Mechanisms Of Cognitive Change Research Articles

Abnormalities in modular connectivity of functional brain networks and cognitive changes in patients with anti -N-methyl-D-aspartate receptor encephalitis

ObjectiveTo explore potential mechanisms of cognitive changes in patients with anti-NMDAR encephalitis (ANMDARE) from intramodule and intermodule effects of brain functional networks. MethodsResting-state functional MRI(rs-fMRI) imaging data was collected from 30 ANMDARE and 30 healthy controls (HCs). A brain functional matrix was constructed, and sparsity was established by module similarity. For both groups, changes in functional connectivity (FC) within and between modules was calculated, and whole-brain functional topology was analyzed. Finally, the association of brain functional with cognitive function in ANMDARE was further analyzed. ResultsCompared to HCs, ANMDARE had enhanced connectivity within the modules that included the occipito-parietal-temporal and parahippocampal gyri. ANMDARE had significantly higher participation coefficients (PC) in the right inferior frontal gyrus than HCs and significantly lower PC in the left superior parietal lobule, left caudate nucleus, and right putamen. No statistically significant differences in global topological properties were found between the two groups. No correlations were found between functional and structural brain indicators and the Cognitive Assessment Scale and the Emotional Deficit Scale. ConclusionsPatients with ANMDARE are manifested by enhanced intramodular FC and intermodular connectivity changes in the brain. This may help to understand the pathophysiological mechanisms of the disease from a global perspective.

Mechanisms of Cognitive Change: Training Improves the Quality But Not the Quantity of Visual Working Memory Representations.

As of yet, visual working memory (WM) training has failed to yield consistent cognitive benefits to performance in untrained tasks, despite large improvements in trained tasks. Investigating the mechanisms underlying training effects can help explain these inconsistencies. In this pre-registered, pre-test/post-test online training study, we examined how training affects the quantity and quality of representations in visual WM using continuous-reproduction tasks. N = 64 young healthy adults were randomly assigned to an experimental group or an active control group to complete four training sessions of practce in an orientation-reproduction or a visual search task, respectively. We observed that, in the trained task, only the quality, but not the quantity, of visual WM representations significantly increased in the experimental group relative to the control group. These improvements did not generalise to untrained stimuli or paradigms. Therefore, our findings suggest that training gains are not driven by enhanced capacity. Instead, gains in the quality of visual WM representations that are tied to specific stimuli and paradigms may reflect enhanced efficiency in using the existing visual WM capacity.

Efficacy and auditory biomarker analysis of fronto-temporal transcranial direct current stimulation (tDCS) in targeting cognitive impairment associated with recent-onset schizophrenia: study protocol for a multicenter randomized double-blind sham-controlled trial

BackgroundIn parallel to the traditional symptomatology, deficits in cognition (memory, attention, reasoning, social functioning) contribute significantly to disability and suffering in individuals with schizophrenia. Cognitive deficits have been closely linked to alterations in early auditory processes (EAP) that occur in auditory cortical areas. Preliminary evidence indicates that cognitive deficits in schizophrenia can be improved with a reliable and safe non-invasive brain stimulation technique called tDCS (transcranial direct current stimulation). However, a significant proportion of patients derive no cognitive benefits after tDCS treatment. Furthermore, the neurobiological mechanisms of cognitive changes after tDCS have been poorly explored in trials and are thus still unclear.MethodThe study is designed as a randomized, double-blind, 2-arm parallel-group, sham-controlled, multicenter trial. Sixty participants with recent-onset schizophrenia and cognitive impairment will be randomly allocated to receive either active (n=30) or sham (n=30) tDCS (20-min, 2-mA, 10 sessions during 5 consecutive weekdays). The anode will be placed over the left dorsolateral prefrontal cortex and the cathode over the left auditory cortex. Cognition, tolerance, symptoms, general outcome and EAP (measured with EEG and multimodal MRI) will be assessed prior to tDCS (baseline), after the 10 sessions, and at 1- and 3-month follow-up. The primary outcome will be the number of responders, defined as participants demonstrating a cognitive improvement ≥Z=0.5 from baseline on the MATRICS Consensus Cognitive Battery total score at 1-month follow-up. Additionally, we will measure how differences in EAP modulate individual cognitive benefits from active tDCS and whether there are changes in EAP measures in responders after active tDCS.DiscussionBesides proposing a new fronto-temporal tDCS protocol by targeting the auditory cortical areas, we aim to conduct a randomized controlled trial (RCT) with follow-up assessments up to 3 months. In addition, this study will allow identifying and assessing the value of a wide range of neurobiological EAP measures for predicting and explaining cognitive deficit improvement after tDCS. The results of this trial will constitute a step toward the use of tDCS as a therapeutic tool for the treatment of cognitive impairment in recent-onset schizophrenia.Trial registrationClinicalTrials.gov NCT05440955. Prospectively registered on July 1st, 2022.

Mechanisms of cognitive changes after carotid endarterectomy

Mechanisms of cognitive changes after carotid endarterectomy

Mechanisms of Cognitive Change

Mechanisms of Cognitive Change

Introduction to the Special Issue: Cognitive Mechanisms of Change in the Treatment of Depression

Depression is a highly debilitating and recurrent mental health condition. Efforts to understand the mechanisms of cognitive change in the treatment of depression are important to optimize psychotherapy outcome and to prevent relapse and recurrence. The articles in this special issue examine cognitive change in cognitive behavioral therapy by incorporating clinical samples and clinical settings, utilizing empirically supported assessment instruments and protocolized psychotherapy techniques, and employing methodologies and statistical strategies designed to address questions related to cognitive mechanisms in treatment outcome. These articles examine the role of cognitive processing, structure, and content over the course of cognitive therapy for depression and evaluate the impact of positive and negative events on treatment outcomes.

Introduction to the Special Issue: Cognitive Mechanisms of Change in the Treatment of Depression

Introduction to the Special Issue: Cognitive Mechanisms of Change in the Treatment of Depression

Cognitive mechanisms of change in delusions: an experimental investigation targeting reasoning to effect change in paranoia.

Background: Given the evidence that reasoning biases contribute to delusional persistence and change, several research groups have made systematic efforts to modify them. The current experiment tested the hypothesis that targeting reasoning biases would result in change in delusions. Methods: One hundred and one participants with current delusions and schizophrenia spectrum psychosis were randomly allocated to a brief computerized reasoning training intervention or to a control condition involving computer-based activities of similar duration. The primary hypotheses tested were that the reasoning training intervention, would improve (1) data gathering and belief flexibility and (2) delusional thinking, specifically paranoia. We then tested whether the changes in paranoia were mediated by changes in data gathering and flexibility, and whether working memory and negative symptoms moderated any intervention effects. Results: On an intention-to-treat analysis, there were significant improvements in state paranoia and reasoning in the experimental compared with the control condition. There was evidence that changes in reasoning mediated changes in paranoia, although this effect fell just outside the conventional level of significance after adjustment for baseline confounders. Working memory and negative symptoms significantly moderated the effects of the intervention on reasoning. Conclusion: The study demonstrated the effectiveness of a brief reasoning intervention in improving both reasoning processes and paranoia. It thereby provides proof-of-concept evidence that reasoning is a promising intermediary target in interventions to ameliorate delusions, and thus supports the value of developing this approach as a longer therapeutic intervention.

Cognitive mechanisms of change in multidisciplinary treatment of patients with chronic widespread pain: A prospective cohort study

To evaluate the contribution of improvement in negative emotional cognitions, active cognitive coping, and control and chronicity beliefs to the outcome of multidisciplinary treatment in patients with chronic widespread pain. Prospective cohort study. A total of 120 subjects diagnosed with chronic widespread pain, who completed a multidisciplinary pain programme. Data from baseline, 6 months and 18 months follow-up measurements were analysed. Longitudinal relationships were analysed between changes in cognitions and outcome, using generalized estimated equations. Outcome domains included: pain, interference of pain in daily life, depression, and global perceived effect. Cognitive domains included: negative emotional cognitions, active cognitive coping and control and chronicity beliefs. Improvements in negative emotional cognitions were associated with improvements in all outcome domains, in particular with improvement in interference of pain with daily life and depression (between baseline and 6 months, and 6 and 18 months). Improvements in active cognitive coping were associated with improvements in interference of pain in daily life (between baseline and 6 months). Improvements in control and chronicity beliefs were associated with improvements in pain and depression (between 6 and 18 months). Improvement in negative emotional cognitions seems to be a key mechanism of change in multidisciplinary treatment of chronic widespread pain. Improvement in active cognitive coping and improvement in control and chronic timeline beliefs may also constitute mechanisms of change, although the evidence is less strong.

Cognitive Mechanisms of Change in CBT for Adolescent Depression: Associations among Client Involvement, Cognitive Distortions, and Treatment Outcome

A substantial body of evidence has supported the efficacy of cognitive-behavioral therapy (CBT) for adolescent depression. Fewer studies have addressed mechanisms that contribute to positive youth CBT outcomes. The CBT model holds that adolescents acquire skills through active involvement in sessions and completion of homework assignments between sessions. Skill acquisition including cognitive modification is assumed to contribute to reductions in depressive symptoms. This study examined hypothesized associations among client involvement in cognitive therapy tasks, change in cognitive distortions, and reductions in depressive symptoms with a sample of 44 clinically depressed adolescents. Results partially supported the CBT model. Specifically, change in cognitive distortions prospectively predicted reductions in depressive symptoms, whereas change in depressive symptoms did not predict change in cognitive distortions. Neither in-session involvement nor between-session homework adherence predicted changes ...

Proposed Mechanisms for Cancer- and Treatment-Related Cognitive Changes

To review the proposed mechanisms of cognitive changes associated with non-central nervous system cancers and cancer treatment. Review and synthesis of databased publications and review articles. Proposed mechanisms include cytokine upregulation, hormonal changes, neurotransmitter dysregulation, attentional fatigue, genetic predisposition, and comorbid symptoms. Oncology nurses need to understand the multiple mechanisms that may contribute to the development of cancer- and treatment-related cognitive changes so that they can identify patients at high risk and help patients understand why these changes occur.

Carotid artery disease and cognitive impairment

The term neurologic symptom usually relates to the loss of motor or sensory functions; cognitive deficit is mostly unrecognized in patients with severe carotid stenosis. In large population studies carotid stenosis has been shown as independent risk factor for mild cognitive impairment (MCI) and it was not due to underlying vascular risk factors. The term MCI refers to a transitional stage between cognitive changes of normal aging and vascular dementia. At this stage, cognitive decline is not severe enough to constitute dementia, but also it is beyond the cognitive functioning deficit which is expected in normal aging. Carotid stenosis detected in population older than 65 is 75% for men and 62% for women, with prevalence of stenosis ≥50% in this population 7% for men and 5% for women. There are two possible underlying pathomorphological mechanisms of cognitive changes in patients with carotid disease — cerebral emboli and hypoperfusion with or without silent brain infarctions. In both cases loss of regional cerebral autoregulation can be recognized by means of neurosonology (transcranial Doppler ultrasonography). Most of the studies which evaluated cognitive functions before and after CEA/CAS have shown improvement or no changes in cognitive functions, but no deteriorations. There are still no clear recommendations about using CEA/CAS in treating cognitive deficit in otherwise asymptomatic patients. It is important to recognize cognitive changes as a symptom of carotid disease in order to follow up such patients and include cognitive deficit as one of the criteria in calculating perioperative risk and benefit from CEA/CAS.

Emotional Outcomes and Mechanisms of Change in Online Cognitive-Behavioral Interventions: A Quantitative Meta-Analysis of Clinical Controlled Studies

The present study investigates whether hypothesized cognitive mechanisms of change mediate the efficacy of cognitive-behavioral therapy (CBT) delivered online for treating depression and anxiety disorders. Articles were included by searching MEDLINE, PsychInfo and PsychArticles databases from January 1980 to March 2011. The inclusion criteria were as follows: (a) randomized clinical trials investigating the role of CBT delivered online, (b) patient sample had clinical or subclinical intensity emotional problems, (c) at least one measure of cognitions was included, (d) the inclusion of a control group, and (e) sufficient data provided to allow calculation of effect sizes. Eleven articles were selected. Results revealed a moderate overall effect size of CBT (d = .67, P < .05) on the combined cognitive and emotional outcomes. A positive impact of online CBT on cognitive factors (d = .69, P < .05) and emotional outcomes (d = .63, P < .05) was independently demonstrated. In conclusion, cognitive-behavioral therapy delivered online can be used as an efficacious treatment for patients with emotional disorders. Assuming causal effects, the data indicate that cognitive factors are an important mechanism of change in online CBT. Future online CBT focusing on changing cognitions are likely to be efficacious.

A preliminary exploration of predictors of outcome and cognitive mechanisms of change in cognitive behaviour therapy for psychosis in people not taking antipsychotic medication

Background Cognitive behaviour therapy (CBT) has been shown to be effective in an open trial for people with psychotic disorders who have not been taking antipsychotic medication. There is little known about predictors of outcome in CBT for psychosis and even less about hypothesised mechanisms of change. Method 20 participants with schizophrenia spectrum disorders received CBT in an exploratory trial. Our primary outcome was psychiatric symptoms measured using the PANSS. Secondary outcomes were dimensions of hallucinations and delusions, self-rated recovery and social functioning, and hypothesised mechanisms of change included appraisals of psychotic experiences, dysfunctional attitudes and cognitive insight. We also measured patient characteristics that may be associated with outcome. Results T-tests revealed that several of the hypothesised mechanisms did significantly change over the treatment and follow-up periods. Correlational analyses showed that reductions in negative appraisals of psychotic experiences were related to improvements on outcome measures and that shorter duration of psychosis and younger age were associated with greater changes in symptoms. Conclusions CBT based on a specific cognitive model appears to change the hypothesised cognitive mechanisms, and these changes are associated with good outcomes. CBT may be more effective for those who are younger with shorter histories of psychosis.

Psychodynamic and cognitive mechanisms of change in adult therapy: A pilot study

To examine the effects of the patient-level mechanisms of change postulated by cognitive-behavioral theory and psychodynamic theory, thirty-three patients in eclectic therapy completed questionnaires at two time points. Decreases in automatic thoughts and immature defenses were each associated with lower symptoms, and were correlated with one another at the level of a trend. The theorized patient mechanisms of cognitive-behavioral therapy and psychodynamic therapy are independently active in eclectic therapy. Implications for research and clinical practice are discussed.

Cognitive and Guided Mastery Therapy of Agoraphobia: Long-Term Outcome and Mechanisms of Change

The aims of this study were to compare thelong-term efficacy of cognitive and guided masterytherapy of panic disorder with moderate to severeagoraphobia and to analyze cognitive mechanisms ofchange. Patients (N = 46) suffering from panic disorderwith moderate or severe agoraphobia, who regardedagoraphobia as their main problem, were randomlyassigned to receive either cognitive therapy or guided mastery therapy in a 6-week inpatient groupprogram. At 1-year follow-up, more of the cognitivetherapy patients were behavioral responders, were freeof spontaneous panic attacks, were able to work, and did not use anxiolytic medication. Oncontinuous outcome measures, overall tests revealed nodifferences between the patients in the two treatmentconditions. Results of path analyses of cognitivevariables were consistent with the cognitive model ofpanic with agoraphobia which is based on catastrophicbeliefs and inconsistent with the guided mastery modelwhich is based on self-efficacy.

Knowledge in transition: Adults' developing understanding of a principle of physical causality

What are the conditions that make it likely that cognitive change will occur? We investigate this issue with respect to 25 college students' developing understanding of gear movement (a particular problem in the domain of physical causation). The participants solved problems, then received minimal instruction, and solved additional problems. Significantly, only some of the participants changed their approach to solving the problems after receiving instruction; the remainder of the participants were stable in their understanding and either continued to solve all problems correctly or continued to solve key problems incorrectly. Most analyses focused on the participants who began by solving problems incorrectly. In particular, we attempted to differentiate those participants who exhibited cognitive change from those who did not. To do this, we examined precursors of knowledge change that were motivated by different theoretical positions on mechanisms of cognitive change and development (i.e., consideration of multiple approaches, cognitive conflict, and instruction as an example of a sociocultural process). Results suggest that having multiple approaches available and using instructional information to build on not-well-developed conceptions are likely candidates for understanding knowledge change for adult participants with respect to their developing understanding of physical causality.

Performance-related anxiety in agoraphobia: Treatment procedures and cognitive mechanisms of change

We contrasted two theoretically derived treatments for high performance-related anxiety in subjects with agoraphobia, and evaluated recently proposed cognitive mechanisms of therapeutic change. Subjects were 45 individuals with agoraphobia who could perform community tasks but became highly anxious doing so. They were assigned at random to either (a) exposure treatment, which seeks to extinguish anxiety by exposing people to scary stimuli, (b) guided mastery treatment, which seeks to raise self-efficacy by guiding people to execute coping tasks proficiently, or (c) delayed treatment. The two treatments proved more effective than delayed treatment but did not differ from one another, a result which is interpreted in light of several previous studies that have found guided mastery to be advantageous. Analyses of cognitions revealed that (a) anticipated anxiety and panic were the most accurate predictors of performance-related anxiety, and (b) self-efficacy for controlling scary thoughts also contributed to the prediction of anxiety, whereas (c) perceptions of danger and self-efficacy for overt performance were less accurate predictors of performance-related anxiety.

Cognitive change processes in psychotherapy.

Several types of cognitive-behavioral therapy are now practiced that use different sets of theoretical concepts and propose different kinds of change mechanisms. None, however, is directly grounded in experimental research in cognitive and social psychology, and few address basic issues such as the relevance of conscious versus nonconscious cognitive processes and the validity of the self-report data on which therapy depends. Put forward in this article is a model that describes the conscious and nonconscious processing of emotional stimuli and distinguishes between knowledge that is verbally accessible and knowledge that can only be recovered by exposure to situational cues. Also proposed are three mechanisms of cognitive change that involve altering verbally accessible knowledge, the accessibility of nonconscious situational memories, and self-regulatory strategies. These mechanisms are related to the current practices of behavioral and cognitive-behavioral therapists.