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PubMed2004

Durability of cognitive remediation training in schizophrenia: performance on two memory tasks at 6-month and 12-month follow-up.

Patients with schizophrenia have consistently been found to exhibit cognitive deficits, particularly in memory, which have been suggested to mediate functional outcomes. Several recent reviews of cognitive retraining have concluded that these deficits respond to training, although the sustainability of cognitive improvement following completion of training has not been adequately evaluated. Most studies had small samples and very short follow-up periods. As part of a larger study, we examined performance on two memory tasks in two groups of participants: those who received computerized cognitive remediation training in addition to work therapy (n=45), vs. those who only received work therapy (n=49). Computerized cognitive remediation included hierarchical training on a computerized digit span task and a computerized words serial position task. Assessments using the same computerized tasks were made at three time points: baseline, end of active intervention, and 6-month follow-up. Compared to the active control condition (work therapy only), the group receiving computerized cognitive remediation in addition to work therapy showed significantly greater improvements on the trained digit span task following training. These improvements were maintained at the 6-month follow-up. There were no significant group differences on the word serial position task at any time point. Results indicate that computerized training can lead to sustained improvements on some, but not all, training tasks.

Adult↗
PubMed2001

Conceptualisation and evaluation of a cognitive-behavioural training programme for children and adolescents with obesity.

OBJECTIVE: Obesity is common in children and adolescents with incidence rates increasing both nationally and internationally. Its causes are complex and multifaceted, and obesity is associated with high morbidity and mortality as well as psychological distress. Multidimensional programmes are necessary in the treatment of this chronic disease in order to change eating and physical activity habits. A cognitive-behavioural training programme was developed and evaluated. In combination with diet and exercise, this special group programme that includes well established behavioural methods, was expected to result in long-term weight reduction and decrease of psychological distress in connection with obesity. DESIGN: As part of the six week in-patient rehabilitation for children and adolescents at Viktoriastift in Bad Kreuznach, the three-part programme (experimental group, EG) was compared with a programme that differed only in the psychological intervention component (instead of the specific training programme they undertook muscle relaxation training, comparison group, CG). SUBJECTS: In total, 197 children and adolescents between 9 and 19 y-of-age were recruited into the study. MEASUREMENTS: Somatic (eg weight status), behavioural (eg eating behaviour) and psychological (eg quality of life) outcomes were assessed at five points in time: two weeks before the intervention, at the beginning and end of the programme, as well as six months and one year post-intervention. The study started in spring 1997. Main outcomes will be presented. RESULTS: Pre- vs post-intervention-tests showed significant improvements in self-reported eating behaviours for the EG compared with the CG (F=6.38, P<0.05); these changes were independent of age and sex. The weight status measured as the percentage of overweight dependent on height was reduced in both groups immediately after the intervention and at follow-up (F=16.51, P<0.01). Reduction in the prevalence of obesity tended to be higher in the EG than in the CG (15% vs 10%). Self-reported quality of life increased from before the intervention to follow-up more in the EG than in the CG (F=3.27, P=0.08). In all, the acceptance of the behavioural patient education programme was good. CONCLUSION: In summary, evaluation results indicate that the cognitive-behavioural training programme is a promising approach to alter obesity-related habits and to reduce somatic and psychosocial consequences. Long-term effects after two years are expected to underscore these results.

Adolescent↗
PubMed1993

Social skills training and cognitive restructuring for adolescents on hemodialysis.

The purpose of this study was to test a social skills and cognitive restructuring intervention designed for adolescents undergoing hemodialysis. A single-case experimental design with multiple baselines across subjects was used. Cognitive restructuring and assertive skills training were incorporated into eight weekly instructional modules. A convenience sample of 6 adolescents entered the program; 3 subjects completed the program. Data were analyzed using visual analysis. Although no striking changes could be seen between pre- and post-intervention phases for self-efficacy and self-report of assertive behaviors, there was a trend toward growth in overall social skills for 2 subjects. Another subject made some obvious increases in all areas of self-efficacy in comparison to other subjects. This study points out the merit of identifying depression as a factor in cognitive impairment and the exercise of personal efficacy.

Adolescent↗
PubMed1995

Relaxation and imagery and cognitive-behavioral training reduce pain during cancer treatment: a controlled clinical trial.

Few controlled clinical trials of psychological interventions for cancer pain relief exist in spite of frequent support for their importance as adjuncts to medical treatment. This study compared oral mucositis pain levels in 4 groups of cancer patients receiving bone marrow transplants (BMT): (1) treatment as usual control, (2) therapist support, (3) relaxation and imagery training, and (4) training in a package of cognitive-behavioral coping skills which included relaxation and imagery. A total of 94 patients completed the study which involved two training sessions prior to treatment and twice a week 'booster' sessions during the first 5 weeks of treatment. Results confirmed our hypothesis that patients who received either relaxation and imagery alone or patients who received the package of cognitive-behavioral coping skills would report less pain than patients in the other 2 groups. The hypothesis that the cognitive-behavioral skills package would have an additive effect beyond relaxation and imagery alone was not confirmed. Average visual analogue scale (VAS) report of pain within the therapist support group was not significantly lower than the control group (P = 0.103) nor significantly higher than the training groups. Patient reports of relative helpfulness of the interventions for managing pain and nausea matched the results of VAS reports. From these results, we conclude that relaxation and imagery training reduces cancer treatment-related pain; adding cognitive-behavioral skills to the relaxation with imagery does not, on average, further improve pain relief.

Adaptation, Psychological↗
PubMed1994

Autogenic training and cognitive self-hypnosis for the treatment of recurrent headaches in three different subject groups.

The aims of this study were to (a) investigate the efficacy of autogenic training (AT) and cognitive self-hypnosis training (CSH) for the treatment of chronic headaches in comparison with a waiting-list control (WLC) condition, (b) investigate the influence of subject recruitment on treatment outcome and (c) explore whether the level of hypnotizability is related to therapy outcome. Three different subjects groups (group 1, patients (n = 58) who were referred by a neurological outpatient clinic; group 2, members (n = 48) of the community who responded to an advertisement in a newspaper; and group 3, students (n = 40) who responded to an advertisement in a university newspaper) were allocated at random to a therapy or WLC condition. During treatment, there was a significant reduction in the Headache Index scores of the subjects in contrast with the controls. At post-treatment and follow-up almost no significant differences were observed between the 2 treatment conditions or the 3 referral sources regarding the Headache Index, psychological distress (SCL-90) scores and medication use. Follow-up measurements indicated that therapeutic improvement was maintained. In both treatment conditions, the high-hypnotizable subjects achieved a greater reduction in headache pain at post-treatment and follow-up than did the low-hypnotizable subjects. It is concluded that a relatively simple and highly structured relaxation technique for the treatment of chronic headache subjects may be preferable to more complex cognitive hypnotherapeutic procedures, irrespective of the source of recruitment. The level of hypnotic susceptibility seems to be a subject characteristic which is associated with a more favourable outcome in subjects treated with AT or CSH.

Adult↗
PubMed1997

Cognitive bladder training in the community.

Following a study trip sponsored through a Cow & Gate scholarship award, the author of this article introduced a cognitive bladder training programme for children with daytime wetting problems. This article looks at how the programme was introduced and describes the components of the programme including educational tools, motivation and bio-feedback. As a result of the programme district-wide, multidisciplinary management guidelines have been introduced.

Biofeedback, Psychology↗
PubMed2003

Effects of Attention Process Training on cognitive functioning of schizophrenic patients.

The goal of this study was to investigate the impact of Attention Process Training (APT) on cognitive functioning in schizophrenia. Twenty-four patients with schizophrenia were randomly assigned to one of the two following conditions: training by means of APT or no training. The dependent variables included measures of attention, memory and executive functions derived from a cancellation task, dichotic listening, dual task, Trail Making Test, Paced Auditory Serial Addition Task, Everyday Attention Questionnaire, Spain-Complutense Verbal Learning Test and Wisconsin Card Sorting Test (WCST). All participants were also rated on measures of positive and negative symptoms. The tasks were administrated to all participants at baseline. Participants in the training group received individual intensive APT twice a week, whereas the control group did not receive training. All participants were subsequently retested on the same tests. Although, contrary to expectations, neither group improved on clinical and information-processing measures of attention and memory, patients in the trained group had a significantly higher performance on executive function (as measured by the WCST) than did the control group. We conclude that it is feasible to use practice in attention to remediate executive function deficits in schizophrenia.

Adult↗
PubMed1990

Inpatient social-cognitive skills training groups with conduct disordered and attention deficit disordered children.

The impact of group treatment programs on the social skills and peer relations of psychiatrically hospitalized children with disruptive behavior disorders was evaluated. Children assigned to a social-cognitive skills training group (SCST; n = 36) were matched to children who participated in a social activity group (SA; n = 20). The results indicated significantly greater pre-post improvements for the SCST than the SA group in child-reported loneliness, staff sociometric ratings, role-play performances, and in vivo behavioral observations of individual social skills. Child diagnoses did not differentially effect treatment outcomes. The findings are discussed in the context of training, clinical, and methodological issues.

Aggression↗
PubMed1982

Social skills training and cognitive restructuring with sexual unassertiveness in women.

From those responding to a newspaper advertisement, 29 female subjects were placed in one of four treatment groups aimed at overcoming sexual unassertiveness. The four groups were: Social Skills Training (SST); Cognitive Restructuring (CR); a combined SST and CR group; and a nondirective placebo discussion group. All treatment groups received four two-hour treatment sessions over four weeks. Self-reports and videotape behavioral assessments were used as dependent measures to monitor changes among the four groups. In general, the results showed that the SST and SST/CR procedures were effective in reducing sexual unassertiveness on the self-report and behavioral rating measures when compared to the control and the CR groups. Women in the SST group showed greatest improvement at posttreatment on the sexual assertiveness role-playing test. However, at three-month follow-up the combined SST/CR group maintained gains in comparison to the other groups. The findings thus suggest that the SST/CR procedures are superior in the treatment of sexual unassertiveness in women.

Adult↗
PubMed1999

Effectiveness of cognitive therapy training.

Despite growing demands for effective training there remains a lack of convincing evaluations. Reviews of the training literature specify the need for multiple measures, homogeneous therapies, generalization assessments and longitudinal designs. The present analysis responds by evaluating the training of 20 mental health professionals in cognitive therapy (CT). The evaluation focussed on changes in the professionals' competence and its generalization to their patients' coping strategies (N = 20). Results indicated that a 40 day training programme led to significantly higher post-training competence scores and to improved patient coping. The implications for professional training and its evaluation are discussed.

Adult↗
PubMed2005

Cognitive-behavioural training interventions for assisting foster carers in the management of difficult behaviour.

BACKGROUND: The provision of training for foster carers is now seen as an important factor contributing to the successful outcome of foster care placements. It is believed to be associated with enhancing caring attitudes and skills, reducing behaviour problems in foster children, improving relationships between foster carers and child welfare agencies, and decreasing foster carer attrition. Since the late 1960s, foster carer training programs have proliferated, and few of the many published and unpublished training curricula have been systematically assessed and evaluated. The advent of cognitive-behavioural therapy (CBT) and the research evidence demonstrating its effectiveness as a psychotherapeutic treatment of choice, has prompted many working in the social care field to devise CBT-based training programmes. CBT approaches to foster care training derive from a 'skill-based' training format that also seeks to identify and correct problematic thinking patterns that are associated with dysfunctional behaviour by changing and/or challenging maladaptive thoughts and beliefs. OBJECTIVES: To assess the effectiveness of cognitive-behavioural training interventions in improving a) looked-after children's behavioural/relationship problems, b) foster carers' psychological well-being and functioning, c) foster family functioning, d) foster agency outcomes. SEARCH STRATEGY: We searched databases including: CENTRAL (Cochrane Library Issue 2, 2004), MEDLINE (January 1966 to April 2004), EMBASE (January 1980 to April 2004), CINAHL (January 1982 to April 2004), PsycINFO (January 1872 to April 2004), ASSIA (January 1987 to April 2004), LILACS (up to April 2004), ERIC (January 1965 to April 2004), Sociological Abstracts (January 1963 to April 2004), and the National Research Register 2004 (Issue 1). We contacted experts in the field concerning current research. SELECTION CRITERIA: All studies in which participants were foster parents/carers, and who were allocated by random or quasi-random methods to a CBT-based training intervention (in a group and/or one-to-one settings) versus a no-treatment or wait-list control, were selected. DATA COLLECTION AND ANALYSIS: Results from the five eligible trials (total n = 443 ) are reported narratively. Due to the diversity of measures employed, no meta-analysis was performed. MAIN RESULTS: Training interventions evaluated to date appear to have very little effect on outcomes relating to looked-after children, assessed in relation to psychological functioning, extent of behavioural problems and interpersonal functioning. Results relating to foster carer(s) outcomes indicate some improvements in measures of behavioural management skills, attitudes and psychological functioning. Analysis pertaining to fostering agency outcomes did not show any significant results. AUTHORS' CONCLUSIONS: Inconclusive evidence exists about the efficacy of CBT-based training intervention for foster carers. The need for further research in this area is highlighted.

Aggression↗
PubMed2006

Effectiveness of brief training in cognitive behaviour therapy techniques for palliative care practitioners.

We describe training in CBT techniques for 20 palliative care practitioners delivered as 12 days' equivalent teaching plus skills-building supervision over a six month period. Audiotapes of trainees' interactions with patients during their usual work were rated using a specially devised 'Cognitive First Aid' rating scale (CFARS). The CFARS was highly internally consistent (Cronbach's Alpha 0.93) and inter-rater reliability was high. Trainees showed significant gain in CBT skills competency over six months (p=0.001). After initial training, half the trainees were randomised to discontinue supervision; their measured CBT skill dropped as did their self-reported confidence when reassessed six months later, whereas those who continued in supervision gained further skill and maintained confidence (p=0.007). Palliative care practitioners can be trained in CBT skills by a simple and brief training course and supportive, skills-building supervision. These skills are compatible with national guidelines on delivery of psychological support to patients at all stages of cancer. Supervision is necessary to ensure maintenance of skills and confidence to use them.

Clinical Competence↗
PubMed2006

Improvement of episodic memory in persons with mild cognitive impairment and healthy older adults: evidence from a cognitive intervention program.

The efficacy of cognitive training was assessed in persons with mild cognitive impairment (MCI) and persons with normal cognitive aging. Forty-seven participants were included in this study: 28 with MCI and 17 controls. Twenty-one participants received intervention (20 MCI and 9 controls) and 16 participants (8 MCI and 8 controls) received no intervention (waiting-list group). The intervention focused on teaching episodic memory strategies. Three tasks of episodic memory (list recall, face-name association, text memory) were used as primary outcome measures. Results were analyzed using analyses of variance. The intervention effect (pre- and post-intervention difference) was significant on two of the primary outcome measures (delayed list recall and face-name association). A significant pre-post-effect was also found on measures of subjective memory and well-being. There was no improvement in the performance of groups of individuals with MCI and normal elderly persons who did not receive the intervention. These results suggest that persons with MCI can improve their performance on episodic memory when provided with cognitive training.

Aged↗
PubMed2026

Effects of Exergame Balance Training with Variable Cognitive Motor Challenges on Serum BDNF, p-tau181, and Cognitive Functions in Adults with Mild Cognitive Impairment: A Randomized Trial.

INTRODUCTION: Cognitive-motor exergame balance training may increase attentional demands and neuronal processing, potentially affecting serum levels of brain-derived neurotrophic factor (BDNF), A&#x3b2;1-42, and p-tau181, as well as train cognitive abilities in adults with mild cognitive impairment (MCI). This study aimed to compare the effects of exergame balance training of mild, moderate, high-difficulty, and Wii Fit&#x2122; groups on blood serum levels of BDNF, A&#x3b2;1-42, p-tau181, and cognition function in adults with MCI. METHODS: In this four-arm, parallel group randomized clinical trial, 97 adults with MCI were randomly assigned to exergame balance training groups of mild, moderate, high-difficulty, and Wii Fit exergame as a control group. All participants received 40 min/session, 3 times/week for 8 weeks. Assessment of serum levels of p-tau181, A&#x3b2;1-42, BDNF, and cognitive functions was conducted at baseline, after weeks 4 and 8. A mixed-model analysis of covariance was used, with post-baseline measurements (weeks 4 and 8) specified as the within-subject factor and the corresponding baseline value entered as a covariate to adjust for initial between-group variability. RESULTS: A significant group &#xd7; time interaction was found for BDNF, F(3,92) = 6.413, P = 0.017, &#x3b7;p2 = 0.181; p-tau181, F(3,92) = 4.640, P = 0.040, &#x3b7;p2 = 0.138; attention, F(3,92) = 4.171, P = 0.045, &#x3b7;p2 = 0.057; abstraction, F(3,92) = 4.263, P = 0.043, &#x3b7;p2 = 0.058; and visuospatial skills, F(3,92) = 6.931, P < 0.001, &#x3b7;p2 = 0.234. CONCLUSION: Cognitive-motor challenge-based exergame balance training was associated with an increase in serum BDNF, a reduction in p-tau181. In contrast, the A&#x3b2;1-42 levels remained stable. These changes were accompanied by improvement in selective cognitive functions (attention, abstraction, and visuospatial skills) in individuals with MCI. Greater effects were observed in moderate and high-difficulty groups, suggesting the importance of intervention intensity in promoting cognitive and neurobiological outcomes in MCI.

Humans↗
PubMed2006

Self-efficacy outcomes of people with brain injury in cognitive skill training using different types of trainer-trainee interaction.

PRIMARY OBJECTIVE: To evaluate the effects of different trainer-trainee interaction patterns on the self-efficacy outcomes of trainees with brain injury. RESEARCH DESIGN: A pre-test and post-test randomized clinical trial design. METHODS AND PROCEDURES: One hundred and three subjects with brain injury were recruited and 83 subjects participated in analogical problem-solving training that was delivered in three respective interaction modes: (a) direct trainer-trainee interaction, (b) self-paced computer-assisted and (c) on-line training with real-time audio-visual interaction. Quizzes on daily behavioural problem- solving and a problem-solving self-efficacy rating scale were adopted as outcome measures. The trainees in the trainer-administered group that received instructions in person with a continuous 'human touch' showed more significant improvement in their problem-solving self-efficacy than the two other groups. CONCLUSIONS: Interactive modes of cognitive skill training can be flexible enough to match the needs of individual trainees. However, human interaction is considered important in promoting self-efficacy in trainees with brain injury.

Adult↗
PubMed1982

Relaxation training and cognitive redirection strategies in the treatment of acute pain.

Relaxation training, relaxation instructions, and redirection of attention techniques were compared to a no-treatment control in the treatment of acute ischemic pain. Relaxation instructions were ineffective in reducing state anxiety, verbally reported pain or distress or pain measured during presentation of the stimulus by cross-modality matching. Relaxation training was effective in reducing distress during presentation of the stimulus and verbally reported pain. The attention-redirection technique reduced pain as measured by cross-modality matching. The interaction hypothesis was supported, re. the two measures of distress during presentation of the painful stimulus. As externality increased, the effectiveness of relaxation training increased. However, there was no consistent decrease in distress for subjects high on externality in the relaxation instruction group.

Attention↗
PubMedDate not supplied

[Effectiveness of cognitive skills training in schizophrenia].

AIM: This study evaluated methods for improving cognitive skills of patients with schizophrenia. METHOD: Subjects in the experimental group received 12 sessions of practice with various cognitive tasks, while patients in the control group participated in sessions of psychoeducation. RESULTS: Cognitive assessment before and after the study phase showed that patients in the experimental group had made significantly more improvement than the control group. Both groups improved on the insight scores, however, reductions in the level of psychopathology were less tangible.

Adult↗