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PubMed2006

Training of executive functions in Parkinson's disease.

Cognitive disturbances are common in Parkinson's disease (PD). Examination of cognitive function often reveals deficits in executive functions, including maintenance and inhibition of attention, flexibility in thinking, and planning. The involvement of the dopaminergic system in cognitive executive functions has been suggested by numerous studies. The aim of the present study was to analyze the effect of cognitive training on cognitive performance of PD-patients (N=26). Half of the patients participated in a cognitive training regimen, while the other patients only received standard treatment. The outcome showed improved performance of the group with cognitive treatment in two executive tasks after the training period, while no improvement was seen in the standard-treatment group. The results indicate that specific training is required for improvement of executive functions, while general rehabilitation is not sufficient. Thus, PD-patients might benefit from a short-term cognitive executive function training program that is tailored to the individual patient's needs.

Aged↗

PubMed1978

Toward applying cognitive skill training to memory problems.

Four elements of a successful program of cognitive skill training for the elderly include: (a) the use of mnemonic aids for the memorization of new information; (b) the development of motivational techniques to enhance attention to materials and maintenance of cognitive skills acquired through training; (c) the design of techniques which utilize individual differences in abilities, personality, and cognitive style to enhance individual programs of cognitive skill training; and (d) the use of appropriate medical and/or psychiatric care when necessary.

Aged↗

PubMed2006

Impact of intellectual status on response to cognitive task training in patients with schizophrenia.

Cognitive remediation is a promising rehabilitation procedure for people with schizophrenia, but very little is known about who can benefit. In the current analyses, we examined the role of pre-morbid and morbid intellectual function in predicting response to cognitive remediation in a sample of 152 patients diagnosed with schizophrenia or schizoaffective disorder. They were participants in a trial of work therapy and cognitive remediation and had been randomized to receive either Neurocognitive Enhancement Therapy with Work Therapy (NET+WT) or Work Therapy only (WT only). For the current analyses, patients were divided into three intellectual subgroups based on their pattern of premorbid and morbid deficits (preserved intelligence, compromised intelligence, and deteriorated intelligence), and their cognitive remediation outcomes were examined. Cognitive remediation response was measured in two ways: normalization of performance on a computerized training task, and pre-post neuropsychological test performance. Subjects in NET+WT showed greater improvement in cognition than those in WT only, but response differed by intellectual group. For patients in the compromised group, those in NET+WT showed a significantly higher proportion of task normalization than those in the WT only condition, but no such differences were found with the preserved and deteriorated intellectual groups. For patients in the preserved and deteriorated intellectual groups, those in the NET+WT condition showed significantly greater improvement in the analysis of pre-post neuropsychological test performance, but this difference was not found in the compromised intellectual group. These findings suggest that the compromised intellectual group, which had the lowest frequency of normal performers at intake, benefited from NET by achieving dramatic increases in normalization, but that they had difficulty in generalizing these gains to untrained tasks. Those in the preserved and deteriorated intellectual groups were more successful in generalizing their training.

Adult↗

PubMed2006

Preventing chronic back pain: evaluation of a theory-based cognitive-behavioural training programme for patients with subacute back pain.

OBJECTIVE: For long-term treatment effects, patients with subacute back pain need to adhere to treatment recommendations beyond the prescribed exercise treatment. Adherence rates are as low as 30%, so we developed a cognitive-behavioural training programme to enhance patients' self-efficacy, maximise severity perceptions and reduce barrier perceptions. METHOD: A 2 x 4 (group x time) repeated measurement design was applied. Forty-seven patients with non-specific, subacute back pain were randomly assigned to a training group (exercise treatment plus cognitive-behavioural training programme) or a control group (exercise treatment only). RESULTS: Repeated measures ANOVA revealed significant main and interaction effects; the training group reported enhanced self-efficacy and severity perceptions, reduced barrier perceptions, and self-reported that they exercised more often than the control group over time. However, no group differences regarding pain intensity emerged. CONCLUSION: Our findings demonstrate that a short and inexpensive cognitive-behavioural training programme is an effective tool to enable back pain patients to follow treatment recommendations on a regular basis. PRACTICE IMPLICATIONS: The short and simple intervention can easily be conducted by personnel, other than psychologists, i.e., physiotherapists.

Adult↗

PubMed2005

A cognitive-behavioural program for adolescents with chronic pain-a pilot study.

The purpose of this pilot study is to evaluate the feasibility of a cognitive-behavioural training program for adolescents with chronic pain irrespective of pain localisation. A secondary aim was to give an impression of the effect of the program on pain and quality of life. Eight adolescents (14-18 years) with chronic non-organic pain recruited from the general population (and their parents) participated in this pilot study. The intervention included five group meetings alternated with four telephone contacts (during the self-management weeks) over a period of 9 weeks. The training aimed to change pain behaviour through pain education, relaxation strategies, problem-solving techniques, assertiveness training, cognitive restructuring and by stimulating the adolescent's physical activity level. The training further addresses the social context of pain by inviting parents to attend two meetings for the parents only, and by asking the adolescents to bring a peer to one of the meetings. Adolescents and their parents were positive about the program. Adolescents felt they were more in control of their pain and parents valued the support they experienced in helping their children to master the pain. The training was considered to be feasible in daily life. Further, the preliminary data showed an effect on pain and quality of life in the expected direction. The results underline the need for a definitive study with a larger sample size and a random controlled design.

Adaptation, Psychological↗

PubMed1981

Cognitive skills training versus EMG biofeedback in the treatment of tension headaches.

In an effort to study the role of cognitive skills training in the treatment of psychosomatic disorders, two single-case design experiments were conducted to assess the relative effectiveness of biofeedback procedures and cognitive coping techniques in the alleviation of tension headaches. For both subjects, biofeedback training influenced mean frontalis EMG levels, although such changes were not associated with concomitant reductions in headache activity. It was the presence or absence of cognitive skills training, however, that determined whether each subject reported changes in headache levels. These results suggest that a more efficient treatment approach for tension headaches would involve an increased emphasis on the modification of maladaptive cognitive activity. The present findings support the general view that a comprehensive approach in the treatment of stress-related disorders requires a concomitant focus on the cognitive, behavioral, and affective dimensions of the symptom. It was also suggested that biofeedback technology may be a useful tool for studying the physiological consequences of particular cognitive processes and in identifying particular cognitions with anxiety-provoking properties.

Adult↗

PubMed1978

Social skills training and cognitive restructuring with alcoholics.

Social skills training (SST) has been shown to produce significant increases in skills immediately after training. However, persistence of skills has not been demonstrated during the follow-up period. The present study investigated this issue using SST and cognitive restructuring (CR) methods. Twenty-four hospitalized "alcoholics" were allocated to one of the following three group: (i) SST, (ii) CR, and (iii) traditional supportive therapy (TST). Twelve 2-hour sessions were conducted with each group. Before, following, and three months after treatment (i) behaviour ratings through structured interview, (ii) nurses' ratings, (iii) self-reported ratings of social skills and (iv) alcohol intake were recorded. Analysis of variance indicated SST to be significantly superior on all measures compared to CR, which was superior to TST immediately after training. However, 3 months after treatment, the subjects in the CR group indicated greater skill increments than the SST group subjects who, in turn, showed greater improvement than subjects in the TST group. These results led to the conclusion that CR was more effective than SST and TST in producing long-term skill increments. The significance of these findings in providing support for the social learning model of alcohol dependence and cognitive restructuring theory of social skills modification is discussed.

Alcoholism↗

PubMedDate not supplied

The screening role of an introductory course in cognitive therapy training.

OBJECTIVE: This study examines the role of an introductory course in cognitive therapy and the relative importance of trainees' characteristics in the selection process for an advanced course in cognitive therapy. METHOD: The authors assessed the files of all trainees who completed one academic year introductory course in cognitive therapy over the last seven consecutive years (N = 203). The authors examined variables such as previous training, overall involvement during the course, performance, and ability to relate to others, as well as the trainer's evaluations of their performance. RESULTS: Interaction skills in group situations and performance in written assignments were better predictors for admission into the advanced course. CONCLUSIONS: Trainees' abilities to learn and to successfully relate to others in group situations are critical for entering an advanced cognitive therapy training course. These findings question the policy of full-scale training in cognitive therapy based merely on the candidates' professional background, stressing instead the merits of an introductory course as an appropriate screening procedure.

Academic Medical Centers↗

PubMed1997

Biofeedback, relaxation training, and cognitive behaviour modification as treatments for lower functional gastrointestinal disorders.

Biofeedback, relaxation training, and cognitive behaviour modification are being increasingly proposed for the treatment of numerous functional disorders of the gastrointestinal tract. Among these, those related to the lower part of the gut seem to be more likely to benefit from this therapeutic approach. We examine and discuss the literature studies adopting such techniques.

Adult↗

PubMed2006

Effects of trainer reputation and trainees' need for cognition on training outcomes.

The authors examined the effects of trainer reputation and trainees' need for cognition on training outcomes. Participants (N = 75) read a sheet describing a trainer as either effective or ineffective or they were given no information. Participants then viewed a videotaped lecture, evaluated the lecture, and completed a self-efficacy scale and knowledge test. The authors did not find an interaction of trainer reputation and need for cognition on clarity ratings. Participants with low need for cognition were influenced by the trainer reputation, whereas participants with high need for cognition were not. Self-efficacy mediated the relationship between the interaction of trainer reputation and need for cognition on declarative knowledge.

Cognition↗

PubMed1996

Effects of cognitive coping skills training on coping strategies and experimental pain sensitivity in African American adults with sickle cell disease.

The present study examined whether training in cognitive coping skills would enhance pain coping strategies and alter pain perception in adults with sickle cell disease (SCD). Sixty-four African Americans with SCD were randomly assigned to either a cognitive coping skills condition (three 45-min sessions in which patients were trained to use 6 cognitive coping strategies) or a disease-education control condition (three 45-min didactic-discussion sessions about SCD). Pain sensitivity to calibrated noxious stimulation was measured at pre- and posttesting, as were cognitive coping strategies, clinical pain, and health behaviors. Results indicated that, compared with the randomly assigned control condition, brief training in cognitive coping skills resulted in increased coping attempts, decreased negative thinking, and lower tendency to report pain during laboratory-induced noxious stimulation.

Adaptation, Psychological↗

PubMedDate not supplied

Responders and nonresponders to autogenic training and cognitive self-hypnosis: prediction of short- and long-term success in tension-type headache patients.

The present study was conducted to determine whether demographic variables, medical status variables, and psychological measures at pretreatment were related to pain reduction immediately following behavioral treatment for headache and at a 6-month follow-up. The study sample consisted of 156 subjects, who were selected for participation in a behavioral outcome study on the efficacy of autogenic training and cognitive self-hypnosis training. A Headache Index based on pain diaries constituted the main outcome measure. Psychological measures included the Symptom Checklist-90, Dutch Personality Questionnaire, Coping Strategy Questionnaire, Multidimensional Locus of Pain Control Questionnaire, and treatment expectations. Subjects who expected more pain reduction at pretreatment achieved a lower level of pain at posttreatment, independent of pretreatment pain levels. None of the other pretreatment variables were related with pain reduction at posttreatment or at the follow-up. Finally, at the 6-month follow-up, 43 subjects were classified as responders (more than 50% pain reduction) and 113 as nonresponders (less than 50% pain reduction and dropouts). At pretreatment, the responders perceived more pain control than the nonresponders. None of the other pretreatment differences between responders and nonresponders proved to be significant. The main conclusion that could be drawn from this study was that pain reduction, in the short- and long-term, cannot be predicted with any accuracy by demographic and medical status variables or scores for psychological distress, personality traits, coping strategy use, and pain appraisals.

Adaptation, Psychological↗

PubMed2006

Social cognition enhancement training for schizophrenia: a preliminary randomized controlled trial.

The purpose of this study was to evaluate whether social cognition enhancement training (SCET) is effective in improving social context appraisal and perspective-taking abilities of patients with schizophrenia. A total of 34 patients were randomly assigned to receive SCET plus standard psychiatric rehabilitation training or standard psychiatric rehabilitation training only. SCET was conducted twice weekly on a group basis for 6 months. Some social cognitive abilities were improved rapidly after 2-month treatment whereas some improved only after 6-month treatment. These results show promise for the impact of SCET on the social cognitive functioning of individuals with chronic schizophrenia, and further investigation is merited.

Adolescent↗

PubMedDate not supplied

A survey of accredited and other rehabilitation facilities: education, training and cognitive rehabilitation in brain-injury programmes.

Although it is routinely acknowledged that cognitive rehabilitation therapy comprises a major part of the services provided to survivors of brain injury, there continues to be no general consensus regarding the methods and training of those who provide cognitive rehabilitation services. This survey of 398 head-injury rehabilitation facilities includes information on which disciplines are providing and supervising cognitive rehabilitation therapy, which therapy formats are used, and a first attempt to define the costs and providers for cognitive therapy staff training in Commission on Accreditation of Rehabilitation Facilities (CARF) approved and other (non-CARF) facilities. The education and training of junior and senior staff members is compared, and respondents suggest changes in the education and training of those who provide cognitive rehabilitation therapy. The results of this survey suggest no significant differences in the organization and delivery of cognitive rehabilitation therapy in CARF and non-CARF programmes. They indicate that cognitive rehabilitation therapy and the education and training of providers deserve further study and definition, given the widespread provision of cognitive rehabilitative services.

Accreditation↗

PubMed1997

Cognitive coping skills training in children with sickle cell disease pain.

This study was designed to examine whether brief training in cognitive coping skills would enhance pain coping strategies and alter pain perception in children and adolescents with sickle cell disease (SCD). Forty-nine participants with SCD were randomly assigned to either a cognitive coping skills condition or a standard care control condition. At pre- and posttesting, coping strategies and pain sensitivity using laboratory pain stimulation were measured. Results indicated that in comparison to the randomly assigned control condition, brief training in cognitive coping skills resulted in decreased negative thinking and lower pain ratings during low intensity laboratory pain stimulation.

Journal Article↗

PubMed2001

The reduced oxygen breathing paradigm for hypoxia training: physiological, cognitive, and subjective effects.

UNLABELLED: The current training program for hypoxia familiarization requires a low-pressure chamber that places aviator trainees at risk for decompression sickness. A cost-effective reduced oxygen-breathing (ROB) paradigm that decreases oxygen (O2) concentration leading to normobaric hypoxia was assessed as an alternative to the hypobaric chamber. PURPOSE: To help establish the validity of the ROB paradigm, this report documents cognitive performance, cardiopulmonary and subjective changes during ROB exposure. METHODS: Performance on a two-dimensional tracking task, as well as BP, heart rate, end-tidal carbon dioxide (ETCO2), O2 saturation, and subjective reports of hypoxia symptoms were observed in 12 U.S. Navy divers during exposure to normoxic air followed by one of four experimental gas mixtures per session. All participants received all gas conditions that differed in their relative concentrations of O2 and nitrogen (6.20/93.80, 7.00/93.00, 7.85/92.15, and 20.85/79.15% O2/N2). RESULTS: ROB caused increases in tracking task error (p < 0.0001). ROB also increased heart rate (p < 0.001) and systolic BP (p = 0.004), and decreased ETCO2 and O2 saturation (p < 0.0001). Finally, subjects responded to ROB-induced hypoxia with higher subjective symptom ratings (p < 0.0001). CONCLUSIONS: These data are consistent with those expected from hypoxic states and support the validity of the ROB paradigm for hypoxia training. Future validation studies comparing a ROB device with hypobaric chambers are needed.

Adaptation, Physiological↗

PubMed2005

The impact of speed of processing training on cognitive and everyday performance.

The purpose of the present investigation was to examine the impact of speed of processing training on the cognitive and everyday abilities of older adults with initial processing speed or processing difficulty. Participants were randomized to either a speed of processing intervention or a social- and computer-contact control group. Results indicate that speed of processing training not only improves processing speed, as indicated by performance on the Useful Field of View test (UFOV), but also transfers to certain everyday functions, as indicated by improved performance on Timed Instrumental Activities of Daily Living (Timed IADL). Transfer of speed of processing training to other cognitive domains was not evident. This study provides additional evidence that speed of processing training has the potential to enhance everyday functions that maintain independence and quality of life, particularly when the training is targeted toward individuals who most need it. Further study is needed to learn about the long-term effects of such training in relation to everyday abilities.

Activities of Daily Living↗

PubMed1984

Self-control in hyperactive boys in anger-inducing situations: effects of cognitive-behavioral training and of methylphenidate.

The effects of cognitive-behavioral intervention and methylphenidate on anger control in hyperactive boys were investigated in two studies. The anger-inducing stimuli in both studies involved verbal provocation from peers. Study 1 assessed a brief intervention using self-control strategies, while Study 2 employed a longer training period and a control intervention that focused on enhancement of empathy. Both studies included methylphenidate versus placebo comparisons. Methylphenidate reduced the intensity of the hyperactive boys' behavior but did not significantly increase either global or specific measures of self-control. Cognitive-behavioral treatment, when compared to control training, was more successful in enhancing both general self-control and the use of specific coping strategies. There was no advantage for the combination of methylphenidate plus cognitive-behavioral intervention. Implications for intervention to ameliorate the social and interpersonal difficulties of hyperactive children are discussed.

Adolescent↗