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PubMed2001

Effects of tactile training on visual speechreading: performance changes related to individual differences in cognitive skills.

We report on a follow-up study of the Rönnberg, Andersson, Lyxell, & Spens (1998) speech tracking training study. The purpose was to examine, initially and after training, the effects of different tactile aids on tasks of visual speechreading. We also examined cognitive prerequisites for initial baseline speechreading and posttraining speechreading performance. Compared with speechreading alone, tactile aids impaired sentence-based speechreading at first, although performance improved with training. No effects of vibrotactile aids or training were obtained for visual word-decoding. Initial baseline speechreading performance and posttraining performance correlated with cognitive skills, but the size of the correlations changed. The size of the correlations also varied with the different tactually mediated speechreading conditions.

Journal Article↗

PubMed2003

Effects of stress management on PNI-based outcomes in persons with HIV disease.

A pretest-posttest, repeated-measures design was used to evaluate the effects of two stress management interventions on a battery of outcomes derived from a psychoneuroimmunological (PNI) framework. The effects of cognitive-behavioral relaxation training groups (CBSM) and social support groups (SSG) were compared with a WAIT-listed control group on the outcomes of psychosocial functioning, quality of life, neuroendocrine mediation, and somatic health. Participants were 148 individuals (119 men, 29 women), diagnosed with HIV disease; 112 (76%) completing the study groups. Using analysis of covariance, the CBSM group was found to have significantly higher postintervention emotional well-being and total quality-of-life scores than did either the SSG or WAIT groups. SSG participants had significantly lower social/family well-being scores immediately postintervention and lower social support scores after 6 months. The findings point to a pressing need for further, well-controlled research with these common intervention modalities.

Adaptation, Psychological↗

PubMed2006

Active for Life After Cancer: a randomized trial examining a lifestyle physical activity program for prostate cancer patients.

BACKGROUND: Active for Life After Cancer is a randomized trial evaluating the efficacy of a 6-month group-based lifestyle physical activity program (Lifestyle) for prostate cancer patients to improve quality of life (QOL) including physical and emotional functioning compared to a group-based Educational Support Program and a Standard Care Program (no group). METHOD: A total of 134 prostate cancer patients receiving continuous androgen-ablation were randomly assigned to one of the three study conditions. RESULTS: Results indicated no significant improvements in QOL at 6 or 12 months. Both group-based programs were positively received and yielded good attendance and retention. Lifestyle participants demonstrated significant improvements in most theoretical mediators proposed by the Transtheoretical Model and Social Cognitive Theory to affect physical activity. Despite these improvements, no significant changes were found for most physical activity measures. CONCLUSIONS: Results suggest a lifestyle program focusing on cognitive-behavioral skills training alone is insufficient for promoting routine physical activity in these patients.

Adaptation, Psychological↗

PubMed2002

[Interventions for improvement of primary care in patients with low back pain: how effective are advice to primary care physicians on therapies and a multimodal therapy program arising out of cooperation of outpatient health care structures?].

BACKGROUND: Treatment for chronic low back pain in primary care has a poor-quality outcome. There is evidence that multimodal therapy is the most successful approach to its management. We tried to evaluate whether giving primary care physicians evidence-based recommendations on therapy of chronic back pain or directly implementing a multimodal program would improve the outcome of patients with low back pain treated in primary care. METHODS: In the first phase, physicians were asked to document the course of patients suffering from low back pain of at least 4 weeks' duration with no decrease in intensity, noting pain intensity before and after 6 months of conventional, nonsurgical treatments. In the present, second, phase of the study, recommendations issued by the Medicines Committee of the German Medical Profession and the U.S. Agency for Health Care Policy and Research for the management of back pain were presented to doctors in printed form and at conferences. In parallel with this, a multimodal program for the treatment of chronic low back pain (4 h/day for 20 days: medical training therapy, cognitive-behavioral therapy, physiotherapy, and patient education) was organized in a private health-oriented sports center in cooperation with three private physiotherapy practices, and a psychologist and a pain specialist from the outpatient pain clinic at the University Hospital in Erlangen. We examined how physicians changed the therapy and how effective it was, the latter as reflected in the mean sum value of the percent pre- to posttreatment changes in pain intensity, how much pain interfered with daily living, depressivity, and quality of life. Data after interventions were compared with baseline data from the first phase. RESULTS: Data relating to 36 patients following treatment by 14 primary care physicians who had been given information about therapy recommendations and to 51 patients who had participated in the multimodal therapy program were compared with baseline data recorded in 157 patients. Recommendations changed neither the therapy preferred by primary care physicians nor the quality of outcome of conventional treatment. In contrast, the multimodal program of therapy for chronic low back pain improved the outcome significantly more than conventional therapy (mean improvement in general outcome score 22 vs. 7%, respectively, compared with baseline data; P<0.001). CONCLUSIONS: Giving primary care physicians information on the therapy recommended for treatment of low back pain does not lead to any change in physicians' preferred therapy. Multimodal programs for treatment of chronic low back pain should be organized locally, with existing health care providers joining forces to improve the quality of outcome in chronic low back pain managed in primary care.

Adult↗

PubMed2002

Effective treatments of school-aged conduct disordered children: recommendations for changing clinical and research practices.

The present article discusses reviews, meta-analytical and other relevant outcome studies of treating school-aged conduct-disordered children. Meta-analytical studies of Parent Management Training and Cognitive-behavioural Therapy for the child have demonstrated that these interventions affect conduct disorder in children positively. However, most studies involved in these meta-analyses are conducted in research conditions and are not representative of the treatment effectiveness in everyday clinical practice. We believe there is a gap between the so-called efficacy studies in research conditions and the effectiveness studies in clinical practice and we discuss how clinical and research practice could be brought together.

Adolescent↗

PubMed2006

Towards a "virtual pigeon": a new technique for investigating avian social perception.

The purpose of the present study is to examine the applicability of a computer-generated, virtual animal to study animal cognition. Pigeons were trained to discriminate between movies of a real pigeon and a rat. Then, they were tested with movies of the computer-generated (CG) pigeon. Subjects showed generalization to the CG pigeon, however, they also responded to modified versions in which the CG pigeon was showing impossible movement, namely hopping and walking without its head bobbing. Hence, the pigeons did not attend to these particular details of the display. When they were trained to discriminate between the normal and the modified version of the CG pigeon, they were able to learn the discrimination. The results of an additional partial occlusion test suggest that the subjects used head movement as a cue for the usual vs. unusual CG pigeon discrimination.

Animals↗

PubMed2003

Psychologic and behavioral management of tension-type headache: treatment procedures.

Used as an adjunct or alternative to medication treatment, psychologic and behavioral approaches to tension-type headache decrease headache frequency, affective distress, and headache-related disability. These approaches directly address the psychologic and behavioral factors that contribute to the disorder and to the individual headache episodes. There is well-established evidence of efficacy for the three broad approaches: relaxation training, electromyographic biofeedback training, and cognitive-behavioral stress management. Treatment has been difficult to access, with most care provided by behavioral specialists in tertiary care settings using clinic-based or home-based treatment protocols. Recent attempts to make treatment more accessible to a wider range of tension-type headache sufferers include using medical personnel to deliver treatment from physician practices and using existing and emerging technologies to provide care in a purely self-administered format without face-to-face contact with therapists. These attempts are promising, but remain preliminary; therefore, there is a need for further development and testing.

Behavior Therapy↗

PubMed1989

Stuttering severity and treatment outcome.

This study evaluated a multidimensional treatment of stuttering (awareness training, regulated breathing, cognitive restructuring and relapse prevention) for mild, moderate and severe stutterers. Behavioral measures (percentage of syllables stuttered and rate of speech) and cognitive measures (self-efficacy perception, locus of control and Erickson Scale) were taken. Using three multiple baseline designs across subjects, results showed that all mild stutterers and most moderate stutterers were clinically improved at the end of treatment and at six months follow-up. No severe stutterers (more than 15% of syllables stuttered) achieved clinical improvement. Self-efficacy perceptions were quite accurate in predicting the performance of successfully treated patients. No consistent changes were observed on the locus of control or the Erickson Scale. The clinical and theoretical implications of the results are discussed.

Adaptation, Psychological↗

PubMed1989

Relationship of client participation to psychotherapy.

Dimensions of client participation in psychotherapy were assessed to investigate whether participation is unidimensional or multidimensional, stable over therapy, and/or related to measures of psychotherapy outcome. Participation dimensions included compliance with scheduling (lateness, rescheduling, no-show) and with homework assignments (completion of a daily diary and relaxation home-practice), reported acceptance of the credibility of therapy rationale, satisfaction with global and specific aspects of therapy, expectation of personal improvement in anxiety symptomatology, self-rated engagement in therapy activities, and reported judgments about therapist characteristics and relationship qualities. Outcome measures included assessor ratings, daily client self-report of anxiety severity, and questionnaire measures. Subjects were 30 clients participating in a 12-session generalized anxiety disorder comparative treatment study in which they receive progressive relaxation training plus either cognitive therapy or nondirective therapy. Across clients in both treatment groups, behavioral compliance measures were poorly intercorrelated and unrelated to the other participation measures. Canonical correlation of participation variables with change on pre-post outcome measures showed a significant relationship between some participation variables representing satisfaction with specific aspects of therapy and the therapeutic relationship and improvement in daily level of subjective anxiety.

Anxiety Disorders↗

PubMed1984

Interaction between the socio-demographic variables of physicians and their patients: its impact upon patient satisfaction.

An investigation of resident physician socio-demographic characteristics and how they may interact with patient socio-demographic characteristics to influence satisfaction was done. Physician characteristics of gender, age, marital and parental status, ethnic background, level of training and demonstrated cognitive skills, was compared with similar patient socio-demographics, to ascertain if a patient's preconceived images of who a physician is, rather than what a physician does will impact significantly upon patient satisfaction outcome. Results suggest that patients make these judgments separately from physician socio-demographic variables and support the belief that communication skills are a major determinant of patient satisfaction.

Adult↗

PubMed1992

Applied use of cardiac and respiration measures: practical considerations and precautions.

Cardiac and respiratory measures can be successfully applied to "real world" environments and these measures have certain advantages over both performance and subjective measures that are typically used to monitor operator state and workload. However, because of large differences between laboratory and "real world" environments one must utilize caution in directly applying laboratory data and theories to the day-to-day world environment. While most workers are highly over-trained in their jobs, laboratory subjects are often under-trained in the cognitive tasks that are used to study cognitive activity. It is possible that a substantial portion of experimental effects reported in laboratory studies is due to learning effects. In addition, relatively small changes in cardiac and respiration measures are reported to experimental manipulations in the laboratory while a much larger range of changes are reported in "real world" environments. These differences highlight questions about laboratory/real world similarities and the need to develop a database of actual work environment data. A third area of concern is the relative lack of control over the experimental situation that is the case with most applied research. The possible confounding of changes due to cognitive and physical activity levels is a major concern and strategies for overcoming these problems are suggested. The potential for valuable contributions by cardiac and respiratory measures to applied research make overcoming these difficulties worthwhile.

Arousal↗

PubMed1985

Self-concepts and illness attitudes in chronic pain. A repertory grid study of a pain management programme.

Four patients completed a 10-session out-patient pain management programme which included didactic information, relaxation training and cognitive-behavioural techniques. At the beginning and completion of the programme a number of measures were taken, including symptom inventories and a repertory grid designed to tap the patients' self-concepts and attitudes towards illness. These two sets of before and after measures were compared. No changes in the symptom inventories nor in daily visual analogue measurements of pain were shown. Despite this, the repertory grids showed a significant increase in the distance between 'as I would like to be' and 'like a physically ill person;' suggesting that physical illness had become less desirable. At the same time the distance between 'like a physically ill person' and 'like a hypochondriac' decreased, suggesting that these two concepts were less clearly distinguished in the patients' minds. Analysis of the raw data suggested that emotional factors were considered more relevant to physical illness at the completion of the programme. It would seem, therefore, that the main impact of our programme was on the patients' attitudes towards illness rather than on symptoms. Since attitudes may partly determine subsequent illness behaviour, it is encouraging to note changes here which suggest that our patients have adopted a more healthy view of physical illness.

Adult↗

PubMed2004

A conceptual framework for drug treatment process and outcomes.

Evidence from specialized treatment evaluations and large-scale natural studies of treatment effectiveness is organized conceptually into a "treatment model" for summarizing how drug treatment works. Sequential relationships between patient and treatment program attributes, early patient engagement, recovery stages, retention, and favorable outcomes are discussed--along with behavioral, cognitive, and skills training interventions that have been shown to be effective for enhancing specific stages of the patient recovery process. Applications of the treatment model for incorporating science-based innovations into clinical practice for improving early engagement and retention, performance measurements of patient progress, program monitoring and management using aggregated patient records, and organizational functioning and systems change also are addressed.

Evidence-Based Medicine↗

PubMed2005

Nature of stress: differential effects on brain acetylcholinesterase activity and memory in rats.

Effect of acute, chronic-predictable and chronic-unpredictable stress on memory and acetylcholinesterase (AChE) was investigated in rats. The animals were subjected to 3 type of stressors--(1) acute immobilization stress, (2) chronic-predictable stress i.e., immobilization daily for 5 consecutive days and (3) chronic-unpredictable stress that included reversal of light/dark cycle, over-night fasting, forced-swimming, immobilization and forced exercise in random unpredictable manner daily for 5 consecutive days. Learning and memory function was studied by single trial Passive avoidance test. AChE activity was assayed spectrophotometrically in the detergent (DS) and salt (SS) soluble fractions in different brain regions. Learning was obtained in acute and chronic-predictable stress groups but not in chronic-unpredictable group. Acute, chronic-predictable and chronic-unpredictable stress caused significant decrease in AChE activity in the DS fraction of cortex, hippocampus and hypothalamus as compared to control. Results indicate that AChE in DS fraction is predominantly affected in stressed and stressed-trained group but cognition is affected only by chronic-unpredictable stress. In acute and chronic-predictable groups the decreased AChE activity in the hippocampal DS fraction during learning may be responsible to maintain cognitive function by enhancing the cholinergic activity.

Acetylcholinesterase↗

PubMed2004

Applied psychophysiology, clinical biofeedback, and rehabilitation neuropsychology: a case study--mild traumatic brain injury and post-traumatic stress disorder.

This article presents a case study of a 39-year-old European American married woman with a history of child and adolescent incest,marital rape, and physical abuse from her husband for more than 10 years. She was referred to a pain clinic for treatment of headaches and Tourette's syndrome. The client was evaluated with the Ackerman-Banks Neuropsychological Rehabilitation Battery to identify neuropsychological strengths and weaknesses. The Vulnerability to Stress Audit was used to identify life events that were positively and negatively influencing her life. The client was treated for mild traumatic brain injury, post-traumatic stress disorder,cognitive difficulties, impulsivity, confabulation, low frustration tolerance, and inability to evaluate and make decisions about socially appropriate behaviors. Treatment involved traditional psychotherapy, hypnosis, cognitive rehabilitation, biofeedback training, electromyography, finger temperature, and blood pressure.

Adult↗

PubMed2003

The Arthritis, Diet and Activity Promotion Trial (ADAPT): design, rationale, and baseline results.

Osteoarthritis (OA) of the knee leads to restrictions of physical activity and ability to perform activities of daily living. Obesity is a risk factor for knee OA and it appears to exacerbate knee pain and disability. The Arthritis, Diet, and Activity Promotion Trial (ADAPT) was developed to test the efficacy of lifestyle behavioral changes on physical function, pain, and disability in obese, sedentary older adults with knee OA. This controlled trial randomized 316 sedentary overweight and obese older adults in a two-by-two factorial design into one of four 18-month duration intervention groups: Healthy Lifestyle Control; Dietary Weight Loss; Structured Exercise; or Combined Exercise and Dietary Weight Loss. The weight-loss goal for the diet groups was a 5% loss at 18 months. The intervention was modeled from principles derived from the group dynamics literature and social cognitive theory. Exercise training consisted of aerobic and strength training for 60 minutes, three times per week in a group and home-based setting. The primary outcome measure was self-report of physical function using the Western Ontario and McMaster University Osteoarthritis Index. Other measurements included timed stair climb, distance walked in 6 minutes, strength, gait, knee pain, health-related quality of life, knee radiographs, body weight, dietary intake, and cost-effectiveness of the interventions. We report baseline data stratified by level of overweight and obesity focusing on self-reported physical function and physical performance tasks. The results from ADAPT will provide approaches clinicians should recommend for behavioral therapies that effectively reduce the incidence of disability associated with knee OA.

Body Mass Index↗

PubMed2000

Psychosocial interventions for individuals with dementia: an integration of theory, therapy, and a clinical understanding of dementia.

We reviewed six psychosocial interventions for individuals with dementia. Interventions are described in terms of theoretical basis, how knowledge about dementia is incorporated, techniques, and empirical support. Psychodynamic approaches appear helpful for understanding intrapsychic concerns of demented individuals. Support groups and cognitive/behavioral therapy assist early stage individuals to build coping strategies and reduce distress. Reminiscence and life review provide mild to moderate stage individuals with interpersonal connections. Behavioral approaches and memory training target specific cognitive and behavioral impairments and help to optimize remaining abilities. Reality orientation reflects a similar goal, yet is probably more useful for its interpersonal functions.

Aged↗

PubMed2001

Long-term outcome of patients with West syndrome.

The long-term outcome of Finnish children with West syndrome was evaluated. Two hundred and fourteen patients were followed up for 20-35 years or until death. A third of the patients died before the age of 3 years. The most common cause of death was infection. Autopsy revealed brain anomalies in 25 of 38 (66%) autopsied patients. Intellectual outcome was normal or slightly impaired in a quarter of the patients. All of them completed their education at a normal school or in a school for the educationally impaired children. Another fourth were taught in special training schools. Specific cognitive deficits were seen in some patients with normal intelligence. Nine attended secondary schools and seven of them had a professional occupation. Ten were married and five had children. One third of the patients were seizure-free, another third had seizures daily or monthly, and the remaining patients had seizures less frequently. Factors associated with a good prognosis were cryptogenic etiology, normal development before the onset of the spasms, a short treatment lag, and a good response to adrenocorticotropic hormone; this was seen in both the symptomatic and the cryptogenic group, and there were no relapses. In this study, the late appearance of focal abnormalities in electroencephalography was not associated with an unfavorable outcome. Focal abnormalities in temporal region were often seen in patients with autism. The location of an abnormality may be of importance for the prognosis. In this study, all the patients (100%) could be followed, which may be due to the special circumstances characteristic of Finland. The outcome in children with West syndrome seems to be better than is generally believed.

Adrenocorticotropic Hormone↗