scholarly journals Cognitive Reserve Profiles in Chronic Schizophrenia: Effects on Theory of Mind Performance and Improvement after Training

2018 ◽  
Vol 24 (6) ◽  
pp. 563-571 ◽  
Author(s):  
Mariachiara Buonocore ◽  
Margherita Bechi ◽  
Paola Uberti ◽  
Marco Spangaro ◽  
Federica Cocchi ◽  
...  
Keyword(s):  
Treatment Outcome ◽  
Individual Differences ◽  
Theory Of Mind ◽  
Cognitive Rehabilitation ◽  
Cognitive Reserve ◽  
Chronic Schizophrenia ◽  
Post Treatment ◽  
Analysis Of Covariance ◽  
Intellectual Impairment ◽  
Premorbid Functioning

AbstractObjectives: Cognitive reserve (CR), defined as individual differences in the ability to cope with brain damage, seem to be associated to the several psychopathological features in psychiatric patients, such as the functional outcome. This study aims to identify different profiles of CR by combining intelligence quotient (IQ) and premorbid functioning, two measures independently associated to CR in previous works, as well as to explore CR effect on both Theory of Mind (ToM) baseline performance and improvement after socio-cognitive trainings. Methods: Sixty patients with chronic schizophrenia underwent a socio-cognitive rehabilitation. All patients were assessed for psychopathology, neurocognition, and ToM at baseline and post-treatment. CR profiles were explored with K-means cluster analysis, while differences between clusters in both baseline assessments and post-treatment ToM improvement, were analyzed by means of analysis of variance and repeated measures analysis of covariance. Results: The analysis revealed three CR profiles, respectively, characterized by low early premorbid functioning and mild intellectual impairment, average/high early premorbid functioning trend with moderate intellectual impairment and good early premorbid functioning associated to IQ within normal limits. Analyses showed a significant effect of CR on both baseline ToM performance and treatment outcome: patients with higher CR reached significantly better ToM scores. Conclusions: These results underline the clinical relevance of defining CR profiles of patients to customize trainings: subjects with a lower CR may benefit from more intensive programs. A deeper knowledge about CR may considerably increase our understanding of individual differences and thus potentiate treatment outcome. (JINS, 2018, 24, 563–571)

Do people with schizophrenia display theory of mind deficits in clinical interactions?

2004 ◽  
Vol 34 (3) ◽  
pp. 401-412 ◽  
Author(s):  
R. McCABE ◽  
I. LEUDAR ◽  
C. ANTAKI
Keyword(s):  
Theory Of Mind ◽  
Mental Health Professionals ◽  
Negative Symptoms ◽  
Experimental Studies ◽  
Chronic Schizophrenia ◽  
Mental States ◽  
Behaviour Therapy ◽  
Cognitive Behaviour ◽  
Clinical Interactions ◽  
Therapy Sessions

Background. Having a ‘theory of mind’ (ToM) means that one appreciates one's own and others' mental states, and that this appreciation guides interactions with others. It has been proposed that ToM is impaired in schizophrenia and experimental studies show that patients with schizophrenia have problems with ToM, particularly during acute episodes. The model predicts that communicative problems will result from ToM deficits.Method. We analysed 35 encounters (>80 h of recordings) between mental health professionals and people with chronic schizophrenia (out-patient consultations and cognitive behaviour therapy sessions) using conversation analysis in order to identify how the participants used or failed to use ToM relevant skills in social interaction.Results. Schizophrenics with ongoing positive and negative symptoms appropriately reported first and second order mental states of others and designed their contributions to conversations on the basis of what they thought their communicative partners knew and intended. Patients recognized that others do not share their delusions and attempted to reconcile others' beliefs with their own but problems arose when they try to warrant their delusional claims. They did not make the justification for their claim understandable for their interlocutor. Nevertheless, they did not fail to recognize that the justification for their claim is unconvincing. However, the ensuing disagreement did not lead them to modify their beliefs.Conclusions. Individuals with schizophrenia demonstrated intact ToM skills in conversational interactions. Psychotic beliefs persisted despite the realization they are not shared but not because patients cannot reflect on them and compare them with what others believe.

scholarly journals Statistical analysis of two arm randomized pre-post designs with one post-treatment measurement

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fei Wan
Keyword(s):  
Treatment Effect ◽  
Repeated Measures ◽  
Informed Choice ◽  
Clinical Effectiveness ◽  
Change Score ◽  
Post Treatment ◽  
Analysis Of Covariance ◽  
Alternative Methods ◽  
Main Effect ◽  
Comparable Performance

Abstract Background Randomized pre-post designs, with outcomes measured at baseline and after treatment, have been commonly used to compare the clinical effectiveness of two competing treatments. There are vast, but often conflicting, amount of information in current literature about the best analytic methods for pre-post designs. It is challenging for applied researchers to make an informed choice. Methods We discuss six methods commonly used in literature: one way analysis of variance (“ANOVA”), analysis of covariance main effect and interaction models on the post-treatment score (“ANCOVAI” and “ANCOVAII”), ANOVA on the change score between the baseline and post-treatment scores (“ANOVA-Change”), repeated measures (“RM”) and constrained repeated measures (“cRM”) models on the baseline and post-treatment scores as joint outcomes. We review a number of study endpoints in randomized pre-post designs and identify the mean difference in the post-treatment score as the common treatment effect that all six methods target. We delineate the underlying differences and connections between these competing methods in homogeneous and heterogeneous study populations. Results ANCOVA and cRM outperform other alternative methods because their treatment effect estimators have the smallest variances. cRM has comparable performance to ANCOVAI in the homogeneous scenario and to ANCOVAII in the heterogeneous scenario. In spite of that, ANCOVA has several advantages over cRM: i) the baseline score is adjusted as covariate because it is not an outcome by definition; ii) it is very convenient to incorporate other baseline variables and easy to handle complex heteroscedasticity patterns in a linear regression framework. Conclusions ANCOVA is a simple and the most efficient approach for analyzing pre-post randomized designs.

scholarly journals Individual differences in the theory of mind and superior temporal sulcus

2009 ◽  
Vol 463 (2) ◽  
pp. 150-153 ◽  
Author(s):  
Yuki Otsuka ◽  
Naoyuki Osaka ◽  
Takashi Ikeda ◽  
Mariko Osaka
Keyword(s):  
Individual Differences ◽  
Theory Of Mind ◽  
Superior Temporal Sulcus

scholarly journals Effectiveness of Neurofeedback Associated with Cognitive Rehabilitation Therapy on Children with Attention Defect Hyperactivity Disorder (ADHD)

2015 ◽  
Vol 2 (4) ◽  
Author(s):  
Mohammad Kianbakht ◽  
Sedighe Naghel ◽  
Freshte Alidadi ◽  
Vahid Nejati ◽  
Hossien Kohandel ◽  
...  
Keyword(s):  
Cognitive Rehabilitation ◽  
Analysis Of Covariance ◽  
Control Group ◽  
Meaningful Difference ◽  
Rehabilitation Therapy ◽  
Performance Factors ◽  
Positive Effects ◽  
Adhd Children ◽  
Cognitive Rehabilitation Therapy ◽  
And Control

Objectives: Neurofeedback is known as a modern therapy for hyperactive children, nevertheless it is not a complete therapy for these patients. The goal of this therapy is to create a complete therapy for ADHD children, so neurofeedback is used with cognitive rehabilitation therapy to make more integrated therapy. Method: this is an experimental study. 30 subjects were selected through random selection from women who referred to 5 clinics of Tehran city, and they were placed into 2 experimental groups and 1 control group. Groups are matched in age, sexuality and economic situation. One group just received neurofeedback into 10 sessions, another group received neurofeedback plus cognitive rehabilitation therapy at the same during, and control group received no therapy or they leaved the therapy at the first steps. Integrated visual and auditory test (IVA) was used as pretest and posttest, to measure two factors (attention and impulsivity) in ADHD children. Cognitive rehabilitation therapy protocol is based on work of Nejati (1391). Data evaluated by dependent T test and analysis of covariance. Results: according to findings, there is meaningful difference between all groups in attention and impulsivity factors. The group who received neurofeedback plus cognitive rehabilitation therapy showed more improvement in attention and impulsivity factors. Also there was a meaningful difference between neurofeedback group and control group in attention factor. Conclusion: neurofeedback is supposed as a facilitator therapy to improve attention factor in ADHD children, but not as a complete therapy, especially about performance factors. Also, it is better to use a complementary therapy such as cognitive rehabilitation therapy that focuses more on performance factors. It leads to more positive effects on impulsivity or even hyperactivity.

Personalized attention control therapy for PTSD: effectiveness and moderators of outcome in a randomized controlled trial

2020 ◽  
pp. 1-11
Author(s):  
Adva Segal ◽  
Daniel S. Pine ◽  
Yair Bar-Haim
Keyword(s):  
Treatment Outcome ◽  
Clinical Symptoms ◽  
Controlled Trial ◽  
Post Treatment ◽  
Attention Control ◽  
Randomized Controlled ◽  
Control Therapy ◽  
Pre Treatment ◽  
Attentional Interference

Abstract Background Previous randomized controlled trials (RCTs) suggest that attention control therapy (ACT), targeting aberrant fluctuations of attention toward and away from threats in patients with PTSD, may be effective in reducing symptoms. The current RCT examined whether the use of personalized-trauma stimuli enhances ACT efficacy in patients with PTSD. Additional moderators of treatment outcome were tested on an exploratory basis. Methods Sixty patients with PTSD were randomly assigned to either personalized ACT, non-personalized ACT, or a control condition. Changes in symptoms were examined across pre-treatment, post-treatment, and a 3-month follow-up. Attentional interference was examined pre- and post-treatment. Baseline clinical and cognitive indices as well as the time elapsed since the trauma were tested as potential moderators of treatment outcome. Results A significant reduction in clinical symptoms was noted for all three conditions with no between-group differences. Attention bias variability decreased following ACT treatment. Personalized ACT was more effective relative to the control condition when less time had elapsed since the trauma. Baseline clinical and cognitive indices did not moderate treatment outcome. Conclusions In this RCT of patients with PTSD, ACT was no more effective in reducing PTSD symptoms than a control condition. The data also suggest a potential benefit of personalized ACT for patients who experienced their trauma more recently.

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