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At least 451 records · Page 25Linked to original sources
PubMed2000

Psychological therapy in schizophrenia: what is the evidence?

OBJECTIVE: The present contribution provides a critical outline of the current position of psychological therapies in schizophrenia. METHOD: Therefore, empirical research into the efficacy of psychological interventions in the treatment of schizophrenic disorders has been reviewed. RESULTS: Four cognitive-behavioural approaches have emerged as preeminently effective, or at least especially promising, as adjuncts to pharmacotherapy, i.e. the training of social skills, cognitive training programs for the remediation of neurocognitive deficits, psychoeducative, coping-orientated interventions with patients and their families, and cognitive-behavioural therapy of residual symptoms. These approaches are discussed with regard to their efficacy in reducing relapse rates, psychopathology as well as cognitive and social disability. CONCLUSION: Open questions and possibilities for the further development of these approaches are considered and prognostications are made concerning the future of psychotherapy research in schizophrenia, notably in the light of changing conditions in public health care systems.

Adaptation, Psychological↗
PubMed2026

Sustained cognitive and functional effects of pro-cognitive interventions for bipolar disorder: A systematic review of randomised controlled trials.

A substantial proportion of individuals with bipolar disorder (BD) experience considerable cognitive deficits. Existing systematic reviews have evaluated the efficacy of pro-cognitive interventions in BD, but have not established whether any cognitive benefits translate into functional improvements, with evidence for sustained functional effects remaining limited. A systematic search was conducted on MEDLINE, EMBASE, PsycINFO and Cochrane Library from inception until 21 May 2026. Eligible studies were randomised controlled trials (RCTs) in BD reporting cognitive or functional outcomes at three or more months following a pro-cognitive intervention, or examining the translation of cognitive benefits into improvements in functional outcomes at any timepoint. Seven unique RCTs plus three secondary analyses of these trials (n = 615) met the inclusion criteria. Approximately 13% (7/55) of RCTs identified in the search of pro-cognitive interventions in adult BD assessed cognitive or functional outcomes at least 3 months after treatment end. Of the seven unique RCTs, most evaluated cognitive remediation (CR; k = 4). The average follow-up length was 4 months (range: 3-6 months). Three of the four RCTs examining CR reported cognitive benefits at 3 to 6 months, whereas only one CR RCT found consistent functional effects at 3 months. Evidence on the translation of cognitive benefits to functional improvements is scarce and inconsistent. Most trials examining pro-cognitive interventions do not examine whether potential benefits are sustained or whether they translate into improvements in real-world functioning. CR appears to be a promising intervention for achieving durable cognitive gains in BD, although evidence for sustained effects of other interventions is limited.

Humans↗
PubMed2001

[Instrument for the functional evaluation of disability rehabilitation. Study on the reliability and clinical experience with the use of functional independence measure].

BACKGROUND: The Functional Independence Measure (FIM) is an instrument widely used to assess the results and progress of a medical rehabilitation program. AIM: To assess the inter rater agreement in the application of FIM and show the clinical experience with its use in disabled patients enrolled in a rehabilitation program. PATIENTS AND METHODS: FIM was applied in 40 patients and the inter rater agreement was assessed, comparing raters with and without training in its use. Agreement was evaluated using Kappa test. Afterwards, the FIM was used to assess changes in 100 patients hospitalized and being rehabilitated at the Rehabilitation ward of a general hospital. RESULTS: Inter rater agreement is high in physical areas of the FIM and low in cognitive areas. Training significantly improves agreement in communication and cognitive areas. During a mean period of hospitalization of 38 days, FIM score changed from a mean of 47.2 to 92 points, with an improvement of 1.18 points per hospitalization day. The higher improvement was achieved in the physical area of the instrument. CONCLUSIONS: Training is required for a proper application of FIM. When used adequately, this instrument allows an assessment of the degree of disability and the changes obtained with rehabilitation programs.

Clinical Competence↗
PubMed1983

A cognitive behavioral analysis of relaxation training in drug abusers.

The process of autogenic training, a form of relaxation training, was studied in a sample of 23 drug abusers in outpatient treatment. Different theories of drug abuse and treatment generate different predictions of perceived emotional effects of treatment. The relationships among symptomatology and affect as assessed by the three-factor emotionality constructs of pleasure, arousal and dominance were examined to provide information on the relative importance of perceptions of tension-reduction, sense of control and hedonic state to the treatment process. Symptomatology and affect were significantly related and improved over the course of treatment. The euphoria-dysphoria dimension was more salient than perceptions of arousal reduction or increased sense of control. Results suggested the importance of further investigation of patients' perceptions of the desired effects of drug taking on mood in order to optimize the impact of treatment interventions such as relaxation training.

Adult↗
PubMed1975

Modification of an impulsive cognitive tempo in emotionally disturbed boys.

In order to determine the relative effectiveness of verbal self-instructions and training to delay before responding in modifying an impulsive cognitive style, 15 impulsive emotionally disturbed boys were assigned to one of three groups. The cognitive-training group was given practice in verbal self-instructions, the delay-training group received practice in delaying before responding, and the control group received no training. Posttreatment scores on the Matching Familiar Figures Test showed a significant increase in latencies for both the cognitive and delay-training groups. However, only the cognitive-training group, which had received practice in verbal self-instructions, made fewer errors following training. Implications for future research and potential treatment strategies for verbal self-instructions are discussed.

Affective Symptoms↗
PubMed2006

Transfer of training effects in stroke patients with apraxia: an exploratory study.

The goal of the present study was to examine the transfer of the effects of cognitive strategy training for stroke patients with apraxia from trained to non-trained tasks. In strategy training, the occurrence of transfer is expected as the training programme is aimed, not at relearning specific tasks, but at teaching patients new ways to handle the problems resulting from the impairment. Exploratory analyses were conducted on data previously collected in a randomised controlled trial on the efficacy of the strategy training. A total of 113 left hemisphere stroke patients were randomly assigned to a strategy training group and a group receiving occupational therapy as usual. Assessment of apraxia, motor functioning and activities of daily living (ADL) took place at baseline, after an eight-week treatment period, and five months after baseline. The primary outcome measure consisted of standardised ADL observations of trained and non-trained tasks. The analyses showed that in both treatment groups, the scores on the ADL observations for non-trained tasks improved significantly after eight weeks of training as compared with the baseline score. Change scores of non-trained activities were larger in the strategy training group as compared with the usual treatment group. By using previously collected data we are able to illustrate the potential transfer of treatment effects in a large sample of stroke patients. We found indications for the occurrence of transfer, although the study was not originally designed for the purpose of evaluating transfer. Therefore these results are worth exploring more profoundly. We will further investigate our preliminary conclusions in a new prospective study which is specifically designed to examine the transfer of training effects.

Aged↗
PubMed1999

Assessment of mental health nursing competence using level III academic marking criteria: the Eastbourne assessment of practice scale.

The assessment of clinical competence in nursing represents a challenge to the profession. There is a need for assessment of practice skills through evaluative observation of performance but unfortunately such methods are not regularly used as a basis for assessment within most academic nursing institutions. Instead there is still a reliance upon more traditional types of academic assessment usually done through a written medium. Such methods whilst academically rigorous do not easily assess actual real life competence. This paper will describe how this tension was addressed through the development of a tool that combines observation of real life practice and viva style questioning with an assessment marking grid whose descriptors represent level III practice. Its inter rater reliability (rs = 0.88, P < 0.01) was established by 14 clinical nurse specialists in cognitive behaviour therapy who assessed a single video taped recording of a post-registration students performance whilst undergoing training in cognitive behaviour therapy.

Clinical Competence↗
PubMed1998

A Cognitive Evaluation of Frame-of-Reference Rater Training: Content and Process Issues.

A multivariate, cognitive evaluation model was used to examine the previously noted effects of frame-of-reference (FOR) training on rating accuracy. The tested model emphasized two content-related issues associated with FOR training: (a) the content of the training itself and the extent that raters agreed with it, which provided an index of the amount of overlap between the theory of performance taught in training and a rater's implicit theory of performance following training; and (b) the content of raters' performance impressions of ratees based on a comprehensive and integrative model of the cognitive representations of persons- Associated Systems Theory (Carlston, 1992, 1994). Undergraduates (N = 172) were trained with FOR or control procedures using two different performance theories, observed and rated videotaped manager performance on three performance dimensions, and engaged in written free-recall of target performance vignettes. A structural model was tested incorporating a latent differential rating accuracy construct. FOR training was associated with higher demonstrated levels of agreement and with changes in ratee representation that were more abstract and more target-referent (i.e., less idiosyncratic) than control training. Agreement was found to be associated with enhanced rating accuracy and more self-referent impressions; however, target-referent impressions were shown to be related to better rating accuracy. Discussion focuses on the interrelated nature of content and process issues in performance appraisal. Using the AST framework, it is also proposed that longstanding manager/subordinate dyads could be expected to benefit the most from FOR training. Copyright 1998 Academic Press.

Journal Article↗
PubMed2003

Linking depressive symptoms and functional disability in late life.

We hypothesized that the relationship of depressive symptoms to functional disability might be mediated by cognitive processes such as memory and problem-solving. The study sample consisted of 147 community-dwelling older adults (mean age = 74.0 years, SD = 5.9). In regression models that included terms for age, gender, and years of education, depressive symptoms were significantly inversely associated with two performance-based measures of functioning: everyday problems test (beta = -0.15, p = 0.04) and observed tasks of daily living (beta = -0.14, p = 0.02). When memory and problem-solving ability were added to the model, the relationship of depressive symptoms with function was attenuated. A structural equation model based on our conceptual framework revealed that both memory and problem-solving abilities were important mediators in the relationship of depressive symptoms and functional disability. The results suggest that intervention studies intended to limit functional disability secondary to depression among older adults may need to consider the effect of depression on cognition.

Aged↗
PubMed1992

A stress inoculation training program for adolescents in a high school setting: a multiple baseline approach.

This study examined the effectiveness of stress inoculation training with adolescents in a high school setting using a multiple baseline approach. Through this intervention procedure, youths were trained in cognitive restructuring, anxiety management, and problem solving skills. Self-reports of state and trait anxiety were gathered during baseline and each training session. Five of the six youths displayed improvement on state and trait anxiety scores with the initiation of treatment. In addition, significant improvements were noted on pre- to post-assessments of state and trait anxiety and trait anger. Non-significant decreases were evident on self-reports of total, daily, and major negative stress events. No changes occurred on measures of depression, self-esteem, and anger expression. Similar patterns were obtained at a 3 month follow-up.

Adolescent↗
PubMed2004

Computerized cognitive-behaviour therapy for anxiety and depression: a practical solution to the shortage of trained therapists.

Computerized cognitive-behaviour therapy (CCBT) programmes have been developed to help meet the enormous need for evidence-based psychological treatment of common mental health problems in the context of a severe shortage of trained therapists to meet that need. Randomized controlled trials have confirmed the efficacy of such programmes. We present the experience of a community mental health team (CMHT) resource centre with one such programme, Beating the Blues, together with outcome data on a small sample of its clients. We conclude that experience and data, taken together, demonstrate the practical benefits of CCBT in routine practice.

Aged↗
PubMed2006

Effectiveness of physical training on motor performance and fall prevention in cognitively impaired older persons: a systematic review.

OBJECTIVE: To determine whether older cognitively impaired people benefit from physical training with regard to motor performance or fall risk reduction and to critically evaluate the methodologic approach in identified randomized controlled intervention trials. DESIGN: Published randomized controlled intervention trials from 1966 through 2004 were identified in PubMed, CINAHL, Gerolit, and the Cochrane Central Register of Controlled Trials according to predefined inclusion criteria and evaluated by two independent reviewers using a modified rating system for randomized controlled intervention trials developed by the Cochrane Library. RESULTS: There were 11 randomized controlled intervention trials that met the predefined inclusion criteria. There was a large heterogeneity regarding methodology, sample size, type of intervention, study outcomes, and analyses. We found conflicting evidence regarding the effect of physical training on motor performance and falls in older people with cognitive impairment. However, a considerable number of the studies had methodologic limitations, which hampered the evaluation of the effectiveness of training. CONCLUSIONS: The randomized controlled intervention trials showed only limited effectiveness of physical training in patients with cognitive impairment. More studies with adequate sample size, sensitive and validated measurements, and higher specificity for the types of intervention targeting subgroups of patients with different degrees of cognitive impairment are required to give evidence-based recommendations.

Accidental Falls↗
PubMed2002

Development of specific social skills training programmes for schizophrenia patients: results of a multicentre study.

OBJECTIVE: The efficacy of three newly developed cognitive social skills training programmes for residential, vocational and recreational functioning (experimental groups) were compared with a traditional social skills training programme (control group) referring to cognitive and social abilities, psychopathology and generalisation effects. METHOD: One hundred and five patients with a diagnosis of schizophrenia or schizoaffective disorder according to ICD-10 criteria were selected and assigned to the different treatment groups, using a matching procedure. The treatment phase lasted 6 months. A follow-up assessment was carried out after 1 year. RESULTS: Higher global therapy effects were obtained on almost all dependent variables in the experimental groups. Analyses of variance and covariance indicated higher symptom reduction for the experimental groups, but significantly greater improvements in some cognitive variables for the control group. Correlation analysis suggested associations between improvement of social behaviour with symptom reduction and improvements of cognitive skills. CONCLUSION: In view of these favourable effects, the developed cognitive social skills training programmes might facilitate the abilities of schizophrenia patients for their integration in the community.

Adult↗
PubMed2003

Group cognitive-behavioral therapy for generalized anxiety disorder: treatment outcome and long-term follow-up.

A recently developed cognitive-behavioral treatment for generalized anxiety disorder (GAD) targets intolerance of uncertainty by the reevaluation of positive beliefs about worry, problem-solving training, and cognitive exposure. As previous studies have established the treatment's efficacy when delivered individually, the present study tests the treatment in a group format as a way to enhance its cost-benefit ratio. A total of 52 GAD patients received 14 sessions of cognitive-behavioral therapy in small groups of 4 to 6 participants. A wait-list control design was used, and standardized clinician ratings and self-report questionnaires assessed GAD symptoms, intolerance of uncertainty, anxiety, depression, and social adjustment. Results show that the treatment group, relative to the wait-list group, had greater posttest improvement on all dependent variables and that treated participants made further gains over the 2-year follow-up phase of the study.

Adult↗
PubMedDate not supplied

Brief report: a cognitive behavioral intervention for distressed adolescents with type I diabetes.

OBJECTIVE: To examine the impact of a cognitive behavioral intervention for distressed adolescents with Type I diabetes. METHODS: Six youths with elevated levels of anxiety, anger, or diabetes stress received training in cognitive restructuring and problem solving in individual sessions. A multiple baseline design across participants was used. Treatment effectiveness was assessed through measures of anxiety, anger expression, and diabetes stress. RESULTS: Four youths displayed some improvement on one or more variables for which they had elevated levels during baseline, while others showed no impact. CONCLUSIONS: Cognitive behavioral interventions show some promise for distressed youths with Type I diabetes. Individual youths responded to treatment differently. Further research is needed in developing procedures to better meet the needs of youths, improve youth participation, and enhance treatment effectiveness.

Adaptation, Psychological↗
PubMed1990

Power spectral analysis of heart rate variability after biofeedback training.

This study investigated the effects of biofeedback/self-management training on heart rate variability (HRV) in six sudden cardiac arrest survivors. The physiological-theoretical basis of the training was cognitively inducing respiratory sinus arrhythmia. Power spectral analyses and nonspectral analyses (Kleiger, Magid, SCANN, BB50 measures) of HRV measured before and after 5 weeks of biofeedback training are described. The posttraining Kleiger measure of mean HRV increased compared to the pretraining mean HRV (159 +/- 37 ms vs 147 +/- 38 ms). After training, the high frequency components (0.27-0.30 Hz) of the power density spectra were markedly increased, suggesting an increase of respiratory-driven parasympathetic activity. After training, the low frequency components (0.05 Hz) were slightly decreased, suggesting a decrease in sympathetic activity. The increases noted in the high frequency components were more striking during 9 hours at night than during the day. These data indicate that subjects who have had sudden cardiac arrest can, through biofeedback/self-management, cognitively increase their HRV over a 5-week period, consequently increasing parasympathetic activity.

Arrhythmia, Sinus↗
PubMed1989

Reserve capacity of the elderly in aging sensitive tests of fluid intelligence: a reanalysis via a structural equation modelling approach.

In the last decade there has been a growing interest among developmental psychologists to investigate whether the cognitive performance of older adults can be improved by means of training programs. A number of cognitive training studies involving aging sensitive abilities of fluid intelligence have been performed with healthy older adults (Willis et al. 1981; Baltes et al., 1984/1986). In this paper we reanalyse data from Baltes et al. (1986) concerning the ADEPT Induction, ADEPT Figural Relations, Induction Standard and the Raven's Advanced Progressive Matrices Tests. In contrast to the above study, where the data analysis was based on a MANOVA approach, usually carried out when experimental data were gathered, this discussion implements an approach to change measurement for which the structural equation of different aspects of change in means as manifested in the moment matrices. The results here confirm these by Baltes et al. (1986), and suggest conclusions concerning change in means over time in the experimental and control groups, which are not implied by their study.

Aged↗