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PubMed1985

[Effectiveness of acupuncture and attitude-relaxation training in the treatment of primary sleep disorders].

UNLABELLED: The present study focuses on the differential efficiency of specific psychological and medical procedures for the treatment of chronic sleep disorders (primary symptoms). 32 selected subjects with chronic sleep disorders were assigned to one of the following groups according to their own choice: cognitive change and relaxation training (n = 12), needle acupuncture (n = 8), laser acupuncture (n = 12), and a waiting control group (n = 12). Before, during, and after the respective therapy each subject kept a record with 13 items about his/her sleeping behaviour which had to be filled out every morning. RESULTS: All treatment groups showed an increase in the subjective recovery by sleep as well as a decrease in the use of drugs. On a follow up after two weeks the cognitive change/relaxation group showed a significant decrease in the time required to fall asleep and in the frequency of waking up.

Acupuncture Therapy↗
PubMedDate not supplied

A randomized controlled trial of intensive neurophysiology education in chronic low back pain.

OBJECTIVES: Cognitive-behavioral pain management programs typically achieve improvements in pain cognitions, disability, and physical performance. However, it is not known whether the neurophysiology education component of such programs contributes to these outcomes. In chronic low back pain patients, we investigated the effect of neurophysiology education on cognitions, disability, and physical performance. METHODS: This study was a blinded randomized controlled trial. Individual education sessions on neurophysiology of pain (experimental group) and back anatomy and physiology (control group) were conducted by trained physical therapist educators. Cognitions were evaluated using the Survey of Pain Attitudes (revised) (SOPA(R)), and the Pain Catastrophizing Scale (PCS). Behavioral measures included the Roland Morris Disability Questionnaire (RMDQ), and 3 physical performance tasks; (1) straight leg raise (SLR), (2) forward bending range, and (3) an abdominal "drawing-in" task, which provides a measure of voluntary activation of the deep abdominal muscles. Methodological checks evaluated non-specific effects of intervention. RESULTS: There was a significant treatment effect on the SOPA(R), PCS, SLR, and forward bending. There was a statistically significant effect on RMDQ; however, the size of this effect was small and probably not clinically meaningful. DISCUSSION: Education about pain neurophysiology changes pain cognitions and physical performance but is insufficient by itself to obtain a change in perceived disability. The results suggest that pain neurophysiology education, but not back school type education, should be included in a wider pain management approach.

Adult↗
PubMed1993

The effectiveness of cognitive self-management as an adjunct to a behavioural intervention for childhood obesity: a research note.

This study investigated the effectiveness of cognitive self-management training as an adjunct to the behavioural management of childhood obesity. Twenty-seven overweight children aged 7-13 years were randomly assigned to either behavioural management plus relaxation placebo or a combined behavioural-cognitive self-management approach. Evaluations following the eight treatment sessions revealed a significant reduction in percentage overweight for children in both experimental groups and improvements were maintained at 3- and 6-month follow-ups. Both conditions were also effective in reducing the number of high-risk foods consumed. No difference in outcome was found between treatments at the post-treatment assessment or 3- and 6-month follow-ups. Although a reduction in percentage overweight of around 9% was found for both procedures, subjects in general remained considerably overweight.

Adolescent↗
PubMed2005

CAD-aided mammogram training.

RATIONALE AND OBJECTIVES: Although computer-aided detection (CAD) improves the diagnosis rate of early breast cancer, it has not been well integrated into radiology residency and technician training program. Moreover, CAD performance studies ignore the reader's training and experience with CAD. The purpose of this study was to investigate whether CAD training via a cognitive-perceptual based hypermedia program has effects on the performance studies of mammogram reading. MATERIALS AND METHODS: Three observers read a pretest set of 80 breast cancer cases (43 negative, 23 benign, and 14 malignant cancer cases). During 4 weeks' training, the observers used a hypermedia instructional program in CAD-aided mammography interpretation. The program includes modules of CAD attention-focusing schemes, CAD procedural knowledge, and case-based simulations in mammography interpretation in consensus with CAD. By the end of the fourth week of the training, they reviewed a posttest set of cases. Data were analyzed with multireader, multicase receiver operating characteristic methods. RESULTS: Three readers performed better in mammogram reading after training in CAD knowledge than they did before CAD training. CAD training and experience improved the performance of CAD-aided mammography interpretation. CONCLUSION: A statistically significant difference was found in each observer's performance in CAD-aided mammogram reading before and after the training. CAD training will influence the perception, recognition, and interpretation of early breast cancer and CAD performance studies. Furthermore, the young generation of radiologic professionals can have more training in various attention-focusing features, declarative knowledge, procedural knowledge, and conditional knowledge of CAD and incorporate them into their knowledge base and strategic processing for the purpose of improving the accuracy of mammography interpretation performance.

Breast Neoplasms↗
PubMed1997

Cognitive and symptom correlates of participation in social skills training groups.

In a study of 19 hospitalized chronic schizophrenic patients participating in a manualized skills training program, neuropsychological functioning was found to be an important mediating variable. Executive functioning capacity was positively associated with level of participation in the training groups, and deficits in sustained attention together with negative symptoms correlated negatively with overall program attendance. Neuropsychological functioning should be considered as an important assessment domain when identifying patients with minimal requirements to begin skills training.

Adult↗
PubMed1998

[Behavioral psychotherapy: possibilities in the framework of general medicine].

A SOLUTION FOR A COMMON PROBLEM: General practitioners regularly see patients with psychiatric problems. Cognitive and behavioral therapy offer reasonable complements or alternatives to drug therapy. Physicians should be aware of the possibilities and inform their patients. VARIOUS INDICATIONS: The principle indications are anxiety and depressive states, but indications can be widened to other areas such as psychological approach to health and behavioral medicine. A RECOGNIZED THERAPY: Cognitive and behavior psychotherapy offers a good cost/benefit ratio. More widespread use has been achieved by reinforcing university training.

Cognition Disorders↗
PubMed2001

Multicontextual occupational therapy intervention: A case study of traumatic brain injury.

Cognitive deficits after a traumatic brain injury can result in significant functional limitations in all areas of daily living. An individual's ability to generalize learning may be limited, thus making it harder to live independently in the community. Assessing a client's metacognitive skills and awareness level may help to establish a baseline understanding about the supervision required and the most suitable living arrangements. This study describes a multicontextual, community re-entry occupational therapy programme directed at awareness training and compensation for cognitive problems in a 34-year-old man with traumatic brain injury. Intervention consisted of metacognitive training, exploration and use of effective processing strategies, task gradations and practice of functional activities in multiple environmental contexts. Strategies such as self-prediction, self-monitoring, role reversal and the use of checklists were used. Results after six months of intervention show improvements in the client's awareness level, enhancement of his occupational function, increased satisfaction with performance and a decrease in the level of attendant care. Additional studies are recommended to validate the findings.

Journal Article↗
PubMed2004

Cognitive enhancement therapy for schizophrenia: effects of a 2-year randomized trial on cognition and behavior.

BACKGROUND: Deficits in social cognition and neurocognition are believed to underlie schizophrenia disability. Attempts at rehabilitation have had circumscribed effects on cognition, without concurrent improvement in broad aspects of behavior and adjustment. OBJECTIVE: To determine the differential effects of cognitive enhancement therapy (a recovery-phase intervention) on cognition and behavior compared with state-of-the-art enriched supportive therapy. DESIGN: A 2-year, randomized controlled trial with neuropsychological and behavioral assessments completed at baseline and at 12 and 24 months. SETTING: An outpatient research clinic housed in a medical center's comprehensive care service for patients with severe mental illness. PATIENTS: A total of 121 symptomatically stable, non-substance-abusing but cognitively disabled and chronically ill patients with schizophrenia or schizoaffective disorder. INTERVENTIONS: Cognitive enhancement therapy is a multidimensional, developmental approach that integrates computer-assisted training in neurocognition with social cognitive group exercises. Enriched supportive therapy fosters illness management through applied coping strategies and education. MAIN OUTCOME MEASURES: Six highly reliable summary measures--Processing Speed, Neurocognition, Cognitive Style, Social Cognition, Social Adjustment and Symptoms--were tested using analysis of covariance and linear trend analysis. RESULTS: At 12 months, robust cognitive enhancement therapy effects were observed on the Neurocognition and Processing Speed composites (P<.003), with marginal effects observed on the behavioral composites. By 24 months, differential cognitive enhancement therapy effects were again observed for the 2 neuropsychological composites and for Cognitive Style (P=.001), Social Cognition (P=.001), and Social Adjustment (P=.01). As expected, no differences were observed on the residual Symptoms composite. Effects were unrelated to the type of antipsychotic medication received. Enriched supportive therapy also demonstrated statistically significant within-group effect sizes, suggesting that supportive psychotherapy can also have positive, although more modest, effects on cognitive deficits. CONCLUSION: Many cognitive deficits and related behaviors of patients with stable schizophrenia are improved when sufficient exposure to relevant rehabilitation is provided.

Adult↗
PubMed1992

Temporal correlates of information processing during visual short-term memory.

The question is raised whether the sequence of spikes of a cortical neuron, i.e. its spike train, is related to cognitive functions. Neuronal patterns of firing in the inferotemporal cortex of monkeys performing visual delayed-matching tasks showed that short-term memory was accompanied by decreased bursting and changes in the incidence of recurrent spike-interval patterns. The temporal structure of the spike train suggests an inverse relationship between the incidence of repeated patterns and the degree of selectivity of sustained firing frequency elicited by the memorandum (sample stimulus).

Animals↗
PubMed1990

Research and practice with congenital amputees: making the whole greater than the sum of its parts.

This paper highlights the need for methodologically sound research on the motor, cognitive and psychosocial development of children with congenital limb deficiencies and the integration of findings in these three areas. Such topics have received little attention in the literature and systematic attempts to apply developmental theory to the assessment, fitting, training and evaluation of these children seldom have been made. A number of important current issues in research and practice are critically reviewed including optimal age for fitting, training procedures, prosthesis usage, cognitive deficits and vulnerability to psychosocial problems. Recommendations for the adoption of a more holistic approach to research and practice with amputee children are presented and the need to develop strategies for systematic evaluation and follow up is emphasized.

Abnormalities, Drug-Induced↗
PubMed2005

Progress testing: evaluation of four years of application in the school of medicine, University of São Paulo.

BACKGROUND: Progress testing is a longitudinal tool for evaluating knowledge gains during the medical school years. OBJECTIVES: (1) To implement progress testing as a form of routine evaluation; (2) to verify whether cognitive gain is a continuous variable or not; and (3) to evaluate whether there is loss of knowledge relating to basic sciences in the final years of medical school. METHODS: A progress test was applied twice a year to all students from 2001 to 2004. The mean percentage score was calculated for each school year, employing ANOVA with post hoc Bonferroni test evaluation for each test. RESULTS: Progress testing was implemented as a routine procedure over these 4 years. The results suggest a cognitive gain from first to sixth year in all eight tests, as a continuum (P for trend < .0001). Gain was found to be continuous for basic sciences (taught during the first 2 years), clinical sciences (P < .0001), and clerkship rotation (P < .0001). There was no difference between the performance of men and women. CONCLUSION: Progress testing was implemented as a routine, applied twice a year. Data suggest that cognitive gain during medical training appears to be a continuum, even for basic science issues.

Analysis of Variance↗
PubMed1996

Personality: a moderator of the relation between cognitive functioning and depression in adults aged 55-85?

Previous studies found modest associations between cognitive functioning and depressive symptoms in community samples of older adults. Low levels of cognitive functioning are associated with depressive symptoms. The present study investigates whether personality (locus of control and neuroticism) moderates this relation, and whether gender-differences in moderating effects can be established. The study is based on data of the baseline sample of 3107 participants of the Longitudinal Aging Study Amsterdam (LASA), which was age (55-85 years) and sex-stratified. Multiple regression analyses are used to detect moderating effects. The findings show modest effects, indicating that personality is a moderator of the relation between cognitive functioning and depressive symptoms, particularly in women. In women, a relatively strong internal locus of control is protective of becoming depressed when experiencing impairment in general cognitive functioning (MMSE), and impairment in fluid intelligence and information processing speed. In men, a low level of neuroticism is protective of becoming depressed when experiencing memory impairment. If these findings are replicated and extended in future studies, pertinent interventions such as cognitive therapy or memory training may be designed to alleviate depressive symptoms.

Adaptation, Psychological↗
PubMed1994

Cognitive-behavioral group intervention to assist substance-dependent adolescents in lowering HIV infection risk.

Substance dependent adolescents (N = 19), court referred into a residential drug treatment facility received a five-session HIV risk-reduction intervention that provided risk education, social competency skills (sexual assertion, partner negotiation, and communication skills), technical skills (condom use), and problem-solving training. Before and after the intervention, subjects completed measures of AIDS risk knowledge, health locus of control, social support, attitudes toward HIV prevention, attitudes toward condoms, self-efficacy, and perceptions of risk in addition to role-play assessments of behavioral skill resisting high-risk coercions. Postintervention, subjects exhibited increased knowledge about HIV/AIDS, more favorable attitudes toward prevention, greater internal and lower external locus of control scores, more favorable attitudes toward condom use, increased self-efficacy, and greater recognition of HIV vulnerability. Following intervention, the percentage of participants reporting sexual activity in high-risk contexts decreased, substantiating the intervention's effectiveness. Self-report data were corroborated by sexually transmitted disease treatment records. This uncontrolled demonstration effort suggests that skills training based on cognitive-behavioral principles may be a promising intervention strategy to lower vulnerable adolescents' risk of HIV infection.

Adolescent↗
PubMed1996

Executive cognitive functioning and aggressive behavior in preadolescent boys at high risk for substance abuse/dependence.

OBJECTIVE: This study had three purposes; (1) to assess the underlying factor structure of a battery of neuropsychological tests putatively measuring executive cognitive functioning (ECF) in a sample of boys at high and low risk for substance abuse/dependence; (2) to assess the relationship between ECF and aggressive behavior; and (3) to determine the interactive effects of ECF and a family history (FH) of substance dependence on aggressive behavior. METHOD: Multiple measures of ECF and aggressive behavior were used to test these relationships in a sample of 291 10-12 year old boys with and without a FH of substance dependence. RESULTS: Analyses indicated that the measures of ECF loaded on one factor. ECF was related to aggressive behavior even when accounting for IQ and SES. The interaction between ECF and a FH of substance dependence was also associated with aggressive behavior. CONCLUSIONS: The central finding of this investigation indicates that ECF and its interaction with a FH of substance dependence are associated with aggressive behavior. These results suggest that violence prevention and treatment efforts in high risk groups should incorporate cognitive habilitation focusing on training in ECFs.

Adolescent↗
PubMed2004

Coping skills training and problem solving in diabetes.

Diabetes requires a substantial degree of patient involvement for effective self-management. Although diabetes education has been the standard of care, it is clear that provision of knowledge alone does not change behavior. Coping skills training is a cognitive-behavioral intervention that focuses on improving competence and mastery by retraining inappropriate or nonconstructive coping styles and patterns of behavior into more constructive behavior. Children, adolescents, and parents caring for children with type 1 diabetes demonstrated improved metabolic and psychosocial outcomes after coping skills training. Similar results have been found in adults with type 2 diabetes. Principles of this technique can be applied in practice to assist patients with diabetes to improve their self-management.

Adaptation, Psychological↗
PubMed1987

How do supervising doctors construe the medical student in clinical training?

Basing the prediction of student performance in medical school on intellective-cognitive abilities alone has proved to be more pertinent to academic achievement than to clinical practice. A major obstacle to the development of adequate measures has been the elusive nature of requirements for successful clinical performance. The present study aimed at defining the relevant variables through an analysis of the concept of the medical student held by supervising doctors. With the aid of a methodology derived from cognitive-social psychology, the components of how training doctors of a large medical school evaluate their students were first explicated in structured interviews. In a second phase of the research, 18 supervisors in five major clinical departments rated their student-supervisees on 15 obtained traits. Findings of trait correlations with an overall evaluation, as well as Guttman's 'Smallest Space Analysis' (1968), indicated a clear priority of cognitive-motivational traits in supervisors' judgements and reduced relevance of personal and interpersonal variables. Certain inconsistencies between avowed ideology of medical training and actual supervising practice could be detected.

Attitude of Health Personnel↗