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Overcoming unwanted intrusive thoughts : a CBT-based guide to getting over frightening, obsessive, or disturbing thoughts
People who experience unwanted, intrusive, or frightening thoughts often suffer shamefully and struggle silently for fear of what the thoughts might mean about them. In this powerful book, two anxiety disorder experts offer powerful and proven-effective cognitive behavioral therapy (CBT) skills to help readers get unstuck from disturbing thoughts, overcome intense shame, and reduce anxiety.
eBook
Efficacy of home based computerized adaptive cognitive training in patients with post stroke cognitive impairment: a randomized controlled trial
Post-stroke cognitive impairment is a common consequence of stroke, characterized by deficits in language, cognitive functioning, functional abilities. Innovative technological approaches, such as computerized cognitive retraining, offer promising strategies for mitigating the cognitive challenges. Despite their potential, the impact of these interventions on neuropsychological function and daily living capabilities has poor outcomes. In this randomized controlled trial (RCT), we assessed the effectiveness of a 4-week, remotely-delivered, multi-domain, computer-adaptive cognitive retraining (CACT) program in patients with post-cognitive cognitive impairment. Fifty male participants were randomly assigned to either the experimental group, which underwent the CACT program tailored to individual performance levels, or an active control group that received standard care. The evaluation focused on neuropsychological functions such as attention, memory, and executive processes, alongside daily living skills. Results indicated that participants in the CACT group exhibited notable improvements in several cognitive areas, including processing speed, category fluency, and visual confrontation naming, when compared to the control group. Nonetheless, enhancements in functional abilities, encompassing basic and instrumental activities of daily living (ADL), were minimal, with no significant changes reported post-intervention. This study demonstrates that CACT effectively improves cognitive functions in patients with post-stroke cognitive impairment during the spontaneous recovery period, suggesting that training patients at their optimal performance levels can lead to meaningful cognitive benefits. These findings are specific to patients recovering from stroke-induced cognitive deficits and highlight the need for further research to generalize these results to other populations with vascular cognitive impairment.
Journal Article
APOE genotype, hippocampal volume, and cognitive reserve predict improvement by cognitive training in older adults without dementia: a randomized controlled trial
Cognitive training (CT) programs aim to improve cognitive performance and impede its decline. Thus, defining the characteristics of individuals who can benefit from these interventions is essential. Our objectives were to assess if the cognitive reserve (CR), APOE genotype (e4 carriers/non-carriers) and/or hippocampal volume might predict the effectiveness of a CT program. Participants were older adults without dementia (n = 226), randomized into parallel experimental and control groups. The assessment consisted of a neuropsychological protocol and additional data regarding total intracranial, gray matter, left/right hippocampus volume; APOE genotype; and Cognitive Reserve (CR). The intervention involved multifactorial CT (30 sessions, 90 min each), with an evaluation pre- and post-training (at six months); the control group simply following the center’s routine activities. The primary outcome measures were the change in cognitive performance and the predictors of change. The results show that APOE-e4 non-carriers (79.1%) with a larger left hippocampal volume achieved better gains in semantic verbal fluency (R
2
= .19). Subjects with a larger CR and a greater gray matter volume better improved their processing speed (R
2
= .18). Age was correlated with the improvement in executive functions, such that older age predicts less improvement (R
2
= .07). Subjects with a larger left hippocampal volume achieved more significant gains in general cognitive performance (R
2
= .087). In conclusion, besides the program itself, the effectiveness of CT depends on age, biological factors like genotype and brain volume, and CR. Thus, to achieve better results through a CT, it is essential to consider the different characteristics of the participants, including genetic factors.
Trial registration
: Trial retrospectively registered on January 29th, 2020—(
ClinicalTrials.gov
-NCT04245579).
Journal Article
Mindfulness-based cognitive therapy for dummies
Outlines the eight-week MBCT course, using the principles of mindfulness to complement established CBT techniques.
Book
Effects of a dual intervention (motor and virtual reality-based cognitive) on cognition in patients with mild cognitive impairment: a single-blind, randomized controlled trial
Background
The increase in cases of mild cognitive impairment (MCI) underlines the urgency of finding effective methods to slow its progression. Given the limited effectiveness of current pharmacological options to prevent or treat the early stages of this deterioration, non-pharmacological alternatives are especially relevant.
Objective
To assess the effectiveness of a cognitive-motor intervention based on immersive virtual reality (VR) that simulates an activity of daily living (ADL) on cognitive functions and its impact on depression and the ability to perform such activities in patients with MCI.
Methods
Thirty-four older adults (men, women) with MCI were randomized to the experimental group (
n
= 17; 75.41 ± 5.76) or control (
n
= 17; 77.35 ± 6.75) group. Both groups received motor training, through aerobic, balance and resistance activities in group. Subsequently, the experimental group received cognitive training based on VR, while the control group received traditional cognitive training. Cognitive functions, depression, and the ability to perform activities of daily living (ADLs) were assessed using the Spanish versions of the Montreal Cognitive Assessment (MoCA-S), the Short Geriatric Depression Scale (SGDS-S), and the of Instrumental Activities of Daily Living (IADL-S) before and after 6-week intervention (a total of twelve 40-minutes sessions).
Results
Between groups comparison did not reveal significant differences in either cognitive function or geriatric depression. The intragroup effect of cognitive function and geriatric depression was significant in both groups (
p
< 0.001), with large effect sizes. There was no statistically significant improvement in any of the groups when evaluating their performance in ADLs (control,
p
= 0.28; experimental,
p
= 0.46) as expected. The completion rate in the experimental group was higher (82.35%) compared to the control group (70.59%). Likewise, participants in the experimental group reached a higher level of difficulty in the application and needed less time to complete the task at each level.
Conclusions
The application of a dual intervention, through motor training prior to a cognitive task based on Immersive VR was shown to be a beneficial non-pharmacological strategy to improve cognitive functions and reduce depression in patients with MCI. Similarly, the control group benefited from such dual intervention with statistically significant improvements.
Trial registration
ClinicalTrials.gov NCT06313931;
https://clinicaltrials.gov/study/NCT06313931
.
Journal Article
Japan‐Multimodal Intervention Trial for the Prevention of Dementia: A randomized controlled trial
INTRODUCTION We examined the efficacy of a multidomain intervention in preventing cognitive decline among Japanese older adults with mild cognitive impairment (MCI). METHODS Participants aged 65‐85 years with MCI were randomized into intervention (management of vascular risk factors, exercise, nutritional counseling, and cognitive training) and control groups. The primary outcome was changes in the cognitive composite score over a period of 18 months. RESULTS Of 531 participants, 406 completed the trial. The between‐group difference in composite score changes was 0.047 (95% CI: −0.029 to 0.124). Secondary analyses indicated positive impacts of interventions on several secondary health outcomes. The interventions appeared to be particularly effective for individuals with high attendance during exercise sessions and those with the apolipoprotein E ε4 allele and elevated plasma glial fibrillary acidic protein levels. DISCUSSION The multidomain intervention showed no efficacy in preventing cognitive decline. Further research on more efficient strategies and suitable target populations is required. Highlights This trial evaluated the efficacy of multidomain intervention in individuals with MCI. The trial did not show a significant difference in preplanned cognitive outcomes. Interventions had positive effects on a wide range of secondary health outcomes. Those with adequate adherence or high risk of dementia benefited from interventions.
Journal Article