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1 – 10 of 798Jaswant Kaur Bajwa, Bobby Bajwa and Taras Gula
The purpose of this paper is to describe the components, structure and theoretical underpinnings of a cognitive remediation intervention that was delivered within a supported…
Abstract
Purpose
The purpose of this paper is to describe the components, structure and theoretical underpinnings of a cognitive remediation intervention that was delivered within a supported education program for mental health survivors.
Design/methodology/approach
In total, 21 participants enrolled in the course Strengthening Memory, Concentration and Learning (PREP 1033 at George Brown College (GBC)) with the diagnosis of depression, anxiety, PTSD, ED and substance use disorder were included in the research. After a baseline assessment, participants completed 14 week cognitive remediation training (CRT) protocol that included six essential components that were integrated and implemented within the course structure of the supported education program at GBC. This was followed by a post-training assessment.
Findings
Analysis of the participants’ performance on CRT protocol using computerized games showed little significant progress. However, the research found a positive change in the self-esteem of the participants that was statistically significant and the findings also aligned with the social and emotional learning framework.
Research limitations/implications
One of the limitations in the research was the use of computer-assisted cognitive remediation in the form of the HappyNeuron software. The value and relevance of computer assisted needs are to be further examined. It seems that the implementation of the course that explicitly address cognitive challenges creates a supportive environment can be helpful.
Practical implications
Despite the mixed results and the few limitations associated with the CRT intervention reported in the research, the study offers reminders of the complexity of cognitive remediation and all the factors involved that need to be taken into consideration.
Social implications
This research created explicit space for addressing some of the implicit assumptions about the cognitive abilities when in post-secondary education.
Originality/value
This work is based on author’s previous work on cognitive remediation research within the supported education setting.
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Mathieu Dumont, Joanie Thériault, Catherine Briand, Alexandre Dumais and Stéphane Potvin
The purpose of this paper is to identify the psychosocial approaches that have been studied and for which positive outcomes have been reported for individuals with schizophrenia…
Abstract
Purpose
The purpose of this paper is to identify the psychosocial approaches that have been studied and for which positive outcomes have been reported for individuals with schizophrenia in correctional and forensic psychiatric settings.
Design/methodology/approach
A rapid review of the literature was undertaken. A search was conducted on MEDLINE and PsycNET electronic databases. Each identified approach was analyzed to define their types and components.
Findings
In total, 24 studies pertaining to 18 different psychosocial approaches were identified. Half of the studies used a quasi-experimental design with control group. Most frequent outcomes reported were improvements in knowledge about illness and problem solving. Seven studies reported positive outcomes related to issues more specific to this population (violence, aggression, and recidivism). Approaches associated with these studies used mainly traditional cognitive behavior therapy and cognitive remediation. The focus was on neurocognition, social cognition, social skills, emotion management and problem solving.
Practical implications
This rapid review may enlighten clinical settings on psychosocial approaches for which positive outcomes have been reported with individuals with schizophrenia in correctional and forensic psychiatric settings. The picture obtained supports the idea of using integrated rehabilitation approaches that cover the aforementioned intervention focuses with this population.
Originality/value
A significant contribution of the rapid review is based on the analysis of the psychosocial approaches identified. This process offers a closer look at the nature and content of the approaches used according to the outcomes reported.
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Rajesh Kumar, Keshav J. Kumar, Vivek Benegal, Bangalore N. Roopesh and Girikematha S. Ravi
This study aims to examine the effectiveness of an integrated intervention program for alcoholism (IIPA) for improving verbal encoding and memory, visuospatial construction…
Abstract
Purpose
This study aims to examine the effectiveness of an integrated intervention program for alcoholism (IIPA) for improving verbal encoding and memory, visuospatial construction, visual memory and quality of life (QoL) in persons with alcohol dependence.
Design/methodology/approach
The sample comprised treatment-seeking alcohol-dependent persons (n = 50), allotted into two groups: (1) the treatment as usual (TAU) group (n = 25) and (2) the treatment group (n = 25)]. The groups were matched on age (±1 year) and education (±1 year). The TAU group received standard pharmacological treatment, psychotherapeutic sessions on relapse prevention and yoga for 18 days, while the treatment group received IIPA sessions in addition to the usual treatment. Auditory verbal learning test, complex figure test and QoL scale were administered at pre- and post-treatment along with screening measures.
Findings
The two groups were comparable on demographic variables, clinical characteristics and outcome measures at baseline. Pre- to post-treatment changes (gain scores) comparison between the treatment and TAU groups revealed a significant difference in verbal encoding, verbal and visual memory, verbal recognition, visuospatial construction and QoL.
Research limitations/implications
This study suggests that IIPA is effective for improving learning and memory in both modality (verbal and visual) and QoL in persons with alcoholism. The IIPA may help in better treatment recovery.
Practical implications
The IIPA may help in treatment for alcoholism and may enhance treatment efficacy.
Originality/value
IIPA is effective for improving learning and memory in both modalities and QoL in persons with alcohol dependence. The IIPA may help in better treatment recovery.
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Mathieu Dumont, Catherine Briand, Ginette Aubin, Alexandre Dumais and Stéphane Potvin
This study aims to develop immersive scenarios (immersive videos) to foster generalization of learning while addressing social cognition, a factor associated to violence in…
Abstract
Purpose
This study aims to develop immersive scenarios (immersive videos) to foster generalization of learning while addressing social cognition, a factor associated to violence in schizophrenia. The authors sought to develop immersive videos that generate a sense of presence; are socially realistic; and can be misinterpreted and, if so, lead to anger.
Design/methodology/approach
A multiphase mixed method was used to develop and validate the immersive scenarios. The development phase consisted of preliminary interviews and co-design workshops with patients (n = 7) and mental health practitioners (n = 7). The validation phase was conducted with patients (n = 7) and individuals without mental disorders (n = 7).
Findings
The development phase led to the creation of five scenarios (S1, S2, S3, S4, S5); they included social cues which could lead to self-referential and intentional biases. Results of the validation phase showed that all scenarios generated a sense of presence and were considered highly realistic. Three scenarios elicited biases and, consequently, moderate levels of anger (annoyance).
Practical implications
Immersive videos represent a relevant and accessible technological solution to address social-cognitive domains such as self-reference bias.
Originality/value
No intervention using immersive technologies had been developed or studied yet for individuals with schizophrenia at risk of violence in secure settings. This project demonstrated the feasibility of creating immersive videos which have relevant attributes to foster generalization of learning in the remediation of social-cognitive deficits.
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Pasquale Caponnetto, Marilena Maglia, Roberta Auditore, Marta Bocchieri, Antonio Caruso, Jennifer DiPiazza and Riccardo Polosa
Cognitive dysfunctions are a common clinical feature of schizophrenia and represent important indicators of outcome among patients who are affected. Therefore, a randomized…
Abstract
Cognitive dysfunctions are a common clinical feature of schizophrenia and represent important indicators of outcome among patients who are affected. Therefore, a randomized, controlled, monocentric, single-blind trial was carried out to compare two different rehabilitation strategies adopted for the restoration and recovery of cognitive functioning of residential patients with schizophrenia. A sample of 110 residential patients were selected and, during the experimental period, a group of 55 patients was treated with sets of domain-specific exercises (SRT+CRT), whereas an equal control group was treated with sets of non-domain-specific exercises (SRT+PBO) belonging to the Cogpack® software. The effects on the scores (between T0 and T1) of the variables treatment and time and of the interaction time X treatment were analyzed: for the total BACS, the main effect of the between-factors variable treatment is statistically significant (F=201.562 P=0.000), as well as the effect of the within-factors variable “time” (F=496.68 P=0.000).The interaction of these two factors is also statistically significant (F=299.594 P=0.000). The addition of cognitive remediation therapy (CRT) to a standard treatment of metacognitive training (MCT) resulted in a significant improvement in global neurocognitive functioning and has reported positive effects with regard to the strengthening of verbal and working memory, selective and sustained attention at T1. A relevant result is the statistically significance of “time X treatment” for all the tests administered: we can assume that the domain-specific cognitive training amplifies the effects of SRT, as the primary and secondary goals of the present study were achieved.
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Lucinda Charlotte Flinn, Charlotte Louise Hassett and Louise Braham
The Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV) (Wechsler, 2008) is a cognitive assessment that is often used in secure forensic settings, however it has not been…
Abstract
Purpose
The Wechsler Adult Intelligence Scale – Fourth Edition (WAIS-IV) (Wechsler, 2008) is a cognitive assessment that is often used in secure forensic settings, however it has not been normed on this population. The purpose of this paper is to develop forensic normative data.
Design/methodology/approach
Patient files in a high secure forensic hospital were reviewed in order to obtain completed WAIS-IV (Wechsler, 2008) assessments and scores from the five indexes (verbal comprehension, perceptual reasoning, working memory, processing speed and full scale intelligence quotient (FSIQ)). This included reviewing patient files from all directorates, including male mental health, male learning disability, male personality disorder and the women’s service, yielding a sample size of n=86.
Findings
The qualitative descriptors obtained across the hospital ranged between extremely low and superior. The learning disability service scored significantly lower than the mental health and personality disorder services in verbal comprehension index, perceptual reasoning index, working memory index and FSIQ, and significantly lower than the mental health, personality disorder and women’s services in processing speed index. Mean scores from this study were significantly lower in comparison to those from the UK validation study (Wechsler, 2008).
Practical implications
The significant difference between scores from the current study and those from the UK validation study (Wechsler, 2008) highlights the need to have appropriate normative data for forensic populations. Clinicians should consider interventions that may serve to increase cognitive function, such as cognitive remediation therapy.
Originality/value
Whilst several special group studies have previously been conducted, this study is the first to develop forensic normative data for the WAIS-IV (Wechsler, 2008). Whilst the sample size was relatively small with limited female participants, the data collated will enable clinicians working in forensic establishments to interpret their assessments in light of this information.
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Suzanne Igier and Valérie Pennequin
Studies on intellectual disabilities describe difficulties at the cognitive level but little about the other factors that can impact the individual’s performance. The aim of this…
Abstract
Purpose
Studies on intellectual disabilities describe difficulties at the cognitive level but little about the other factors that can impact the individual’s performance. The aim of this research was thus to assess the effects of the socio-emotional context on the performance of adults with intellectual disabilities in a cognitive task. The main hypothesis was that people with intellectual disabilities will not have the cognitive ability to see the socioemotional environment as a potential resource, and that they could not use it to mobilize their cognitive resources to try and improve their performance and adopt more positive behavior.
Design/methodology/approach
A total of 32 people with moderate to severe intellectual disabilities were recruited. They performed a categorization task and were then given their results. Throughout the test, the psychologist observed the participants’ behavior and, more specifically, their emotional expressions, their pro-social behavior and their respect for social rules.
Findings
The results support the hypotheses, with better performance among participants who adopted pro-social behaviors, respected the rules and displayed positive emotional expressions. These results highlight the central role played by others in the ability of adults with intellectual disabilities to adapt to a given situation.
Research limitations/implications
This study was conducted by a psychologist, which could have biased the relationship with the participants. A complementary study is in progress to measure the effects.
Practical implications
These findings have implications for cognitive remediation tasks aimed at mobilizing the cognitive resources of adults with intellectual disabilities.
Originality/value
To the best of the authors’ knowledge, this is the only study to evaluate the role of the socio-emotional environment on the performance of adults with intellectual disabilities.
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For decades, psychopathy has been thought to be untreatable. Yet, conceptualisations, and indeed its assessment, have deviated away from viewing the disorder as personality…
Abstract
Purpose
For decades, psychopathy has been thought to be untreatable. Yet, conceptualisations, and indeed its assessment, have deviated away from viewing the disorder as personality pathology towards a behavioural focus where the core underlying deficits in cognition and affect have been ignored. Interventions have followed suit leading to a premature discounting of the role of therapy in adjusting psychopathic traits. The paper aims to discuss these issues.
Design/methodology/approach
The review critically evaluates the conceptual and empirical evidence relevant to the treatment of psychopathy, deciphering components integral to the disorder that require intervention. Psychopathy is approached from a developmental perspective, with the review identifying several mechanisms thought to be responsible for precipitating and perpetuating its expression.
Findings
There appears some utility in targeting psychopathy from multiple angles, addressing experiences of trauma, associated schemas and the underlying cognitive-affective dysfunction noted to give rise to psychopathic traits. A new model for treatment was proposed integrating these factors to encourage the design of effective interventions that will address the origins and underlying deficits of the disorder, rather than symptomology.
Originality/value
The review encourages future research to consider the aetiology of psychopathy, with the aim of informing early intervention and containing the disorder whilst in its infancy, as well as addressing neurobiological dysfunction when most malleable.
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Aditi Agrawal, Rayah Touma Sawaya, Margaret Ojeahere, Vanessa Padilla and Samer El Hayek
This study aims to review the presentation of substance use disorders in older adults, how addiction intertwines with neurocognitive disorders and how to approach this vulnerable…
Abstract
Purpose
This study aims to review the presentation of substance use disorders in older adults, how addiction intertwines with neurocognitive disorders and how to approach this vulnerable population.
Design/methodology/approach
Electronic data searches of PubMed, Medline and the Cochrane Library (years 2000–2021) were performed using the keywords “neurocognitive,” “dementia,” “substance use,” “addiction,” “older adults” and “elderly.” The authors, in consensus, selected pivotal studies and conducted a narrative synthesis of the findings.
Findings
Research about substance use disorders in older adults is limited, especially in those with superimposed neurocognitive disorders. Having dual diagnoses can make the identification and treatment of either condition challenging. Management should use a holistic multidisciplinary approach that involves medical professionals and caregivers.
Originality/value
This review highlights some of the intertwining aspects between substance use disorders and neurocognitive disorders in older adults. It provides a comprehensive summary of the available evidence on treatment in this population.
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Stephen Linacre, Jessica Green and Vishal Sharma
Carers of people with eating disorders (EDs) experience high levels of burden which can lead to clinical levels of depression and anxiety, high levels of expressed emotion and can…
Abstract
Purpose
Carers of people with eating disorders (EDs) experience high levels of burden which can lead to clinical levels of depression and anxiety, high levels of expressed emotion and can lead to a non-conducive environment to support recovery. The Maudsley Method skills-based workshops can empower carers to support people with ED to move towards recovery, reduce carer burden and high levels of distress. The paper aims to discuss these issues.
Design/methodology/approach
Adaptations have been made to the Maudsley Method skills based workshops to include evidence based approaches from cognitive remediation therapy; mindfulness and acceptance commitment therapy. The adapted workshops were assessed via a pilot study with ten carers of people with ED using a mixed method design. The Experience of Caregiving Inventory and SF-36 were used to assess aspects of caregiving and carer wellbeing, respectively pre and post intervention. Thematic analysis was used to evaluate carers’ views on the intervention.
Findings
Results indicated that carers reduced their level of burden particularly in their experience of stigma, dependency and loss. Furthermore, positive aspects of the relationship with the person with the ED improved. Thematic analysis was used to obtain feedback from carers of the workshops. Qualitative data identified that carers improved their self-awareness, understanding of ED and the techniques they could use, and increased their social support.
Research limitations/implications
Further research is required to compare the original workshops with this adapted intervention.
Originality/value
Although this is a pilot study, the results suggest that further evidence based interventions could be added to the Maudsley Method approach to support carers.
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