of attention. Modified implicit orienting paradigms [Q. J. Exp. Psychol. 32A (1980) 2; J. Exp. Psychol. Gen. 109 (1980) 160] are used in which cues elicit a shift of attention but gaze is maintained on a central fixation point. A third paradigm is designed to study the time-course of focusing; two circles (focusing cues) of different diameters are randomly presented on a point of the visual space where attention has been previously shifted. Seven SOAs (stimulus onset asynchrony) are used. The fourth paradigm was designed to evaluate visual search; three circular arrays of four, eight and twelve stimuli are randomly presented around a fixation point and subjects have to detect the target stimulus inside one of the circles (the other circles are distracters). Since some attentional deficits are associated with myopia [Invest. Ophthalmol. Vis. Sci. 38 (1997) 1725; Cogn. Brain Res. 8 (1999) 369], these protocols could be useful both in the detection of deficits in subjects on the verge of becoming myopics and in the development of cognitive training programs to reduce attentional deficits.

Adolescent↗

PubMed1993

A meta-analysis of treatments for panic disorder.

In a meta-analysis, the authors compared the effectiveness of psychological and pharmacological treatments for panic disorder. Percentage of agoraphobic subjects in the sample and duration of the illness were unrelated to effect size (ES). Type of dependent variable was generally unrelated to treatment outcome, although behavioral measures yielded significantly smaller ESs. Dependent measures of general anxiety, avoidance, and panic attacks yielded larger ESs than did depression measures. Choice of control was related to ES, with comparisons with placebo controls greater than comparisons with exposure-only or "other treatment" controls. Psychological coping strategies involving relaxation training, cognitive restructuring, and exposure yielded the most consistent ESs; flooding and combination treatments (psychological and pharmacological) yielded the next most consistent ESs. Antidepressants were the most effective pharmacological intervention.

Agoraphobia↗

PubMed1991

Cognitive mediators of pain perception and tolerance.

A social learning model of pain perception and tolerance was evaluated. Responses to cold-pressor pain were examined in 4 groups of 20 Ss each. One group was given instruction in cognitive coping strategies, the 2nd was given a monetary incentive contingent on tolerance time, the 3rd was given both cognitive training and monetary reinforcement, and a no-treatment control group was given neither. Incentive and coping instructions significantly increased tolerance but did not alter pain perception. A path analysis indicated that pain tolerance was affected by self-efficacy, which in turn was predicted by pain expectancy and the provision of incentives. Incentive also had an impact on tolerance that was independent of self-efficacy. Pain perception was strongly affected by pain expectancy, but was unrelated to self-efficacy.

Adaptation, Psychological↗

PubMed2006

Adaptation in very old age: exploring the role of resources, beliefs, and attitudes for centenarians' happiness.

When individuals reach very old age, accumulating negative conditions represent a serious challenge to their capacity to adapt and are likely to reduce the quality of life. By examining happiness and its determinants in centenarians, this study investigated the proposal that psychological resilience may come to an end in extremely old age. Data from the population-based Heidelberg Centenarian Study indicated high levels of happiness. Basic resources (i.e., job training, cognition, health, social network, extraversion) explained a substantial proportion of variance in happiness, but some resource effects were mediated through self-referent beliefs (e.g., self-efficacy) and attitudes toward life (e.g., optimistic outlook). Results challenge the view that psychological resilience reaches a critical limit or that the self-regulatory adaptation system loses its efficiency in very advanced age.

Activities of Daily Living↗

PubMed2001

The role of unilateral spatial neglect in rehabilitation of right brain-damaged ischemic stroke patients: a matched comparison.

OBJECTIVE: To assess the specific influence of unilateral spatial neglect (USN) on rehabilitation outcome. DESIGN: A case-control study in consecutive stroke inpatients. SETTING: Rehabilitation hospital. PATIENTS: One hundred seventy-eight patients with sequelae of first stroke, enrolled in homogeneous subgroups, matched for age (within 1yr) and onset admission interval (within 3d), and difference because of the presence of USN, evaluated by a specific neuropsychologic battery. INTERVENTIONS: All patients received physical rehabilitation: physiotherapy for 60 minutes twice a day (once on Saturday), 6 days a week, within 24 hours of admission. USN-positive (USN(+)) patients received specific treatment of 5, 1-hour sessions per week, for 8 consecutive weeks: (1) visual scanning, (2) reading and copying, (3) copying of line drawings on a dot matrix, and (4) describing a scene. Patients were assessed with neurologic (Canadian Neurological Scale), neuropsychiatric (Hamilton Depression Rating Scale), neuroradiologic, and functional (Barthel Index, Rivermead Mobility Index [RMI]) examinations. MAIN OUTCOME MEASURES: Length of stay, efficiency (average daily increase in Barthel Index), effectiveness (amount of potential improvement achieved during rehabilitation) of treatment and percentage of low- and high-response patients calculated on the Barthel Index and the RMI, and percentage of urinary incontinence and return home were evaluated. Odds ratios (ORs) of dropouts and of low and high therapeutic response were also quantified. RESULTS: Compared with USN-negative patients, USN(+) patients had significantly more severe baseline neurologic and functional status at admission, less effectiveness and efficiency on activities of daily living (ADLs) and mobility, a higher percentage of low responders, longer hospitalization, a higher percentage of persistent incontinence at discharge (20.5% vs 4.9%), and a lower percentage of high responders and patients returning home. The presence of USN was incompatible with a high therapeutic response, for both ADLs (OR= 2.94, 95% confidence interval [CI]= 1.05-8.20; b +/- standard error = 1.08 +/- .52, p< .05), and mobility (OR = 7.16, 95% CI = 2.78-18.44; b = 1.97 +/- .52, p < .001) and was a relevant prognostic factor for institutional discharge (OR = 5.62, 95% CI = 1.63-19.38; b = 1.73 +/-.63, p < .01, accuracy 88.41%). CONCLUSIONS: The results of this study provide further strong evidence of the relationship between USN and disability in right brain-damaged patients and of its unfavorable impact on rehabilitation, despite the cognitive training performed by all USN(+) patients.

Aged↗

PubMed2003

[A systematic comparison of national and international dementia guidelines].

Several guidelines for the evidence-based diagnosis and treatment of dementing disorders have been published in Germany and worldwide during the last years. This review analyses the content and methodological quality of 13 recently published dementia guidelines. There are some unequivocal recommendations for diagnostic procedures (e. g. clinical evaluation, neuropsychological screening, structural brain imaging) and treatment (e. g. cholinesterase inhibitors). There is a broad range of opinions on other procedures (e. g. routine EEG, FDG PET, cognitive training). A discussion of the prevalent guideline pluralism and a pleading for regionally adapted international guidelines conclude this article.

Dementia↗

PubMed1992

[Possibilities in therapy of anxiety disorders in DSM-III-R].

Between 2% and 5% of the population are affected by anxiety disorders. Several studies have shown that imipramine possesses anti-panic and anti-phobic properties. Its response rate is at least 70%. In panic disorder with agoraphobia it is therefore the medication of first choice. Agoraphobia, simple and social phobias are highly responsive to behavioural therapy (desensitization, flooding, social skills training, cognitive restructuring). Drugs have not been found useful in controlled studies. In conjunction with the tricyclic antidepressant clomipramine, behavioural therapy is superior to other psychotherapeutic strategies in the treatment of obsessive-compulsive disorders. Patients suffering from posttraumatic stress disorders require first of all supportive psychotherapy. Pharmacological treatment is of limited value. Neuroleptics, benzodiazepines, sedating antidepressants and beta-blockers are the most appropriate agents for the treatment of generalised anxiety disorders. In addition to that, intense psychotherapy and relaxation techniques should be applied. Further research should address the question of relapse rates after termination of therapy and the elaboration of therapeutic strategies that take individual psychopathology into consideration.

Anxiety Disorders↗

PubMedDate not supplied

Premature ejaculation: a psychophysiological approach for assessment and management.

This article distinguishes several subtypes of biogenic and psychogenic premature ejaculation (PE) according to their etiologic features: the physiological PE types of (a) neurologic constitution, (b) acute physical illness, (c) physical injury, and (d) pharmacologic side effect; and the psychological PE types of (a) psychological constitution, (b) acute psychological distress, (c) relationship distress, and (d) psychosexual skills deficit. Attention is given to assessment and differential diagnosis, and to specific treatment of the types of PE, such as the pharmacologic management of difficult neurologic cases. Effective psychosexual treatment combines multiple strategies such as physiological relaxation, pubococcygeal muscle training, cognitive and behavioral pacing strategies, and the involvement of the partner in the therapy. Treatment should determine the specific type of PE and comprehensively address its particular features in order to improve long-term treatment effectiveness.

Combined Modality Therapy↗

PubMed2001

A classroom mind/body wellness intervention for older adults with chronic illness: comparing immediate and 1-year benefits.

The authors tested the efficacy of a mind/body wellness intervention for older adults with chronic illness. They randomly assigned 243 physician-referred patients from an urban HMO to a classroom intervention or a wait-list control group. The intervention provided instruction on mind/body relationships; relaxation training; cognitive restructuring; problem-solving; communication; and behavioral treatment for insomnia, nutrition, and exercise. At posttreatment, the intervention group had significant decreases in self-reported sleep difficulties, pain, anxiety, and depression symptoms compared with controls. The intervention also led to a significant decrease in "chance" and "powerful others" health locus of control beliefs. At 1-year follow-up, the intervention group maintained benefits in sleep and health locus of control and also reported a significant increase in health behaviors compared with controls. Pain, anxiety, and depression benefits were not maintained. This type of classroom intervention appears to have some lasting effects on health behaviors and beliefs.

Aged↗

PubMed1999

Comparing mind-body wellness interventions for older adults with chronic illness: classroom versus home instruction.

Two versions of a multicomponent mind-body wellness intervention were tested. One hundred seventy-eight physician-referred HMO patients (mean age = 64.5) were randomly assigned to a classroom intervention, a home study intervention, or a wait-list control group. Both interventions provided instruction on mind-body relationships, relaxation training, cognitive restructuring, problem solving, communication, behavioral treatment for insomnia, nutrition, and exercise. The home version was delivered by class videotapes and readings. Compared with the control condition, both interventions led to significant decreases in self-reports of pain, sleep difficulties, and symptoms of depression and anxiety. The home course also led to a significant decrease in self-reported frequency of medical symptoms, and the classroom program resulted in a significant decrease in "chance" health locus of control beliefs. No effects were obtained for health behaviors, life satisfaction, HMO satisfaction, and other health locus of control beliefs. A lower cost, more accessible home study version of a mind-body wellness program can be an effective alternative to classroom instruction.

Adaptation, Psychological↗

PubMed2000

The effect of fluvoxamine and behavior therapy on children and adolescents with obsessive-compulsive disorder.

OBJECTIVE: The efficacy of medications, consisting of serotonin partial and specific reuptake blockers, and behavior therapy, consisting of exposure and response prevention in addition to social skills training, cognitive therapy, and habit reversal, in the treatment of obsessive-compulsive disorder are well documented. The purpose of the study was to explore if adding behavior therapy to medication would enhance treatment efficacy. METHODS: Ten children/adolescents who had not previously responded to behavior therapy were randomly assigned to two groups: fluvoxamine alone or fluvoxamine with behavior therapy. All 10 patients received fluvoxamine for 10 weeks-five continued solely on fluvoxamine for one year and five engaged in behavior therapy for 20 sessions along with fluvoxamine and then continued solely on medication until the end of the year. RESULTS: Eight of 10 patients improved significantly on fluvoxamine at week 10 on the primary outcome variable, the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS). According to the other measurements-National Institute of Mental Health-Global Obses-sive-Compulsive Scale, Clinical Global Impression-Improvement (assessing level of im-provement from week to week), and Clinical Global Impression-Severity of Illness Scale (as-sessing how ill the patient is from week to week)-improvement was not as evident. According to the CY-BOCS, those who received a combination of fluvoxamine and exposure with response prevention showed significantly more improvement than those who only took medication. At two-year follow-up, all patients continued to improve, with those in the combined approach improving more than those in the medication-alone group. CONCLUSIONS: Future studies should determine the specific effect of each treatment group, combined and singularly. Reasons for discrepancy in improvement ratings as noted by the different instruments are discussed. The addition of behavior therapy to fluvoxamine seems to enhance treatment efficacy, according to the CY-BOCS.

Adolescent↗

PubMed2004

Congruence of self-reported medications with pharmacy prescription records in low-income older adults.

PURPOSE: This study examined the congruence of self-reported medications with computerized pharmacy records. DESIGN AND METHODS: Pharmacy records and self-reported medications were obtained for 294 members of a state pharmaceutical assistance program who also participated in ACTIVE, a clinical trial on cognitive training in nondemented elderly persons. The average age of the sample participants was 74.5 years (range = 65-91); 87.8% were females. RESULTS: Congruence between self-report and pharmacy data was generally high. Self-reports omitted drug classes in the pharmacy records less often than the pharmacy records did not include self-reported drug classes. The percentage of individuals with perfect agreement between self-reports and pharmacy records varied from 49% for major drug classes to 81% for specific cardiovascular and central nervous system drugs. Within a drug class, agreement tended to be higher for individuals without a prescription in that class. Poorer health was consistently related to poorer self-report of medications. IMPLICATIONS: Self-reported medications are most likely to be congruent with pharmacy records for drugs prescribed for more serious conditions, for more specific classes of drugs, and for healthier individuals.

Aged↗