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PubMed2005

A behavioral group treatment program for menopausal hot flashes: results of a pilot study.

In the present study, we tested the effectiveness of a cognitive-behavioral group treatment (CBGT) for hot flashes in menopausal women. Treatment was administered over 8, 90 min weekly sessions and consisted of education, relaxation training and cognitive restructuring. Nineteen women meeting STRAW staging criteria for the menopause transition (stages -1 to +1) were randomly assigned to immediate or delayed treatment (wait list) and were asked to monitor their hot flashes and night sweats prospectively. They also completed questionnaires, including the Women's Health Questionnaire and the Menopause Specific Quality of Life Questionnaire to determine psychosocial benefits of treatment. Results suggested that the CBGT was moderately successful in reducing the frequency of total vasomotor symptoms [F (1, 17) = 6.16, p < .01], as measured by daily symptom diaries. While there were arithmetic improvements in psychosocial functioning in this sample, these results were not significant. Despite the limitations of small sample size and possible placebo effect, this pilot study supports the notion that cognitive-behavioral interventions aimed at reducing vasomotor symptoms may be of value for menopausal hot flashes when administered in a small-group format.

Cognitive Behavioral Therapy↗
PubMed1997

Cognitive-behavioral remediation of problem solving deficits in children with acquired brain injury.

The inability to problem solve can have a deleterious impact on a student's academic performance and social adjustment. Children with an acquired brain injury (ABI) are at risk for deficits in problem solving skills. This case study and series of multiple baseline experiments examined the effects of a multi-component cognitive-behavioral training program on the remediation of problem solving deficits in five children with ABI. Results indicated that the training program resulted in a substantial decrease in errors on a computerized problem solving task used to monitor problem solving performance during baseline and treatment. In addition, significant improvements were found on two of four standardized measures of problem solving abilities. Finally, students, parents and teaching staff reported a high degree of satisfaction with and generalization of the training program.

Brain Injuries↗
PubMed2003

Use of a training program to enhance NICU nurses' cognitive abilities for assessing preterm infant behaviors and offering supportive interventions.

This study tested the use of a developmentally supportive care (DSC) training program in the form of videotaped and personalized instruction to increase nurses' cognitive abilities for assessing preterm infant behavioral signals and offering supportive care. The study used a two-group pre-test post-test quasi-experimental repeated measures design. The participants were 25 NICU nurses, 13 in the intervention group, and 12 in the control group. An instrument developed for the purpose of the study was a video test that measured the effectiveness of the DSC training. The video test questionnaires were administered to the participants twice with an interval of four weeks. ANCOVA controlling the baseline scores was used for data analysis. In general, the results support the hypothesis that nurses' cognitive abilities were enhanced after the DSC training. The increase in nurses' cognitive abilities is the prerequisite for behavioral change, based on the assumptions of Bandura's Social Cognitive Learning Theory (Bandura, 1986). As nurses' cognitive abilities increased, it would be possible that nurse behaviors in taking care of these preterm infants might change. Therefore, the author recommends that in order to improve NICU care quality and the outcomes of preterm infants, the concepts of developmentally supportive care be incorporated into NICU caregiving practice by educating nurses.

Adult↗
PubMed1989

Cognitive therapy vs. self-management training in the treatment of chronic headaches.

In view of the association between chronic headaches and depression, this study compared a cognitive therapy package designed for depression with a relatively standard behavioural treatment package designed for headaches (self-management training), in terms of their effects on headaches and depressive symptoms. Fifty-five subjects suffering from chronic headaches (tension, migraine and combined) were randomly assigned to the two treatment conditions. Cognitive therapy and self-management training were equally effective at decreasing headaches and depressive symptoms on most measures. Changes in headaches and depressive symptoms were not significantly correlated in either condition, however. Greater headache improvement was associated with high pre-treatment headache activity for both conditions but, whilst self-management training was more effective for subjects low on depression, cognitive therapy was more effective for subjects high on chronicity. This suggests that the latter approach, or some variation of it, may be the treatment of choice for more chronic headache sufferers with depressive symptoms.

Adult↗
PubMed2003

Predicting cross-cultural training performance: the validity of personality, cognitive ability, and dimensions measured by an assessment center and a behavior description interview.

This study examined the validity of a broad set of predictors for selecting European managers for a cross-cultural training program in Japan. The selection procedure assessed cognitive ability, personality, and dimensions measured by assessment center exercises and a behavior description interview. Results show that the factor Openness was significantly related to cross-cultural training performance, whereas cognitive ability was significantly correlated with language acquisition. The dimensions of adaptability, teamwork, and communication as measured by a group discussion exercise provided incremental variance in both criteria, beyond cognitive ability and personality. In general, these results are consistent with the literature on domestic selection, although there are some important differences.

Adult↗
PubMed2002

Mapping training: the transfer of a cognitive technology for improving counseling.

To provide information that will reduce the gap between research and practice, the transfer of a complex drug abuse counseling technology is examined. This technology, cognitive mapping, is a graphic tool shown to effectively facilitate communication and problem solving in group and individual counseling sessions. Unlike some techniques, mapping requires substantial counselor time, effort, and expertise to learn and to use. This article briefly describes the development and evolution of mapping and supporting research. It then focuses on our efforts to develop mapping training that will facilitate use of this evidence-based technique in drug abuse treatment. Major training and transfer pitfalls are noted, and strategies for successful training are recommended.

Cognition↗
PubMed2004

Learned regulation of spatially localized brain activation using real-time fMRI.

It is not currently known whether subjects can learn to voluntarily control activation in localized regions of their own brain using neuroimaging. Here, we show that subjects were able to learn enhanced voluntary control over task-specific activation in a chosen target region, the somatomotor cortex. During an imagined manual action task, subjects were provided with continuous direction regarding their cognitive processes. Subjects received feedback information about their current level of activation in a target region of interest (ROI) derived using real-time functional magnetic resonance imaging (rtfMRI), and they received automatically-adjusted instructions for the level of activation to achieve. Information was provided both as continously upated graphs and using a simple virtual reality interface that provided an image analog of the level of activation. Through training, subjects achieved an enhancement in their control over brain activation that was anatomically specific to the target ROI, the somatomotor cortex. The enhancement took place when rtfMRI-based training was provided, but not in a control group that received similar training without rtfMRI information, showing that the effect was not due to conventional, practice-based neural plasticity alone. Following training, using cognitive processes alone subjects could volitionally induce fMRI activation in the somatomotor cortex that was comparable in magnitude to the activation observed during actual movement. The trained subjects increased fMRI activation without muscle tensing, and were able to continue to control brain activation even when real-time fMRI information was no longer provided. These results show that rtfMRI information can be used to direct cognitive processes, and that subjects are able to learn volitionally regulate activation in an anatomically-targeted brain region, surpassing the task-driven activation present before training.

Arousal↗
PubMed2003

Stress management and psychoneuroimmunology in HIV infection.

Does stress management affect psychological and immune functioning in persons with human immunodeficiency virus infections? Stress-management techniques, such as relaxation training and imagery, cognitive restructuring, coping-skills training, and interpersonal-skills training, may reduce anxiety, depression, and social isolation in HIV-infected persons by lowering physical tension and increasing a sense of control and self-efficacy. A psychoneuroimmunologic model is proposed wherein these psychological changes are hypothesized to be accompanied by an improved ability to regulate neuroendocrine functioning, which in turn may be associated with a partial normalization of immune system functions such as lymphocyte proliferation and cytotoxicity, providing more efficient surveillance of latent viruses that may contribute directly to increased HIV replication and generate opportunistic infections or cancer if left unchecked. Such a normalization of stress-associated immune system decrements are hypothesized to forestall or minimize increases in viral load and expression of clinical symptoms. This model is useful for testing the factors contributing to the health effects of stress-management interventions in HIV-infected persons. In this context, one general research strategy for testing the effects of stress-management interventions is to target them toward the more prevalent psychosocial challenges that HIV-infected people face at various points in the disease process; enroll an HIV-infected population (eg, HIV-positive homosexual and bisexual men) into a randomized trial; and monitor changes in cognitive, affective, behavioral, and social factors in parallel with hormonal, immunologic, viral, and clinical changes over the course of time. This article will review the major psychoneuroimmunologic findings that have emerged using this paradigm and suggest future research directions and clinical applications.

Adaptation, Psychological↗
PubMed2005

Factors associated with a positive response to cognitive remediation in a community psychiatric sample.

This study examined some of the factors associated with a positive response to cognitive remediation. Forty-eight adult participants completed 26 hours of cognitive skills training at an outpatient psychiatric clinic. Results showed significant posttreatment improvement on measures of sustained attention and readiness for employment. Notably, participant-determined attendance was associated with greater cognitive improvement. In addition, there was a threshold of treatment intensity below which there was no treatment effect. This study underscores the importance of addressing treatment intensity in the implementation of cognitive remediation in the community and highlights the potential contribution of motivation to treatment adherence.

Adult↗
PubMed1995

The evaluation of a burnout workshop for community nurses.

This study evaluates the effects of a burnout workshop that was conducted for community nurses (N = 64). The workshop included relaxation training, didactic and cognitive stress management, interpersonal skills training, and the enhancement of a more realistic professional role. The nurses' symptom levels (i.e., emotional exhaustion, tedium, psychological strain, and somatic complaints decreased significantly. However no significant changes were observed in the attitudinal component of burnout: the nurses' negative attitudes toward their recipients (depersonalization) and toward their performance on the job (reduced personal accomplishment) did not decrease. In addition, personality (i.e., the nurses' level of reactivity) played a moderating role: low reactive nurses who, by definition, are rather resistant to stress benefited more from the workshop than did high reactive nurses who are less resistant to stress. Since no control group was included, the results of this study are tentative and should be confirmed by future research.

Adaptation, Psychological↗
PubMed1998

The lifetime total physical activity questionnaire: development and reliability.

OBJECTIVE: To develop and test the intra-rater reliability of an interview-administered questionnaire that assesses lifetime patterns of total physical activity including occupational, household, and exercise/sports activities. METHODS: The questionnaire was developed and pretested using cognitive interviewing techniques on a sample of women with and without previous breast cancer diagnoses. A pilot study was conducted with 115 women who were interviewed twice, 6 to 8 wk apart by interviewers trained in cognitive interviewing methods. Respondents used recall calendars to record their education, occupations, life events, and physical activity patterns before the interviews. Interviewers helped respondents recall their lifetime exposures, including their occupational, household, and exercise/sports activities, using these calendars and memory-probing strategies. Activity levels were estimated as the average number of hours of activity per week over different time periods. Means and correlation coefficients were estimated and compared for the two time periods. RESULTS: The questionnaire was found to be highly reliable. The test-retest correlations for hours per week spent in total lifetime physical activity was 0.74, for lifetime occupational activity was 0.87, for household activity was 0.77, and for exercise/sports activities was 0.72. CONCLUSIONS: This is the first questionnaire to measure lifetime physical activity by collecting data on each type of physical activity separately over lifetime and by measuring frequency, intensity, and duration of each activity. It is also the first physical activity questionnaire to be developed, refined, and administered using cognitive-based methods employed in survey research. Respondents were able to reliably recall their lifetime physical activity patterns. This instrument can be used for any disease outcome for which physical activity may be a risk factor.

Breast Neoplasms↗
PubMed1999

Behavioral analysis of the freezing phenomenon in Parkinson's disease: a case study.

The "freezing" phenomenon was examined in a 77 yr old male patient suffering from Parkinsons's disease (PD). Motor blocks occurred several times a day, mainly affected walking, and lasted mostly between 2 and 5 min. Behavioral analysis showed that freezing was elicited and intensified not only by external factors (limited space and room to move), but also by negative cognitions, negative emotions and tension. The most effective behavior to overcome freezing was a combination of relaxation and loud rhythmic counting. Effectiveness in overcoming freezing correlated positively with self-rated mobility before trials. Relaxation training improved self-rated mobility. It is suggested that relaxation training and cognitive techniques should be used to reduce tension, negative thoughts and negative emotions contributing to freezing and to improve the ability to cope with freezing.

Aged↗
PubMed1986

Cognitive changes after social skills training with young mildly mentally handicapped adults.

There have been several recent reports which indicate that social skills training may be a useful technique for helping mentally handicapped adults who have social defects. These reports have focused on the acquisition of skills and abilities and there has been a relative lack of emphasis on cognitive factors. In general clinical work, the author has been aware that cognitions are crucial in the social performance of mildly mentally handicapped people and this paper uses three case studies to illustrate the importance of cognitions in their social functioning. The case studies provide examples of poor self concept, lack of confidence, anxiety-related self statements and antagonistic attitudes towards interaction. They also illustrate that it is not necessary for patients to change their social skills for there to be concurrent cognitive changes.

Adolescent↗
PubMedDate not supplied

A dyadic remediation program for care recipients with dementia.

A cognitive remediation intervention was tested for its effect on functional outcomes of older care recipients with the diagnosis of dementia of the Alzheimer's type. The 78 community-dwelling care recipients were assessed on cognitive and behavioral functioning and randomly assigned to one of three conditions. Care recipients were expected to benefit most from active cognitive stimulation training as compared to placebo (passive) activity or wait-list control conditions. Following each weekly instruction session, the intervention was executed in the home by the family caregiver. Care recipients in the experimental group improved in cognitive and behavioral performance with treatment, but returned to former level of functioning by the 9th month. In contrast, the control group declined, while the placebo group remained static on these variables. These findings support the viability of remediation interventions in dementia despite the trajectory of cognitive decline.

Adult↗
PubMed1985

Psychological intervention for adults with cystic fibrosis.

This study assessed the effects of a stress management and life-style modification program on the physical and psychological well-being of young adults with cystic fibrosis. Four fibrocystic patients recently transferred to an adult rehabilitation centre completed this 6-week program. Instruction in stress management consisted of both behavioural (e.g. relaxation training) and cognitive techniques. Discussion on life-style included the topics of drug and alcohol abuse, leisure, and nutrition. Individual assessments were conducted before and after a 6-week non-intervention control period and after a 6-week training program. Assessments included a battery of psychometric inventories as well as electromyographic testing of trapezius muscle tension. At the end of the program, participants reported that they experienced fewer physical and psychological symptoms of stress. Electromyographic measures provided some suggestion of a trend toward greater stability at posttest.

Adult↗
PubMed1994

COMPETE: a model for vocational evaluation, training, employment, and community for integration for persons with cognitive impairments.

This paper describes a job skills training program for young adults with cognitive impairments called COMPETE, an acronym for Computer Preparation: Evaluation, Training, and Employment. Participants in COMPETE trained in use of information-age machines, (e.g., computers, fax machines). The 3-year demonstration project resulted in successful placement of 17 of 27 persons who were unemployed before entering the program.

Activities of Daily Living↗
PubMed1987

Perceived self-efficacy and pain control: opioid and nonopioid mechanisms.

In this experiment, we tested for opioid and nonopioid mechanisms of pain control through cognitive means and the relation of opioid involvement to perceived coping efficacy. Subjects were taught cognitive methods of pain control, were administered a placebo, or received no intervention. Their pain tolerance was then measured at periodic intervals after they were administered either a saline solution or naloxone, an opiate antagonist that blocks the effects of endogenous opiates. Training in cognitive control strengthened perceived self-efficacy both to withstand and to reduce pain; placebo medication enhanced perceived efficacy to withstand pain but not reductive efficacy; and neither form of perceived self-efficacy changed without any intervention. Regardless of condition, the stronger the perceived self-efficacy to withstand pain, the longer subjects endured mounting pain stimulation. The findings provide evidence that attenuation of the impact of pain stimulation through cognitive control is mediated by both opioid and nonopioid mechanisms. Cognitive copers administered naloxone were less able to tolerate pain stimulation than were their saline counterparts. The stronger the perceived self-efficacy to reduce pain, the greater was the opioid activation. Cognitive copers were also able to achieve some increase in pain tolerance even when opioid mechanisms were blocked by naloxone, which is in keeping with a nonopioid component in cognitive pain control. We found suggestive evidence that placebo medication may also activate some opioid involvement. Because placebos do not impart pain reduction skills, it was perceived self-efficacy to endure pain that predicted degree of opioid activation.

Female↗