Relationship between essential hypertension and cognitive functioning. II. Effects of biofeedback training generalize to non-laboratory environment.
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Adult↗
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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.
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Utilizing neuropsychological measures to predict vocational outcome in a head trauma population.
The present study examined the ability of traditional neuropsychological measures to predict successful vocational training in a severely neurologically impaired population. Eighty head trauma patients were evaluated prior to pre-vocational training which involved cognitive remediation and psychosocially-based intervention. Subjects were approximately 2 years post-injury. Results showed that of the total population studies, 73.8% participated in vocational evaluations, 23.8% did not, and 2.4% of the sample returned to work or college. Neuropsychological assessments were over 77% accurate in predicting whether subjects would successfully complete this vocational evaluation. The most significant predictors were reading comprehension, immediate and delayed verbal memory, level of depression, and dysphasic symptomatology. Issues relating to generalizability of cognitive retraining to the vocational evaluation and/or vocational training setting are discussed. Future considerations for both clinical practice and research include the use of ecologically valid measures.
Adolescent↗
Cognitive coping and appraisal processes in the treatment of chronic headaches.
The purpose of the present study was to investigate the active cognitive ingredients of change in psychological treatments for long-term chronic headache complaints. The primary questions this study addressed were: (1) Is a cognitive self-hypnosis training which explicitly attempts to change appraisal and cognitive coping processes more effective in producing these changes than a relaxation procedure, and (2) are changes in pain appraisal and cognitive coping related to changes in pain and adjustment in the short and long term? A total of 144 patients were assigned at random to a cognitive self-hypnosis (CSH) treatment or autogenic training (AT) with a duration of 7 weeks. Measures used were: Headache Index (HI), Symptom Checklist-90 (SCL-90), Coping Strategy Questionnaire (CSQ), Multidimensional Locus of Pain Control Questionnaire (MLPC) and treatment expectations. The results indicated that patients successfully changed their use of coping strategies and pain appraisals. Cognitive therapy was more effective than relaxation training in changing the use of cognitive coping strategies which were the direct targets of treatment. However, treatment effects were only related with changes in the use of coping strategies and appraisal processes to a limited extent and the mediational role of cognitive processes in pain reduction and better adjustment was inconclusive.
Adaptation, Psychological↗
A psychological pulse train: how young children use this cognitive framework to structure simple rhythms.
This paper examines the reproduction of both regular rhythms and irregular sequences by 5- and 7-year-old children, concentrating on the important role played by their organization around a pulse train. It is shown that: (a) the closer rhythms are to a regular beat the easier they are to reproduce and the greater are the improvements with age; (b) memory capacity is limited by the number of pulses around which the rhythm is organized rather than by the number of elements it contains; (c) all the children's productions contain two interval lengths that are in a ratio close to 1:2 and arranged in preferential sequences which we have called "stereotypes"; (d) arrhythmic sequences can only be reproduced if the intervals undergo a systematic distortion towards regularity. These results are interpreted in relation to a pulse-train hypothesis which states that on hearing a rhythm an "internal clock" or "time base" is evoked around which the rhythm is structured.
Attention↗
Readiness of psychiatry residency training programs to meet the ACGME requirements in cognitive-behavioral therapy.
The authors assessed the readiness of adult psychiatry residency programs to train residents in cognitive-behavioral therapy (CBT) prior to the January 2001 revision of program requirements by the Accreditation Council for Graduate Medical Education (ACGME). Adult residency training program directors were surveyed. Data analysis evaluated relationships between directors' confidence in CBT training and the program and faculty characteristics. Responses were received from 54.2% of programs. Half had no requirement for resident-performed CBT. Directors' confidence in CBT training was significantly related to didactic hours (P=0.041), psychotherapy hours (P=0.007), and ACT-certified faculty (P=0.035). A substantial lack of required training in CBT exists in least 25% of accredited programs. Assessing faculty credentials and working with specialty organizations recommended in this article could assist in developing better programs in CBT.
Journal Article↗
Experience-dependent recovery of cognitive deficits in alcoholics: extended transfer of training.
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Adult↗
Effects of active and passive EMG biofeedback training on performance of motor and cognitive tasks.
The goal of this study was to compare the effects of general relaxation (passive group) and neuromuscular tension control (active group), both using EMG biofeedback techniques, on the performance of memorization, simple reaction time, and rotary pursuit. 18 subjects were given five consecutive daily sessions of training or were placed under control conditions, after which their performance on these various tasks was evaluated. Results indicate that control of neuromuscular tension seemed to facilitate performance on all tasks over that of the control group. Except for simple reaction time, there was no difference between the "active" and "passive" groups. The results are interpreted in terms of factors in selection of subjects and experimental conditions.
Biofeedback, Psychology↗
Characteristics associated with behavioral symptoms related to dementia in long-term care residents.
This article describes care for behavioral symptoms related to dementia (BSRD) and identifies their potential correlates among 347 residents with dementia living in 45 assisted living facilities and nursing homes from four states. The prevalence of BSRD was associated with staff training and resident cognition, mood, mobility, and psychotropic use. Attention to staff training and depression management might improve BSRD.
Aged, 80 and over↗
Evaluation of two test-anxiety reduction treatments in a secondary prevention program.
The study evaluated the effectiveness of both a new anxiety management training program and a cognitive modification procedure as part of a secondary prevention effort to identify and treat test anxiety early in the academic career of college students. Subjects were 40 college freshmen who had been identified as high test-anxious in an initial mail-out survey of the Test Anxiety scale. Subjects were randomly assigned to three experimental conditions: anxiety management training, a cognitive modification procedure, and a no-treatment control group. Results indicated that both the cognitive modification and anxiety management training treatments were effective in reducing test anxiety on a posttreatment administration of the Test Anxiety scale. Especially interesting, a significant difference in academic performance emerged between treatment and control groups three semesters after treatment, underscoring the preventive value of the program.
Adaptation, Psychological↗
Virtual Reality Mastoidectomy as Precadaver Training for Novices: A Randomized Crossover Study.
OBJECTIVES: To compare cognitive load during virtual reality (VR) simulation and cadaveric dissection (CD) mastoidectomy training in novice learners. To determine whether training order influences cognitive load, characterize cognitive load progression during the procedure, and assess whether VR training improves subsequent cadaveric performance. METHODS: In this randomized crossover study, 24 core surgical trainees with no prior mastoidectomy experience performed a cortical mastoidectomy in both VR and CD settings. Participants were randomized to either VR-first or CD-first training sequences. Cognitive load was measured using a bespoke auditory reaction-time device at baseline and 10, 30, and 50 min. Relative reaction time (RRT) served as an objective index of cognitive load. Cadaveric performance was assessed using the Modified Welling Scale by two blinded otologists. RESULTS: Cognitive load was significantly lower during VR than CD, with mean RRT rising 26% from baseline in VR versus 60% in CD (p < 0.001). Training order did not affect cognitive load in either modality, and RRT increased progressively throughout mastoidectomy in both VR and CD. Participants who began with VR achieved significantly higher cadaveric performance scores than those who began with CD (mean 9.50 vs. 4.96; p < 0.001), and inter-rater reliability for performance scoring was high. CONCLUSION: VR mastoidectomy reduces cognitive load and enhances subsequent cadaveric performance in novice trainees, supporting its role as a cognitively optimized precadaver training modality that complements, rather than replaces, cadaveric dissection. These findings suggest VR enhances early learning efficiency and resource utilization in novice otolaryngology training. LEVEL OF EVIDENCE: N/A.
Humans↗
Cognitive-behavioral treatment of health-impairing food phobias in children.
Three cases reports describe assessment and treatment of three boys (ages 6 to 8 years) hospitalized because of weight loss and malnutrition, caused by severe dietary restriction and/or refusal to eat solid food. Psychological, behavioral, and medical assessments indicated that the boys were of average intelligence, without other significant psychological or medical disorders. Their eating disturbances were conceptualized as phobic disorders maintained by family factors reinforcing the children's avoidant behaviors. Cognitive-behavioral treatment consisted of an individualized combination of contingency management, shaping, desensitization, relaxation training, education, and cognitive restructuring. Generalization and maintenance were promoted by training parents to implement treatment at home before discharge. Treatment positively affected overall caloric intake, weight gain, number of solid foods accepted, and incidence of emesis.
Child↗
A controlled trial of cognitive remediation in schizophrenia.
A randomized, controlled trial of a 3-month cognitive remediation program was examined for its efficacy at ameliorating deficits in social and emotion perception in 42 hospitalized patients with schizophrenia. Generalization of training effects to attention, memory, and executive functioning was also examined. The program included an eclectic mix of self-instruction, memory enhancement, inductive reasoning, and compensatory training procedures, while the control condition included participation in a leisure group that was matched to the experimental group for staff involvement time. Patient care management, including type and dose of antipsychotic medication, remained constant throughout the study period. The results indicated that the cognitive training program improved emotion perception, with some evidence of generalization to measures of executive functioning; other areas of neurocognitive functioning were largely unaffected. While cognitive training programs may improve targeted areas of neurocognitive processing, broad generalization effects to domains outside those targeted for intervention are not likely concomitants.
Adult↗
Fitness effects on the cognitive function of older adults: a meta-analytic study.
A meta-analytic study was conducted to examine the hypothesis that aerobic fitness training enhances the cognitive vitality of healthy but sedentary older adults. Eighteen intervention studies published between 1966 and 2001 were entered into the analysis. Several theoretically and practically important results were obtained. Most important fitness training was found to have robust but selective benefits for cognition, with the largest fitness-induced benefits occurring for executive-control processes. The magnitude of fitness effects on cognition was also moderated by a number of programmatic and methodological factors, including the length of the fitness-training intervention, the type of the intervention, the duration of training sessions, and the gender of the study participants. The results are discussed in terms of recent neuroscientific and psychological data that indicate cognitive and neural plasticity is maintained throughout the life span.
Aged↗
Cardiorespiratory fitness: A predictor of cortical plasticity in multiple sclerosis.
Deficits in cognitive abilities are commonly observed among individuals with multiple sclerosis (MS). Recent neuroimaging studies have provided evidence for the existence of cortical plasticity in MS, with cognitively impaired participants recruiting additional brain areas to perform challenging tasks. The existence of altered cerebral activations in MS provides hope for the utilization of neural resources to reduce cognitive deficits that challenge everyday living in MS by employing alternative interventions such as cognitive and fitness training. In this study, we examined whether higher physical fitness levels enhance cognitive and neural plasticity in MS patients. The present study is the first to investigate the impact of cardiorespiratory fitness on cerebrovascular functioning of MS patients. 24 participants with relapsing-remitting MS were recruited for the study. All participants went through a fitness assessment and were scanned in a 3 T MRI system during the Paced Visual Serial Addition Test (PVSAT). Higher fitness levels were associated with faster behavioral performance and greater recruitment of right IFG/MFG, a region of the cerebral cortex recruited by MS patients during performance of PVSAT to purportedly compensate for the cognitive deterioration attributable to MS. In contrast, lower levels of fitness were associated with enhanced ACC activity, suggestive of the presence of greater interference and the potential for error in lower fit MS participants. These results are promising, suggesting the need for further investigation of the utility of aerobic fitness training as a possible method to support the development of additional cortical resources in an attempt to counter the cognitive decline resulting from MS.
Adult↗
The brief Kingston Standardized Cognitive Assessment--revised.
OBJECTIVES: The Kingston Standardized Cognitive Assessment-Revised (KSCA-R) was designed to be a cognitive screening tool available to health professionals who were not trained in specialized cognitive assessment techniques. It was introduced to bridge the gap between brief, narrowly focused rating scales, and intensive, expensive, full neuropsychological assessments. We now present the Brief Kingston Standardized Cognitive Assessment-Revised (BriefKSCA-R). METHODS: Groups of Alzheimer's disease patients, patients suffering from other dementias, and a group of normal community dwelling elderly were assessed using the BriefKSCA-R. RESULTS: This shortened version of the full Kingston Standardized Cognitive Assessment-Revised can be given in half the time while retaining most of the full KSCA-R's effectiveness. CONCLUSIONS: Suitable for a quick screening, or follow-up of patients already more fully assessed.
Aged↗
A novel approach to training pediatrics primary care residents.
From 1984 through 1987, 12 pediatrics residents from the Yale University School of Medicine took part in a three-year program that emphasized four areas in primary care: well-child care, developmental-behavioral pediatrics, chronic illness, and adolescent medicine. Program evaluation included a videotaped interview, an assessment of the residents' skill in the management of patients' behavioral problems, and multiple-choice examinations. The program residents improved their interviewing skills more than did the comparison residents, particularly in the process and psychosocial content areas, and also did better in the management of patients' behavioral problems. There was no difference in factual knowledge of behavioral and developmental pediatrics and adolescent medicine. While traditional residency training in primary care may provide the resident with comparable cognitive knowledge, such training may not always improve the resident's ability to apply the knowledge in the primary care setting.
Child↗
Basic life support skills training in a first year medical curriculum: six years' experience with two cognitive-constructivist designs.
RATIONALE: Although the Basic Life Support (BLS) ability of a medical student is a crucial competence, poor BLS training programs have been documented worldwide. Better training designs are needed. This study aims to share detailed descriptions and the test results of two cognitive-constructivist training models for the BLS skills in the first year of medical curriculum. METHOD: A BLS skills training module was implemented in the first year curriculum in the course of 6 years (1997-2003). The content was derived from the European Resuscitation Council Guidelines. Initially, a competence-based model was used and was upgraded to a cognitive apprenticeship model in 2000. The main performance-content type that was expected at the end of the course was: competent application of BLS procedures on manikins and peers at an OSCE as well as 60% achievement in a test consisting of 25 MCQ items. A retrospective cohort survey design using exam results and a self-completed anonymous student ratings' questionnaire were used in order to test models. RESULTS: Training time for individual students varied from 21 to 29 hours. One thousand seven hundred and sixty students were trained. Fail rates were very low (1.0-2.2%). The students were highly satisfied with the module during the 6 years. CONCLUSION: In the first year of the medical curriculum, a competence-based or cognitive apprenticeship model using cognitive-constructivist designs of skills training with 9 hours theoretical and 12-20 hours long practical sessions took place in groups of 12-17 students; medical students reached a degree of competence to sufficiently perform BLS skills on the manikins and their peers. The cognitive-constructivist designs for skills training are associated with high student satisfaction. However, the lack of controls limits the extrapolation of this conclusion.
Clinical Competence↗
Cognitive intervention in Alzheimer disease: a randomized placebo-controlled study.
The efficacy of a cognitive intervention consisting of training in face-name associations, spaced retrieval, and cognitive stimulation was tested in a sample of 37 patients (16 men, 21 women) with probable Alzheimer disease (AD). Patients with AD were randomly assigned to receive either the cognitive intervention or a mock (placebo) intervention for 5 weeks. The placebo group then crossed over to receive the intervention. During the intervention, AD patients showed significant improvement in recall of personal information, face-name recall, and performance on the Verbal Series Attention Test. Improvement did not generalize to additional neuropsychologic measures of dementia severity, verbal memory, visual memory, word generation, or motor speed, or to caregiver-assessed patient quality of life. Results suggest that although face-name training, spaced retrieval, and cognitive stimulation may produce small gains in learning personal information and on a measure of attention, improvement does not generalize to overall neuropsychologic functioning or patient quality of life.
Aged↗