Cognitive Intervention Research Articles

Cognitive behavioral interventions for depression and anxiety in adults with neurological disorders: a systematic review and meta-analysis.

We examined the efficacy of cognitive and behavioral interventions for improving symptoms of depression and anxiety in adults with neurological disorders. A pre-registered systematic search of Cochrane Central Register of Controlled Trials, MEDLINE, PsycINFO, Embase, and Neurobite was performed from inception to May 2024. Randomized controlled trials (RCTs) which examined the efficacy of cognitive and behavioral interventions in treating depression and/or anxiety among adults with neurological disorders were included. Estimates were pooled using a random-effects meta-analysis. Subgroup analyses and meta-regression were performed on categorical and continuous moderators, respectively. Main outcomes were pre- and post-intervention depression and anxiety symptom scores, as reported using standardized measures. Fifty-four RCTs involving 5372 participants with 11 neurological disorders (including multiple sclerosis, epilepsy, stroke) were included. The overall effect of interventions yielded significant improvements in both depression (57 arms, Hedges' g = 0.45, 95% confidence interval [CI] 0.35-0.54) and anxiety symptoms (29 arms, g = 0.38, 95% CI 0.29-0.48), compared to controls. Efficacy was greater in studies which employed a minimum baseline symptom severity inclusion criterion for both outcomes, and greater in trials using inactive controls for depression only. There was also evidence of differential efficacy of interventions across the neurological disorder types and the outcome measure used. Risk of bias, intervention delivery mode, intervention tailoring for neurological disorders, sample size, and study year did not moderate effects. Cognitive and behavioral interventions yield small-to-moderate improvements in symptoms of both depression and anxiety in adults with a range of neurological disorders.

Association between cognitive functioning and health-related quality of life and its mediation by depressive symptoms in older patients with kidney failure

BackgroundImpaired cognition, poor health-related quality of life (HRQoL) and depressive symptoms are common in older patients with kidney failure. Understanding what influences HRQoL is important, as older patients regard HRQoL as a health priority. This study examines whether cognitive functioning is associated with HRQoL and whether depressive symptoms mediate this effect in older patients with kidney failure.MethodsOutpatients aged ≥ 65 years from 35 Dutch and Belgian hospitals with eGFR 20–10 mL/min/1.73 m2 were included from the ongoing DIALOGICA study. Cognitive functioning was assessed using the Montreal Cognitive Assessment. Depressive symptoms were screened with 2 Whooley Questions and thereafter assessed with the 15-item Geriatric Depression Scale. HRQoL was assessed using the 12-item Short-Form Health Survey. To assess whether cognitive functioning is associated with HRQoL, cross-sectional multivariable linear regression analyses were performed. Subsequent mediation analyses were performed with PROCESS using the product method.ResultsIn total, 403 patients were included, with a mean age of 76.5 years (SD 5.8) and estimated glomerular filtration rate (eGFR) of 14.5 mL/min/1.73 m2 (SD 3.0). Cognitive functioning was associated with mental HRQoL (adjusted β 0.30, 95% CI 0.05;0.55) but not physical HRQoL (adjusted β 0.18, 95% CI -0.09;0.44). This effect is mediated by depressive symptoms (adjusted β 0.14, 95% CI 0.04;0.25).ConclusionLower cognitive functioning was negatively associated with mental HRQoL, which was mediated by depressive symptoms in older patients with kidney failure. Future research should explore whether cognitive interventions and treatment of depression improve HRQoL in this vulnerable patient population.Graphical

Feasibility of a nurse-initiated brief cognitive behavioral strategy intervention program for symptom clusters experienced by patients with advanced non-small cell lung cancer

BackgroundA nurse-initiated brief cognitive behavioral Strategy (CBS) intervention program has shown alleviation effects of single symptoms. However, the feasibility of the brief CBS for symptoms included in the Pain and Fatigue symptom clusters in patients with advanced nonsmall cell lung cancer (NSCLC) has not been evaluated. ObjectiveTo evaluate the feasibility of application of the nurse-initiated brief CBS intervention program focusing on pain and fatigue symptoms among the Pain and Fatigue/anorexia symptom clusters experienced by patients with advanced NSCLC. MethodsIn this one-group pretest-posttest design, participants were 15 outpatients with NSCLC undergoing medical treatment (UMIN 000026996). After expressing consent to the study participation, the participants completed a baseline questionnaire and were given a booklet explaining brief cognitive behavioral therapies (relaxation, problem-solving strategies for symptom relief), exercise therapy, and tools. We provided follow-up calls five times and evaluated the retention and changes in symptom severities till the 10th week after the intervention. ResultsOf 15 participants, 10 (66.7%) completed the program. For pain relief strategies, 87% chose deep breathing for relaxation, and 80% fatigue relief with exercises. The median symptom severities (at the baseline and Wk10) showed downward tendencies: pain (2.00, 1.00), sadness (1.00, 0.00), and anxiety (1.00, 0.50). Implications for practiceWe need a randomized controlled trial to further test the effectiveness of the intervention in alleviating symptom and improving QOL of this population. ConclusionsThe nurse-initiated brief CBS intervention program is clinically practical in this population. Nurses may provide useful support for patient symptom management by brief CBS.

Education program and experiential learning in Chinese entrepreneurship education: A year-long Social Cognitive Theory intervention's impact on self-efficacy and intention

Entrepreneurship education helps young people create their first job, typically through either experiential learning or education programs. Our study evaluated the effect of integrating both methods in a single intervention involving 40 people aged 18 to 25.Our research intervention was grounded in the Social Cognitive Theory. We assessed its impact via ANCOVA analyses. We looked for shifts in entrepreneurial self-efficacy (across six subdimensions) and intention of 20 intervention participants compared with an equal number of control participants. The results indicated statistically significant changes in all the measures except initiating investor relationships and building an innovative environment.To the best of the authors' knowledge, this study is the first to examine the effect of delivering entrepreneurial education in non-formal Chinese settings. It also pioneers exploring the impact of education programs and experiential learning in a single intervention. Finally, it assesses this impact over one year, sharply contrasting with the more typical exploring of relationships at a single time point.Our findings contribute to the ongoing discourse on the efficacy of entrepreneurship education programs in China, providing support for offering such programs outside formal education. Our results also emphasize the significance of comprehending the surroundings in which the programs are being delivered and the potential external forces that participants may be exposed to.

The Relationship Between Exercise Frequency and Cognitive Flexibility in Anxiety Disorder Patients Undergoing Combined Exercise and Cognitive Behavioral Therapy

This study investigates the relationship between exercise frequency and cognitive flexibility in patients with anxiety disorders undergoing combined Cognitive Behavioral Therapy (CBT) and exercise interventions. A longitudinal follow-up design was employed, with 80 participants randomized into four groups: low-frequency exercise, moderate-frequency exercise, high-frequency exercise, and a control group receiving CBT without exercise. Cognitive flexibility was assessed using the Wisconsin Card Sorting Test (WCST), and anxiety levels were measured by the Hamilton Anxiety Rating Scale (HAM-A) at baseline, post-intervention, and during 3-month and 6-month follow-ups. Results demonstrated a significant dose-response relationship, with higher exercise frequencies leading to greater improvements in cognitive flexibility and reductions in anxiety symptoms. The high-frequency exercise group exhibited the most substantial and sustained cognitive and emotional benefits, suggesting the importance of frequent exercise in enhancing and maintaining therapeutic outcomes in anxiety disorder treatment. These findings have critical implications for optimizing treatment strategies that integrate physical exercise with CBT to improve cognitive and emotional health in anxiety disorder patients.

Predictive models of post-traumatic stress disorder, complex post-traumatic stress disorder, depression, and anxiety in children and adolescents following a single-event trauma.

This study examined the power of theory-derived models to account for the development of PTSD, Complex PTSD (CPTSD), depression, and anxiety in children and adolescents who had experienced a single-event trauma. Children (n = 234, aged 8-17 years) recruited from local Emergency Departments were assessed at two and nine weeks post-trauma. Data obtained from self-report questionnaires completed by the child, telephone interviews with parents, and hospital data were used to develop four predictive models of risk factors for PTSD, CPTSD, depression, and Generalized Anxiety Disorder (GAD). ICD-11 proposed diagnostic criteria were used to generate measures for CPTSD and PTSD to assess for risk factors and identify the sample prevalence of these disorders. At nine weeks post-trauma, 64% did not meet criteria for any disorder, 23.5% met criteria for PTSD, and 5.2% met criteria for CPTSD. 23.9% and 10.7% had developed clinically significant symptoms of depression and GAD, respectively. A cognitive model was the most powerful predictive model, a psychosocial model was weak, and subjective markers of event severity were more powerful than objective measures. Youth exposed to single-incident trauma may develop different forms of psychopathology, and PTSD and CPTSD are frequently experienced alongside other conditions. The cognitive model of PTSD shows utility in identifying predictors of PTSD, CPTSD, depression, and GAD, particularly the role of trauma-related negative appraisals. This supports the application of cognitive interventions which focus upon re-appraising trauma-related beliefs in youth.

Identifying exercise and cognitive intervention parameters to optimize executive function in older adults with mild cognitive impairment and dementia: a systematic review and meta-analyses of randomized controlled trials

Physical exercise is recognized for its beneficial effects on brain health and executive function, particularly through the careful manipulation of key exercise parameters, including type, intensity, and duration. The aim of this systematic review and meta-analysis was to delineate the optimal types, intensities, and durations of exercise that improve cognitive functions in older adults with mild cognitive impairment (MCI) or dementia. A comprehensive search was conducted in Scopus, Web of Science, and PubMed from their inception until December 2023. The methodological quality and publication bias of the included studies were assessed using the PEDro scale and Egger’s regression test, respectively. Separate meta-analyses were performed to assess the overall impact of exercise on cognitive assessments and to explore the effects of different exercise types (i.e., aerobic, resistance, dual-task, mind-body, and multi-component exercises) and intensities (i.e., low, moderate, and high) on executive function. Results were presented as standardized mean differences (SMD) and 95% confidence intervals (95% CI). A meta-regression analysis was conducted to examine the correlation between exercise duration and mean effects. In total, 15,087 articles were retrieved from three databases, of which 35 studies were included in our final analyses. The results indicated high overall methodological quality (PEDro score = 8) but a potential for publication bias (t = 2.08, p = 0.045). Meta-analyses revealed that all types of exercise (SMD = 0.691, CI [0.498 to 0.885], p < 0.001) and intensities (SMD = 0.694, CI [0.485 to 0.903], p < 0.001) show significant effects favoring exercise. Notably, dual-task exercises (SMD = 1.136, CI [0.236 to 2.035], p < 0.001) and moderate-intensity exercises (SMD = 0.876, CI [0.533 to 1.219], p < 0.001) exhibited the greatest effect. No significant correlation was observed between exercise duration and SMD (R² = 0.038, p = 0.313). Overall, our meta-analyses support the role of physical exercise in enhancing executive function in older adults with MCI or dementia. It is essential to carefully tailor exercise parameters, particularly type and intensity, to meet the specific needs of older adults with MCI or dementia. Such customization is crucial for optimizing executive function outcomes and improving overall brain health.

Negative global metacognitive biases are associated with depressive and posttraumatic stress disorder symptoms and improve with targeted or game-based cognitive training.

Metacognition is disrupted in several clinical populations. One aspect of metacognition, global metacognitive bias (difference between objective and self-reported abilities), has shown to be particularly relevant to clinical functioning. However, previous studies of global metacognitive biases in populations with elevated depressive/posttraumatic stress disorder (PTSD) symptoms have not measured objective and self-reported abilities relative to normative samples, limiting the quantification of biases. Additionally, few studies have examined whether cognitive interventions can improve metacognitive biases or how this relates to depressive/PTSD symptom severity. A total of 84 participants with mild traumatic brain injury (77% veterans) performed PTSD and depression assessments along with self-reported and objective measures of global cognition. Age-adjusted norm-based z scores were used for self-reported and objective cognition, and bias was calculated by subtracting objective minus self-report scores. Participants then received 13 weeks of targeted cognitive training or entertainment games training (both providing performance feedback). Participants were assessed at baseline, immediately posttraining, and 3 months posttraining. We found large negative metacognitive biases in those with clinically significant severity of depressive symptoms (z score difference = -1.77), PTSD symptoms (-1.47), and depressive + PTSD symptoms (-2.29). Metacognitive biases improved after both targeted and entertainment training and was associated with reductions in depressive/PTSD symptom severity (r = -.41/-.42, respectively), led by the entertainment training group (r = -.54/-.46, respectively). These findings show that clinically significant severity of depressive/PTSD symptoms is associated with substantial negative global metacognitive biases and preliminarily suggests that cognitive training may improve these biases and depressive/PTSD symptom severity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Intensive Interdisciplinary Rehabilitation in the Pediatric Hematology/Oncology Setting: Feasibility and Perceived Benefit of the Acute Neurological Injury Service.

(1) Background: Intensive interdisciplinary rehabilitation services more effectively promote recovery from acquired brain injury than a single discipline approach. However, research literature is lacking regarding the perceived feasibility and utility of an interdisciplinary approach across disciplines for patients within a tertiary care pediatric hematology/oncology setting. (2) Methods: The Acute Neurological Injury (ANI) service applied an acquired brain injury/inpatient rehabilitation interdisciplinary approach to a pediatric hematology/oncology population, with a focus on interdisciplinary communication, shared goal setting, and coordinated transition planning. Caregivers whose children received coordinated ANI program care were interviewed regarding the perceived feasibility and utility of ANI program components. (3) Results: An interdisciplinary approach to a pediatric hematology/oncology population is feasible for caregivers and for providers of rehabilitation and psychosocial services within a tertiary care cancer hospital setting. Parents perceived benefits from aspects of this approach including coordinated interdisciplinary care planning, the implementation of an interdisciplinary goal, parent brain injury education, neuropsychological assessment reports, and weekly cognitive intervention sessions. Parents were interested in both having a peer mentor while managing new cancer diagnoses and later serving in a mentor role for a newly diagnosed family. (4) Conclusions: An interdisciplinary acquired brain injury approach to a pediatric hematology/oncology population is feasible with perceived benefits to families managing new cancer diagnoses.

Occupational Therapy Practice Guidelines for Adults Living With and Beyond Cancer

Abstract Importance: Occupational therapy practitioners play an important role in addressing the impairments, occupational performance, and participation needs of adults living with and beyond cancer. Objective: These Practice Guidelines aim to assist occupational therapy practitioners, educators, and researchers in applying evidence and expert opinion to occupational therapy practice across the cancer continuum of care, including identifying gaps in care. Key focus areas include psychosocial function, fatigue, cognition, pain, sleep, and physical activity. These guidelines can serve as a reference for policymakers, health care professionals, health care managers, regulators, third-party payers, and managed care organizations to manage, reimburse, and set policy. Method: We examined, synthesized, and integrated the results of systematic reviews, supporting literature, and expert opinion to develop and provide clinical recommendations for practice in the care of adults living with and beyond cancer. Results: Sixteen systematic reviews with moderate to strong strength of evidence published between 2019 and 2022 served as the foundation for these Practice Guidelines. Conclusions and Recommendations: To support symptom management for adults living with and beyond cancer, occupational therapy practitioners can consider using psychosocial interventions for anxiety, depression, posttraumatic growth, and overall psychological distress. Practitioners can consider using physical activity interventions for cancer-related fatigue, cognitive performance, and sleep. Practitioners could also consider using interventions for cognition, pain management, and self-management for the improvement of cancer-related symptoms. Plain-Language Summary: These Practice Guidelines provide strong and moderate levels of evidence for occupational therapy practitioners to support adults living with and beyond cancer. They provide specific guidance for addressing pain, cancer-related fatigue, cancer-related cognitive impairments, psychosocial well-being, sleep, and physical activity. The guidelines also include case examples and an infographic to support occupational therapy practitioners in integrating evidence to support interventions in cancer care, and they highlight gaps and expert opinions in practice for continued clinically relevant research.

Dose Response of Transcranial Photobiomodulation on Cognitive Efficiency in Healthy Older Adults: A Task-Related Functional Near-Infrared Spectroscopy Study.

Alzheimer's disease has become increasingly prevalent among the older population, leading to significant social and economic burdens. Transcranial photobiomodulation (tPBM) has shown promise as a cognitive intervention for enhancing cognitive efficiency in healthy older adults, and individuals with mild cognitive impairment and Alzheimer's disease. However, determining the optimal tPBM dosage is crucial for ensuring effective and efficient intervention. This study aimed to compare the effects of different dosages in a single tPBM session on cognitive efficiency in healthy older adults. In this randomized controlled trial, 88 healthy older participants were assigned to either a single dose (irradiance = 30 mW/cm2, fluence = 10.8 J/cm2; n = 44) or a double dose (irradiance = 30 mW/cm2, fluence = 21.6 J/cm2; n = 44) tPBM session. Cognitive efficiency was assessed using functional near-infrared spectroscopy during a visual working memory span task. The single dose group exhibited significantly greater cognitive efficiency enhancement, indicated by a more pronounced reduction in oxygenated hemoglobin during a challenging task level (span level 9) (p = 0.021, d = 0.50), and better working memory task performance (p = 0.045, d = 0.31). Furthermore, participants with better visuospatial abilities demonstrated greater improvement after a single dose (r = -0.42, p = 0.004). In contrast, participants with varying cognitive function did not exhibit additional benefits from a double dose (r = -0.22-0.15, p = 0.16-0.95). These findings suggest that higher tPBM dosages may not necessarily result in superior cognitive improvement in older adults.

The Effect of Cognitive Behavioral Intervention Based on Self-Management on the Ability to Control Hallucinations in People with Schizophrenia

Hallucinations are a common symptoms found in individuals with schizophrenia. These hallucination cause people with schizophrenia (PWS) to experience difficulty in controlling themselves. This has an impact on suicidal behavior, harming other people, and destroying the surrounding environment. Therefore, a cognitive behavioral intervention based on self-management is needed as a non-pharmacological therapy to help PWS control hallucinations. This study aims to identify the effect of cognitive behavioral interventions based on self-management in people with schizophrenia. This study uses a quasy-experimental two groups pretest-posttest design. The sample consists 78 inpatient respondents with schizophrenia, divided into two groups, 39 in the intervention group and 39 in control group. Technique sample in this study using purposive sampling. Research data collection uses a questionnaire instrument for the ability to control hallucinations. The data explained used statistics, such as descriptive, dependent, and independent t-tests. The research results show that there are changes in the ability to control hallucinations in the intervention group and control group before and after self-management-based cognitive behavioral intervention (p-value=0.001). There was a difference in the ability to control hallucinations between the intervention group with the control group after cognitive behavioral intervention based on self-management (p-value= 0.013). The cognitive behavioral intervention based on self-management can be used as an effective cessation intervention to improve the ability of PWS to control hallucinations so that they can optimize their function in carrying out daily activities.

Impact of VR-Based Cognitive Training on Working Memory and Inhibitory Control in IDD Young Adults.

Young people with intellectual developmental disabilities have a persistent delay in the development of executive functions. Virtual reality (VR) is increasingly being used as a cognitive intervention tool, with significant effectiveness demonstrated in different types of populations. This pilot study aims to investigate the impact of a cognitive training program utilizing VR on young adults diagnosed with intellectual developmental disabilities (IDDs). The participants (N = 15) served as their own control group and were assessed three times: weeks 0, 8, and 16, with a rest period (0-8 weeks) and an intervention period (8-16 weeks). The assessments included measures of cognitive function provided by E-Prime® (Version 3). Overall, an improvement in working memory and inhibitory control was found after the intervention, but not in sustained attention. These findings suggest that VR-based cognitive training holds promise as an effective intervention for enhancing cognitive abilities in young adults with intellectual developmental disabilities. This study provides a foundation for future investigations into VR's role in cognitive rehabilitation and its potential to support daily living skills and overall quality of life for individuals with IDDs. Further research is needed to explore the long-term effects and broader applicability of VR interventions.

Effect of cognitive behavior-aided counseling on entrepreneurial self-efficacy of students of home economics education in South-East Nigeria.

Raising potential entrepreneurs to advance the economy of nations through education has been projected by scholars. On the contrary, Nigerian students lack the enthusiasm and internal force to pursue the aims enshrined in their courses of study. Rather they prefer white-cola jobs to the entrepreneurial intention of the institutions. Given this reason, we tested the effect of cognitive behavior-aided counseling on entrepreneurial self-efficacy of students of Home Economics in South-East Nigeria. This is a pretest and posttest with a follow-up group randomized control design. A total of 119 Home Economics Education students from Universities and Colleges of Education were measured and screened using an entrepreneurial self-efficacy scale and inclusion criteria. Data collected from the pretest, post-test, and follow-up test were statistically analyzed using repeated measures of Analysis of Variance statistical method. The effect size of the cognitive behavior-aided counseling intervention on entrepreneurial self-efficacy was reported using partial eta square. The follow-up data was tested using a Univariate analysis. The result showed that cognitive behavior-aided counseling intervention had a significant effect on entrepreneurial self-efficacy among the Universities and Colleges of Education in South-East Nigeria. A follow-up result also showed that intervention had a significant effect on participants' entrepreneurial self-efficacy.

Evaluation of the Implementation of a Day-Treatment Program for Executive Functioning for Individuals With Traumatic Brain Injury in Rehabilitation Settings Using the Consolidated Framework for Implementation Research.

To identify barriers and facilitators to implementation of a cognitive rehabilitation intervention (Short-Term Executive Plus [STEP]) into routine clinical practice using the Consolidated Framework for Implementation Research (CFIR) by comparing high (HI) and low implementation (LI) sites. Qualitative interviews conducted with professionals who work with people who have sustained brain injuries at various rehabilitations sites across the United States. Seven sites completed training, consultation, and agreed to implement STEP. Retrospective qualitative study. Qualitative interview developed for the purposes of this study and the CFIR for evaluation of implementation efforts and identification of barriers and facilitators. Out of 7 sites, 6 completed interviews. Out of the 39 CFIR constructs, 4 distinguished between HI and LI sites. Four distinguishing factors included evidence strength and quality, needs and resources of those served by the organization, leadership engagement, and engaging champions. Five common factors were identified (4 positive and 1 negative) across HI and LI sites, which may reflect aspects of implementation that could inform future implementation efforts. Ten inconclusive factors were identified, having both a positive and a negative influence on implementation. While there were several factors that were viewed positively by all sites, only 4 factors made a difference in implementation outcomes. These distinguishing factors can help inform future implementation efforts, highlighting a need for strong evidence supporting an intervention, a match between the intervention and the needs of the population served, engaging those in leadership and decision-making roles and ensuring their buy-in, and having a strong champion directly involved in implementation. In addition, taking a closer look at common and inconclusive factors may enable us to identify areas in which the implementation efforts could be strengthened.

Cognitive Stimulation with Music in Older Adults with Cognitive Impairment: A Scoping Review.

The use of music in cognitive interventions represents a possibility with potential worthy of further investigation in the field of aging, both in terms of prevention from dementia, in the phase of mild cognitive impairment, and in the treatment of overt dementia. Currently, the types of music-based interventions proposed in the literature are characterized by wide heterogeneity, which is why it is necessary to clarify which interventions present more evidence of effectiveness in stimulating different cognitive domains. The study was conducted in accordance with PRISMA guidelines for scoping reviews. By searching two different databases, PubMed and the Web of Science, all studies evaluating the cognitive effects of music-based interventions on people at early stages of cognitive decline (MCI or mild-to-moderate dementia) were selected. The study selection included a total of 28 studies involving n = 1612 participants (mean age ranged from 69.45 to 85.3 years old). Most of the studies analyzed agree with the observation of an improvement, or at least maintenance, of global cognitive conditions (mainly represented by the results of the MMSE test) following music-based interventions, together with a series of other positive effects on verbal fluency, memory, and executive processes. The results of this review suggest the introduction of music-based interventions as complementary approaches to usual cognitive treatments. Also, the use of standardized and well-defined protocols, in addition to strong methodological research approaches, is suggested. Music-based interventions are recommended in the early stages of dementia, in MCI, and in a preventive sense in healthy older adults.

“I'm not afraid to be alone with the baby now”: Parents' experiences of an online self-guided cognitive intervention for unwanted intrusive thoughts about harming their child

Half of parents to infants and toddlers experience unwanted intrusive thoughts (UITs) about intentionally harming their child. For some, this can lead to impaired parental self-efficacy, elevated parental stress, and symptoms of depression. Many do not disclose their thoughts due to shame. Our research group has developed a self-guided online cognitive intervention for parents with distressing UITs of intentional child-related harm. A previous randomized pilot trial (N = 43) showed that the intervention was more effective than waitlist in reducing distress related to UITs. It also improved parental self-efficacy. This study is an qualitative investigation of the participants’ experiences with the intervention. We conducted semi-structured interviews with 8 participants. A thematic analysis revealed two overarching themes: (1) Changed perception of the unwanted intrusive thoughts and (2) Different paths to recovery. The parents reported that the intervention taught skills to approach their UITs in a more flexible way, which had positive effects on well-being and parenting. The flexibility and anonymity of the online format was highlighted as positive. Some would have liked additional therapist support and better adaptations to a smartphone format. The findings provide additional qualitative data how an online self-guided intervention can help parents who struggle with UITs.

Patient perspectives on the Tailored intervention for Anxiety and Depression Management in COPD (TANDEM): a qualitative evaluation

BackgroundChronic obstructive pulmonary disease (COPD) is commonly associated with anxiety/depression which can affect self-management and quality of life. The TANDEM trial evaluated a cognitive behavioural approach intervention targeting COPD-related symptoms of anxiety and/or depression, comprising up to eight one-to-one sessions delivered by respiratory healthcare professionals prior to pulmonary rehabilitation (PR). The intervention showed no improvement in anxiety/depression or uptake/completion of PR. We present patient perspectives of the intervention to help understand these results.MethodSemi-structured individual interviews, using a semi-structured topic guide informed by Sekhon’s Theoretical Framework of Acceptability, were conducted with 19 patients between September 2019 and April 2020. The interviews were audio-recorded, transcribed verbatim and analysed thematically.ResultsThe following could have limited the impact of the intervention: (1) The lives of patients were complex and commonly affected by competing comorbidities or other external stressors which they managed through previously adopted long-standing coping strategies. (2) Some patients were reluctant to talk about their mood despite the Facilitators' training and person centred-skills which aimed to enable patients to talk freely about mood. (3) The intervention handouts and ‘home-practice’ were perceived as helpful for some, but not suitable for all. (4) Many patients perceived improvements in their physical and mental health, but this was not sustained due to a mix of personal and external factors, and some did not perceive any benefits. (5) PR non-attendance/non-completion was a result of personal and PR service-related reasons. (6) Discussing COPD and mental health with the Facilitator was a novel experience. Many patients felt that TANDEM could be of benefit if it was offered earlier on/at different time points in the COPD illness journey.ConclusionWe found the delivery of TANDEM prior to PR was not helpful for patients with advanced COPD often experiencing other comorbidities, and/or difficult personal/external events. These patients already utilised long-standing coping strategies to manage their COPD. Holistic interventions, that address the impact of COPD in relation to wider aspects of a patients’ life, may be more beneficial.Trial registrationISRCTN Registry 59,537,391. Registration date 20 March 2017.

Computer-Based Cognitive Behavioral Therapy Intervention for Depression, Anxiety, and Stress Disorders: A Systematic Review

Computer-Based Cognitive Behavioral Therapy Intervention for Depression, Anxiety, and Stress Disorders: A Systematic Review

Effects of computerized working memory training on neuroplasticity in healthy individuals: A combined neuroimaging and neurotransmitter study

Working memory (WM) is an essential cognitive function that underpins various higher-order cognitive processes. Improving WM capacity through targeted training interventions has emergered as a potential approach for enhancing cognitive abilities. The present study employed an 8-week regimen of computerized WM training (WMT) to investigate its effect on neuroplasticity in healthy individuals, utilizing neuroimaging data gathered both before and after the training. The key metrics assessed included the amplitude of low-frequency fluctuations (ALFF), voxel-based morphometry (VBM), and the spatial distribution correlations of neurotransmitter. The results indicated that post-training, compared to baseline, there was a reduction in ALFF in the medial superior frontal gyrus and an elevation in ALFF in the left middle occipital gyrus within the training group. In comparison to the control group, the training group also exhibited decreased ALFF in the anterior cingulate cortex, angular gyrus, and superior parietal lobule, along with increased ALFF in the postcentral gyrus post-training. VBM analysis revealed a significant increase in gray matter volume (GMV) in the right dorsal superior frontal gyrus after the training period, compared to the initial baseline measurement. Furthermore, the training group showed GMV increases in the dorsal superior frontal gyrus, Rolandic operculum, precentral gyrus, and postcentral gyrus when compared to the control group. In addition, significant associations were identifed between neuroimaging measurements (AFLL and VBM) and the spatial patterns of neurotransmitters such as serotonin (5-HT), dopamine (DA), and N-methyl-D-aspartate (NMDA), providing insights into the underlying neurochemical processes. These findings clarify the neuroplastic changes caused by WMT, offering a deeper understanding of brain plasticity and highlighting the potential advantages of cognitive training interventions.