Cognitive Therapy Research Articles

Dynamics of clinical manifestations of social phobia, bulimia nervosa, and anorexia nervosa in medical university students during cognitive behavioral therapy and sertraline pharmacotherapy

In recent years, there has been a significant incidence of psychopathology, leading to a decrease in social adaptation and more serious consequences. In particular, one of these nosologies is social phobia. Social phobia in young people, in particular, in medical students, often leads to the development of eating disorders. A significant part of young people during their studies at the higher educational institution are under constant strain of adaptive resources, sometimes even in a state of decompensation. The purpose of the study was to investigate the dynamics of clinical manifestations of social phobia, bulimia nervosa, and anorexia nervosa in medical students against the background of cognitive behavioral psychotherapy and sertraline pharmacotherapy. The study was conducted in 2020–2021 among students of the Voronezh State Medical University named after N. N. Burdenko. 106 participants were divided into 4 groups. Group I was treated with individual cognitive behavioral therapy (CBT), group II received a combination of psychotherapy and pharmacotherapy with sertraline at a dosage of 100 mg/day, group III — psychopharmacotherapy with sertraline without cognitive psychotherapy, and group IV had cognitive behavioral group psychotherapy. During the two-month study positive dynamics in the frequency of symptoms of social anxiety, anorexia nervosa, and bulimia nervosa were noted among the patients of all groups. The best dynamics of symptoms of social phobia and eating disorders was noted among the participants of the first and second groups. The results in both groups are comparable. The next most effective method of therapy of the combined social phobia and eating disorders according to the two-month study was group cognitive psychotherapy. Sertraline pharmacotherapy without cognitive psychotherapy in the third group of the participants showed the least effectiveness. The results of the study allow recommending the use of individual and group CBT protocols and a combination of individual CBT and sertraline pharmacotherapy in the treatment of comorbid social phobia, anorexia ner vosa, and bulimia ner vosa in students of higher medical institutions.

The effect of cognitive stimulation therapy on daily life activities, depression and life satisfaction of older adults living with dementia in nursing home: Randomized controlled trial.

In this research, it was aimed to evaluate the effects of Cognitive Stimulation Therapy on activities of daily living, depression, and life satisfaction in older adults with dementia in nursing homes. It is a randomized controlled experimental study. The study consisted of a total of 60 older adults, 30 in the intervention group and 30 in the control group, in two different nursing homes. In the post-CST comparison, BADLI posttest measurements, IADLS posttest, follow-up test measurements (p < .001, Fr = 45.982, Fr = 42.54) and SWLS posttest (p < .001, Fr = 38.47) of the individuals in the intervention group measurements were significantly higher. The mean depression level of the CSDD posttest and follow-up test intervention group was significantly lower (p < .001, F = 0.402). It was found that Cognitive Stimulation Therapy is effective in increasing the levels of daily life activity and life satisfaction and reducing the level of depression in older adults with dementia. It is recommended to be used by psychiatric nurses.

Erratum in the article “Results from the open-label, single-center, clinical study assessing the efficacy and safety of a group cognitive stimulation therapy in Russian-speaking patients with the moderate dementia stage of Alzheimer's disease”

Erratum in the article “Results from the open-label, single-center, clinical study assessing the efficacy and safety of a group cognitive stimulation therapy in Russian-speaking patients with the moderate dementia stage of Alzheimer's disease”

Effects of an online mindfulness-based cognitive therapy for caregivers of children with allergic rhinitis.

The incidence of allergic rhinitis in children is high across the world, as well as in China. Allergic rhinitis in children has serious impact on physical and mental health of the children. At the same time, the caregivers of allergic rhinitis children have heavy burden of care, and their mental problems are severe. It is necessary to implement timely psychological intervention for the caregivers of allergic rhinitis children. Mindfulness-Based Cognitive Therapy (MBCT) is a safe and effective psychological therapy, and the effect of online intervention can be comparable to the traditional face-to-face intervention program. This study focused on the mental health status in the main caregivers of children with allergic rhinitis, and conducted a modified online MBCT intervention on the caregivers, in order to improve their adverse mental state, meanwhile, improve the quality of care they provide. The results show that online MBCT intervention is applicable to the main caregivers of children with allergic rhinitis, and can effectively reduce caregiver burden, relieve anxiety and depression, and improve the level of mindfulness in the caregivers.

A Comprehensive Assessment of Generalized Anxiety Disorder Treatments

Generalized Anxiety Disorder (GAD), which is commonly known as a mental health disorder. GAD has the characteristic of sustained and excessive anxieties, which seriously affects the daily lives of patients. The present study comprehensively evaluated the clinical characteristics, treatment methods, and efficacy of GAD. The research involves Pharmacotherapy (such as benzodiazepines and antidepressants), psychotherapy (such as cognitive-behavioral therapy (CBT) and mindfulness based cognitive therapy (MBCT), and innovative therapies such as sandplay therapy (SPT). The results indicate that psychotherapy and drug therapy are still the first choices, and innovative therapies can be used to assist and improve treatment. Choosing a treatment method requires comprehensive consideration of multiple factors, including the individual condition of the patient and possible side effects. In this study, a systematic review of the typical features of GAD and its etiology was performed. In addition, the advantages of different therapies as well as typical representatives are discussed and analysed. The results of this study provide implications for related research and suggest future research directions.

Long COVID Brain Fog Treatment: Findings from a Pilot Randomized Controlled Trial of Constraint-Induced Cognitive Therapy.

Long COVID brain fog is often disabling. Yet, no empirically-supported treatments exist. This study's objectives were to evaluate feasibility and efficacy, provisionally, of a new rehabilitation approach, Constraint-Induced Cognitive Therapy (CICT), for post-COVID-19 cognitive sequelae. Sixteen community-residents ≥ 3-months post-COVID-19 infection with mild cognitive impairment and dysfunction in instrumental activities of daily living (IADL) were enrolled. Participants were randomized to Immediate-CICT or treatment-as-usual (TAU) with crossover to CICT. CICT combined behavior change techniques modified from Constraint-Induced Movement Therapy with Speed of Processing Training, a computerized cognitive-training program. CICT was deemed feasible if (a) ≥80% of participants completed treatment, (b) the same found treatment highly satisfying and at most moderately difficult, and (c) <2 study-related, serious adverse-events occurred. The primary outcome was IADL performance in daily life (Canadian Occupational Performance Measure). Employment status and brain fog (Mental Clutter Scale) were also assessed. Fourteen completed Immediate-CICT (n=7) or TAU (n=7); two withdrew from TAU before their second testing session. Completers were [M (SD)]: 10 (7) months post-COVID; 51 (13) years old; 10 females, 4 males; 1 African American, 13 European American. All the feasibility benchmarks were met. Immediate-CICT, relative to TAU, produced very large improvements in IADL performance (M=3.7 points, p<.001, d=2.6) and brain fog (M=-4 points, p<.001, d=-2.9). Four of five non-retired Immediate-CICT participants returned-to-work post-treatment; no TAU participants did, p=.048. CICT has promise for reducing brain fog, improving IADL, and promoting returning-to-work in adults with Long COVID. Findings warrant a large-scale RCT with an active-comparison group.

Evaluating the efficacy of cognitive restructuring and exposure therapies on secondary school chemistry students' test anxiety: A randomized trial.

This study explored how cognitive restructuring (CR) and cognitive exposure therapy (CET) impacted test anxiety in chemistry students from Nsukka, Enugu State. Three research questions and hypotheses guided the investigation. A quasi-experimental design with a pretest, posttest, and 2 experimental groups was employed. The study involved 154 SSII chemistry students from 4 purposefully chosen schools within Nsukka. The Chemistry Test Anxiety Scale, Cognitive Restructuring Chemistry Treatment Package, and Cognitive Exposure Chemistry Treatment Package served as the data collection instruments. The Chemistry Text Anxiety Scale's internal consistency, measured by Cronbach alpha, was found to be 0.86, indicating good reliability. Descriptive statistics (mean and standard deviation) addressed the research questions, while Analysis of Covariance tested the hypotheses at a 0.05 significance level. Results showed that the students who were exposed to CR therapy had pretest mean test anxiety score of M̄ = 78.31, standard deviation (SD) = 8.63 and posttest mean test anxiety of mean [M] = 27.06, SD = 5.71, while those exposed to cognitive exposure had a pretest mean test anxiety score of M = 77.39, SD = 8.68 and a posttest mean test anxiety score of M = 32.62, SD = 11.04. The reduction in text anxiety scores of -51.25 and -44.77 for the students exposed to CR and cognitive exposure respectively. The students exposed to CR therapy had lesser posttest mean test anxiety score than those exposed to CET. The results revealed that students receiving CR therapy displayed lower posttest anxiety scores compared to those receiving CET. Additionally, no significant interaction between treatment and gender on test anxiety was found. It was concluded that CR therapy is better than CET in the management of test anxiety among chemistry students. Based on these findings, it was recommended that cognitive behavioral therapists should be invited periodically to educate students on the negative effects of irrational thoughts on academic performance.

Reductions in PTSD severity precede reductions in pain intensity among veterans receiving intensive treatment.

Chronic pain often co-occurs with posttraumatic stress disorder (PTSD). The mutual maintenance hypothesis proposes that there may be shared underlying mechanisms of symptoms of pain exacerbating PTSD, and vice versa. The association between PTSD and pain intensity remains understudied. To elucidate the relationship, the present study examined the temporality of changes in PTSD severity and pain intensity in veterans undergoing intensive PTSD treatment. Data from 332 veterans undergoing intensive 2-week cognitive processing therapy- (CPT-) based treatment (ITP) with adjunctive components (i.e., mindfulness, art therapy). Random intercepts cross-lagged panel models (RI-CLPMs) were used to examine within-subjects relationships between pain intensity and PTSD severity over the course of the program. Veterans experienced large PTSD severity reductions (Essg = 1.20; p < .001) and small pain severity reductions (Essg = 0.21; p < .001) over the course of treatment, despite pain not being a treatment target. RI-CLPMs revealed that PTSD severity significantly predicted subsequent pain severity. Results indicate the absence of a bidirectional relationship in that changes in pain intensity did not predict later PTSD severity improvement during the ITP. Time trends for both PTSD severity and pain intensity were generally consistent with respect to baseline demographic characteristics. Our findings support the mutual maintenance regarding the association between PTSD and pain intensity. Future research should investigate temporal associations in other evidence-based PTSD treatments and formats and evaluate the long-term impacts of PTSD treatment on pain intensity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

OPENING THE BLACK BOX OF COGNITIVE FUNCTIONAL THERAPY FOR LOW BACK PAIN: A REVIEW OF INTERVENTIONS USING THE TEMPLATE FOR INTERVENTION DESCRIPTION AND REPLICATION (TIDIER) CHECKLIST

Background and study purposeA recent systematic review with meta-analysis of eight randomised controlled trials concluded that Cognitive Functional Therapy (CFT) for low back pain might be effective in reducing disability, pain and fear-avoidance beliefs. However, the descriptions of a CFT intervention are not always clear. This study aimed to rate the replicability of the CFT interventions and control groups in the systematic review.MethodsTwo reviewers independently extracted data from the study articles, protocols and appendices into Microsoft Excel using the Template for Intervention Description and Replication (TIDieR) checklist. This checklist has 12 items to describe the ‘why’, ‘what’, ‘who’, ‘how’, ‘where’, ‘when and how much’, ‘tailoring’, ‘modifications’, and ‘how well’ for each intervention. We rated the replicability of the CFT interventions and control groups as ‘reported’, ‘partially reported’ and ‘not reported’ and resolved discrepancies by consensus.ResultsNo studies reported 100% of the TIDieR items; the mean ‘reported’ rating was 54% (range 33–67%) for the CFT interventions and 35% (range 8–67%) for controls. The six most replicable items were the same for both CFT and control groups. These were ‘brief name’ (CFT=100%; control=100%), ‘why’ (CFT=100%; control=50%), ‘how’ (CFT=100%; control=50%), ‘what procedures’ (CFT=88%; control=63%), ‘where’ (CFT=88%; control=75%) and ‘planned adherence’ (CFT=75%; control=38%). Items that were not sufficiently ‘reported’ for either CFT or control groups included ‘when and how much’, ‘tailoring’ and ‘adherence’.ConclusionIncomplete descriptions of CFT interventions mean that clinicians and patients cannot implement those that have demonstrated effectiveness, and poor descriptions of control groups prevent researchers from replicating them in future studies.Conflict of interestNo conflicts of interestSources of fundingNo funding obtained

Comparative effect of different mindfulness-based intervention types and deliveries on depression in patients with breast cancer: a protocol for a systematic review and network meta-analysis

IntroductionBreast cancer has become the most common cancer worldwide. Various types of mindfulness-based interventions (e.g., mindfulness-based cognitive therapy, mindfulness-based stress reduction) have been conducted in different delivery methods (including face...

The combination of donepezil and cognitive training for improving treatment outcomes for alcohol use disorder: Design of a randomized controlled trial

BackgroundThe development of alcohol use disorder (AUD) is a major concern in public health, and cognitive impairments caused by alcohol are involved in this process. Emerging neurobiological evidence suggests that donepezil, an anticholinesterase agent, may improve AUD treatment outcomes by enhancing neurocognitive functioning. Previous research has also suggested that cognitive remediation therapy (CRT) could potentially improve cognitive function and AUD treatment outcomes. We present the rationale and design of a trial to evaluate the combination of donepezil and cognitive remediation therapy (donepezil + CRT) as an intervention for AUD. MethodsWe propose a 13-week, randomized, double-blind, placebo-controlled, between-subjects trial comparing 4 groups (donepezil + CRT vs. donepezil alone vs. CRT alone vs. placebos) as an intervention for AUD. The main goal of the study is to evaluate if donepezil + CRT is superior to placebo in reducing heavy drinking days and improving neurocognitive functioning. A total of 160 patients (4 groups, 40 per each group) with AUD between the ages of 18–80 years will be recruited at Yale University and the VA Connecticut Healthcare System. Primary outcome measures include 1) heavy drinking by Timeline Follow Back (TLFB) over 13 weeks and 2) global neurocognitive functioning by a global index of neurocognitive function score at 7 and 13 weeks. DiscussionThis protocol paper describes the rationale and proposed methods for the randomized controlled trial for improving AUD treatment outcomes. This project has significant clinical potential to help patients suffering from AUD by improving their cognition and reducing alcohol consumption.Trial Registration:NCT05042102

Efficacy of Cognitive Stimulation Therapy for Cognition in Patients with Vascular Cognitive Impairment: A Pilot Randomized Controlled Trial.

The efficacy of cognitive stimulation therapy (CST) in patients with vascular cognitive impairment has not been explored, and no studies investigating CST in the convalescent rehabilitation phase have been reported. This study examined the effect of CST on the cognitive function of patients with vascular cognitive impairment. A randomized controlled, assessor-blinded, single-centered trial with two parallel groups was conducted in a convalescent rehabilitation hospital. Twenty participants were randomly allocated to CST (n=10) and control (n=10) groups. Participants in the CST group underwent two CST sessions a day, five times a week for 8 weeks, in addition to conventional rehabilitation. Participants in the control group underwent conventional rehabilitation only. The primary outcome was the Mini-Mental State Examination (MMSE) score, and the outcome between the groups was compared using a generalized linear mixed model (GLMM). The mean (standard deviation) scores of MMSE increased by 3.50 (3.08) points and 4.50 (1.61) points from baseline to the end of the study (week 8) in the CST and control groups, respectively. The GLMM showed a significant effect of TIME on MMSE (F=21.121, P<0.001), whereas no significant effect on MMSE was observed for GROUP (intervention vs. control, P=0.817) or the interaction term (TIME×GROUP, P=0.649). Although a significant improvement in cognitive function was observed in each group, no significant effect of CST was evident. This result indicates that the effect may have been masked by improvements caused by natural history or rehabilitation. Future studies with a sufficient sample size are required to confirm the findings.

"It made me feel more alive": A qualitative analysis of quality of life improvements following completion of trauma-focused therapy for posttraumatic stress disorder.

Posttraumatic stress disorder (PTSD) is associated with poor quality of life. Although randomized clinical trial data show improvements in quality of life following trauma-focused therapies (TFTs), including prolonged exposure therapy (PE) and cognitive processing therapy (CPT), less is known about how these improvements are experienced from the trauma survivor's perspective. A national sample of 60 veterans who recently completed TFT as part of routine care at U.S. Department of Veterans Affairs facilities participated in semistructured qualitative interviews during which the impact of treatment on quality of life was explored. Following a mixed deductive/inductive approach, six interrelated themes describing changes in quality of life emerged: full participation in social activities, greater emotional intimacy in relationships, improvements in parenting, expanded engagement in hobbies and community, increased occupational commitment and confidence, and more joy in life. The data highlight the positive impact of treatment on quality of life and provide depth to quantitative findings demonstrating improvements in quality of life following TFT.

Feasibility, Safety, and Acceptability of Cognitive Processing Therapy for PTSD Following a Recent Suicide Attempt: A Case Study

While cognitive processing therapy (CPT) has been found to be highly effective in the treatment of posttraumatic stress disorder (PTSD) and comorbid suicidal ideation, it is unknown how soon after a suicide attempt this treatment may be safe and effective. This case study investigates the effectiveness of weekly, telehealth-delivered CPT for a client with PTSD following a suicide attempt on the anniversary of a traumatic event. Results indicate a clinically meaningful reduction in PTSD symptoms and loss of PTSD diagnosis, as measured by the PTSD Checklist for DSM-5 (PCL-5), and a lack of further suicidal ideation or attempts. These results were maintained at long-term follow-ups at 1-, 3-, and 12-month periods. Qualitative data from the client further supported the effectiveness and acceptability of treatment. This case study suggests the potential of CPT as a valuable intervention for individuals with PTSD recovering from suicide attempts and highlights the importance of further research in this area. In support of this, the case study also suggests the use of nuanced suicide risk assessments, such as the fluid vulnerability theory (FVT), to respond to fluctuations in suicide risk in high-risk clients.

Integrating brief exposure exercises to support cognitive processing therapy for treatment of PTSD: A case study

Posttraumatic stress disorder (PTSD) is a prevalent and concerning mental health diagnosis across the globe. There are multiple evidence-based treatments that have been shown to effectively treat PTSD, including cognitive processing therapy (CPT) and exposure-based interventions. This case study depicts using CPT for treating uncomplicated PTSD in a 28-year-old woman, while integrating brief exposure exercises in the client’s homework. These exercises helped target avoidance symptoms and acute distress as well as increase quality of life, such that the client was better able to engage in CPT. Follow up data indicated a significant reduction in PTSD symptoms as measured by the Posttraumatic Stress Disorder Checklist (PCL-5) such that she no longer met clinical criteria for a diagnosis of PTSD or experienced significant distress related to her trauma. This data reflects the utility of integrating other evidence-based exercises into manualized treatment to create nuanced, individualized treatment plans. Clinical and research implications regarding the utility of implementing an integrated, conceptualization-driven treatment approach are discussed.

An evaluation of the associations among posttraumatic stress disorder, depression, and complicated grief in active duty military personnel with traumatic loss.

Between 44% and 87% of active duty service members and veterans who deployed following the September 11, 2001, terrorist attacks know someone who was killed or seriously injured in combat. Considering the high frequency and known impact of traumatic loss, it is important to understand if and how traumatic loss may impede posttraumatic stress disorder (PTSD) treatment progress in military personnel. Additionally, experiencing a traumatic loss elevates the risk of developing prolonged grief disorder (PGD), which is associated with higher levels of PTSD symptoms, more functional impairment, and more lifetime suicide attempts among military personnel. Given what is known about the association between PGD and PTSD in treatment-seeking service members and veterans, it is also important to understand whether grief-related symptom severity negatively impacts PTSD treatment response. The current study examined associations among traumatic loss, complicated grief, depressive symptoms, and PTSD treatment response among military personnel (N = 127) who participated in variable-length cognitive processing therapy (CPT). There was no direct, F(2, 125) = 0.77, p =.465, or indirect, β =.02, p =.677, association between a traumatic loss index event and PTSD treatment response compared with other trauma types. Prior assessments of depressive symptom severity were directly related to PTSD at later assessments across two models, ps <.001-p =.021 Participants with a traumatic loss index trauma demonstrated significant reductions in complicated grief, depressive symptoms, and PTSD following CPT, ps <.001, ds = -0.61--0.83. Implications, study limitations, and suggestions for future research are presented.

The Effect Of General Exercise Program Combined With Cognitive Functional Therapy On Pain, Quality Of Life And Muscle Endurance Of Women With Chronic Non-Specific Low Back Pain

The Effect Of General Exercise Program Combined With Cognitive Functional Therapy On Pain, Quality Of Life And Muscle Endurance Of Women With Chronic Non-Specific Low Back Pain

Comparison of the Effectiveness of Cognitive Hypnotherapy and Schema Therapy on Difficulty in Emotion Regulation in Substance-Dependent Individuals

Comparison of the Effectiveness of Cognitive Hypnotherapy and Schema Therapy on Difficulty in Emotion Regulation in Substance-Dependent Individuals

Inpatient Care for Elderly Suicide Survivors: Nurse-Led Mindfulness-Based Cognitive Therapy.

The aim was to analyze the effects of nurse-led mindfulness-based cognitive therapy (MBCT) in hospitalized elderly suicide survivors. The data of middle-aged and elderly suicide survivors in the medical system and nursing records of our hospital from January 2018 to August 2023 were retrospectively collected. The patients were divided into conventional group and MBCT group according to whether they actively received MBCT. The general demographic data of the patients and the changes in the scores of Suicidal Ideation Scale (SSI), Beck Hopelessness Scale (BHS), Patient Health Questionnaire 15 (PHQ-15), and Geriatric Depression Scale (GDS-15) at admission and 3 and 6 months of follow-up were collected. Propensity score matching was used to balance the baseline data of the 2 groups. Multiple logistic regression analysis was used to determine the effect of the inpatient care program on each score. A total of 160 patients were included in the study, including 100 patients in the MBCT group and 60 patients in the conventional group. There was no significant difference in baseline data between the 2 groups after matching (P > .05). Suicidal Ideation Scale score, BHS score, PHQ-15 score, and GDS-15 score in MBCT group were lower than those in conventional group at 6 months of follow-up (P < .05). At the same time, multiple logistic regression analysis showed that the intervention program was the main factor affecting the SSI (OR = 1.538, P = .010), BHS (OR = 1.614, P = .006), PHQ-15 (OR = 1.797, P = .001), and GDS-15 scores (OR = 1.642, P = .004) at 6 months of follow-up. The application of nurse-led MBCT in hospitalized elderly suicide survivors may reduce suicidal ideation, hopelessness, and depression and improve physical symptoms.

Comparing the Effects of Lavender Aromatherapy and Mindfulness-Based Cognitive Therapy on Sexual Function in Women in Iran

ObjectiveTo compare the effects of aromatherapy with lavender and mindfulness-based cognitive therapy for sexuality (MBCT-S) on female sexual function. DesignRandomized controlled trial. SettingHealth centers in Roudan city, Iran. ParticipantsSixty married women, ages 18 to 45 years, were recruited using the Female Sexual Function Index (FSFI). Participants were selected from health centers in 2022 via convenience sampling. Intervention and MeasurementsUpon their completion of a demographic checklist and the FSFI as a pretest, participants were divided into three groups, including lavender aromatherapy (n = 20), MBCT-S (n = 20), and control (n = 20) through random selection with permutation blocks. All groups completed FSFI as a posttest. Data were analyzed by SPSS 26 using chi-square, Wilcoxon, Kruskal–Wallis, and Mann–Whitney statistical tests. ResultsThere was no statistically significant difference among the three groups before the intervention (p = .652), but there was a significant difference among them after the intervention (p = .001). There was a significantly positive difference between the intervention groups and the control group (p < .001). A significant relationship was observed among the three groups in sexual desire, pain, satisfaction, lubrication, and arousal. The mean scores of the posttest in sexual desire, pain, satisfaction, and lubrication were positively higher in the MBCT-S group than in the aromatherapy group, and both intervention groups showed the same effect for sexual arousal. Aromatherapy and counseling had no significant effect on improving sexual orgasm. ConclusionMBCT-S can be used to improve many aspects of female sexual function, except for orgasm disorders; aromatherapy may improve sexual arousal.