Science.gov

Sample records for cognition disorders

  1. Cognitive style in bipolar disorder.

    PubMed

    Jones, Lisa; Scott, Jan; Haque, Sayeed; Gordon-Smith, Katherine; Heron, Jessica; Caesar, Sian; Cooper, Caroline; Forty, Liz; Hyde, Sally; Lyon, Louisa; Greening, Jayne; Sham, Pak; Farmer, Anne; McGuffin, Peter; Jones, Ian; Craddock, Nick

    2005-11-01

    Abnormalities of cognitive style in bipolar disorder are of both clinical and theoretical importance. To compare cognitive style in people with affective disorders and in healthy controls. Self-rated questionnaires were administered to 118 individuals with bipolar I disorder, 265 with unipolar major recurrent depression and 268 healthy controls. Those with affective disorder were also interviewed using the Schedules for Clinical Assessment in Neuropsychiatry and case notes were reviewed. Those with bipolar disorder and those with unipolar depression demonstrated different patterns of cognitive style from controls; negative self-esteem best discriminated between those with affective disorders and controls; measures of cognitive style were substantially affected by current levels of depressive symptomatology; patterns of cognitive style were similar in bipolar and unipolar disorder when current mental state was taken into account. Those with affective disorder significantly differed from controls on measures of cognitive style but there were no differences between unipolar and bipolar disorders when current mental state was taken into account.

  2. Cognitive Enhancers for Anxiety Disorders

    PubMed Central

    Hofmann, Stefan G.; Smits, Jasper A. J.; Asnaani, Anu; Gutner, Cassidy A.; Otto, Michael W.

    2010-01-01

    Cognitive behavioral therapy is an effective intervention for anxiety disorders. However, a significant number of people do not respond or only show partial response even after an adequate course of the treatment. Recent research has shown that the efficacy of the intervention can be improved by the use of cognitive enhancers that augment the core learning processes of cognitive-behavior therapy. This manuscript provides a review of the current state of cognitive enhancers for the treatment of anxiety disorders. PMID:21134394

  3. Cognitive Therapy of Anxiety Disorders.

    ERIC Educational Resources Information Center

    Chambless, Dianne L.; Gillis, Martha M.

    1993-01-01

    Reviews studies of cognitive-behavioral therapy (CBT) for generalized anxiety disorder, panic disorder with and without agoraphobia, and social phobia. Sees CBT as consistently more effective than waiting-list and placebo control groups. Notes that cognitive change may be strong predictor of treatment outcome but that such change may be produced…

  4. [Anxiety and cognition disorders].

    PubMed

    Peretti, C S

    1998-01-01

    Anxious subjects present attentional disorders that are manifest with an increased bias towards threatening contents stimuli. In tasks derived from the Stroop task (such as emotional Stroop, a variant of the classic Stroop task) congruence between anxious themes or manifestations and stimuli content induces information processing changes leading to a slowness of response speed. In this case, results are similar to those obtained in signal detection tasks either when information is visually or auditorily presented. In anxious subjects an inconscious activation provoked by anxiogenic words is observed. Because such activation is independent from the semantic content of the words, an emotional priming has been hypothesized. Berck formulated an hypervigilance theory according to which anxiety provokes a selective distractibility regarding non pertinent stimuli. Such attentional selectivity would be responsible of a cognitive vulnerability in anxious subjects. State but not trait anxiety induces working memory performances deficit. On the bases of Baddeley's working memory framework, Eysenck proposed that anxiety uses part of the limited attentional capacity, placing the subject in a dual task situation. In that, he has to cope with pertinent information and anxiety generated information. If anxiety leads to better performance in simple tasks by recruiting motivational capacities, in tasks with high information content, anxious subjects performances are impaired. Changes in the long-term memory do not seem to fit with the theoretical models based on cognitive impairment observed in patients suffering from depressive states. Anxious subjects presented a memory bias towards anxiogenic information in implicit memory tasks. But experimental data are still too searce to describe implicit performance of anxious subjects and more systematic studies are therefore needed.

  5. Cognitive impairment in bipolar disorder.

    PubMed

    Latalova, Klara; Prasko, Jan; Diveky, Tomas; Velartova, Hana

    2011-03-01

    Provide an overview of how bipolar disorder affects cognitive function in patients. MEDLINE and PsycInfo data bases were searched for articles indexed by the combinations of MESH term or key word "bipolar disorder" with the following terms: "cognition", "memory", "neuropsychology", "neuropsychological tests", "lithium", "anticonvulsants", "antipsychotics", and "schizophrenia". Constraints limiting time period of publications or their language were not applied. Reference lists of publications identified by these procedures were hand-searched for additional relevant citations. There is evidence of stable and lasting cognitive impairment in all phases of bipolar disorder, including the remission phase, particularly in the following domains: sustained attention, memory and executive functions. But research on the cognitive functions has yielded inconsistent results over recent years. There is a growing need for clarification regarding the magnitude, clinical relevance and confounding variables of cognitive impairment in bipolar patients. The impact of bipolar illness on cognition can be influenced by age of onset, pharmacological treatments, individual response, familial risk factors, and clinical features. In addition to the mood state, cognitive performance in bipolar patients is influenced by seasonality. Previous optimistic assumptions about the prognosis of bipolar disorder were based on the success of the control of mood symptoms by pharmacotherapy. However, it is now clear that the "remitted" euthymic bipolar patients have distinct impairments of executive function, verbal memory, psychomotor speed, and sustained attention. Mood stabilizers and atypical antipsychotics may reduce cognitive deficits in certain domains and may have a positive effect on quality of life and social functioning.

  6. Physical Exercise And Cognitive Engagement Outcomes for Mild Neurocognitive Disorder

    ClinicalTrials.gov

    2017-09-14

    Mild Cognitive Impairment; Memory Disorders; Mild Dementia; Impaired Cognition; Mild Cognitive Disorder; Amnestic Disorder; Dementia and Amnestic Conditions; Poor Short-term Memory; Memory Impairment; Mild Neurocognitive Disorder

  7. Learning and Cognitive Disorders

    PubMed Central

    Chacko, Anil; Uderman, Jodi; Feirsen, Nicole; Bedard, Anne-Claude; Marks, David

    2014-01-01

    Synopsis The purpose of this article is to provide a select review of treatments for addressing reading disorder, mathematics disorder, disorder of written expression, auditory processing disorder and poor working memory. This information will be valuable to practitioners in determining the suitability of certain treatments for these various disorders/problems which has direct implications for providing comprehensive, multi-disciplinary treatment for youth. PMID:23806314

  8. Cognitive disorders in children's hydrocephalus.

    PubMed

    Zielińska, Dorota; Rajtar-Zembaty, Anna; Starowicz-Filip, Anna

    Hydrocephalus is defined as an increase of volume of cerebrospinal fluid in the ventricular system of the brain. It develops as a result of cerebrospinal fluid flow disorder due to dysfunctions of absorption or, less frequently, as a result of the increase of its production. Hydrocephalus may lead to various cognitive dysfunctions in children. In order to determine cognitive functioning in children with hydrocephalus, the authors reviewed available literature while investigating this subject. The profile of cognitive disorders in children with hydrocephalus may include a wide spectrum of dysfunctions and the process of neuropsychological assessment may be very demanding. The most frequently described cognitive disorders within children's hydrocephalus include attention, executive, memory, visual, spatial or linguistic dysfunctions, as well as behavioral problems. Copyright © 2017 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  9. Cognitive therapy in bipolar disorder.

    PubMed

    Scott, Jan

    2002-07-01

    Stress-vulnerability models are increasingly viewed as plausible explanations of recurrence in severe affective disorders. This has promoted greater interest in the application of evidence-based psychological treatments, such as cognitive therapy, as an adjunct to medication for patients with bipolar disorder. This paper reviews the results from outcome studies of combined treatment approaches. Preliminary findings indicate that cognitive therapy reduces symptoms, enhances social adjustment and functioning and reduces relapses and hospitalizations in patients with bipolar disorder. However, the lack of published data from large scale randomized controlled trials and the absence of an adequate psychological model of manic relapse means that the role of cognitive therapy in bipolar disorders will be the subject of intense debate for some time to come.

  10. Cognitive dysfunction in mitochondrial disorders.

    PubMed

    Finsterer, J

    2012-07-01

    Among the various central nervous system (CNS) manifestations of mitochondrial disorders (MIDs), cognitive impairment is increasingly recognized and diagnosed (mitochondrial cognitive dysfunction). Aim of the review was to summarize recent findings concerning the aetiology, pathogenesis, diagnosis and treatment of cognitive decline in MIDs. Among syndromic MIDs due to mitochondrial DNA (mtDNA) mutations, cognitive impairment occurs in patients with mitochondrial encephalopathy, lactic acidosis and stroke-like episodes syndrome, myoclonus epilepsy with ragged-red fibres syndrome, mitochondrial chronic progressive external ophthalmoplegia, Kearns-Sayre syndrome, neuropathy, ataxia and retinitis pigmentosa syndrome and maternally inherited diabetes and deafness. Among syndromic MIDs due to nuclear DNA (nDNA) mutations, cognitive decline has been reported in myo-neuro-gastro-intestinal encephalopathy, mitochondrial recessive ataxia syndrome, spinocerebellar ataxia with encephalopathy, Mohr-Tranebjaerg syndrome, leuko-encephalopathy; brain and spinal cord involvement and lactic acidosis, CMT2, Wolfram syndrome, Wolf-Hirschhorn syndrome and Leigh syndrome. In addition to syndromic MIDs, a large number of non-syndromic MIDs due to mtDNA as well as nDNA mutations have been reported, which present with cognitive impairment as the sole or one among several other CNS manifestations of a MID. Delineation of mitochondrial cognitive impairment from other types of cognitive impairment is essential to guide the optimal management of these patients. Treatment of mitochondrial cognitive impairment is largely limited to symptomatic and supportive measures. Cognitive impairment may be a CNS manifestation of syndromic as well as non-syndromic MIDs. Correct diagnosis of mitochondrial cognitive impairment is a prerequisite for the optimal management of these patients. © 2012 John Wiley & Sons A/S.

  11. Cognitive-Behavioral Theories of Eating Disorders

    ERIC Educational Resources Information Center

    Williamson, Donald A.; White, Marney A.; York-Crowe, Emily; Stewart, Tiffany M.

    2004-01-01

    This article presents an integrated cognitive-behavioral theory of eating disorders that is based on hypotheses developed over the past 30 years. The theory is evaluated using a selected review of the eating disorder literature pertaining to cognitive biases, negative emotional reactions, binge eating, compensatory behaviors, and risk factors for…

  12. Cognitive-Behavioral Theories of Eating Disorders

    ERIC Educational Resources Information Center

    Williamson, Donald A.; White, Marney A.; York-Crowe, Emily; Stewart, Tiffany M.

    2004-01-01

    This article presents an integrated cognitive-behavioral theory of eating disorders that is based on hypotheses developed over the past 30 years. The theory is evaluated using a selected review of the eating disorder literature pertaining to cognitive biases, negative emotional reactions, binge eating, compensatory behaviors, and risk factors for…

  13. Classification of cognitive performance in bipolar disorder.

    PubMed

    Sparding, Timea; Silander, Katja; Pålsson, Erik; Östlind, Josefin; Ekman, Carl Johan; Sellgren, Carl M; Joas, Erik; Hansen, Stefan; Landén, Mikael

    2017-09-01

    To understand the etiology of cognitive impairment associated with bipolar disorder, we need to clarify potential heterogeneity in cognitive functioning. To this end, we used multivariate techniques to study if the correlation structure of cognitive abilities differs between persons with bipolar disorder and controls. Clinically stable patients with bipolar disorder (type I: n = 64; type II: n = 44) and healthy controls (n = 86) were assessed with a wide range of cognitive tests measuring executive function, speed, memory, and verbal skills. Data were analysed with multivariate techniques. A distinct subgroup (∼30%) could be identified that performed significantly poorer on tests concerning memory function. This cognitive phenotype subgroup did not differ from the majority of bipolar disorder patients with respect to other demographic or clinical characteristics. Whereas the majority of patients performed similar to controls, a subgroup of patients with bipolar disorder differed substantially from healthy controls in the correlation pattern of low-level cognitive abilities. This suggests that cognitive impairment is not a general trait in bipolar disorder but characteristic of a cognitive subgroup. This has important clinical implications for cognitive rehabilitation and remediation.

  14. The cognitive psychology of Internet gaming disorder.

    PubMed

    King, Daniel L; Delfabbro, Paul H

    2014-06-01

    Internet gaming disorder (IGD) has received nomenclatural recognition as a potential mental health disorder, despite evident variability in its core psychopathology and psychometric assessment. Although cognitive-behavioural therapy (CBT) is considered an efficacious treatment for IGD, the underlying cognitions of the disorder are not well understood. This review aimed to synthesise research evidence on Internet gaming cognition toward identification of cognitive factors underlying IGD. A systematic review of 29 quantitative studies on Internet gaming cognition and 7 treatment studies employing cognitive therapy for IGD was conducted. Four cognitive factors underlying IGD were identified. Factors included (a) beliefs about game reward value and tangibility, (b) maladaptive and inflexible rules about gaming behaviour, (c) over-reliance on gaming to meet self-esteem needs, and (d) gaming as a method of gaining social acceptance. It is proposed that IGD-related cognition may be more complex than "preoccupation" (i.e., criterion A of IGD). IGD cognition may involve the persistent overvaluation of video gaming rewards, activities, and identities, combined with a need to adhere to maladaptive rules governing use and completion of video games. Greater understanding of the proposed cognitive factors may advance clinical research agendas on identification of individuals with IGD, as well as the expansion and improvement of cognitive therapies for the disorder.

  15. Cognitive deficits in psychiatric disorders: Current status

    PubMed Central

    Trivedi, J.K.

    2006-01-01

    Cognition denotes a relatively high level of processing of specific information including thinking, memory, perception, motivation, skilled movements and language. Cognitive psychology has become an important discipline in the research of a number of psychiatric disorders, ranging from severe psychotic illness such as schizophrenia to relatively benign, yet significantly disabling, non-psychotic illnesses such as somatoform disorder. Research in the area of neurocognition has started unlocking various secrets of psychiatric disorders, such as revealing the biological underpinnings, explaining the underlying psychopathology and issues related to course, outcome and treatment strategies. Such research has also attempted to uproot a number of previously held concepts, such as Kraepelin's dichotomy. Although the range of cognitive problems can be diverse, there are several cognitive domains, including executive function, attention and information processing, and working memory, which appear more frequently at risk. A broad range of impairment across and within the psychiatric disorders are highlighted in this oration. The oration summarizes the studies investigating cognitive processing in different psychiatric disorders. I will also discuss the findings of my own research on neurocognitive deficits in mood disorders, schizophrenia, obsessive–compulsive disorder, somatoform disorder, including studies on ‘high-risk’ individuals. Tracing the evaluation of neurocognitive science may provide new insights into the pathophysiology and treatment of psychiatric disorders. PMID:20703409

  16. [Cognitive behavior therapy for anxiety disorders].

    PubMed

    Sakano, Yuji

    2012-01-01

    It is necessary to take the psychological characteristics of anxiety into account when we consider the improvement of anxiety. Anxiety is generally observed basic emotion in human and never extinguishable. Therefore, it is important for patients with anxiety disorders to learn how to manage their daily anxious responses, even after their pathological anxiety is successfully treated and improved. Considering these points, comprehensive psychological treatment, including not only effective intervention to pathological anxiety but also anxiety management program, is needed in treating anxiety disorders effectively. Reviewing previous studies on effectiveness of psychotherapy for anxiety disorders shows that the cognitive behavior therapy is the most effective intervention in terms of extinction of pathological anxiety, prolonged effectiveness of the treatment, prognosis, prevention of recurrence, and improvement of patients' quality of life. In this article, firstly, basic conceptualization and case formulation of anxiety disorders are discussed theoretically. Secondly, effectiveness of cognitive behavior therapy for anxiety disorders, including panic disorder, obsessive compulsive disorder, social anxiety disorder, post-traumatic stress disorder, general anxiety disorder, and specific phobia, is reviewed. And finally, challenges of cognitive behavior therapy are discussed in terms of further development and dissemination of cognitive behavior therapy in Japan.

  17. Cognitive remediation therapy for eating disorders.

    PubMed

    Danner, Unna N; Dingemans, Alexandra E; Steinglass, Joanna

    2015-11-01

    This review compares the literature on cognitive remediation therapy (CRT) for eating disorders with findings in the field of schizophrenia, and discusses future directions for CRT for eating disorders. First studies using a randomized controlled trial design show the added value of CRT for eating disorders. Patients reported lessened symptoms and further improvements in quality of life and cognitive flexibility. Furthermore, the acceptability of the intervention was good and attrition rates for CRT itself were low. Research into the use of cognitive remediation for schizophrenia is extensive and the results on global cognition appeared to be robust at post-treatment and durable at follow-up, with small to medium effect sizes. Recent articles within the field of schizophrenia emphasize the necessity of intrinsic motivation to translate cognitive gains into actual changes in everyday life. A next step is to examine the impact of CRT for eating disorders on motivation. It is also important to focus on the transdiagnostic use of CRT, considering the overlap in cognitive inefficiencies between eating disorders. Another important step may be to develop effective personalized methods of CRT by taking into account individual differences in cognitive processes most relevant to improvement in outcome.

  18. [Cognitive behavior therapy in eating disorders].

    PubMed

    Tölgyes, Tamás; Unoka, Zsolt

    2009-01-01

    Author's aim is to give a comprehensive review of the behavioural and cognitive-behavioural psychotherapeutic development in the treatment of anorexia nervosa and bulimia nervosa, on the base of the literature as well as on own clinical experiences. Behavioural therapies, currently applied as part of integrative therapies mainly, will be shown, and theoretical background and techniques of classical cognitive behavioural therapy of anorexia and bulimia nervosa will be shortly summarized. Theory and therapeutic techniques of the schema-focused cognitive behavioural therapy, applied in the treatment of eating disorders more frequently in the last few years, will be made acquainted in details. Indications and contraindications of classic cognitive behavioural therapy and schema-focused cognitive behavioural therapy in eating disorders will be discussed. Stress will be laid on the fact, that schema-focused cognitive behaviour therapy is to be chosen mostly in the cases where comorbid dissociation, personality disorder, very low self-esteem or traumatic history diminishes the applicability of traditional cognitive behavioural therapy. Authors emphasize the importance of further controlled efficacy studies in the field of schema-focused cognitive behavioural therapy, to define the indication fields regarding different subgroups of eating disorders.

  19. [Cognitive behavior therapy in eating disorders.

    PubMed

    Tölgyes, Tamás; Unoka, Zsolt

    2009-01-01

    Author's aim is to give a comprehensive review of the behavioural and cognitive-behavioural psychotherapeutic development in the treatment of anorexia nervosa and bulimia nervosa, on the base of the literature as well as on own clinical experiences. Behavioural therapies, currently applied as part of integrative therapies mainly, will be shown, and theoretical background and techniques of classical cognitive behavioural therapy of anorexia and bulimia nervosa will be shortly summarized. Theory and therapeutic techniques of the schema-focused cognitive behavioural therapy, applied in the treatment of eating disorders more frequently in the last few years, will be made acquainted in details. Indications and contraindications of classic cognitive behavioural therapy and schema-focused cognitive behavioural therapy in eating disorders will be discussed. Stress will be laid on the fact, that schema-focused cognitive behaviour therapy is to be chosen mostly in the cases where comorbid dissociation, personality disorder, very low self-esteem or traumatic history diminishes the applicability of traditional cognitive behavioural therapy. Authors emphasize the importance of further controlled efficacy studies in the field of schema-focused cognitive behavioural therapy, to define the indication fields regarding different subgroups of eating disorders.

  20. [Cognitive disorders of head trauma patients].

    PubMed

    Vallat-Azouvi, Claire

    2017-03-01

    The repercussions of cognitive disorders resulting from a traumatic brain injury are considerable in patients' daily life. Their quality of life and that of their families is significantly reduced; their reintegration into working life difficult. This chronic cognitive disability requires adapted treatment. Copyright © 2017. Publié par Elsevier Masson SAS.

  1. Bipolar Disorder and Cognitive Therapy: A Commentary

    ERIC Educational Resources Information Center

    Riskind, John H.

    2005-01-01

    This article comments on the three articles (Leahy, 2005; Newman, 2005; and Reilly-Harrington & Knauz, 2005) that deal with the applications of cognitive therapy to treatment of bipolar disorder. They focus on the uses of cognitive therapy in treating three important facets of the special problems of bipolar patients: rapid cycling, severe…

  2. Bipolar Disorder and Cognitive Therapy: A Commentary

    ERIC Educational Resources Information Center

    Riskind, John H.

    2005-01-01

    This article comments on the three articles (Leahy, 2005; Newman, 2005; and Reilly-Harrington & Knauz, 2005) that deal with the applications of cognitive therapy to treatment of bipolar disorder. They focus on the uses of cognitive therapy in treating three important facets of the special problems of bipolar patients: rapid cycling, severe…

  3. Cognitive Coping in Anxiety-Disordered Adolescents

    ERIC Educational Resources Information Center

    Legerstee, Jeroen S.; Garnefski, Nadia; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2011-01-01

    The present study investigated differences in cognitive coping strategies between anxiety-disordered and non-anxious adolescents. In addition, the interaction effect with gender as well as differences between specific anxiety diagnoses was examined. A clinical sample of 159 anxiety-disordered adolescents and a general community sample of 370…

  4. Cognitive Coping in Anxiety-Disordered Adolescents

    ERIC Educational Resources Information Center

    Legerstee, Jeroen S.; Garnefski, Nadia; Verhulst, Frank C.; Utens, Elisabeth M. W. J.

    2011-01-01

    The present study investigated differences in cognitive coping strategies between anxiety-disordered and non-anxious adolescents. In addition, the interaction effect with gender as well as differences between specific anxiety diagnoses was examined. A clinical sample of 159 anxiety-disordered adolescents and a general community sample of 370…

  5. [Cognitive and affective disorders in the elderly].

    PubMed

    Novikova, I A; Soloviev, A G; Popov, V V

    2017-01-01

    To develop algorithm of diagnostics of cognitive and affective disorders in elderly and senile age 98 representatives of this age group were examined (1st group - 68 persons 60-74 years, 2nd group - 30 patients older than 75 years). For the diagnosis of cognitive disorders the developed and adapted «Short rating scale of cognitive functions», to diagnose emotional disorders - «Нospital scale of anxiety and depression HADS» were used. Cognitive impairment was revealed in 39,8% of the elderly (1st group - 28,7% in 2nd group - 61,6%). Affective disorders 51,6% of respondents had; however, signs of anxiety - 40,9% and depression - 27,7%. Algorithm for the diagnosis of cognitive and emotional disorders in elderly and senile age, comprising the steps of: screening and diagnostic, clinical and pathopsychological, laboratory and instrumental diagnostic, psychodiagnostic, can be recommended for use in general medical practice (therapists, general practitioners, geriatrics) for an earlier secondary prevention and, if necessary, early correction of mental health disorders.

  6. Cognitive Dysfunction in Obsessive-Compulsive Disorder.

    PubMed

    Benzina, Nabil; Mallet, Luc; Burguière, Eric; N'Diaye, Karim; Pelissolo, Antoine

    2016-09-01

    Obsessive-compulsive disorder (OCD) is a mental disorder featuring obsessions (intrusive thoughts) and compulsions (repetitive behaviors performed in the context of rigid rituals). There is strong evidence for a neurobiological basis of this disorder, involving limbic cortical regions and related basal ganglion areas. However, more research is needed to lift the veil on the precise nature of that involvement and the way it drives the clinical expression of OCD. Altered cognitive functions may underlie the symptoms and thus draw a link between the clinical expression of the disorder and its neurobiological etiology. Our extensive review demonstrates that OCD patients do present a broad range of neuropsychological dysfunctions across all cognitive domains (memory, attention, flexibility, inhibition, verbal fluency, planning, decision-making), but some methodological issues temper this observation. Thus, future research should have a more integrative approach to cognitive functioning, gathering contributions of both experimental psychology and more fundamental neurosciences.

  7. [Cognition - the core of major depressive disorder].

    PubMed

    Polosan, M; Lemogne, C; Jardri, R; Fossati, P

    2016-02-01

    Cognitive deficits have been only recently recognized as a major phenotype determinant of major depressive disorder, although they are an integral part of the definition of the depressive state. Congruent evidence suggest that these cognitive deficits persist beyond the acute phase and may be identified at all ages. The aim of the current study was to review the main meta-analyses on cognition and depression, which encompasses a large range of cognitive domains. Therefore, we discuss the "cold" (attention, memory, executive functions) and "hot" (emotional bias) cognitive impairments in MDD, as well as those of social cognition domains (empathy, theory of mind). Several factors interfere with cognition in MDD such as clinical (melancholic, psychotic...) features, age, age of onset, illness severity, medication and comorbid condition. As still debated in the literature, the type of relationship between the severity of cognitive symptoms and functioning in depression is detailed, thus highlighting their predictive value of functional outcome, independently of the affective symptoms. A better identification of the cognitive deficits in MDD and a monitoring of the effects of different treatments require appropriate instruments, which may be developed by taking advantage of the increasing success of computing tools. Overall, current data suggest a core role for different cognitive deficits in MDD, therefore opening new perspectives for optimizing the treatment of depression.

  8. Cognitive hypnotherapy for major depressive disorder.

    PubMed

    Alladin, Assen

    2012-04-01

    Since the publication of the special issue on cognitive hypnotherapy in the Journal of Cognitive Psychotherapy: An International Quarterly (1994), there have been major developments in the application of hypnosis to the treatment of depression. However, there is no "one-size-fits-all" treatment for depressive disorders as the conditions represent a complex set of heterogeneous symptoms, involving multiple etiologies. It is thus important for therapists to promote a multimodal approach to treating depressive disorders. This article describes cognitive hypnotherapy (CH), an evidence-based multimodal psychological treatment that can be applied to a wide range of depressed patients. CH combines hypnosis with cognitive behavior therapy as the latter provides the best integrative lodestone for assimilating empirically supported treatment techniques derived from various psychotherapies.

  9. [Cognitions in eating disorders and their assessment].

    PubMed

    Eiber, R; Mirabel-Sarron, C; Urdapilleta, I

    2005-01-01

    Cognitions are of crucial importance in the -aetiology and the maintenance of eating disorders. Dysfunctional cognitions in eating disorders are related to body image, self-esteem and feeding. The aim of this paper is to review the actual knowledge in this area. First, we will display -cognitive models in eating disorders. Cognitive factors in -eating disorders are logical errors, cognitive slippage and conceptual complexity. Eating disorder patients seem to have a deficient cognitive development. Some cognitive models stipulate that eating disorder patients may develop organised cognitive structures schemas concerning the issues of weight and its implications for the self. These schemas can account for the persistence and for the understanding the "choice of the eating disorder symptomatology. Cognitive pheno-mena of interest are self-schema, weight-related schema and weight-related self-schema. The maintenance model of ano-rexia nervosa argued that, initially there is an extreme need to control eating which is supported by low self-esteem. The maintenance of the disorder is reinforced by three mechanisms: dietary restriction enhances the sense of being in control; aspects of starvation encourage further dietary restriction; concerns about shape and weight encourage restriction. The development and maintenance of bulimic symptomatology are explained by placing a high value on attaining an idealised weight and body shape accompanied by inaccurate beliefs. The cognitive model of specific family of origin experiences puts forward the development of -maladaptative expectancies for eating and thinness. Second, we discuss distortions in information processing. a) In feeding laboratories, bulimics show a wide range of caloric intake and a disruption of circadian feeding patterns. In overeating bulimics, large meals occurred mainly during afternoon and evening with high fat and carbohydrate intake, but the majority of meals were of normal size and frequency. Responsivity

  10. Cognitive inflexibility in Obsessive-Compulsive Disorder.

    PubMed

    Gruner, Patricia; Pittenger, Christopher

    2017-03-14

    Obsessive-Compulsive Disorder (OCD) is characterized by maladaptive patterns of repetitive, inflexible cognition and behavior that suggest a lack of cognitive flexibility. Consistent with this clinical observation, many neurocognitive studies suggest behavioral and neurobiological abnormalities in cognitive flexibility in individuals with OCD. Meta-analytic reviews support a pattern of cognitive inflexibility, with effect sizes generally in the medium range. Heterogeneity in assessments and the way underlying constructs have been operationalized point to the need for better standardization across studies, as well as more refined overarching models of cognitive flexibility and executive function (EF). Neuropsychological assessments of cognitive flexibility include measures of attentional set shifting, reversal and alternation, cued task-switching paradigms, cognitive control measures such as the Trail-Making and Stroop tasks, and several measures of motor inhibition. Differences in the cognitive constructs and neural substrates associated with these measures suggest that performance within these different domains should be examined separately. Additional factors, such as the number of consistent trials prior to a shift and whether a shift is explicitly signaled or must be inferred from a change in reward contingencies, may influence performance, and thus mask or accentuate deficits. Several studies have described abnormalities in neural activation in the absence of differences in behavioral performance, suggesting that our behavioral probes may not be adequately sensitive, but also offering important insights into potential compensatory processes. The fact that deficits of moderate effect size are seen across a broad range of classic neuropsychological tests in OCD presents a conceptual challenge, as clinical symptomatology suggests greater specificity. Traditional cognitive probes may not be sufficient to delineate specific domains of deficit in this and other

  11. HDL and Cognition in Neurodegenerative Disorders

    PubMed Central

    Hottman, David A.; Chernick, Dustin; Cheng, Shaowu; Wang, Zhe; Li, Ling

    2014-01-01

    High-density lipoproteins (HDL) are a heterogeneous group of lipoproteins composed of various lipids and proteins. HDL is formed both in the systemic circulation and in the brain. In addition to being a crucial player in the reverse cholesterol transport pathway, HDL possesses a wide range of other functions including anti-oxidation, anti-inflammation, pro-endothelial function, anti-thrombosis, and modulation of immune function. It has been firmly established that high plasma levels of HDL protect against cardiovascular disease. Accumulating evidence indicates that the beneficial role of HDL extends to many other systems including the central nervous system. Cognition is a complex brain function that includes all aspects of perception, thought, and memory. Cognitive function often declines during aging and this decline manifests as cognitive impairment/dementia in age-related and progressive neurodegenerative disorders such as Alzheimer's disease, Parkinson's disease, Huntington's disease, and amyotrophic lateral sclerosis. A growing concern is that no effective therapy is currently available to prevent or treat these devastating diseases. Emerging evidence suggests that HDL may play a pivotal role in preserving cognitive function under normal and pathological conditions. This review attempts to summarize recent genetic, clinical and experimental evidence for the impact of HDL on cognition in aging and in neurodegenerative disorders as well as the potential of HDL-enhancing approaches to improve cognitive function. PMID:25131449

  12. Oxytocin and social cognition in affective and psychotic disorders.

    PubMed

    Mercedes Perez-Rodriguez, M; Mahon, Katie; Russo, Manuela; Ungar, Allison K; Burdick, Katherine E

    2015-02-01

    Impairments in social cognition are now recognized as core illness features in psychotic and affective disorders. Despite the significant disability caused by social cognitive abnormalities, treatments for this symptom dimension are lacking. Here, we describe the evidence demonstrating abnormalities in social cognition in schizophrenia, major depressive disorder, and bipolar disorder, as well as the neurobiology of social cognition including the role of oxytocin. We then review clinical trials of oxytocin administration in psychotic and affective disorders and the impact of this agent on social cognition. To date, several studies have demonstrated that oxytocin may improve social cognition in schizophrenia; too few studies have been conducted in affective disorders to determine the effect of oxytocin on social cognition in these disorders. Future work is needed to clarify which aspects of social cognition may be improved with oxytocin treatment in psychotic and affective disorders.

  13. Oxytocin and Social Cognition in Affective and Psychotic Disorders

    PubMed Central

    Perez-Rodriguez, M. Mercedes; Mahon, Katie; Russo, Manuela; Ungar, Allison K.; Burdick, Katherine E.

    2014-01-01

    Impairments in social cognition are now recognized as core illness features in psychotic and affective disorders. Despite the significant disability caused by social cognitive abnormalities, treatments for this symptom dimension are lacking. Here, we describe the evidence demonstrating abnormalities in social cognition in schizophrenia, major depressive disorder, and bipolar disorder, as well as the neurobiology of social cognition including the role of oxytocin. We then review clinical trials of oxytocin administration in psychotic and affective disorders and the impact of this agent on social cognition. To date, several studies have demonstrated that oxytocin may improve social cognition in schizophrenia; too few studies have been conducted in affective disorders to determine the effect of oxytocin on social cognition in these disorders. Future work is needed to clarify which aspects of social cognition may be improved with oxytocin treatment in psychotic and affective disorders. PMID:25153535

  14. Cognition in circadian rhythm sleep disorders.

    PubMed

    Reid, Kathryn J; McGee-Koch, Lori L; Zee, Phyllis C

    2011-01-01

    Circadian rhythms in physiology and behavior exist in all living organisms, from cells to humans. The most evident rhythms are the recurrent cycles of sleep and wake as well as changes in alertness and cognitive performance across the 24h. Clearly, sleep pressure can exert a strong influence on cognitive performance, but the influence of circadian modulation of alertness and cognitive function is evident even when the pressure for sleep is high. Circadian rhythms also influence more complex cognitive tasks, such as selective attention and executive function, which are important for work performance and safety. The circadian timekeeping system also ensures that circadian rhythms are appropriately synchronized to the external physical environment and work and social schedules. Circadian misalignment is the basis for all circadian rhythm sleep disorders. These disorders are often associated with impairments of cognitive performance that can have adverse effects on school and work performance, overall quality of life, and safety. Copyright © 2011 Elsevier B.V. All rights reserved.

  15. Cognitive styles in individuals with bipolar disorders.

    PubMed

    Scott, Jan; Pope, Marie

    2003-08-01

    Published studies of emotional processing and cognitive style in bipolar disorders tend to have small sample sizes or use non-clinical samples. Larger clinically representative studies are needed. Self-esteem, dysfunctional attitudes and personality style were compared in unipolar (N=16) and bipolar disorder (N=77); and then investigated in the different phases of bipolar disorder (remitted=26; depressed=38; hypomanic=13). One-year outcome was assessed in 36 bipolar subjects. Unipolar subjects and bipolar subjects differed significantly in their mean levels of negative self-esteem (unipolar=15.5; bipolar=12.7; P<0.05). Bipolar subjects with hypomania reported mean levels of dysfunctional beliefs that were higher than individuals in remission but lower than depressed subjects (remitted=136.7; depressed=153.8; hypomanic=144.8; P<0.05). Hypomanic subjects recorded the highest levels of negative as well as positive self-esteem. In the exploratory analysis of outcome, negative self-esteem (Exp [B] 1.91; 95% CI 1.11 to 3.32; P<0.05) was the most robust predictor of relapse. There are similarities in the cognitive style of individuals with unipolar as compared to bipolar disorders. Cognitive style in hypomania represents a phase between remission and depression rather than the polar opposite of depression. The implications of these findings are considered for psychological and neural network models.

  16. Cognitive behavioral hypnotherapy for dissociative disorders.

    PubMed

    Fine, Catherine G

    2012-04-01

    Dissociative disorders (DD) prevail as sequelae to overwhelming experiences in childhood. These readily formed post-traumatic responses and trance states develop in high hypnotizable subjects whose dysregulations become organized into ego states. A cognitive behavioral hypnotherapeutic treatment model will effectively contain, explore, metabolize, and resolve these life-endangering conditions. This article will detail the cognitive hypnotic world of DD patients, the relational spaces of the ego states, and the triphasic treatment mode to successfully resolve the dissociative pathology. Structured and phase appropriate hypnotic interventions will be described.

  17. Cognitive behavioral therapy for substance use disorders.

    PubMed

    McHugh, R Kathryn; Hearon, Bridget A; Otto, Michael W

    2010-09-01

    Cognitive behavioral therapy (CBT) for substance use disorders has shown efficacy as a monotherapy and as part of combination treatment strategies. This article provides a review of the evidence supporting the use of CBT, clinical elements of its application, novel treatment strategies for improving treatment response, and dissemination efforts. Although CBT for substance abuse is characterized by heterogeneous treatment elements such as operant learning strategies, cognitive and motivational elements, and skills-building interventions, across protocols several core elements emerge that focus on overcoming the powerfully reinforcing effects of psychoactive substances. These elements, and support for their efficacy, are discussed. Copyright 2010 Elsevier Inc. All rights reserved.

  18. Early improvement in eating attitudes during cognitive behavioural therapy for eating disorders: the impact of personality disorder cognitions.

    PubMed

    Park, Emma C; Waller, Glenn; Gannon, Kenneth

    2014-03-01

    The personality disorders are commonly comorbid with the eating disorders. Personality disorder pathology is often suggested to impair the treatment of axis 1 disorders, including the eating disorders. This study examined whether personality disorder cognitions reduce the impact of cognitive behavioural therapy (CBT) for eating disorders, in terms of treatment dropout and change in eating disorder attitudes in the early stages of treatment. Participants were individuals with a diagnosed eating disorder, presenting for individual outpatient CBT. They completed measures of personality disorder cognitions and eating disorder attitudes at sessions one and six of CBT. Drop-out rates prior to session six were recorded. CBT had a relatively rapid onset of action, with a significant reduction in eating disorder attitudes over the first six sessions. Eating disorder attitudes were most strongly associated with cognitions related to anxiety-based personality disorders (avoidant, obsessive-compulsive and dependent). Individuals who dropped out of treatment prematurely had significantly higher levels of dependent personality disorder cognitions than those who remained in treatment. For those who remained in treatment, higher levels of avoidant, histrionic and borderline personality disorder cognitions were associated with a greater change in global eating disorder attitudes. CBT's action and retention of patients might be improved by consideration of such personality disorder cognitions when formulating and treating the eating disorders.

  19. Cognitive behavioral therapy for compulsive buying disorder.

    PubMed

    Mitchell, James E; Burgard, Melissa; Faber, Ron; Crosby, Ross D; de Zwaan, Martina

    2006-12-01

    To our knowledge, no psychotherapy treatment studies for compulsive buying have been published. The authors conducted a pilot trial comparing the efficacy of a group cognitive behavioral intervention designed for the treatment of compulsive buying to a waiting list control. Twenty-eight subjects were assigned to receive active treatment and 11 to the waiting list control group. The results at the end of treatment showed significant advantages for cognitive behavioral therapy (CBT) over the waiting list in reductions in the number of compulsive buying episodes and time spent buying, as well as scores on the Yale-Brown Obsessive Compulsive Scale--Shopping Version and the Compulsive Buying Scale. Improvement was well-maintained at 6-month follow-up. The pilot data suggests that a cognitive behavioral intervention can be quite effective in the treatment of compulsive buying disorder. This model requires further testing.

  20. Social cognition in "pure" delusional disorder.

    PubMed

    Bömmer, Isabel; Brüne, Martin

    2006-09-01

    Introduction. Delusional disorders are characterised by monothematic, "encapsulated" and incorrigible false beliefs and misinterpretations of social signals. Due to the rarity of cases with "pure" delusional disorder (DD) in clinical settings most studies of social cognition in delusional patients have focused on patients with paranoid schizophrenia. In the present study we sought to examine emotion recognition, theory of mind abilities, and pragmatic language comprehension in patients with delusional disorder. Methods. Social cognition was assessed in 21 patients recruited over a 3-year period who were diagnosed with delusional disorder, paranoid, erotomanic, or jealous type. In addition to an emotion recognition and theory of mind test battery, we included a novel German Proverb Test, which has been found indicative of subtle theory of mind deficits in schizophrenic patients. Executive functioning was assessed using the Wisconsin Card Sorting Test (WCST). Psychopathology was measured using the Positive and Negative Symptoms Scale (PANSS). Patients' task performance was compared to a group of 22 healthy control persons paralleled for verbal intelligence, education, and age. Results. Patients with DD made significantly more perseverative errors in the WCST, they performed more poorly on the theory of mind tasks and the proverb test, but were unimpaired in basic emotion recognition abilities relative to controls. When executive functioning was co-varied out, the group differences in theory of mind disappeared, whereas the greater propensity of patients with DD to interpret proverbs literally remained significant. Conclusions. In "pure" DD the basic social cognitive abilities appear to be preserved. Difficulties in metaphorical speech comprehension and executive functioning could, however, indicate more subtle social cognitive deficits in these patients.

  1. Cognitive and depressive disorders in multiple sclerosis.

    PubMed

    Alajbegović, Azra; Loga, Natasa; Tiro, Naida; Alajbegović, Salem; Cindro, Veselin; Hozo, Izet

    2009-03-01

    Among other symptoms, multiple sclerosis can also produce symptoms of affective and cognitive disorders. The majority of patients have certain cognitive dysfunctions, and the' most common affective disorder is reactive depression. The aim of the study was to determine the correlation of the Mini-Mental State (MMS) and Beck Depression Inventory (BDI) scale scores with the Expanded Disability Status Scale (EDSS) score in patients with multiple sclerosis treated at University Department of Neurology, Sarajevo University Clinical Center in Sarajevo. We evaluated 50 randomly selected patients with various types of multiple sclerosis using the MMS, BDI and EDSS instruments. The study included 33 women and 17 men (66% : 34%), mean age 40.74 years (SD 9.236). The mean value of EDSS score was 3.98, ranging from 1.0 to 8.5 in women and from 1.0 to 6.5 in men. BDI scale scores showed a mean value of 12.56. The mean MMS score in baseline sample was 26.88. Statistically significant positive correlation was found between age and EDSS score, and negative correlation between EDSS and MMS, as well as between BDI and MMS. Study results indicated older patients with multiple sclerosis to have a higher EDSS score with more pronounced cognitive disturbances. There was no statistically significant correlation between EDSS score and depression.

  2. Social cognition in borderline personality disorder

    PubMed Central

    Roepke, Stefan; Vater, Aline; Preißler, Sandra; Heekeren, Hauke R.; Dziobek, Isabel

    2013-01-01

    Many typical symptoms of borderline personality disorder (BPD) occur within interpersonal contexts, suggesting that BPD is characterized by aberrant social cognition. While research consistently shows that BPD patients have biases in mental state attribution (e.g., evaluate others as malevolent), the research focusing on accuracy in inferring mental states (i.e., cognitive empathy) is less consistent. For complex and ecologically valid tasks in particular, emerging evidence suggests that individuals with BPD have impairments in the attribution of emotions, thoughts, and intentions of others (e.g., Preißler et al., 2010). A history of childhood trauma and co-morbid PTSD seem to be strong additional predictors for cognitive empathy deficits. Together with reduced emotional empathy and aberrant sending of social signals (e.g., expression of mixed and hard-to-read emotions), the deficits in mental state attribution might contribute to behavioral problems in BPD. Given the importance of social cognition on the part of both the sender and the recipient in maintaining interpersonal relationships and therapeutic alliance, these impairments deserve more attention. PMID:23335877

  3. [Cannabis-induced cognitive and psychiatric disorders].

    PubMed

    Dervaux, Alain; Krebs, Marie-Odile; Laqueille, Xavier

    2014-03-01

    Several studies have shown that Δ-9-THC the main psychoactive constituent of cannabis, can impair cognitive functions, especially attention, episodic memory, working memory and executive functions. These impairments have been related to the duration, frequency, dose and age at onset of cannabis use. Cognitive deficits may disappear with abstinence, but abnormalities may be long-lasting in subjects who began smoking cannabis before age 15. The lifetime prevalence of cannabis use disorders is about 1% in the general population. The main characteristics of cannabis use disorders are craving, persistent desire or unsuccessful efforts to cut down or control cannabis use, and persistent avoidance of familial, social occupational or recreational activities because of cannabis use. Nine prospective longitudinal studies in the generalpopulation have shown that cannabis use is associated with a two-fold increase in the risk of psychotic disorders, particularly schizophrenia, compared to controls. The risk of psychosis increases in a dose-related fashion. A higher risk of schizophrenia is predicted by earlier onset of cannabis use. The effects of cannabis are exerted primarily through THC interaction with cannabinoid (CB) 1 receptors in the brain. Cannabis exposure may disrupt the last steps of brain maturation, through the endocannabinoid system, thereby increasing the risk of psychosis during adolescence.

  4. [Empathy, social cognition and autism spectrum disorders].

    PubMed

    Ruggieri, Victor L

    2013-02-22

    From their earliest reports, Kanner and Asperger included the hierarchy of difficulties in socialisation as one of the key axes in persons affected with autism spectrum disorders (ASD), associated to development delay or language disorders and restricted interests. This deficiency in social cognition has been related with a deficit in empathy. The theory of deficit in empathising and hypersystematisation provides a coherent, comprehensible explanation with which to partially understand the genesis of these disorders. Empathy is an essential component for emotional experiencing and social interaction, and denotes an affective response to mental states that are either perceived directly or imagined or are feelings inferred by another person. It enables us to understand, feel and respond appropriately to social stimuli, thereby giving rise to an adequate socialisation. Empathy has been considered a synonym of emotional contagion, mimicry, sympathy, compassion and empathic interest. Although these are concepts that are related and necessary for the development of adequate social cognition, they are not the same; nonetheless, they are all essential for the development of empathy or its consequences. Empathy allows individuals to 'feel with', whereas sympathy, compassion and empathic interest are related with 'feeling for' or feeling what is appropriate. Studies conducted in persons with ASD have shown them to have a low empathy quotient. In this work, different aspects of empathy, its components, its neurobiological foundations, the manifestations related with its deficit and its relation with the development of ASDs are all analysed.

  5. Tryptophan breakdown and cognition in bipolar disorder.

    PubMed

    Platzer, Martina; Dalkner, Nina; Fellendorf, Frederike T; Birner, Armin; Bengesser, Susanne A; Queissner, Robert; Kainzbauer, Nora; Pilz, René; Herzog-Eberhard, Simone; Hamm, Carlo; Hörmanseder, Christa; Maget, Alexander; Rauch, Philipp; Mangge, Harald; Fuchs, Dietmar; Zelzer, Sieglinde; Schütze, Gregor; Moll, Natalie; Schwarz, Markus J; Mansur, Rodrigo B; McIntyre, Roger S; Reininghaus, Eva Z

    2017-07-01

    It has been demonstrated that bipolar disorder (BD) is often accompanied by cognitive deficits across all subdomains including verbal memory, attention and executive functioning. Cognitive deficits are observed both during episodes of mania or depression, as well as during the euthymic phase. It has been proposed that chronic immune-mediated inflammation in the central nervous system results in alterations in neural structures that subserve cognitive function. Kynurenine is an intermediate in the inflammatory cascade and can be peripherally measured to proxy inflammatory activity. Herein, we sought to determine whether serum levels of kynurenine and/or its metabolites were associated with cognitive function in BD. In this investigation 68 euthymic individuals with BD according to DSM-IV completed a cognitive test battery to asses premorbid intelligence (Multiple Choice Word Test; MWT-B), verbal memory (California Verbal Learning Test; CVLT), attention (d2 Test of Attention; d2 test, Trail Making Test-A; TMT-A, Stroop word reading/Stroop color naming) and executive functioning (TMT-B, Stroop interference). In addition, fasting blood samples were taken and serum levels of kynurenine and its metabolites 3-hydroxykynurenine and kynurenic acid were analyzed. Subsequently ratios were formed from individual parameters. Patient data were compared with those of a mentally healthy control group (n=93). In male participants with BD only we found a significant negative correlation between the 3-hydroxykynurenine to kynurenic acid ratio and performance on the CVLT. Additionally, the kynurenine to 3-hydroxykynurenine ratio was associated with performance on a sub-score of the CVLT. Those associations were neither present in female individuals with BD nor in the control group. Our findings suggest that a shift towards the hydroxykynurenine arm of the kynurenine pathway may be associated with poorer memory performance due to its effects on neuronal functioning and neurogenesis in

  6. Some cognitive correlates of affective disorders.

    PubMed

    Robertson, G; Taylor, P J

    1985-05-01

    Seventy-one men completed a battery of cognitive tests which were designed to reflect verbal analytic and non-verbal holistic functioning. Interest centred around pattern of response. Thirty men were suffering from an affective disorder and forty-one were well. All the men were in prison, the majority awaiting trial. The affective disorder group was subdivided into three categories: men who had a history of manic-depressive illness; a group of unipolar, psychotically depressed men; and men who were regarded as being depressed in reaction to circumstances. All three groups showed specific difficulty in dealing with spatial/holistic tasks, other factors being held constant. They were also found to differ in a number of other respects. The possible significance of these differences is discussed.

  7. [Treatment of generalized anxiety disorder in terms of cognitive behavioral].

    PubMed

    Kamrowska, Anna; Gmitrowicz, Agnieszka

    2016-02-01

    Risk of generalized anxiety disorder (GAD) within life is estimated at 2.6-5.1%. Amongst etiological factors that affect the development of the disorder are: biological and psychological problems, including cognitive models. There are known several cognitive models: metacognitive, Borkovec'c model and the model developed in Quebec. Key cognitive contents that occur with generalized anxiety disorder are focused on two aspects: metacognitive beliefs and intolerance of uncertainty. A primary purpose of cognitive-behavioural therapy (CBT) is the modification of dysfunctional beliefs about worry. Cognitive behavioural therapy is effective in reducing anxiety, makes it easier to operate in the professional sphere and improves the quality of life.

  8. Disorder-specific cognitive profiles in major depressive disorder and generalized anxiety disorder

    PubMed Central

    2014-01-01

    Background This investigation examines differences in cognitive profiles in subjects with major depressive disorder (MDD) and generalized anxiety disorder (GAD). Methods Data were used from subjects with current MDD (n = 655), GAD (n = 107) and comorbid MDD/GAD (n = 266) diagnosis from the Netherlands Study of Depression and Anxiety (NESDA). The Composite Interview Diagnostic Instrument was used to diagnose MDD and GAD. Cognitive profiles were measured using the Leiden Index of Depression Sensitivity, the Anxiety Sensitivity Index, and the Penn State Worry Questionnaire. Results Results showed that differences in cognitive profiles between single MDD and single GAD subjects were present: scores on hopelessness/suicidality and rumination were significantly higher in MDD than GAD, whereas anxiety sensitivity for physical concerns and pathological worry were higher in GAD than MDD. The cognitive profile of comorbid MDD/GAD showed more extreme depression cognitions compared to single disorders, and a similar anxiety profile compared to single GAD subjects. Conclusions Despite the commonalities in cognitive profiles in MDD and GAD, there are differences suggesting that MDD and GAD have disorder-specific cognitive profiles. Findings of this investigation give support for models like the cognitive content-specificity model and the tripartite model and could provide useful handles for treatment focus. PMID:24690413

  9. Disorder-specific cognitive profiles in major depressive disorder and generalized anxiety disorder.

    PubMed

    Hendriks, Sanne M; Licht, Carmilla M M; Spijker, Jan; Beekman, Aartjan T F; Hardeveld, Florian; de Graaf, Ron; Penninx, Brenda W J H

    2014-04-01

    This investigation examines differences in cognitive profiles in subjects with major depressive disorder (MDD) and generalized anxiety disorder (GAD). Data were used from subjects with current MDD (n = 655), GAD (n = 107) and comorbid MDD/GAD (n = 266) diagnosis from the Netherlands Study of Depression and Anxiety (NESDA). The Composite Interview Diagnostic Instrument was used to diagnose MDD and GAD. Cognitive profiles were measured using the Leiden Index of Depression Sensitivity, the Anxiety Sensitivity Index, and the Penn State Worry Questionnaire. Results showed that differences in cognitive profiles between single MDD and single GAD subjects were present: scores on hopelessness/suicidality and rumination were significantly higher in MDD than GAD, whereas anxiety sensitivity for physical concerns and pathological worry were higher in GAD than MDD. The cognitive profile of comorbid MDD/GAD showed more extreme depression cognitions compared to single disorders, and a similar anxiety profile compared to single GAD subjects. Despite the commonalities in cognitive profiles in MDD and GAD, there are differences suggesting that MDD and GAD have disorder-specific cognitive profiles. Findings of this investigation give support for models like the cognitive content-specificity model and the tripartite model and could provide useful handles for treatment focus.

  10. Review of cognitive performance in hoarding disorder.

    PubMed

    Woody, Sheila R; Kellman-McFarlane, Kirstie; Welsted, Alison

    2014-06-01

    Hoarding disorder is characterized by extreme difficulty letting go of objects other people would routinely discard or give away, such that the home becomes dysfunctionally cluttered with possessions. Specific cognitive processes, such as decision-making, categorization, and attention, have been hypothesized to contribute to the overvaluing of objects. This review synthesizes the evidence related to those propositions and other executive functioning processes that have received research attention. In this paper, we are primarily interested in cognitive processes that can be, but are not always, studied using performance tasks. Compared to both healthy controls and clinical controls, participants with clinical levels of compulsive hoarding show replicable performance deficits in several areas: planning/problem-solving decisions, visuospatial learning and memory, sustained attention/working memory, and organization. Categorization/concept formation, visuospatial processing, and inhibitory control require further investigation and more detailed testing methods to address inconsistencies in reported findings. Many studies fail to account for potential confounds presented by comorbid depression and between-group differences in age, a problem that should be rectified in future research on this topic. The article concludes with recommendations for a research agenda to better understand contributors to abnormal valuing of objects in hoarding disorder. Copyright © 2014 Elsevier Ltd. All rights reserved.

  11. Cognitive disorders in type 2 diabetic patients with recognized depression.

    PubMed

    Janocha, Anna; Bolanowski, Marek; Pilecki, Witold; Małyszczak, Krzysztof; Salomon, Ewa; Woźniak, Wojciech; Skalik, Robert; Tumińska, Anna; Kałka, Dariusz; Sobieszczańska, Małgorzata

    2010-01-01

    The most important factors in the pathogenesis of cognitive disorders in diabetes mellitus (DM) are metabolic changes directly caused by hyperglycemia. Impairment of cognitive function is accompanied by a decrease in cerebral insulin. Insulin improves cognitive processes, including somatosensoric cognitive functions. Cognitive disorders are especially pronounced if diabetic patients suffer also from depression. The evaluation of cognitive functions, especially sensomotoric skills were obtained from three study groups (aged 37-52 years): 30 healthy subjects, 40 diabetic patients with clinically documented depression and 30 depressive patients without DM. The sensomotoric skills were carried out using a SPS-2001E apparatus - a computer working stress simulator. The examination with Beck Depression Inventory (BDI) were also performed in all the investigated persons. Sensomotoric skills investigation revealed slight cognitive disorders in the early stages DM (subgroup IA) and its intensification according to increasing BDI scores and HbA1c blood concentration (from subgroup IA to IC). Intensification of sensomotoric cognitive disorders was significantly higher (p<0.001) in the depressive patients with DM (group I), than in these without DM (group III). The obtained results suggest that coincidence of aggravating factors, such as depression and metabolic disorders in DM, may cause mutual interactions leading to premature and more intense cognitive impairment. The method proposed by the authors may serve as a screening examination in early diagnosis of CNS disorders reflected by somatosensoric cognitive disorders. The presented work indicates importance of sensomotoric skills investigation for the early diagnosis of the nervous system damage related to DM.

  12. The social-cognitive basis of personality disorders.

    PubMed

    Herpertz, Sabine C; Bertsch, Katja

    2014-01-01

    The review summarizes recent results on abnormalities in social cognition in patients with personality disorders that predispose them to develop dysfunctional interaction with others. The review starts with more basic social cognition processes, such as emotion recognition and reactions to social exclusion that are followed by more complex processes such as cognitive and affective empathy. The deficits in social cognition depend on the particular function that is investigated and is strongly associated with characteristic symptoms of particular personality disorders. Thus, patients with borderline personality disorder are hypersensitive for social threat, they show deficits in cognitive empathy and high emotion contagion, that is, they share emotions of others without properly discriminating between one's own feelings and those of others. Psychopaths are characterized by deficiency in facial fear recognition and emotional empathy similar to patients with narcissistic personality disorder. Studies on social cognition in cluster A and C personality disorders are sparse. Research indicates deficits in social cognition in patients with personality disorders, but more research is needed to investigate social cognition in cluster A and C personality disorders and to compare deficits in social cognitive functions across personality disorders.

  13. Cognitive factors in panic disorder, agoraphobic avoidance and agoraphobia.

    PubMed

    Berle, David; Starcevic, Vladan; Hannan, Anthony; Milicevic, Denise; Lamplugh, Claire; Fenech, Pauline

    2008-02-01

    There remains a lack of consensus regarding the possibility that especially high levels of panic-related cognitions characterise panic disorder with agoraphobia. We administered the Anxiety Sensitivity Index, the Agoraphobic Cognitions Questionnaire and the Anxious Thoughts and Tendencies Scale as well as measures of agoraphobic avoidance to patients diagnosed with panic disorder with agoraphobia (n=75) and without agoraphobia (n=26). Patients with panic disorder with agoraphobia did not score significantly higher on any of the cognitive variables than did panic disorder patients without agoraphobia. However, most of the cognitive variables showed small to moderate-strength correlations with self-report measures of agoraphobic avoidance. Our findings suggest that anxiety sensitivity, catastrophising of the consequences of panic and a general anxiety-prone cognitive style, although to some extent associated with agoraphobic avoidance, do not discriminate panic disorder with agoraphobia from panic disorder without agoraphobia.

  14. The Cycle of Schizoaffective Disorder, Cognitive Ability, Alcoholism, and Suicidality

    ERIC Educational Resources Information Center

    Goldstein, Gerald; Haas, Gretchen L.; Pakrashi, Manish; Novero, Ada M.; Luther, James F.

    2006-01-01

    In this study we investigated the putative role of cognitive dysfunction, diagnosis (schizoaffective versus schizophrenia disorder), and alcoholism as risk factors for suicidal behavior among individuals with DSM-IV schizophrenia or schizoaffective disorders. Subjects received cognitive tests and medical records were reviewed for evidence of a…

  15. The Cycle of Schizoaffective Disorder, Cognitive Ability, Alcoholism, and Suicidality

    ERIC Educational Resources Information Center

    Goldstein, Gerald; Haas, Gretchen L.; Pakrashi, Manish; Novero, Ada M.; Luther, James F.

    2006-01-01

    In this study we investigated the putative role of cognitive dysfunction, diagnosis (schizoaffective versus schizophrenia disorder), and alcoholism as risk factors for suicidal behavior among individuals with DSM-IV schizophrenia or schizoaffective disorders. Subjects received cognitive tests and medical records were reviewed for evidence of a…

  16. Explicit versus Implicit Social Cognition Testing in Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Callenmark, Björn; Kjellin, Lars; Rönnqvist, Louise; Bölte, Sven

    2014-01-01

    Although autism spectrum disorder is defined by reciprocal social-communication impairments, several studies have found no evidence for altered social cognition test performance. This study examined explicit (i.e. prompted) and implicit (i.e. spontaneous) variants of social cognition testing in autism spectrum disorder. A sample of 19 adolescents…

  17. Explicit versus Implicit Social Cognition Testing in Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Callenmark, Björn; Kjellin, Lars; Rönnqvist, Louise; Bölte, Sven

    2014-01-01

    Although autism spectrum disorder is defined by reciprocal social-communication impairments, several studies have found no evidence for altered social cognition test performance. This study examined explicit (i.e. prompted) and implicit (i.e. spontaneous) variants of social cognition testing in autism spectrum disorder. A sample of 19 adolescents…

  18. Cognitive Flexibility in Children with and without Speech Disorder

    ERIC Educational Resources Information Center

    Crosbie, Sharon; Holm, Alison; Dodd, Barbara

    2009-01-01

    Most children's speech difficulties are "functional" (i.e. no known sensory, motor or intellectual deficits). Speech disorder may, however, be associated with cognitive deficits considered core abilities in executive function: rule abstraction and cognitive flexibility. The study compares the rule abstraction and cognitive flexibility of…

  19. Cognitive conflict adaptation in generalized anxiety disorder.

    PubMed

    Larson, Michael J; Clawson, Ann; Clayson, Peter E; Baldwin, Scott A

    2013-10-01

    Individuals with generalized anxiety disorder (GAD) display poor emotional conflict adaptation, a cognitive control process requiring the adjustment of performance based on previous-trial conflict. It is unclear whether GAD-related conflict adaptation difficulties are present during tasks without emotionally-salient stimuli. We examined conflict adaptation using the N2 component of the event-related potential (ERP) and behavioral responses on a Flanker task from 35 individuals with GAD and 35 controls. Groups did not differ on conflict adaptation accuracy; individuals with GAD also displayed intact RT conflict adaptation. In contrast, individuals with GAD showed decreased amplitude N2 principal component for conflict adaptation. Correlations showed increased anxiety and depressive symptoms were associated with longer RT conflict adaptation effects and lower ERP amplitudes, but not when separated by group. We conclude that individuals with GAD show reduced conflict-related component processes that may be influenced by compensatory activity, even in the absence of emotionally-salient stimuli.

  20. Developmental disorders: what can be learned from cognitive neuropsychology?

    PubMed Central

    Castles, Anne; Kohnen, Saskia; Nickels, Lyndsey; Brock, Jon

    2014-01-01

    The discipline of cognitive neuropsychology has been important for informing theories of cognition and describing the nature of acquired cognitive disorders, but its applicability in a developmental context has been questioned. Here, we revisit this issue, asking whether the cognitive neuropsychological approach can be helpful for exploring the nature and causes of developmental disorders and, if so, how. We outline the key features of the cognitive neuropsychological approach, and then consider how some of the major challenges to this approach from a developmental perspective might be met. In doing so, we distinguish between challenges to the methods of cognitive neuropsychology and those facing its deeper conceptual underpinnings. We conclude that the detailed investigation of patterns of both associations and dissociations, and across both developmental and acquired cases, can assist in describing the cognitive deficits within developmental disorders and in delineating possible causal pathways to their acquisition. PMID:24324246

  1. Developmental disorders: what can be learned from cognitive neuropsychology?

    PubMed

    Castles, Anne; Kohnen, Saskia; Nickels, Lyndsey; Brock, Jon

    2014-01-01

    The discipline of cognitive neuropsychology has been important for informing theories of cognition and describing the nature of acquired cognitive disorders, but its applicability in a developmental context has been questioned. Here, we revisit this issue, asking whether the cognitive neuropsychological approach can be helpful for exploring the nature and causes of developmental disorders and, if so, how. We outline the key features of the cognitive neuropsychological approach, and then consider how some of the major challenges to this approach from a developmental perspective might be met. In doing so, we distinguish between challenges to the methods of cognitive neuropsychology and those facing its deeper conceptual underpinnings. We conclude that the detailed investigation of patterns of both associations and dissociations, and across both developmental and acquired cases, can assist in describing the cognitive deficits within developmental disorders and in delineating possible causal pathways to their acquisition.

  2. Cognitive functioning in psychiatric disorders following deep brain stimulation.

    PubMed

    Bergfeld, Isidoor O; Mantione, Mariska; Hoogendoorn, Mechteld L C; Denys, Damiaan

    2013-07-01

    Deep brain stimulation (DBS) is routinely used as a treatment for treatment-refractory Parkinson's disease and has recently been proposed for psychiatric disorders such as Tourette syndrome (TS), obsessive-compulsive disorder (OCD) and major depressive disorder (MDD). Although cognitive deterioration has repeatedly been shown in patients with Parkinson's disease following DBS, the impact of DBS on cognitive functioning in psychiatric patients has not yet been reviewed. Reviewing the available literature on cognitive functioning following DBS in psychiatric patients. A systematic literature search in PubMed, EMBASE and Web of Science, last updated in September 2012, found 1470 papers. Abstracts were scrutinized and 26 studies examining cognitive functioning of psychiatric patients following DBS were included on basis of predetermined inclusion criteria. Twenty-six studies reported cognitive functioning of 130 psychiatric patients following DBS (37 TS patients, 56 OCD patients, 28 MDD patients, 6 patients with Alzheimer's disease, and 3 patients with other disorders). None of the studies reported substantial cognitive decline following DBS. On the contrary, 13 studies reported cognitive improvement following DBS. Preliminary results suggest that DBS in psychiatric disorders does not lead to cognitive decline. In selected cases cognitive functioning was improved following DBS. However, cognitive improvement cannot be conclusively attributed to DBS since studies are hampered by serious limitations. We discuss the outcomes in light of these limitations and offer suggestions for future work. Copyright © 2013 Elsevier Inc. All rights reserved.

  3. Explicit versus implicit social cognition testing in autism spectrum disorder.

    PubMed

    Callenmark, Björn; Kjellin, Lars; Rönnqvist, Louise; Bölte, Sven

    2014-08-01

    Although autism spectrum disorder is defined by reciprocal social-communication impairments, several studies have found no evidence for altered social cognition test performance. This study examined explicit (i.e. prompted) and implicit (i.e. spontaneous) variants of social cognition testing in autism spectrum disorder. A sample of 19 adolescents with autism spectrum disorder and 19 carefully matched typically developing controls completed the Dewey Story Test. 'Explicit' (multiple-choice answering format) and 'implicit' (free interview) measures of social cognition were obtained. Autism spectrum disorder participants did not differ from controls regarding explicit social cognition performance. However, the autism spectrum disorder group performed more poorly than controls on implicit social cognition performance in terms of spontaneous perspective taking and social awareness. Findings suggest that social cognition alterations in autism spectrum disorder are primarily implicit in nature and that an apparent absence of social cognition difficulties on certain tests using rather explicit testing formats does not necessarily mean social cognition typicality in autism spectrum disorder. © The Author(s) 2013.

  4. Explicit versus implicit social cognition testing in autism spectrum disorder

    PubMed Central

    Callenmark, Björn; Kjellin, Lars; Rönnqvist, Louise

    2014-01-01

    Although autism spectrum disorder is defined by reciprocal social-communication impairments, several studies have found no evidence for altered social cognition test performance. This study examined explicit (i.e. prompted) and implicit (i.e. spontaneous) variants of social cognition testing in autism spectrum disorder. A sample of 19 adolescents with autism spectrum disorder and 19 carefully matched typically developing controls completed the Dewey Story Test. ‘Explicit’ (multiple-choice answering format) and ‘implicit’ (free interview) measures of social cognition were obtained. Autism spectrum disorder participants did not differ from controls regarding explicit social cognition performance. However, the autism spectrum disorder group performed more poorly than controls on implicit social cognition performance in terms of spontaneous perspective taking and social awareness. Findings suggest that social cognition alterations in autism spectrum disorder are primarily implicit in nature and that an apparent absence of social cognition difficulties on certain tests using rather explicit testing formats does not necessarily mean social cognition typicality in autism spectrum disorder. PMID:24104519

  5. Diagnostic criteria for vascular cognitive disorders: a VASCOG statement

    PubMed Central

    Sachdev, Perminder; Kalaria, Raj; O’Brien, John; Skoog, Ingmar; Alladi, Suvarna; Black, Sandra E; Blacker, Deborah; Blazer, Dan; Chen, Christopher; Chui, Helena; Ganguli, Mary; Jellinger, Kurt; Jeste, Dilip V.; Pasquier, Florence; Paulsen, Jane; Prins, Niels; Rockwood, Kenneth; Roman, Gustavo; Scheltens, Philip

    2014-01-01

    Background Several sets of diagnostic criteria have been published for vascular dementia (VaD) since the 1960s. The continuing ambiguity in VaD definition warrants a critical re-examination. Methods Participants at a special symposium of the International Society for Vascular Behavioral and Cognitive Disorders (VASCOG) in 2009 critiqued the current criteria. They drafted a proposal for a new set of criteria, later reviewed through multiple drafts by the group, including additional experts and the members of the Neurocognitive Disorders Work Group of the DSM-5 Task Force. Results Cognitive disorders of vascular etiology are a heterogeneous group of disorders with diverse pathologies and clinical manifestations, discussed broadly under the rubric of vascular cognitive disorders (VCD). The continuum of vascular cognitive impairment is recognized by the categories of Mild Vascular Cognitive Disorder, and Vascular Dementia or Major Vascular Cognitive Disorder. Diagnostic thresholds are defined. Clinical and neuroimaging criteria are proposed for establishing vascular etiology. Subtypes of VCD are described, and the frequent co-occurrence of Alzheimer’s disease pathology emphasized. Conclusions The proposed criteria for VCD provide a coherent approach to the diagnosis of this diverse group of disorders, with a view to stimulating clinical and pathological validation studies. These criteria can be harmonized with the DSM-5 criteria such that an international consensus on the criteria for VCD may be achieved. PMID:24632990

  6. [Speech evoked auditory brainstem response and cognitive disorders].

    PubMed

    Zhou, M; Wang, N Y

    2016-12-07

    Speech evoked auditory brainstem response(s-ABR)is evoked by compound syllable, and those stimulus are similar to the daily language which convey both semantic information and non-semantic information. Speech coding program can take place at brainstem. As a new method, s-ABR may reveal the mystery of speech coding program. Many tests have proved that s-ABR is somehow related to cognitive ability. We mainly illustrated the possibility of grading the cognitive ability using s-ABR, the abnormal test result from those cognitive disorders, and the family factors that contribute to cognitive disorder.

  7. Cognitive behavior therapy of binge eating disorder.

    PubMed

    Vaidya, Varsha

    2006-01-01

    Binge eating disorder (BED) is characterized by recurrent episodes of uncontrollable eating, even when not hungry, until uncomfortably full, occurring at least twice a week for a 6-month period. This is differentiated from bulimia nervosa (BN) by the lack of compensatory mechanisms such as purging/laxative abuse. There are significantly higher levels of psychiatric symptoms in patients with BED as compared to those without BED. Furthermore, depressive symptomatology may increase the patient's vulnerability to binge eating as well as to relapse after treatment. Grazing is defined as eating small amounts of food continuously. BED in the pre-bariatric patient can manifest as 'grazing' about 2 years post-bariatric surgery. Treatment should be directed at eating behavior, associated psychopathology, weight and psychiatric symptoms. Cognitive behavior therapy is based on changing the patient's erroneous ways of thinking about themselves, the world and how others perceive them. This includes a focus on normalizing food intake as well as challenging dysfunctional thinking, identifying feelings, and developing non-food coping skills. It increases a sense of control and therefore helps the patient adhere to behavior change strategy, as well as improving mood and reducing associated psychopathology. Interpersonal therapy is based on the relationship between negative mood low self-esteem traumatic life events, interpersonal functioning and the patient's eating behavior. The rationale being that eating represents maladaptive coping with underlying difficulties. While psychotherapy either CBT or IPT leads to decrease in disordered eating behaviors and improved psychiatric symptoms, it has little effect on weight hence; its benefit is optimal when used in conjunction with bariatric surgery.

  8. [Cognitive and Cognitive-Behavioral Therapy for substance abuse disorders].

    PubMed

    Silva, Cláudio Jerônimo da; Serra, Ana Maria

    2004-05-01

    This article describes the current status of Cognitive and Behavioral Therapy as well Relapse Prevention and Coping Skill approaches applied in drug abuse treatments. The objective is show a review about theories and technique used by Cognitive Therapy and others approaches derived that, specifically Relapse Prevention and Coping Skill Treatments. Cognitive and Behavioral Therapy, Coping Skill, and Relapse Prevention are a short-time, goal-oriented and structured treatments. Thus, they assume a posture directive and active. We pointed out some difference between the theories about Cognitive Therapy, Relapse Prevention and Coping Skill. The Cognitive Therapy accentuated the focus in patients thought, feeling and circumstances that get in a dysfunctional behavioral. Relapse Prevention and Coping Skill are based in behavioral theories besides of the Cognitive. We, finally, look forward to introduce the lasted scientific finding to helpful the general psychiatric to improve the assistance in drug abuse treatment.

  9. Routine clinical assessment of cognitive functioning in schizophrenia, major depressive disorder, and bipolar disorder.

    PubMed

    Belgaied, Wael; Samp, Jennifer; Vimont, Alexandre; Rémuzat, Cécile; Aballéa, Samuel; El Hammi, Emna; Kooli, Amna; Toumi, Mondher; Akhras, Kasem

    2014-01-01

    As more evidence points to the association of cognitive dysfunction with mental health disorders, the assessment of cognitive function in routine clinical care of these disorders is increasingly important. Despite this, it remains unknown how cognitive function is measured in routine clinical practice. The objective of this study was to assess psychiatrists' awareness of cognitive dysfunction in mental health disorders and their methods of cognitive assessment. An online survey was disseminated to psychiatrists in Europe, Asia, Australia and the United States. The survey asked about their perceptions of cognitive dysfunction in several mental health disorders, knowledge of cognitive assessment, method of cognitive assessment, and instruments used to measure cognitive function. Among the 61 respondents, most perceived that schizophrenia was associated with the greatest cognitive dysfunction. Many were unaware whether guidelines were available on cognitive assessment. In schizophrenia, 59% of psychiatrists reportedly used cognitive instruments, while the remainder relied solely on patient history interviews. The use of instruments to assess cognition in major depressive disorder (MDD) and bipolar disorder (BPD) was lower, 38% and 37% respectively. Of the reported instruments used, only a few were actually appropriate for use in the diseases of interest (12% in schizophrenia, 3% in MDD and 0% in BPD). Other instruments reported were clinical measures that did not assess cognition. These findings reveal some inconsistencies in psychiatrists' routine clinical evaluation of cognitive function. There appeared to be low use of true cognitive assessment instruments in clinical practice and confusion regarding what constituted a cognitive assessment instrument. © 2013 Published by Elsevier B.V. and ECNP.

  10. Italian psychiatrists' perception on cognitive symptoms in major depressive disorder.

    PubMed

    Albert, Umberto; Brugnoli, Roberto; Caraci, Filippo; Dell'Osso, Bernardo; Di Sciascio, Guido; Tortorella, Alfonso; Vampini, Claudio; Cataldo, Nazarena; Pegoraro, Valeria

    2016-01-01

    Differently than Schizophrenia, the investigation of cognitive impairment in bipolar disorder and major depressive disorder (MDD) attracted the interest of research only recently. Therefore, it is worth understanding clinicians' perception about cognitive dysfunction in MDD and raising awareness about this issue. Between December 2014 and January 2015, 128 Italian psychiatrists participated in an on-line survey aiming at understanding psychiatrists' perception about cognitive symptoms in MDD. The questionnaire comprised three sections: the first investigating psychiatrists' socio-demographic profile, the second assessing cognitive symptoms relevance without mentioning that they represented the study focus and the third explicitly investigating cognitive symptoms. Cognitive symptoms were considered as a relevant dimension of MDD and appeared among the most frequently cited residual symptoms influencing patients' work and relapse risk. About 70% of psychiatrists declared that cognitive symptoms significantly influence antidepressant choice. However, in the second questionnaire section cognitive symptoms appeared less frequently considered for antidepressant choice. Results revealed a clear understanding of cognitive symptoms relevance in MDD. Nevertheless, the discrepancy between psychiatrists' perception and their therapeutical choices underlines the presence of an unmet-need that should be addressed increasing the awareness about the positive effects on cognitive symptoms of existing drugs, which could allow a more symptom-oriented therapeutical intervention. Key points Major depressive disorder (MDD) is a common mental disorder often associated with deficits in cognitive function. Psychiatrists considered cognitive symptoms among the most relevant residual symptoms in MDD patients that compromise patients working and influence the relapse risk. The importance given to residual cognitive symptoms seemed not to be reflected by psychiatrists' therapeutical choice

  11. A neurobiological approach to the cognitive deficits of psychiatric disorders.

    PubMed

    Etkin, Amit; Gyurak, Anett; O'Hara, Ruth

    2013-12-01

    Deficits in brain networks that support cognitive regulatory functions are prevalent in many psychiatric disorders. Findings across neuropsychology and neuroimaging point to broad-based impairments that cross traditional diagnostic boundaries. These dysfunctions are largely separate from the classical symptoms of the disorders, and manifest in regulatory problems in both traditional cognitive and emotional domains. As such, they relate to the capacity of patients to engage effectively in their daily lives and activity, often persist even in the face of symptomatically effective treatment, and are poorly targeted by current treatments. Advances in cognitive neuroscience now allow us to ground an understanding of these cognitive regulatory deficits in the function and interaction of key brain networks. This emerging neurobiological understanding furthermore points to several promising routes for novel neuroscience-informed treatments targeted more specifically at improving cognitive function in a range of psychiatric disorders.

  12. Cognitive Impairment in Bipolar Disorder: Treatment and Prevention Strategies

    PubMed Central

    Solé, Brisa; Jiménez, Esther; Torrent, Carla; Reinares, Maria; Bonnin, Caterina del Mar; Torres, Imma; Varo, Cristina; Grande, Iria; Valls, Elia; Salagre, Estela; Sanchez-Moreno, Jose; Martinez-Aran, Anabel; Carvalho, André F

    2017-01-01

    Abstract Over the last decade, there has been a growing appreciation of the importance of identifying and treating cognitive impairment associated with bipolar disorder, since it persists in remission periods. Evidence indicates that neurocognitive dysfunction may significantly influence patients’ psychosocial outcomes. An ever-increasing body of research seeks to achieve a better understanding of potential moderators contributing to cognitive impairment in bipolar disorder in order to develop prevention strategies and effective treatments. This review provides an overview of the available data from studies examining treatments for cognitive dysfunction in bipolar disorder as well as potential novel treatments, from both pharmacological and psychological perspectives. All these data encourage the development of further studies to find effective strategies to prevent and treat cognitive impairment associated with bipolar disorder. These efforts may ultimately lead to an improvement of psychosocial functioning in these patients. PMID:28498954

  13. Social cognition and clinical insight in schizophrenia and bipolar disorder.

    PubMed

    Vaskinn, Anja; Sundet, Kjetil; Ueland, Torill; Agartz, Ingrid; Melle, Ingrid; Andreassen, Ole A

    2013-06-01

    The association between clinical insight and social cognition assessed with an emotion perception task was investigated in schizophrenia (n = 29) and bipolar I disorder (n = 19). Persons with schizophrenia had reduced auditory emotion perception compared with individuals with bipolar I disorder, but levels of visual emotion perception and clinical insight were comparable. In the schizophrenia group, clinical insight was moderately associated with auditory and visual emotion perception (r = 0.36-0.44) and negative symptoms (r = -0.33). Better insight was associated with better social cognition and fewer negative symptoms. In the bipolar I disorder group, clinical insight showed small associations with social cognition (largest r = -0.28) and moderate to large associations with positive, negative, manic, and depressive symptoms. Poorer insight was associated with higher symptom load. Social cognition seems to be of importance for clinical insight in schizophrenia, whereas symptoms are important in bipolar I disorder.

  14. Family Cognitive Behavioral Therapy for Child Anxiety Disorders

    ERIC Educational Resources Information Center

    Wood, Jeffrey J.; Piacentini, John C.; Southam-Gerow, Michael; Chu, Brian C.; Sigman, Marian

    2006-01-01

    Objective: This study compared family-focused cognitive behavioral therapy (CBT: the Building Confidence Program) with traditional child-focused CBT with minimal family involvement for children with anxiety disorders. Method: Forty clinically anxious youth (6-13 years old) were randomly assigned to a family- or child-focused cognitive-behavioral…

  15. A Cognitive-Behavioral Treatment Approach for Body Dysmorphic Disorder

    ERIC Educational Resources Information Center

    Wilhelm, Sabine; Buhlmann, Ulrike; Hayward, Laura C.; Greenberg, Jennifer L.; Dimaite, Ruta

    2010-01-01

    Although body dysmorphic disorder (BDD) has been described in the literature for more than a century, there has been only a limited focus on the development of cognitive behavioral treatments for BDD. Our case report provides a detailed description of a course of cognitive behavioral treatment (CBT) for an individual with BDD. The patient was…

  16. Cognitive Discernible Factors between Schizophrenia and Schizoaffective Disorder

    ERIC Educational Resources Information Center

    Stip, Emmanuel; Sepehry, Amir Ali; Prouteau, Antoniette; Briand, Catherine; Nicole, Luc; Lalonde, Pierre; Lesage, Alain

    2005-01-01

    Background: Schizophrenia (SZ) and schizoaffective disorders (SA) are associated with cognitive deficits. Generally, a schizoaffective diagnosis is associated with better prognosis on the level of social integration. It is also well established that cognition is an important factor for good social outcome in schizophrenia. We hypothesized that,…

  17. Cognitive Appraisals in Young People with Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Libby, Sarah; Reynolds, Shirley; Derisley, Jo; Clark, Sarah

    2004-01-01

    Background: A number of cognitive appraisals have been identified as important in the manifestation of obsessive-compulsive disorder (OCD) in adults. There have, however, been few attempts to explore these cognitive appraisals in clinical groups of young people. Method: This study compared young people aged between 11 and 18 years with OCD (N =…

  18. Family Cognitive Behavioral Therapy for Child Anxiety Disorders

    ERIC Educational Resources Information Center

    Wood, Jeffrey J.; Piacentini, John C.; Southam-Gerow, Michael; Chu, Brian C.; Sigman, Marian

    2006-01-01

    Objective: This study compared family-focused cognitive behavioral therapy (CBT: the Building Confidence Program) with traditional child-focused CBT with minimal family involvement for children with anxiety disorders. Method: Forty clinically anxious youth (6-13 years old) were randomly assigned to a family- or child-focused cognitive-behavioral…

  19. Cognitive Discernible Factors between Schizophrenia and Schizoaffective Disorder

    ERIC Educational Resources Information Center

    Stip, Emmanuel; Sepehry, Amir Ali; Prouteau, Antoniette; Briand, Catherine; Nicole, Luc; Lalonde, Pierre; Lesage, Alain

    2005-01-01

    Background: Schizophrenia (SZ) and schizoaffective disorders (SA) are associated with cognitive deficits. Generally, a schizoaffective diagnosis is associated with better prognosis on the level of social integration. It is also well established that cognition is an important factor for good social outcome in schizophrenia. We hypothesized that,…

  20. Cognitive Appraisals in Young People with Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Libby, Sarah; Reynolds, Shirley; Derisley, Jo; Clark, Sarah

    2004-01-01

    Background: A number of cognitive appraisals have been identified as important in the manifestation of obsessive-compulsive disorder (OCD) in adults. There have, however, been few attempts to explore these cognitive appraisals in clinical groups of young people. Method: This study compared young people aged between 11 and 18 years with OCD (N =…

  1. A Cognitive-Behavioral Treatment Approach for Body Dysmorphic Disorder

    ERIC Educational Resources Information Center

    Wilhelm, Sabine; Buhlmann, Ulrike; Hayward, Laura C.; Greenberg, Jennifer L.; Dimaite, Ruta

    2010-01-01

    Although body dysmorphic disorder (BDD) has been described in the literature for more than a century, there has been only a limited focus on the development of cognitive behavioral treatments for BDD. Our case report provides a detailed description of a course of cognitive behavioral treatment (CBT) for an individual with BDD. The patient was…

  2. [Cognitive behavioral therapy for adolescents suffering from complex trauma disorder].

    PubMed

    Schmid, Marc; Goldbeck, Lutz

    2010-01-01

    Complex Posttraumatic Stress Disorder and Developmental Trauma Disorder are discussed as new diagnostic entities representing the broad spectrum of trauma-related symptoms of children and adolescents. However, the psychotherapy of severe and complex trauma during adolescence is challenging because trauma-associated symptoms like attachment problems, the expectation of self-inefficacy and dissociation may complicate therapeutic work and limit treatment outcome. Therefore it is necessary to develop evidence-based treatment approaches for these mental disorders. Trauma-focused cognitive-behavioral therapy has been successfully evaluated for the treatment of posttraumatic stress disorder. Actual treatment approaches combine strategies from Dialectal Behavioral Therapy (DBT) with cognitive behavioral techniques of trauma therapy for the treatment of complex trauma disorder. This article gives a practical overview about cognitive-behavioral treatment approaches and discusses problems of their implementation in the clinical routine of child and adolescent psychiatrists/psychotherapists.

  3. Response inhibition and cognitive appraisal in clients with acute stress disorder and posttraumatic stress disorder.

    PubMed

    Abolghasemi, Abass; Bakhshian, Fereshteh; Narimani, Mohammad

    2013-08-01

    The purpose of the present study was to compare response inhibition and cognitive appraisal in clients with acute stress disorder, clients with posttraumatic stress disorder, and normal individuals. This was a comparative study. The sample consisted of 40 clients with acute stress disorder, 40 patients with posttraumatic stress disorder, and 40 normal individuals from Mazandaran province selected through convenience sampling method. Data were collected using Composite International Diagnostic Interview, Stroop Color-Word Test, Posttraumatic Cognitions Inventory, and the Impact of Event Scale. Results showed that individuals with acute stress disorder are less able to inhibit inappropriate responses and have more impaired cognitive appraisals compared to those with posttraumatic stress disorder. Moreover, results showed that response inhibition and cognitive appraisal explain 75% of the variance in posttraumatic stress disorder symptoms and 38% of the variance in posttraumatic stress disorder symptoms. The findings suggest that response inhibition and cognitive appraisal are two variables that influence the severity of posttraumatic stress disorder and acute stress disorder symptoms. Also, these results have important implications for pathology, prevention, and treatment of posttraumatic stress disorder and acute stress disorder.

  4. Cognitive Hypnotherapy as a Transdiagnostic Protocol for Emotional Disorders.

    PubMed

    Alladin, Assen; Amundson, Jon

    2016-01-01

    This article describes cognitive hypnotherapy (CH), an integrative treatment that provides an evidence-based framework for synthesizing clinical practice and research. CH combines hypnotherapy with cognitive-behavior therapy in the management of emotional disorders. This blended version of clinical practice meets criteria for an assimilative model of integrative psychotherapy, which incorporates both theory and empirical findings. Issues related to (a) additive effect of hypnosis in treatment, (b) transdiagnostic consideration, and (c) unified treatment protocols in the treatment of emotional disorders are considered in light of cognitive hypnotherapy.

  5. Metacognitive, Cognitive and Developmental Predictors of Generalised Anxiety Disorder Symptoms

    ERIC Educational Resources Information Center

    Tan, Shary; Moulding, Richard; Nedeljkovic, Maja; Kyrios, Michael

    2010-01-01

    Generalised anxiety disorder (GAD) is the most significant and common of the anxiety disorders. Intolerance of uncertainty (IU) and negative metacognitive beliefs are two prominent cognitive factors in models of GAD, however only one study to date has examined the relative contribution of these factors. Therefore, this study aimed to investigate…

  6. Optimizing Cognitive-Behavioral Therapy for Childhood Psychiatric Disorders

    ERIC Educational Resources Information Center

    Piacentini, John

    2008-01-01

    Reports that expand the understanding of the treatment of childhood obsessive-compulsive disorder by using exposure-based cognitive-behavioral therapy in the age group of 5 to 8-year-olds are presented. A model for collecting the common core elements of evidence-based psychosocial treatments for childhood disorders is also presented.

  7. Optimizing Cognitive-Behavioral Therapy for Childhood Psychiatric Disorders

    ERIC Educational Resources Information Center

    Piacentini, John

    2008-01-01

    Reports that expand the understanding of the treatment of childhood obsessive-compulsive disorder by using exposure-based cognitive-behavioral therapy in the age group of 5 to 8-year-olds are presented. A model for collecting the common core elements of evidence-based psychosocial treatments for childhood disorders is also presented.

  8. Cognitive-Behavioral Body Image Therapy for Body Dysmorphic Disorder.

    ERIC Educational Resources Information Center

    Rosen, James C.; And Others

    1995-01-01

    Randomly assigned 54 body dysmorphic disorder (BDD) subjects to cognitive behavior therapy or no treatment. BDD symptoms were significantly decreased in therapy subjects and the disorder was eliminated in 82 percent of cases at posttreatment and 77 percent at follow-up. Subjects' overall psychological symptoms and self-esteem also improved. (RJM)

  9. [Cognitive disorders among welders exposed to aluminum].

    PubMed

    Giorgianni, C; Faranda, M; Brecciaroli, R; Beninato, G; Saffioti, G; Muraca, G; Congia, P; Catanoso, R; Agostani, G; Abbate, C

    2003-01-01

    In order to evaluate the relationship between exposure to aluminum and cognitive functions, a group of 50 aluminum welders underwent to the following neuropsychological tests: Wechsler Memory Scale, Color-Word Test and Raven Progressives Matrices test. The results of the tests showed a reduction of memory, of concentration and a slight reduction of attention. The authors conclude that aluminum exposure leads cognitive changes.

  10. Cognitive Behavioral Therapy for Anxiety Disorders in Youth

    PubMed Central

    Seligman, Laura D.; Ollendick, Thomas H.

    2011-01-01

    Synopsis Cognitive behavioral therapies (CBTs) have been shown to be efficacious for the treatment of anxiety disorders in children and adolescents. Randomized clinical trials indicate that approximately two-thirds of children treated with CBT will be free of their primary diagnosis at posttreatment. Although several CBT treatment packages have been investigated in youth with diverse anxiety disorders, common core components have been identified. A comprehensive assessment, development of a good therapeutic relationship and working alliance, cognitive restructuring, repeated exposure with reduction of avoidance behavior, and skills training comprise the core procedures for the treatment of anxiety disorders in youth. PMID:21440852

  11. Identifying a cognitive impairment subgroup in adults with mood disorders

    PubMed Central

    Iverson, Grant L.; Brooks, Brian L.; Langenecker, Scott A.; Young, Allan H.

    2014-01-01

    Background We hypothesized that only a minority of patients with mood disorders have measurable cognitive impairment, and this minority drives the small-to-medium effect sizes detected in group studies. Removal of this minority from group statistical analyses will illustrate that the majority appear to have broadly normal cognitive functioning. Methods Participants were adults between the ages of 20 and 54, including 659 healthy control subjects, 84 unmedicated outpatients diagnosed with depression, 59 outpatients diagnosed with depression who were on medications at the time of the evaluation, and 43 outpatients with bipolar disorder. All completed the CNS Vital Signs computerized cognitive screening battery. Results The prevalence rates of low cognitive test scores were calculated for the healthy control subjects and the patients with mood disorders. Having two scores at or below the 5th percentile occurred in 31.2% of the patients and only 8.2% of the control subjects [χ2(1)=66.67, p<.0001; Odds Ratio=5.1, 95% CI=3.4–7.7]. For the control subjects, this low false positive rate for cognitive impairment was maintained across age groups, sexes, and education levels. A larger proportion of patients with bipolar disorder (41.9%) than patients with depression (27.1–28.6%) met this criterion for cognitive impairment. Conclusions This study suggests that cognitive impairment associated with mood disorders is limited to a minority of patients with the majority being broadly cognitively normal. Future research should determine if this identified subgroup has neuroanatomical, neurophysiological, or neuroendocrine abnormalities. Cognitive screening tools of this type might be useful in selecting participants for studies. PMID:21439647

  12. The neural bases of cognitive processes in gambling disorder

    PubMed Central

    Potenza, Marc N.

    2014-01-01

    Functional imaging is offering powerful new tools to investigate the neurobiology of cognitive functioning in people with and without psychiatric conditions like gambling disorder. Based on similarities between gambling and substance-use disorders in neurocognitive and other domains, gambling disorder has recently been classified in DSM-5 as a behavioral addiction. Despite the advances in understanding, there exist multiple unanswered questions about the pathophysiology underlying gambling disorder and the promise for translating the neurobiological understanding into treatment advances remains largely unrealized. Here we review the neurocognitive underpinnings of gambling disorder with an eye towards improving prevention, treatment and policy efforts. PMID:24961632

  13. An integrated cognitive model of panic disorder: the role of positive and negative cognitions.

    PubMed

    Casey, Leanne M; Oei, Tian P S; Newcombe, Peter A

    2004-09-01

    One reason for the neglect of the role of positive factors in cognitive-behavioural therapy (CBT) may relate to a failure to develop cognitive models that integrate positive and negative cognitions. Bandura [Psychol. Rev. 84 (1977) 191; Anxiety Res. 1 (1988) 77] proposed that self-efficacy beliefs mediate a range of emotional and behavioural outcomes. However, in panic disorder, cognitively based research to date has largely focused on catastrophic misinterpretation of bodily sensations. Although a number of studies support each of the predictions associated with the account of panic disorder that is based on the role of negative cognitions, a review of the literature indicated that a cognitively based explanation of the disorder may be considerably strengthened by inclusion of positive cognitions that emphasize control or coping. Evidence to support an Integrated Cognitive Model (ICM) of panic disorder was examined and the theoretical implications of this model were discussed in terms of both schema change and compensatory skills accounts of change processes in CBT.

  14. Preliminary Evidence for Cognitive Mediation during Cognitive-Behavioral Therapy of Panic Disorder

    ERIC Educational Resources Information Center

    Hofmann, Stefan G.; Meuret, Alicia E.; Rosenfield, David; Suvak, Michael K.; Barlow, David H.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.

    2007-01-01

    Cognitive-behavioral therapy (CBT) and pharmacotherapy are similarly effective for treating panic disorder with mild or no agoraphobia, but little is known about the mechanism through which these treatments work. The present study examined some of the criteria for cognitive mediation of treatment change in CBT alone, imipramine alone, CBT plus…

  15. Cognition about Cognition: Metacognitive Therapy and Change in Generalized Anxiety Disorder and Social Phobia

    ERIC Educational Resources Information Center

    Wells, Adrian

    2007-01-01

    Metacognitive theory and therapy views the persistence of negative beliefs and thoughts as a result of metacognitions controlling cognition. This paper describes, with reference to the treatment of generalized anxiety disorder (GAD) and social phobia, how metacognition contributes to cognitive stability and to change. Metacognitive therapy offers…

  16. Preliminary Evidence for Cognitive Mediation during Cognitive-Behavioral Therapy of Panic Disorder

    ERIC Educational Resources Information Center

    Hofmann, Stefan G.; Meuret, Alicia E.; Rosenfield, David; Suvak, Michael K.; Barlow, David H.; Gorman, Jack M.; Shear, M. Katherine; Woods, Scott W.

    2007-01-01

    Cognitive-behavioral therapy (CBT) and pharmacotherapy are similarly effective for treating panic disorder with mild or no agoraphobia, but little is known about the mechanism through which these treatments work. The present study examined some of the criteria for cognitive mediation of treatment change in CBT alone, imipramine alone, CBT plus…

  17. Cognition about Cognition: Metacognitive Therapy and Change in Generalized Anxiety Disorder and Social Phobia

    ERIC Educational Resources Information Center

    Wells, Adrian

    2007-01-01

    Metacognitive theory and therapy views the persistence of negative beliefs and thoughts as a result of metacognitions controlling cognition. This paper describes, with reference to the treatment of generalized anxiety disorder (GAD) and social phobia, how metacognition contributes to cognitive stability and to change. Metacognitive therapy offers…

  18. Italian neurologists' perception on cognitive symptoms in major depressive disorder.

    PubMed

    Neri, G; Serrati, C; Zolo, P; Cataldo, N; Ripellino, C

    2016-09-01

    The assessment of cognition is an important part of major depressive disorder (MDD) evaluation and a crucial issue is the physicians' perception of cognitive dysfunction in MDD that remains nowadays a little known matter. The present study aims at investigating the understanding of neurologists' perception about cognitive dysfunction in MDD. An on-line survey addressed to 85 Italian neurologists in the period between May and June 2015 was performed. The questionnaire comprised three sections: the first section collecting information on neurologists' socio-demographic profile, the second investigating cognitive symptoms relevance in relation with different aspects and the third one explicitly focusing on cognitive symptoms in MDD. Cognitive symptoms are considered most significant among DSM-5 symptoms to define the presence of a Major Depressive Episode in a MDD, to improve antidepressant therapy adherence, patients' functionality and concurrent neurological condition, once resolved. Furthermore, an incongruity came to light from this survey: the neurologists considered cognitive symptoms a not relevant aspect to choose the antidepressant treatment in comparison with the other DSM-5 symptoms on one side, but they declared the opposite in the third part of the questionnaire focused on cognitive symptoms. Cognitive symptoms appeared to be a relevant aspect in MDD and neurologists have a clear understanding of this issue. Nevertheless, the discrepancy between neurologists' perception on cognitive symptoms and the antidepressant treatment highlights the feeling of an unmet need that could be filled increasing the awareness of existing drugs with pro-cognitive effects.

  19. Cognitive pragmatics of language disorders in adults.

    PubMed

    Davis, G Albyn

    2007-05-01

    Cognitive pragmatics is the study of the mental structures and processes involved in the use of language in communicative contexts. Paradigms of cognitive psychology (off-line and on-line) have been applied to the study of the abilities to go beyond the literal (inference) and derive meaning in relation to context (e.g., metaphor and sarcasm). These pragmatic functions have been examined for the involvement of processes of meaning activation, embellishment, and revision. Clinical investigators have explored abilities and deficits in acquired aphasia, right hemisphere dysfunction, and closed head injury. This article reviews and provides some analysis of clinical studies that are consistent with the themes constituting cognitive pragmatics.

  20. Efficacy of Cognitive-Behavioral Therapy for Comorbid Panic Disorder with Agoraphobia and Generalized Anxiety Disorder

    ERIC Educational Resources Information Center

    Labrecque, Joane; Marchand, Andre; Dugas, Michel J.; Letarte, Andree

    2007-01-01

    The goal of this study was to evaluate the efficacy of cognitive-behavioral therapy for comorbid panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) by combining treatment strategies for both disorders. A single-case, multiple-baseline design across participants was used. Three participants with primary PDA and secondary…

  1. Efficacy of Cognitive-Behavioral Therapy for Comorbid Panic Disorder with Agoraphobia and Generalized Anxiety Disorder

    ERIC Educational Resources Information Center

    Labrecque, Joane; Marchand, Andre; Dugas, Michel J.; Letarte, Andree

    2007-01-01

    The goal of this study was to evaluate the efficacy of cognitive-behavioral therapy for comorbid panic disorder with agoraphobia (PDA) and generalized anxiety disorder (GAD) by combining treatment strategies for both disorders. A single-case, multiple-baseline design across participants was used. Three participants with primary PDA and secondary…

  2. Conduct disorder and cognitive functioning: testing three causal hypotheses.

    PubMed

    Schonfeld, I S; Shaffer, D; O'Connor, P; Portnoy, S

    1988-08-01

    The sample consisted of black adolescents who were members of the Columbia-Presbyterian chapter of the Collaborative Perinatal Project from birth to age 7. At age 17, subjects and their parents were administered a battery of instruments that included standardized psychiatric diagnostic interviews as part of a call-back study. Results from least-squares and logistic regression analyses were compatible with the hypothesis that deficiencies in cognitive functioning are causally related to adolescent conduct disorder as defined by DSM III. The results suggested that the relation of cognitive functioning to psychiatric status appears to be specific to conduct disorders. The results were incompatible with a "third" variable hypothesis (third factors included neurological status and environmental disadvantage) and the hypothesis that conduct problems lead to deficits in cognitive functioning. The 3 most (and equally) important factors in accounting for age-17 conduct disorder were cognitive functioning, parent psychopathology, and early aggression. A closer look at the data tentatively suggested that a broad deficiency in acculturational learning, rather than narrowly focused social cognitive differences or native endowment, constitutes a key element in the link between cognitive functioning and conduct disorder. Test bias was ruled out as a possible explanation for the results.

  3. Clinical assessment of social cognitive function in neurological disorders.

    PubMed

    Henry, Julie D; von Hippel, William; Molenberghs, Pascal; Lee, Teresa; Sachdev, Perminder S

    2016-01-01

    Social cognition broadly refers to the processing of social information in the brain that underlies abilities such as the detection of others' emotions and responding appropriately to these emotions. Social cognitive skills are critical for successful communication and, consequently, mental health and wellbeing. Disturbances of social cognition are early and salient features of many neuropsychiatric, neurodevelopmental and neurodegenerative disorders, and often occur after acute brain injury. Its assessment in the clinic is, therefore, of paramount importance. Indeed, the most recent edition of the American Psychiatric Association's Diagnostic and Statistical Manual for Mental Disorders (DSM-5) introduced social cognition as one of six core components of neurocognitive function, alongside memory and executive control. Failures of social cognition most often present as poor theory of mind, reduced affective empathy, impaired social perception or abnormal social behaviour. Standard neuropsychological assessments lack the precision and sensitivity needed to adequately inform treatment of these failures. In this Review, we present appropriate methods of assessment for each of the four domains, using an example disorder to illustrate the value of these approaches. We discuss the clinical applications of testing for social cognitive function, and finally suggest a five-step algorithm for the evaluation and treatment of impairments, providing quantitative evidence to guide the selection of social cognitive measures in clinical practice.

  4. Inflammatory mediators of cognitive impairment in bipolar disorder

    PubMed Central

    Bauer, Isabelle E.; Pascoe, Michaela C.; Wollenhaupt-Aguiar, Bianca; Kapczinski, Flavio; Soares, Jair C.

    2014-01-01

    Objectives Recent studies have pointed to neuroinflammation, oxidative stress and neurotrophic factors as key mediators in the pathophysiology of mood disorders. Little is however known about the cascade of biological episodes underlying the cognitive deficits observed during the acute and euthymic phases of bipolar disorder (BD). The aim of this review is to assess the potential association between cognitive impairment and biomarkers of inflammation, oxidative stress and neurotrophic activity in BD. Methods Scopus (all databases), Pubmed and Ovid Medline were systematically searched with no language or year restrictions, up to November 2013, for human studies that collected both inflammatory markers and cognitive data in BD. Selected search terms were bipolar disorder, depression, mania, psychosis, inflammatory, cognitive and neurotrophic. Results Ten human studies satisfied the criteria for consideration. The findings showed that high levels of peripheral inflammatory-cytokine, oxidative stress and reduced brain derived neurotrophic factor (BDNF) levels were associated with poor cognitive performance. The BDNF val66met polymorphism is a potential vulnerability factor for cognitive impairment in BD. Conclusions Current data provide preliminary evidence of a link between the cognitive decline observed in BD and mechanisms of neuroinflammation and neuroprotection. The identification of BD specific inflammatory markers and polymorphisms in inflammatory response genes may be of assistance for therapeutic intervention. PMID:24862657

  5. Vascular risk factors and cognitive disorders.

    PubMed

    Debette, S

    2013-10-01

    Delaying the onset of dementia by just a few years could have a major impact on the prevalence of the disease at the population level. Vascular risk factors are modifiable and may offer an important opportunity for preventive approaches. Several studies have shown that diabetes, hypertension, obesity, and smoking are associated with an increased risk of cognitive decline and dementia, but other groups have not observed such a relation. Positive associations were observed mainly in studies where risk factors were assessed in midlife, suggesting that age is an important modulator in the relation between vascular risk factors and cognition. The population attributable risk of dementia is particularly high for hypertension. Associations of vascular risk factors with cognitive decline and dementia are probably mediated largely by cerebrovascular disease, including both stroke and covert vascular brain injury, which can have additive or synergistic effects with coexisting neurodegenerative lesions. To date, randomized trials have not convincingly demonstrated that treating vascular risk factors is associated with a reduction in cognitive decline or dementia risk. Of eight randomized trials testing the effect of antihypertensive agents on dementia risk, only one was positive, and another in a subgroup of individuals with recurrent stroke. In most trials, cognition and dementia were secondary outcomes, follow-up was short and treatment was initiated at an older age. No effect on cognitive decline or dementia could be demonstrated for statins and intensive glycemic control. Future areas of investigation could include differential class effects of antihypertensive drugs on cognitive outcomes and identification of high risk individuals as target population for clinical trials initiated in midlife. Copyright © 2013. Published by Elsevier Masson SAS.

  6. RC2S: A Cognitive Remediation Program to Improve Social Cognition in Schizophrenia and Related Disorders

    PubMed Central

    Peyroux, Elodie; Franck, Nicolas

    2014-01-01

    In people with psychiatric disorders, particularly those suffering from schizophrenia and related illnesses, pronounced difficulties in social interactions are a key manifestation. These difficulties can be partly explained by impairments in social cognition, defined as the ability to understand oneself and others in the social world, which includes abilities such as emotion recognition, theory of mind (ToM), attributional style, and social perception and knowledge. The impact of several kinds of interventions on social cognition has been studied recently. The best outcomes in the area of social cognition in schizophrenia are those obtained by way of cognitive remediation programs. New strategies and programs in this line are currently being developed, such as RC2S (cognitive remediation of social cognition) in Lyon, France. Considering that the social cognitive deficits experienced by patients with schizophrenia are very diverse, and that the main objective of social cognitive remediation programs is to improve patients’ functioning in their daily social life, RC2S was developed as an individualized and flexible program that allows patients to practice social interaction in a realistic environment through the use of virtual reality techniques. In the RC2S program, the patient’s goal is to assist a character named Tom in various social situations. The underlying idea for the patient is to acquire cognitive strategies for analyzing social context and emotional information in order to understand other characters’ mental states and to help Tom manage his social interactions. In this paper, we begin by presenting some data regarding the social cognitive impairments found in schizophrenia and related disorders, and we describe how these deficits are targeted by social cognitive remediation. Then we present the RC2S program and discuss the advantages of computer-based simulation to improve social cognition and social functioning in people with psychiatric disorders

  7. Methodological recommendations for cognition trials in bipolar disorder by the International Society for Bipolar Disorders Targeting Cognition Task Force.

    PubMed

    Miskowiak, K W; Burdick, K E; Martinez-Aran, A; Bonnin, C M; Bowie, C R; Carvalho, A F; Gallagher, P; Lafer, B; López-Jaramillo, C; Sumiyoshi, T; McIntyre, R S; Schaffer, A; Porter, R J; Torres, I J; Yatham, L N; Young, A H; Kessing, L V; Vieta, E

    2017-09-12

    To aid the development of treatment for cognitive impairment in bipolar disorder, the International Society for Bipolar Disorders (ISBD) convened a task force to create a consensus-based guidance paper for the methodology and design of cognition trials in bipolar disorder. The task force was launched in September 2016, consisting of 18 international experts from nine countries. A series of methodological issues were identified based on literature review and expert opinion. The issues were discussed and expanded upon in an initial face-to-face meeting, telephone conference call and email exchanges. Based upon these exchanges, recommendations were achieved. Key methodological challenges are: lack of consensus on how to screen for entry into cognitive treatment trials, define cognitive impairment, track efficacy, assess functional implications, and manage mood symptoms and concomitant medication. Task force recommendations are to: (i) enrich trials with objectively measured cognitively impaired patients; (ii) generally select a broad cognitive composite score as the primary outcome and a functional measure as a key secondary outcome; and (iii) include remitted or partly remitted patients. It is strongly encouraged that trials exclude patients with current substance or alcohol use disorders, neurological disease or unstable medical illness, and keep non-study medications stable. Additional methodological considerations include neuroimaging assessments, targeting of treatments to illness stage and using a multimodal approach. This ISBD task force guidance paper provides the first consensus-based recommendations for cognition trials in bipolar disorder. Adherence to these recommendations will likely improve the sensitivity in detecting treatment efficacy in future trials and increase comparability between studies. © 2017 The Authors Bipolar Disorders Published by John Wiley & Sons Ltd.

  8. Cognitive style in bipolar disorder sub-types.

    PubMed

    Fletcher, Kathryn; Parker, Gordon; Manicavasagar, Vijaya

    2013-04-30

    Clearer understanding of psychological processes and mechanisms such as cognitive style inform more targeted psychological treatments for mood disorders. Studies to date have focused on bipolar I disorder or combined bipolar sub-types, precluding identification of any distinctive cognitive style profiles. We examined cognitive style separately in the bipolar sub-types, contrasted with unipolar and non-clinical controls. A total of 417 participants (94 bipolar I, 114 bipolar II, 109 unipolar, 100 healthy controls) completed cognitive style measures including the Rosenberg Self-Esteem Scale, Dysfunctional Attitudes Scale, Inferential Styles Questionnaire, Stress Appraisal Measure and the Behavioural Inhibition System/Behavioural Activation System Scale. Overall, cognitive styles were similar in unipolar and bipolar participants, but with styles relevant to the Behavioral Activation System differentiating bipolar I disorder in particular. State anxiety influenced negative inferential style in unipolar participants and appraisal of stress in bipolar II participants. Analyses restricted to bipolar I vs. II comparisons revealed subtle differences in terms of dispositional stress appraisal, with higher scores on two stress appraisal sub-scales in the bipolar I group. Further exploration of cognitive style in bipolar sub-types is indicated in order to determine whether there are specific psychological vulnerabilities that would benefit from more targeted psychological interventions. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  9. CAN NONINVASIVE BRAIN STIMULATION ENHANCE COGNITION IN NEUROPSYCHIATRIC DISORDERS?

    PubMed Central

    Demirtas-Tatlidede, Asli; Vahabzadeh-Hagh, Andrew M.; Pascual-Leone, Alvaro

    2013-01-01

    Cognitive impairment is a core symptom of many neuropsychiatric diseases and a key contributor to the patient’s quality of life. However, an effective therapeutic strategy has yet to be developed. Noninvasive brain stimulation techniques, namely transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS), are promising techniques that are under investigation for a variety of otherwise treatment-resistant neuropsychiatric diseases. Notably, these tools can induce alterations in neural networks subserving cognitive operations and thus may provide a means for cognitive restoration. The purpose of this article is to review the available evidence concerning cognitive enhancing properties of noninvasive brain stimulation in neuropsychiatry. We specifically focus on major depression, Alzheimer’s disease, schizophrenia, autism and attention deficit hyperactivity disorder (ADHD), where cognitive dysfunction is a major symptom and some studies have been completed with promising results. We provide a critical assessment of the available research and suggestions to guide future efforts. PMID:22749945

  10. Lithium and cognition in those with bipolar disorder.

    PubMed

    Paterson, Amelia; Parker, Gordon

    2017-03-01

    Although a percentage of patients report cognitive side-effects when taking lithium, it can be difficult to determine from the literature whether any cognitive changes reflect lithium itself, the lithium serum level, residual mood symptoms, the underlying nature of bipolar disorder, or biological alterations such as hypothyroidism. This review was carried out to synthesize and evaluate relevant literature examining any cognitive impact of lithium in those with bipolar disorder. The effect of lithium in those with bipolar disorder was examined across the cognitive domains of attention, psychomotor speed, processing speed, working memory, intellectual functioning, verbal memory, visual memory, and executive functioning by reviewing the published empirical literature. Any impact of hypothyroidism and lithium toxicity was also examined. The literature supports the conclusion that lithium has a distinct impact on psychomotor speed in participants with bipolar disorder. In contrast, there appears to be no impact on attention. Any impact of lithium on memory in patients with bipolar disorder is unclear as the literature is contradictory and any such effect may be overshadowed by the greater impact of residual mood symptoms. The impact on processing speed, intellectual abilities, and executive functioning also remains unclear. Several clinical management strategies are recommended.

  11. Cognitive analytic therapy for personality disorder: randomised controlled trial.

    PubMed

    Clarke, Susan; Thomas, Peter; James, Kirsty

    2013-02-01

    Cognitive analytic therapy (CAT) is a theoretically coherent approach developed to address common processes underlying personality disorders, but is supported by limited empirical evidence. To investigate the effectiveness of time-limited CAT for participants with personality disorder. A service-based randomised controlled trial (trial registration: ISRCTN79596618) comparing 24 sessions of CAT (n = 38) and treatment as usual (TAU) (n = 40) over 10 months for individuals with personality disorder. Primary outcomes were measures of psychological symptoms and interpersonal difficulties. Participants receiving CAT showed reduced symptoms and experienced substantial benefits compared with TAU controls, who showed signs of deterioration during the treatment period. Cognitive analytic therapy is more effective than TAU in improving outcomes associated with personality disorder. More elaborate and controlled evaluations of CAT are needed in the future.

  12. Self-Instructional Cognitive Training to Reduce Impulsive Cognitive Style in Children with Attention Deficit with Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Rivera-Flores, Gladys Wilma

    2015-01-01

    Introduction: Children with attention deficit with hyperactivity disorder (ADHD) have an impulsive, rigid and field-dependent cognitive style. This study examines whether self-instructional cognitive training reduces impulsive cognitive style in children diagnosed with this disorder. Method: The subjects were 10 children between the ages of 6 and…

  13. Self-Instructional Cognitive Training to Reduce Impulsive Cognitive Style in Children with Attention Deficit with Hyperactivity Disorder

    ERIC Educational Resources Information Center

    Rivera-Flores, Gladys Wilma

    2015-01-01

    Introduction: Children with attention deficit with hyperactivity disorder (ADHD) have an impulsive, rigid and field-dependent cognitive style. This study examines whether self-instructional cognitive training reduces impulsive cognitive style in children diagnosed with this disorder. Method: The subjects were 10 children between the ages of 6 and…

  14. Vitamin D Deficiency Associated With Cognitive Functioning in Psychotic Disorders.

    PubMed

    Nerhus, Mari; Berg, Akiah O; Simonsen, Carmen; Haram, Marit; Haatveit, Beathe; Dahl, Sandra R; Gurholt, Tiril P; Bjella, Thomas D; Ueland, Torill; Andreassen, Ole A; Melle, Ingrid

    2017-07-01

    Cognitive dysfunctions are core features of psychotic disorders with substantial impact on daily functioning. Vitamin D deficiency has been found to be related to cognitive dysfunctions, but the associations between vitamin D deficiency and cognition in persons with a psychotic disorder are largely unknown. This cross-sectional study included 225 patients with a DSM-IV psychotic disorder consecutively recruited from 2003 to 2014 and 159 randomly selected healthy controls, assessed by a cognitive test battery, a clinical protocol (including Structured Clinical Interview for DSM-IV Axis I Disorders and Positive and Negative Syndrome Scale), and a physical examination including vitamin D measurements. Multiple regression models were performed to evaluate the effect of vitamin D deficiency (defined serum 25-hydroxyvitamin D [25(OH)D] < 25 nmol/L) on key cognitive domains: processing speed, verbal learning, verbal memory, and executive functioning. Vitamin D deficiency was significantly associated with decreased processing speed (ie, Digit Symbol Coding) (t = -2.6, P = .01; total model: adjusted R² = 0.40, F6, 374 = 43.8, P < .001) and decreased fluency (ie, verbal fluency) (t = -2.1, P = .04; total model: adjusted R² = 0.35, F6, 373 = 34.2, P < .001) when the results were controlled for age, ethnicity, IQ, patient versus control status, and substance or alcohol abuse. Additional analyses indicated that negative symptoms diluted the association between vitamin D deficiency and processing speed (t = -1.72, P = .09) and verbal fluency (t = -1.35, P = .18) in patients. The associations between vitamin D deficiency and processing speed and verbal fluency are good arguments for planning large-scale randomized controlled studies in target populations so conclusions can be made about the potential beneficial effect of vitamin D on cognition in psychotic disorders.

  15. Neural mechanisms of cognitive reappraisal in remitted major depressive disorder.

    PubMed

    Smoski, Moria J; Keng, Shian-Ling; Schiller, Crystal Edler; Minkel, Jared; Dichter, Gabriel S

    2013-10-01

    Down-regulation of negative emotions by cognitive strategies relies on prefrontal cortical modulation of limbic brain regions, and impaired frontolimbic functioning during cognitive reappraisal has been observed in affective disorders. However, no study to date has examined cognitive reappraisal in unmedicated euthymic individuals with a history of major depressive disorder relative to symptom-matched controls. Given that a history of depression is a critical risk factor for future depressive episodes, investigating the neural mechanisms of emotion regulation in remitted major depressive disorder (rMDD) may yield novel insights into depression risk. We assessed 37 individuals (18 rMDD, 19 controls) with functional magnetic resonance imaging (fMRI) during a task requiring cognitive reappraisal of sad images. Both groups demonstrated decreased self-reported negative affect after cognitive reappraisal and no group differences in the effects of cognitive reappraisal on mood were evident. Functional MRI results indicated greater paracingulate gyrus (rostral anterior cingulate cortex, Brodmann area 32) activation and decreased right midfrontal gyrus (Brodmann area 6) activation during the reappraisal of sad images. Trial-by-trial ratings of pre-regulation affect were not collected, limiting the interpretation of post-regulation negative affect scores. Results suggest that activation of rostral anterior cingulate cortex, a region linked to the prediction of antidepressant treatment response, and of the right midfrontal gyrus, a region involved in cognitive control in the context of cognitive reappraisal, may represent endophenotypic markers of future depression risk. Future prospective studies will be needed to validate the predictive utility of these neural markers. © 2013 Elsevier B.V. All rights reserved.

  16. [Neuroprogression and cognition in Bipolar Disorders: A systematic review of cognitive performance in euthymic patients].

    PubMed

    Lolich, María; Holtzman, Jessica N; Rago, Carlo M; Vázquez, Gustavo H

    2015-01-01

    In recent years, investigators have begun to consider the possibility of explaining the physiopathology of bipolar disorder from a neuroprogressive perspective. The evidence that supports the feasibility of such an approach is varied, and arises from neuroimaging studies, batteries of neurocognitive evaluations, and tests to identify the specific biomarkers of the disorder. The present article seeks to perform a review of the research that investigates the cognitive deficits in bipolar disorder. A bibliographic revision was performed of articles published between 1990 and 2015. Levels of cognitive performance were explored in both cross-sectional and longitudinal studies. The compiled studies signal the presence of altered cognitive function, even during periods of euthymia. However, there are contradictory results as to whether bipolar disorder presents a degenerative course. New lines of investigation suggest that only a percentage of individuals with bipolar disorder are affected in a progressive manner. It is of paramount importance to perform new longitudinal studies in high-risk populations, so as to validate or refute a neuroprogressive model of cognitive deficits in patients with bipolar disorder.

  17. Brief Report: Cognitive Control Helps Explain Comorbidity Between Alcohol Use Disorder and Internalizing Disorders

    PubMed Central

    Ellingson, Jarrod M; Richmond-Rakerd, Leah S; Slutske, Wendy S

    2015-01-01

    Objective: Alcohol use and internalizing problems frequently co-occur. Cognitive control has been implicated in their etiology, but no studies have tested whether this construct helps explain the co-occurrence of these disorders. Method: A total of 1,313 undergraduate students completed assessments of cognitive control, negative emotionality, and symptoms of alcohol use disorder (AUD), depression, and generalized anxiety disorder. Structural equation models examined the extent to which overlap between AUD and internalizing problems was explained by variance specific to cognitive control and negative emotionality, as well as variance shared by both constructs. Results: Symptoms of AUD and internalizing disorders were modestly correlated (depression: r = .16; anxiety: r = .14). Variance specific to cognitive control explained a significant proportion of the correlation between AUD and both depression and generalized anxiety (depression: 19%; generalized anxiety: 18%), as did variance common to cognitive control and negative emotionality (depression: 24%; generalized anxiety: 31%). Consistent with previous work, variance specific to negative emotionality also explained a large and statistically significant proportion of the correlation between AUD and internalizing disorder symptoms. Of note, the residualized correlation for AUD symptom endorsement with both depression and generalized anxiety problems was not statistically significant after accounting for both cognitive control and negative emotionality. Conclusions: This study provides new evidence that cognitive control may help explain the overlap between AUD and internalizing disorders while further supporting the contribution of negative emotionality to this overlap. Results have implications for intervention efforts aimed at reducing comorbid alcohol use disorder and internalizing disorders, as well as general psychopathology. PMID:25486397

  18. Genes, Cognition, and Communication: Insights from Neurodevelopmental Disorders

    PubMed Central

    Bishop, DVM

    2009-01-01

    Twin and family studies have demonstrated that most cognitive traits are moderately to highly heritable. Neurodevelopmental disorders such as dyslexia, autism, and specific language impairment (SLI) also show strong genetic influence. Nevertheless, it has proved difficult for researchers to identify genes that would explain substantial amounts of variance in cognitive traits or disorders. Although this observation may seem paradoxical, it fits with a multifactorial model of how complex human traits are influenced by numerous genes that interact with one another, and with the environment, to produce a specific phenotype. Such a model can also explain why genetic influences on cognition have not vanished in the course of human evolution. Recent linkage and association studies of SLI and dyslexia are reviewed to illustrate these points. The role of nonheritable genetic mutations (sporadic copy number variants) in causing autism is also discussed. Finally, research on phenotypic correlates of allelic variation in the genes ASPM and microcephalin is considered; initial interest in these as genes for brain size or intelligence has been dampened by a failure to find phenotypic differences in people with different versions of these genes. There is a current vogue for investigators to include measures of allelic variants in studies of cognition and cognitive disorders. It is important to be aware that the effect sizes associated with these variants are typically small and hard to detect without extremely large sample sizes. PMID:19338500

  19. Phenotypic cognitive impairment in late-onset delusional disorder.

    PubMed

    Harris, Ben S; Kotsopoulos, Eleftheria J; Yamin, Sami

    2014-06-01

    Previous use of heterogeneous diagnostic criteria and insensitive cognitive measures has impeded clarification of the extent and type of cognitive impairment specific to late-onset delusional disorder. We examined whether clinical presentations of late-onset delusional disorder are associated with prodromal or established dementia, and whether it might be a discrete clinical syndrome characterized by its own profile of cognitive impairment. Nineteen patients with late-onset delusional disorder from a hospital psychiatric service and 20 patients with dementia of the Alzheimer's type (AD) from an outpatient memory clinic were recruited in a consecutive case series. All patients underwent comprehensive neuropsychological assessment that included general intellectual function, executive function, new learning and delayed memory, language, processing speed, and visuo-perceptual skills. Late-onset delusional disorder patients showed moderate impairment to conceptual reasoning, visual object recognition, processing speed, and confrontation naming. Severe impairment appeared in visuo-perceptual planning and organization, and divided attention. Compared with the Alzheimer's disease (AD) group, the late-onset delusional disorder group demonstrated significantly poorer visuo-perceptual skills but a significantly better capacity to consolidate information into delayed memory. A high rate of marked cognitive impairment occurs in late-onset delusional disorder. There was evidence of a conceptual reasoning deficit, plus the presence of a visuo-perceptual impairment affecting object recognition. This impairment profile can explain the genesis and maintenance of the observed delusions. Understanding late-onset delusional disorder as other than a purely psychiatric phenomenon or a precursor to AD will lead to better assessment and management approaches.

  20. Cognitive-Behavioral Therapy for Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Rotheram-Fuller, Erin; MacMullen, Laura

    2011-01-01

    Autism spectrum disorders (ASD) represent a continuum of cognitive and social problems that vary considerably in both impact and presentation for each child affected. Although successful interventions have been developed that target specific skill deficits often exhibited by children with autism, many of those interventions are exclusively…

  1. Borderline Personality Disorder: Too Complex for Cognitive Therapy?

    ERIC Educational Resources Information Center

    Pretzer, James L.

    Historically, the literature on psychotherapy with borderline personality disorder has been based on object-relations theory or psychoanalytical approaches, rather than cognitive and behavioral approaches. In clinical assessment, the term borderline has been used to refer to patients with both neurotic and psychotic symptoms, a particular type of…

  2. Cognitive Flexibility in Phenotypes of Pediatric Bipolar Disorder

    ERIC Educational Resources Information Center

    Dickstein, Daniel P.; Nelson, Eric E.; McClure, Erin B.; Grimley, Mary E.; Knopf, Lisa; Brotman, Melissa A.; Rich, Brendan A.; Pine, Daniel S.; Leibenluft, Ellen

    2007-01-01

    Objective: Clinicians and researchers debate whether children with chronic, nonepisodic irritability should receive the diagnosis of bipolar disorder (BD). To address this debate, we evaluated cognitive flexibility, or the ability to adapt to changing contingencies, in three groups of children: narrow-phenotype BD (NP-BD; full-duration manic…

  3. Development of Rostral Prefrontal Cortex and Cognitive and Behavioural Disorders

    ERIC Educational Resources Information Center

    Dumontheil, Iroise; Burgess, Paul W.; Blakemore, Sarah-Jayne

    2008-01-01

    Information on the development and functions of rostral prefrontal cortex (PFC), or Brodmann area 10, has been gathered from different fields, from anatomical development to functional neuroimaging in adults, and put forward in relation to three particular cognitive and behavioural disorders. Rostral PFC is larger and has a lower cell density in…

  4. Development of Rostral Prefrontal Cortex and Cognitive and Behavioural Disorders

    ERIC Educational Resources Information Center

    Dumontheil, Iroise; Burgess, Paul W.; Blakemore, Sarah-Jayne

    2008-01-01

    Information on the development and functions of rostral prefrontal cortex (PFC), or Brodmann area 10, has been gathered from different fields, from anatomical development to functional neuroimaging in adults, and put forward in relation to three particular cognitive and behavioural disorders. Rostral PFC is larger and has a lower cell density in…

  5. Cognitive-Behavioral Therapy for Children with Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Rotheram-Fuller, Erin; MacMullen, Laura

    2011-01-01

    Autism spectrum disorders (ASD) represent a continuum of cognitive and social problems that vary considerably in both impact and presentation for each child affected. Although successful interventions have been developed that target specific skill deficits often exhibited by children with autism, many of those interventions are exclusively…

  6. Cognitive-Behavioral Therapy for Rapid Cycling Bipolar Disorder

    ERIC Educational Resources Information Center

    Reilly-Harrington, Noreen A.; Knauz, Robert O.

    2005-01-01

    This article describes the application of cognitive-behavioral therapy (CBT) to the treatment of rapid cycling bipolar disorder. Between 10% and 24% of bipolar patients experience a rapid cycling course, with 4 or more mood episodes occurring per year. Characterized by nonresponse to standard mood-stabilizing medications, rapid cyclers are…

  7. Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder

    ERIC Educational Resources Information Center

    Greenberg, Jennifer L.; Markowitz, Sarah; Petronko, Michael R.; Taylor, Caitlin E.; Wilhelm, Sabine; Wilson, G. Terence

    2010-01-01

    The onset of appearance-related concerns associated with body dysmorphic disorder (BDD) typically occurs in adolescence, and these concerns are often severe enough to interfere with normal development and psychosocial functioning. Cognitive behavioral therapy (CBT) is an effective treatment for adults with BDD. However, no treatment studies…

  8. Modular Cognitive-Behavioral Therapy for Body Dysmorphic Disorder

    ERIC Educational Resources Information Center

    Wilhelm, Sabine; Phillips, Katharine A.; Fama, Jeanne M.; Greenberg, Jennifer L.; Steketee, Gail

    2011-01-01

    This study pilot tested a newly developed modular cognitive-behavioral therapy (CBT) treatment manual for body dysmorphic disorder (BDD). We tested feasibility, acceptability, and treatment outcome in a sample of 12 adults with primary BDD. Treatment was delivered in weekly individual sessions over 18 or 22 weeks. Standardized clinician ratings…

  9. Neuromodulation Treatments for Geriatric Mood and Cognitive Disorders.

    PubMed

    McDonald, William M

    2016-12-01

    There is increasing evidence for the efficacy of neuromodulation in the treatment of resistant mood disorders and emerging data supporting the use of neuromodulation in cognitive disorders. A significant minority of depressed elders do not respond to pharmacotherapy and/or psychotherapy. This has led clinicians to recommend the increasing use of electroconvulsive therapy (ECT) in the treatment of medication-resistant or life-threatening geriatric depression. Multiple studies have supported the safety and efficacy of ECT in the elderly, yet ECT is associated with side effects including cardiovascular and cognitive side effects. Neuromodulation therapies have the potential for providing effective treatment for treatment-resistant older adults with reduced side effects and this review will outline the risks and benefits of neuromodulation treatment in geriatric psychiatry. There is also emerging evidence of the efficacy of neuromodulation devices in the treatment of cognitive disorders. Pharmacotherapy has been largely ineffective in changing the course of neurodegenerative diseases causing dementia and other treatments are clearly needed. This review will outline the available evidence for neuromodulation in the treatment of mood and cognitive disorders in the elderly. Copyright © 2016 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  10. Cognitive-Behavioral Therapy for Rapid Cycling Bipolar Disorder

    ERIC Educational Resources Information Center

    Reilly-Harrington, Noreen A.; Knauz, Robert O.

    2005-01-01

    This article describes the application of cognitive-behavioral therapy (CBT) to the treatment of rapid cycling bipolar disorder. Between 10% and 24% of bipolar patients experience a rapid cycling course, with 4 or more mood episodes occurring per year. Characterized by nonresponse to standard mood-stabilizing medications, rapid cyclers are…

  11. Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder

    ERIC Educational Resources Information Center

    Greenberg, Jennifer L.; Markowitz, Sarah; Petronko, Michael R.; Taylor, Caitlin E.; Wilhelm, Sabine; Wilson, G. Terence

    2010-01-01

    The onset of appearance-related concerns associated with body dysmorphic disorder (BDD) typically occurs in adolescence, and these concerns are often severe enough to interfere with normal development and psychosocial functioning. Cognitive behavioral therapy (CBT) is an effective treatment for adults with BDD. However, no treatment studies…

  12. Cognitive Flexibility in Phenotypes of Pediatric Bipolar Disorder

    ERIC Educational Resources Information Center

    Dickstein, Daniel P.; Nelson, Eric E.; McClure, Erin B.; Grimley, Mary E.; Knopf, Lisa; Brotman, Melissa A.; Rich, Brendan A.; Pine, Daniel S.; Leibenluft, Ellen

    2007-01-01

    Objective: Clinicians and researchers debate whether children with chronic, nonepisodic irritability should receive the diagnosis of bipolar disorder (BD). To address this debate, we evaluated cognitive flexibility, or the ability to adapt to changing contingencies, in three groups of children: narrow-phenotype BD (NP-BD; full-duration manic…

  13. Cognitive-Behavioral Therapy for Comorbid Generalized Anxiety Disorder and Panic Disorder with Agoraphobia

    ERIC Educational Resources Information Center

    Labrecque, Joane; Dugas, Michel J.; Marchand, Andre; Letarte, Andree

    2006-01-01

    The goal of this study was to evaluate the efficacy of a cognitive-behavioral treatment package for comorbid generalized anxiety disorder (GAD) and panic disorder with agoraphobia (PDA). A single-case, multiple-baseline, across-subjects design was used with 3 primary GAD patients with secondary PDA. The efficacy of the treatment was evaluated with…

  14. The Relationship between Sluggish Cognitive Tempo, Subtypes of Attention-Deficit/Hyperactivity Disorder, and Anxiety Disorders

    ERIC Educational Resources Information Center

    Skirbekk, Benedicte; Hansen, Berit Hjelde; Oerbeck, Beate; Kristensen, Hanne

    2011-01-01

    The objective of the present study was to examine the relationship between sluggish cognitive tempo (SCT), subtypes of attention-deficit/hyperactivity disorder (ADHD), and anxiety disorders (AnxDs). One hundred and forty-one children (90 males, 51 females) aged 7-13 years were assigned to four groups, i.e., referred children with comorbid AnxDs…

  15. Cognitive-Behavioral Therapy for Comorbid Generalized Anxiety Disorder and Panic Disorder with Agoraphobia

    ERIC Educational Resources Information Center

    Labrecque, Joane; Dugas, Michel J.; Marchand, Andre; Letarte, Andree

    2006-01-01

    The goal of this study was to evaluate the efficacy of a cognitive-behavioral treatment package for comorbid generalized anxiety disorder (GAD) and panic disorder with agoraphobia (PDA). A single-case, multiple-baseline, across-subjects design was used with 3 primary GAD patients with secondary PDA. The efficacy of the treatment was evaluated with…

  16. Motor, Emotional, and Cognitive Empathy in Children and Adolescents with Autism Spectrum Disorder and Conduct Disorder

    ERIC Educational Resources Information Center

    Bons, Danielle; van den Broek, Egon; Scheepers, Floor; Herpers, Pierre; Rommelse, Nanda; Buitelaaar, Jan K.

    2013-01-01

    It is unclear which aspects of empathy are shared and which are uniquely affected in autism spectrum disorder (ASD) and conduct disorder (CD) as are the neurobiological correlates of these empathy impairments. The aim of this systematic review is to describe the overlap and specificity of motor, emotional, and cognitive aspects of empathy in…

  17. The Relationship between Sluggish Cognitive Tempo, Subtypes of Attention-Deficit/Hyperactivity Disorder, and Anxiety Disorders

    ERIC Educational Resources Information Center

    Skirbekk, Benedicte; Hansen, Berit Hjelde; Oerbeck, Beate; Kristensen, Hanne

    2011-01-01

    The objective of the present study was to examine the relationship between sluggish cognitive tempo (SCT), subtypes of attention-deficit/hyperactivity disorder (ADHD), and anxiety disorders (AnxDs). One hundred and forty-one children (90 males, 51 females) aged 7-13 years were assigned to four groups, i.e., referred children with comorbid AnxDs…

  18. Motor, Emotional, and Cognitive Empathy in Children and Adolescents with Autism Spectrum Disorder and Conduct Disorder

    ERIC Educational Resources Information Center

    Bons, Danielle; van den Broek, Egon; Scheepers, Floor; Herpers, Pierre; Rommelse, Nanda; Buitelaaar, Jan K.

    2013-01-01

    It is unclear which aspects of empathy are shared and which are uniquely affected in autism spectrum disorder (ASD) and conduct disorder (CD) as are the neurobiological correlates of these empathy impairments. The aim of this systematic review is to describe the overlap and specificity of motor, emotional, and cognitive aspects of empathy in…

  19. Affective Cognition and its Disruption in Mood Disorders

    PubMed Central

    Elliott, Rebecca; Zahn, Roland; Deakin, J F William; Anderson, Ian M

    2011-01-01

    In this review, we consider affective cognition, responses to emotional stimuli occurring in the context of cognitive evaluation. In particular, we discuss emotion categorization, biasing of memory and attention, as well as social/moral emotion. We discuss limited neuropsychological evidence suggesting that affective cognition depends critically on the amygdala, ventromedial frontal cortex, and the connections between them. We then consider neuroimaging studies of affective cognition in healthy volunteers, which have led to the development of more sophisticated neural models of these processes. Disturbances of affective cognition are a core and specific feature of mood disorders, and we discuss the evidence supporting this claim, both from behavioral and neuroimaging perspectives. Serotonin is considered to be a key neurotransmitter involved in depression, and there is a considerable body of research exploring whether serotonin may mediate disturbances of affective cognition. The final section presents an overview of this literature and considers implications for understanding the pathophysiology of mood disorder as well as developing and evaluating new treatment strategies. PMID:20571485

  20. Cognitive behavioral therapy for sleep disorders.

    PubMed

    Babson, Kimberly A; Feldner, Matthew T; Badour, Christal L

    2010-09-01

    More than 70 million people in the United States experience primary insomnia (PI) at some point in their life, resulting in an estimated $65 billion in health care costs and lost productivity. PI is therefore one of the most common health care problems in the United States. To mollify the negative effects of PI, scholars have sought to evaluate and improve treatments of this costly health care problem. A breadth of research has demonstrated that cognitive behavioral therapy (CBT) is an effective intervention for PI. The goal of this article is to provide an overview of CBT for PI, including evidence regarding treatment efficacy, effectiveness, and practitioner considerations.

  1. Cognitive variability in bipolar II disorder: who is cognitively impaired and who is preserved.

    PubMed

    Solé, Brisa; Jiménez, Esther; Torrent, Carla; Del Mar Bonnin, Caterina; Torres, Imma; Reinares, María; Priego, Ángel; Salamero, Manel; Colom, Francesc; Varo, Cristina; Vieta, Eduard; Martínez-Arán, Anabel

    2016-05-01

    Although it is well established that euthymic patients with bipolar disorder can have cognitive impairment, substantial heterogeneity exists and little is known about the extent and severity of impairment within the bipolar II disorder subtype. Therefore, the main aim of this study was to analyze cognitive variability in a sample of patients with bipolar II disorder. The neuropsychological performance of 116 subjects, including 64 euthymic patients with bipolar II disorder and 52 healthy control subjects, was examined and compared by means of a comprehensive neurocognitive battery. Neurocognitive data were analyzed using a cluster analysis to examine whether there were specific groups based on neurocognitive patterns. Subsequently, subjects from each cluster were compared on demographic, clinical, and functional variables. A three-cluster solution was identified with an intact neurocognitive group (n = 29, 48.3%), an intermediate or selectively impaired group (n = 24, 40.0%), and a globally impaired group (n = 7, 11.6%). Among the three clusters, statistically significant differences were observed in premorbid intelligence quotient (p = 0.002), global functional outcome (p = 0.021), and leisure activities (p = 0.001), with patients in the globally impaired cluster showing the lowest attainments. No differences in other clinical characteristics were found among the groups. These results confirm that neurocognitive variability is also present among patients with bipolar II disorder. Approximately one-half of the patients with bipolar II disorder were cognitively impaired, and among them 12% were severely and globally impaired. The identification of different cognitive profiles may help to develop cognitive remediation programs specifically tailored for each cognitive profile. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Contextual Social Cognition Impairments in Schizophrenia and Bipolar Disorder

    PubMed Central

    Villarin, Lilian; Theil, Donna; Gonzalez-Gadea, María Luz; Gomez, Pedro; Mosquera, Marcela; Huepe, David; Strejilevich, Sergio; Vigliecca, Nora Silvana; Matthäus, Franziska; Decety, Jean; Manes, Facundo; Ibañez, Agustín M.

    2013-01-01

    Background The ability to integrate contextual information with social cues to generate social meaning is a key aspect of social cognition. It is widely accepted that patients with schizophrenia and bipolar disorders have deficits in social cognition; however, previous studies on these disorders did not use tasks that replicate everyday situations. Methodology/Principal Findings This study evaluates the performance of patients with schizophrenia and bipolar disorders on social cognition tasks (emotional processing, empathy, and social norms knowledge) that incorporate different levels of contextual dependence and involvement of real-life scenarios. Furthermore, we explored the association between social cognition measures, clinical symptoms and executive functions. Using a logistic regression analysis, we explored whether the involvement of more basic skills in emotional processing predicted performance on empathy tasks. The results showed that both patient groups exhibited deficits in social cognition tasks with greater context sensitivity and involvement of real-life scenarios. These deficits were more severe in schizophrenic than in bipolar patients. Patients did not differ from controls in tasks involving explicit knowledge. Moreover, schizophrenic patients’ depression levels were negatively correlated with performance on empathy tasks. Conclusions/Significance Overall performance on emotion recognition predicted performance on intentionality attribution during the more ambiguous situations of the empathy task. These results suggest that social cognition deficits could be related to a general impairment in the capacity to implicitly integrate contextual cues. Important implications for the assessment and treatment of individuals with schizophrenia and bipolar disorders, as well as for neurocognitive models of these pathologies are discussed. PMID:23520477

  3. Cognitive Training in Mental Disorders: Update and Future Directions

    PubMed Central

    Keshavan, Matcheri S.; Vinogradov, Sophia; Rumsey, Judith; Sherrill, Joel; Wagner, Ann

    2014-01-01

    Objective In this paper, we review the conceptual basis, definitions, and evolution of cognitive training (CT) approaches for the treatment of mental disorders. Method We review the current state of the knowledge on CT in psychiatric illnesses, and its neural and behavioral targets, and summarize the factors that appear to relate to a successful response to CT, including learner characteristics that influence clinical outcome. We also discuss methodological issues relevant to the development and testing of CT approaches, with the goal of creating maximally efficient and effective approaches to training. Finally, we identify gaps in existing knowledge, and outline key research directions for the future. Results While much of the early work has been conducted in schizophrenia, CT has more recently been applied to a widening range of neuropsychiatric illnesses, including attention deficit disorder, mood disorders, and substance use disorders. CT harnesses the inherent neuroplastic capacities of the brain, targeting neural system function across psychiatric disorders, and thus improving cognitive processes that play a role in emotion regulation, clinical symptoms, and adaptive community functioning. Conclusions CT offers considerable promise, especially given the limited efficacy of pharmacological interventions in ameliorating cognitive deficits. However, more work is needed to understand mechanisms underlying CT, predictors of response, generalization and real-world applicability, and approaches to dissemination in practice settings. PMID:24700194

  4. [Disorders of cognitive activity in schizophrenics].

    PubMed

    Follin, S; Perrette, J; Sandretto, M

    1979-01-01

    4 tests are exploring the cognitive activity of 3 groups of persons: normal, mental patients of various types, schizophrenics, homogeneous as far as the I.Q. is concerned (above 110) and education (secondary school, or university). Whereas normal and mental patients give identical results, except that they are worse for the latter, schizophrenics have better success than other patients in two tests of logic-mathematical reasoning and obviously worse in two tests of experimental logic. These results are interpreted in the frame of Piaget's theory as demonstrating the discordance of the very dynamics of schizophrenic thinking whose cognitive activity is at the same time too near to the object by adherence to the perceived structure (too concrete) and too far from it by adherence to formal reasoning schemes acquired under genetic development (too abstract). These results are coherent with clinical features showing that autistic thinking is not only discordant by its contents and its meaning, but also by the formal dynamic patterns of its modus operandi.

  5. Cognitive control deficits associated with antisocial personality disorder and psychopathy.

    PubMed

    Zeier, Joshua D; Baskin-Sommers, Arielle R; Hiatt Racer, Kristina D; Newman, Joseph P

    2012-07-01

    Antisociality has been linked to a variety of executive functioning deficits, including poor cognitive control. Surprisingly, cognitive control deficits are rarely found in psychopathic individuals, despite their notoriously severe and persistent antisocial behavior. In fact, primary (low-anxious) psychopathic individuals display superior performance on cognitive control-type tasks under certain circumstances. To clarify these seemingly contradictory findings, we administered a response competition (i.e., flanker) task to incarcerated offenders, who were assessed for Antisocial Personality Disorder (APD) symptoms and psychopathy. As hypothesized, APD related to poorer accuracy, especially on incongruent trials. Contrary to expectation, however, the same pattern of results was found in psychopathy. Additional analyses indicated that these effects of APD and psychopathy were associated with overlapping variance. The findings suggest that psychopathy and APD symptoms are both associated with deficits in cognitive control, and that this deficit relates to general antisociality as opposed to a specific antisocial syndrome.

  6. Cognitive Control Deficits Associated with Antisocial Personality Disorder and Psychopathy

    PubMed Central

    Zeier, Joshua D.; Baskin-Sommers, Arielle R.; Newman, Joseph P.; Racer, Kristina Hiatt

    2011-01-01

    Antisociality has been linked to a variety of executive functioning deficits, including poor cognitive control. Surprisingly, cognitive control deficits are rarely found in psychopathic individuals, despite their notoriously severe and persistent antisocial behavior. In fact, primary (low-anxious) psychopathic individuals display superior performance on cognitive control-type tasks under certain circumstances. To clarify these seemingly contradictory findings, we administered a response competition (i.e. flanker) task to incarcerated offenders, who were assessed for Antisocial Personality Disorder (APD) symptoms and psychopathy. As hypothesized, APD related to poorer accuracy, especially on incongruent trials. Contrary to expectation, however, the same pattern of results was found in psychopathy. Additional analyses indicated that these effects of APD and psychopathy were associated with overlapping variance. The findings suggest that psychopathy and APD symptoms are both associated with deficits in cognitive control, and that this deficit relates to general antisociality as opposed to a specific antisocial syndrome. PMID:22452754

  7. Cognition and daytime functioning in sleep-related breathing disorders.

    PubMed

    Jackson, Melinda L; Howard, Mark E; Barnes, Maree

    2011-01-01

    Sleep-related breathing disorders encompass a range of disorders in which abnormal ventilation occurs during sleep as a result of partial or complete obstruction of the upper airway, altered respiratory drive, abnormal chest wall movement, or respiratory muscle function. The most common of these is obstructive sleep apnea (OSA), occurring in both adults and children, and causing significant cognitive and daytime dysfunction and reduced quality of life. OSA patients experience repetitive brief cessation of breathing throughout the night, which causes intermittent hypoxemia (reductions in hemoglobin oxygen levels) and fragmented sleep patterns. These nocturnal events result in excessive daytime sleepiness, and changes in mood and cognition. Chronic excessive sleepiness during the day is a common symptom of sleep-related breathing disorders, which is assessed in sleep clinics both subjectively (questionnaire) and objectively (sleep latency tests). Mood changes are often reported by patients, including irritability, fatigue, depression, and anxiety. A wide range of cognitive deficits have been identified in untreated OSA patients, from attentional and vigilance, to memory and executive functions, and more complex tasks such as simulated driving. These changes are reflected in patient reports of difficulty in concentrating, increased forgetfulness, an inability to make decisions, and falling asleep at the wheel of a motor vehicle. These cognitive changes can also have significant downstream effects on daily functioning. Moderate to severe cases of the disorder are at a higher risk of having a motor vehicle accident, and may also have difficulties at work or school. A number of comorbidities may also influence the cognitive changes in OSA patients, including hypertension, diabetes, and stroke. These diseases can cause changes to neural vasculature and result in neural damage, leading to cognitive impairments. Examination of OSA patients using neuroimaging techniques such

  8. The neurobiology of cognitive disorders in temporal lobe epilepsy

    PubMed Central

    Bell, Brian; Lin, Jack J.; Seidenberg, Michael; Hermann, Bruce

    2013-01-01

    Cognitive impairment and especially memory disruption is a major complicating feature of the epilepsies. In this review we begin with a focus on the problem of memory impairment in temporal lobe epilepsy. We start with a brief overview of the early development of knowledge regarding the anatomic substrates of memory disorder in temporal lobe epilepsy, followed by discussion of the refinement of that knowledge over time as informed by the outcomes of epilepsy surgery (anterior temporal lobectomy) and the clinical efforts to predict those patients at greatest risk of adverse cognitive outcomes following epilepsy surgery. These efforts also yielded new theoretical insights regarding the function of the human hippocampus and a few examples of these insights are touched on briefly. Finally, the vastly changing view of temporal lobe epilepsy is examined including findings demonstrating that anatomic abnormalities extend far outside the temporal lobe, cognitive impairments extend beyond memory function, with linkage of these distributed cognitive and anatomic abnormalities pointing to a new understanding of the anatomic architecture of cognitive impairment in epilepsy. Challenges remain in understanding the origin of these cognitive and anatomic abnormalities, their progression over time, and most importantly, how to intervene to protect cognitive and brain health in epilepsy. PMID:21304484

  9. Common Questions About Cognitive Behavior Therapy for Psychiatric Disorders.

    PubMed

    Coffey, Scott F; Banducci, Anne N; Vinci, Christine

    2015-11-01

    Cognitive behavior therapy (CBT) is a time-limited, goal-oriented psychotherapy that has been extensively researched and has benefits in a number of psychiatric disorders, including anxiety, depression, posttraumatic stress disorder, attention-deficit/hyperactivity disorder, autism, obsessive-compulsive and tic disorders, personality disorders, eating disorders, and insomnia. CBT uses targeted strategies to help patients adopt more adaptive patterns of thinking and behaving, which leads to positive changes in emotions and decreased functional impairments. Strategies include identifying and challenging problematic thoughts and beliefs, scheduling pleasant activities to increase environmental reinforcement, and extended exposure to unpleasant thoughts, situations, or physiologic sensations to decrease avoidance and arousal associated with anxiety-eliciting stimuli. CBT can be helpful in the treatment of posttraumatic stress disorder by emphasizing safety, trust, control, esteem, and intimacy. Prolonged exposure therapy is a CBT technique that includes a variety of strategies, such as repeated recounting of the trauma and exposure to feared real-world situations. For attention-deficit/hyperactivity disorder, CBT focuses on establishing structures and routines, and clear rules and expectations within the home and classroom. Early intensive behavioral interventions should be initiated in children with autism before three years of age; therapy consists of 12 to 40 hours of intensive treatment per week, for at least one year. In many disorders, CBT can be used alone or in combination with medications. However, CBT requires a significant commitment from patients. Family physicians are well suited to provide collaborative care for patients with psychiatric disorders, in concert with cognitive behavior therapists.

  10. Mild cognitive impairment: a subset of minor neurocognitive disorder?

    PubMed

    Geda, Yonas E; Nedelska, Zuzana

    2012-10-01

    The field of aging and dementia is increasingly preoccupied with identification of the asymptomatic phenotype of Alzheimer disease (AD). A quick glance at historical landmarks in the field indicates that the agenda and priorities of the field have evolved over time. The initial focus of research was dementia. In the late 1980s and 1990s, dementia researchers reported that some elderly persons are neither demented nor cognitively normal. Experts coined various terms to describe the gray zone between normal cognitive aging and dementia, including mild cognitive impairment. Advances made in epidemiologic, neuroimaging, and biomarkers research emboldened the field to seriously pursue the avenue of identifying asymptomatic AD. Accurate "diagnosis" of the phenotype has also evolved over time. For example, the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM-5) Task Force is contemplating to use the terms major and minor neurocognitive disorders. The six papers published in this edition of the journal pertain to mild cognitive impairment, which is envisaged to become a subset of minor neurocognitive disorders. These six studies have three points in common: 1) All of them are observational studies; 2) they have generated useful hypotheses or made important observations without necessarily relying on expensive biomarkers; and 3) Based on the new National Institute on Aging and the Alzheimer's Association guidelines, all the studies addressed the symptomatic phase of AD. Questionnaire-based observational studies will continue to be useful until such a time that validated biomarkers, be it chemical or neuroimaging, become widely available and reasonably affordable.

  11. Social cognition and functional capacity in bipolar disorder and schizophrenia.

    PubMed

    Thaler, Nicholas S; Sutton, Griffin P; Allen, Daniel N

    2014-12-15

    Social cognition is a functionally relevant predictor of capacity in schizophrenia (SZ), though research concerning its value for bipolar disorder (BD) is limited. The current investigation examined the relationship between two social cognitive factors and functional capacity in bipolar disorder. This study included 48 individuals with bipolar disorder (24 with psychotic features) and 30 patients with schizophrenia. Multiple regression controlling for estimated IQ scores was used to assess the predictive value of social cognitive factors on the UCSD Performance-Based Functional Skills Assessment (UPSA). Results found that for the bipolar with psychosis and schizophrenia groups, the social/emotion processing factor predicted the UPSA. The theory of mind factor only predicted the UPSA for the schizophrenia group.. Findings support the clinical utility of evaluating emotion processing in individuals with a history of psychosis. For BD, theory of mind may be better explained by a generalized cognitive deficit. In contrast, social/emotion processing may be linked to distinct neurobiological processes associated with psychosis.

  12. [Repetitive transcranial magnetic stimulation: A potential therapy for cognitive disorders?

    PubMed

    Nouhaud, C; Sherrard, R M; Belmin, J

    2017-03-01

    Considering the limited effectiveness of drugs treatments in cognitive disorders, the emergence of noninvasive techniques to modify brain function is very interesting. Among these techniques, repetitive transcranial magnetic stimulation (rTMS) can modulate cortical excitability and have potential therapeutic effects on cognition and behaviour. These effects are due to physiological modifications in the stimulated cortical tissue and their associated circuits, which depend on the parameters of stimulation. The objective of this article is to specify current knowledge and efficacy of rTMS in cognitive disorders. Previous studies found very encouraging results with significant improvement of higher brain functions. Nevertheless, these few studies have limits: a few patients were enrolled, the lack of control of the mechanisms of action by brain imaging, insufficiently formalized technique and variability of cognitive tests. It is therefore necessary to perform more studies, which identify statistical significant improvement and to specify underlying mechanisms of action and the parameters of use of the rTMS to offer rTMS as a routine therapy for cognitive dysfunction.

  13. [Social cognition in patients with mood disorders. Part II: bipolar disorder : a selective review of the literature].

    PubMed

    Hoertnagl, Christine Maria; Oberheinricher, Stefan; Hofer, Alex

    2014-01-01

    Overview on the current knowledge regarding social cognition in patients with bipolar disorder. Selective literature research on deficits in social cognition intrinsic to bipolar disorder, their occurrence and effects. Deficits in social cognition are considered to be core features of bipolar disorder. They are apparent during acute episodes of the disorder, endure when patients are in remission and have a significant negative impact on the patients' psychosocial outcomes. It is important to consider deficits in social cognition as an integral part of a treatment approach to achieve mental stabilization in patients with bipolar disorder.

  14. [Social cognition in patients with mood disorders: part I: major depressive disorder : a comprehensive review of the literature].

    PubMed

    Hörtnagl, Christine Maria; Oberheinricher, Stefan; Hofer, Alex

    2014-01-01

    Overview on the current knowledge regarding social cognition in patients with major depressive disorder. Selective literature research on deficits in social cognition intrinsic to major depressive disorders, their occurrence and effects. Deficits in social cognition are considered to be core features of major depressive disorder. They are apparent during acute episodes of the disorders, endure when patients are in remission and have a significant negative impact on the patients' psychosocial outcomes. It is important to consider deficits in social cognition as an integral part of a treatment approach to achieve mental stabilization in patients with major depressive disorder.

  15. Dissemination of Cognitive Therapy for Panic Disorder in Primary Care

    PubMed Central

    Grey, Nick; Salkovskis, Paul; Quigley, Alexandra; Clark, David M.; Ehlers, Anke

    2011-01-01

    This study investigated whether brief training in cognitive therapy for panic disorder (Clark et al., 1994) can improve the outcomes that primary care therapists obtain with their patients. Seven primary care therapists treated 36 patients meeting DSM-IV (APA, 1994) criteria for panic disorder with or without agoraphobia in general practice surgeries. Outcomes for the cohort of patients whom the therapists treated with their usual methods (treatment-as-usual) before the training (N = 12) were compared with those obtained with similar patients treated by the same therapists after brief training and ongoing supervision in cognitive therapy (CT) for panic disorder (N = 24). Treatment-as-usual led to significant improvements in panic severity, general anxiety, and depression. However, only a small proportion (17% of the intent-to-treat sample) became panic free and there was no improvement in agoraphobic avoidance. Patients treated with CT achieved significantly better outcomes on all measures of panic attacks, including panic-free rate (54%, intent-to-treat), and showed significantly greater improvements in agoraphobic avoidance and patient-rated general anxiety. In conclusion, cognitive therapy for panic disorder can be successfully disseminated in primary care with a brief therapist training and supervision programme that leads to significant improvements in patient outcomes. PMID:22661906

  16. Boosting Cognition With Music in Patients With Disorders of Consciousness.

    PubMed

    Castro, Maïté; Tillmann, Barbara; Luauté, Jacques; Corneyllie, Alexandra; Dailler, Frédéric; André-Obadia, Nathalie; Perrin, Fabien

    2015-09-01

    Music listening conveys beneficial effects on cognitive processes in both normal and pathologic cerebral functioning. Surprisingly, no quantitative study has evaluated the potential effects of music on cognition and consciousness in patients with disorders of consciousness. The aim of the present study was to evaluate the effect of music on cerebral processing in patients with disorders of consciousness. Using bedside electroencephalographic recording, we acquired in 13 patients with disorders of consciousness event-related potentials to the patient's first name after either an excerpt of the patient's preferred music (music condition) or a continuous sound (control condition). The cerebral response to the patient's first name was more often observed in the music condition, than in the control condition. Furthermore, the presence or absence of a discriminative response in the music condition seemed to be associated with a favorable or unfavorable outcome, respectively. These findings demonstrate for the first time that music has a beneficial effect on cognitive processes of patients with disorders of consciousness. The autobiographical characteristics of music, that is, its emotional and personal relevance, probably increase arousal and/or awareness. © The Author(s) 2015.

  17. Cognitive-Behavioral Therapy for Substance Use Disorders

    PubMed Central

    McHugh, R. Kathryn; Hearon, Bridget A.; Otto, Michael W.

    2010-01-01

    Cognitive behavioral therapy (CBT) for substance use disorders has demonstrated efficacy as both a monotherapy and as part of combination treatment strategies. This article provides a review of the evidence supporting the use of CBT, clinical elements of its application, novel treatment strategies for improving treatment response, and dissemination efforts. Although CBT for substance abuse is characterized by heterogeneous treatment elements—such as operant learning strategies, cognitive and motivational elements, and skills building interventions—across protocols several core elements emerge that focus on overcoming the powerfully reinforcing effects of psychoactive substances. These elements, and support for their efficacy, are discussed. PMID:20599130

  18. Impaired Cognition and Brain Atrophy Decades After Hypertensive Pregnancy Disorders.

    PubMed

    Mielke, Michelle M; Milic, Natasa M; Weissgerber, Tracey L; White, Wendy M; Kantarci, Kejal; Mosley, Thomas H; Windham, B Gwen; Simpson, Brittany N; Turner, Stephen T; Garovic, Vesna D

    2016-02-01

    Hypertensive pregnancy disorders have been associated with subjective cognitive complaints or brain white-matter lesions 5 to 10 years after the hypertensive pregnancy. The long-term effects of hypertensive pregnancies on brain structure and cognitive function remain unknown. This study included 1279 women who participated in the Family Blood Pressure Project Genetic Epidemiology Network of Arteriopathy (GENOA) study. As part of the ancillary Genetics of Microangiopathic Brain Injury (GMBI) study, a neurocognitive battery was administered; 1075 also had a brain magnetic resonance imaging. A history of a hypertensive pregnancy disorder was obtained by a self-report using a validated questionnaire. Linear models fit with generalized estimating equations were used to assess the association between hypertensive pregnancy disorders and cognition, adjusting for age, race, education, body mass index, smoking, current hypertension, hypertension duration, and family history of hypertension. Regression models for the brain magnetic resonance imaging outcomes also were adjusted for total intracranial volume. Women with histories of hypertensive pregnancy disorders performed worse on all measures of processing speed (Digital Symbol Substitution Test [mean score, 41.2 versus 43.4; P=0.005], Trail Making Test Part A [mean seconds, 45.1 versus 42.2; P=0.035], and Stroop [mean score, 173.9 versus 181.0; P=0.002]) and had smaller brain volumes compared with women with histories of normotensive pregnancies (286 versus 297; P=0.023). Hypertensive pregnancy disorders are associated with worse performance on tests of processing speed and smaller brain volumes decades later. Population-based studies are needed to provide critical insight as to the contribution of hypertensive pregnancies to risk of cognitive decline and dementia. © 2016 American Heart Association, Inc.

  19. Impaired Cognition and Brain Atrophy Decades After Hypertensive Pregnancy Disorders

    PubMed Central

    Mielke, Michelle M.; Milic, Natasa M.; Weissgerber, Tracey L.; White, Wendy M.; Kantarci, Kejal; Mosley, Thomas H.; Windham, B. Gwen; Simpson, Brittany N.; Turner, Stephen T.; Garovic, Vesna D.

    2016-01-01

    Background Hypertensive pregnancy disorders have been associated with subjective cognitive complaints or brain white matter lesions five to ten years after the hypertensive pregnancy. The long-term effects of hypertensive pregnancies on brain structure and cognitive function remain unknown. Methods and Results This study included 1279 women who participated in the Family Blood Pressure Project Genetic Epidemiology Network of Arteriopathy (GENOA) study. As part of the ancillary Genetics of Microangiopathic Brain Injury study, a neurocognitive battery was administered; 1075 also had a brain MRI. A history of a hypertensive pregnancy disorder was obtained by self-report using a validated questionnaire. Linear models fit with generalized estimating equations were used to assess the association between hypertensive pregnancy disorders and cognition, adjusting for age, race, education, body mass index, smoking, current hypertension, hypertension duration, and family history of hypertension. Regression models for the brain MRI outcomes also were adjusted for total intracranial volume. Women with histories of hypertensive pregnancy disorders performed worse on all measures of processing speed: Digital Symbol Substitution Test (mean score 41.2 vs 43.4, P=0.005), Trail Making Test Part A (mean seconds 45.1 vs 42.2, P=0.035), and Stroop (mean score 173.9 vs 181.0, P=0.002) and had smaller brain volumes compared to women with histories of normotensive pregnancies (286 vs 297, P=0.023). Conclusions Hypertensive pregnancy disorders are associated with worse performance on tests of processing speed and smaller brain volumes decades later. Population-based studies are needed to provide critical insight as to the contribution of hypertensive pregnancies to risk of cognitive decline and dementia. PMID:26908863

  20. MANUSCRIPT IN PRESS: DEMENTIA & GERIATRIC COGNITIVE DISORDERS

    PubMed Central

    O’Bryant, Sid E.; Xiao, Guanghua; Barber, Robert; Cullum, C. Munro; Weiner, Myron; Hall, James; Edwards, Melissa; Grammas, Paula; Wilhelmsen, Kirk; Doody, Rachelle; Diaz-Arrastia, Ramon

    2015-01-01

    Background Prior work on the link between blood-based biomarkers and cognitive status has largely been based on dichotomous classifications rather than detailed neuropsychological functioning. The current project was designed to create serum-based biomarker algorithms that predict neuropsychological test performance. Methods A battery of neuropsychological measures was administered. Random forest analyses were utilized to create neuropsychological test-specific biomarker risk scores in a training set that were entered into linear regression models predicting the respective test scores in the test set. Serum multiplex biomarker data were analyzed on 108 proteins from 395 participants (197 AD cases and 198 controls) from the Texas Alzheimer’s Research and Care Consortium. Results The biomarker risk scores were significant predictors (p<0.05) of scores on all neuropsychological tests. With the exception of premorbid intellectual status (6.6%), the biomarker risk scores alone accounted for a minimum of 12.9% of the variance in neuropsychological scores. Biomarker algorithms (biomarker risk scores + demographics) accounted for substantially more variance in scores. Review of the variable importance plots indicated differential patterns of biomarker significance for each test, suggesting the possibility of domain-specific biomarker algorithms. Conclusions Our findings provide proof-of-concept for a novel area of scientific discovery, which we term “molecular neuropsychology.” PMID:24107792

  1. Cognitive Change Predicts Symptom Reduction with Cognitive Therapy for Posttraumatic Stress Disorder

    ERIC Educational Resources Information Center

    Kleim, Birgit; Grey, Nick; Wild, Jennifer; Nussbeck, Fridtjof W.; Stott, Richard; Hackmann, Ann; Clark, David M.; Ehlers, Anke

    2013-01-01

    Objective: There is a growing body of evidence for the effectiveness of trauma-focused cognitive behavior therapy (TF-CBT) for posttraumatic stress disorder (PTSD), but few studies to date have investigated the mechanisms by which TF-CBT leads to therapeutic change. Models of PTSD suggest that a core treatment mechanism is the change in…

  2. Cognitive Change Predicts Symptom Reduction with Cognitive Therapy for Posttraumatic Stress Disorder

    ERIC Educational Resources Information Center

    Kleim, Birgit; Grey, Nick; Wild, Jennifer; Nussbeck, Fridtjof W.; Stott, Richard; Hackmann, Ann; Clark, David M.; Ehlers, Anke

    2013-01-01

    Objective: There is a growing body of evidence for the effectiveness of trauma-focused cognitive behavior therapy (TF-CBT) for posttraumatic stress disorder (PTSD), but few studies to date have investigated the mechanisms by which TF-CBT leads to therapeutic change. Models of PTSD suggest that a core treatment mechanism is the change in…

  3. Patterns of Clinically Significant Cognitive Impairment in Hoarding Disorder

    PubMed Central

    Mackin, R. Scott; Vigil, Ofilio; Insel, Philip; Kivowitz, Alana; Kupferman, Eve; Hough, Christina; Fekri, Shiva; Delucchi, Kevin L.; Mathews, Carol A.

    2017-01-01

    OBJECTIVES The cognitive characteristics of individuals with Hoarding Disorder (HD) are not well understood. Existing studies are relatively few and somewhat inconsistent but suggest that individuals with HD may have specific dysfunction in the cognitive domains of categorization, speed of information processing, and decision-making. However, there have been no studies evaluating the degree to which cognitive dysfunction in these domains reflects clinically significant cognitive impairment (CI). METHODS Participants included 78 individuals who met DSM-V criteria for HD and 70 age- and education-matched controls. Cognitive performance on measures of memory, attention, information processing speed, abstract reasoning, visuospatial processing, decision-making, and categorization ability was evaluated for each participant. Rates of clinical impairment for each measure were compared, as were age and education corrected raw scores for each cognitive test. RESULTS HD participants showed greater incidence of CI on measures of visual memory, visual detection, and visual categorization relative to controls. Raw score comparisons between groups showed similar results with HD participants showing lower raw score performance on each of these measures. In addition, in raw score comparisons HD participants also demonstrated relative strengths compared to control participants on measures of verbal and visual abstract reasoning. CONCLUSIONS These results suggest that HD is associated with a pattern of clinically significant CI in some visually mediated neurocognitive processes including visual memory, visual detection, and visual categorization. Additionally these results suggest HD individuals may also exhibit relative strengths, perhaps compensatory, in abstract reasoning in both verbal and visual domains. PMID:26474146

  4. Predicting Obsessive Compulsive Disorder Subtypes Using Cognitive Factors

    PubMed Central

    Ramezani, Zahra; Mohammadi, Nourollah

    2016-01-01

    Objective: Recent studies have emphasized the important role of cognitive beliefs in etiology and maintenance of obsessive-compulsive disorder (OCD). OCD has different subtypes, but the specific role of cognitive beliefs in OCD symptomatology is not clear. The aim of the current study was to determine whether the cognitive factors proposed by Obsessive Compulsive Cognitions Working Group (OCCWG) could specifically predict subtypes of OCD. Method: The question was investigated in a sample of 208 university students (mean age = 21, SD = 1.6). The target population was selected by cluster sampling. All participants completed two questionnaires including Obsessive Beliefs Questionnaire (OBQ-44) and Obsessive Compulsive Inventory-Revised (OCI-R). Data were analyzed using descriptive statistics and regression analysis. Results: Regression analysis demonstrated that “responsibility/ threat over estimation” was a significant predictor of obsessive and compulsive behaviors and predicted washing, checking, obsessing, hoarding, and neutralizing subtypes of OCD. Furthermore, “perfectionism and intolerance of uncertainty” was the most significant predictor of ordering and hoarding while “importance/ control of thought” predicted ordering only. Conclusion: This study found evidence in support of Salkovskis’ cognitive theory about the central role of inflated responsibility beliefs in developing different subtypes of OCD. Besides, the results revealed those other cognitive beliefs had less important role in the development of OCD symptoms. PMID:27437003

  5. Mindfulness-Action Based Cognitive Behavioral Therapy for concurrent Binge Eating Disorder and Substance Use Disorders.

    PubMed

    Courbasson, Christine M; Nishikawa, Yasunori; Shapira, Leah B

    2011-01-01

    Individuals with Binge Eating Disorder (BED) often evidence comorbid Substance Use Disorders (SUD), resulting in poor outcome. This study is the first to examine treatment outcome for this concurrent disordered population. In this pilot study, 38 individuals diagnosed with BED and SUD participated in a 16-week group Mindfulness-Action Based Cognitive Behavioral Therapy (MACBT). Participants significantly improved on measures of objective binge eating episodes; disordered eating attitudes; alcohol and drug addiction severity; and depression. Taken together, MACBT appears to hold promise in treating individuals with co-existing BED-SUD.

  6. Cognitive Risk Factors for Specific Learning Disorder: Processing Speed, Temporal Processing, and Working Memory

    ERIC Educational Resources Information Center

    Moll, Kristina; Göbel, Silke M.; Gooch, Debbie; Landerl, Karin; Snowling, Margaret J.

    2016-01-01

    High comorbidity rates between reading disorder (RD) and mathematics disorder (MD) indicate that, although the cognitive core deficits underlying these disorders are distinct, additional domain-general risk factors might be shared between the disorders. Three domain-general cognitive abilities were investigated in children with RD and MD:…

  7. Cognitive Risk Factors for Specific Learning Disorder: Processing Speed, Temporal Processing, and Working Memory

    ERIC Educational Resources Information Center

    Moll, Kristina; Göbel, Silke M.; Gooch, Debbie; Landerl, Karin; Snowling, Margaret J.

    2016-01-01

    High comorbidity rates between reading disorder (RD) and mathematics disorder (MD) indicate that, although the cognitive core deficits underlying these disorders are distinct, additional domain-general risk factors might be shared between the disorders. Three domain-general cognitive abilities were investigated in children with RD and MD:…

  8. Cognitive-behavioral therapy for the treatment of anxiety disorders.

    PubMed

    Otto, Michael W; Smits, Jasper A J; Reese, Hannah E

    2004-01-01

    In this article, we consider the evidence supporting the range of applications of cognitive-behavioral therapy (CBT) for anxiety disorders, and we examine some of the complex issues encountered for the combination of pharmacologic and cognitive-behavioral treatment strategies. The available evidence supports CBT as an effective first-line treatment for anxiety disorders offering longer-term maintenance of treatment gains. There is also evidence that CBT is an effective strategy for pharmacotherapy nonresponders, a replacement strategy for patients who wish to discontinue their medications, and a standard strategy for pharmacotherapy patients who need to boost their treatment response. Relative to combination therapy, we review some of the conditions that may influence the longevity of treatment gains from CBT.

  9. Cognitive constructs and social anxiety disorder: beyond fearing negative evaluation.

    PubMed

    Teale Sapach, Michelle J N; Carleton, R Nicholas; Mulvogue, Myriah K; Weeks, Justin W; Heimberg, Richard G

    2015-01-01

    Pioneering models of social anxiety disorder (SAD) underscored fear of negative evaluation (FNE) as central in the disorder's development. Additional cognitive predictors have since been identified, including fear of positive evaluation (FPE), anxiety sensitivity, and intolerance of uncertainty (IU), but rarely have these constructs been examined together. The present study concurrently examined the variance accounted for in SAD symptoms by these constructs. Participants meeting criteria for SAD (n = 197; 65% women) completed self-report measures online. FNE, FPE, anxiety sensitivity, and IU all accounted for unique variance in SAD symptoms. FPE accounted for variance comparable to FNE, and the cognitive dimension of anxiety sensitivity and the prospective dimension of IU accounted for comparable variance, though slightly less than that accounted for by FNE and FPE. The results support the theorized roles that these constructs play in the etiology of SAD and highlight both FNE and FPE as central foci in SAD treatment.

  10. Suicidal behaviours in affective disorders: a deficit of cognitive inhibition?

    PubMed

    Richard-Devantoy, Stéphane; Gorwood, Philip; Annweiler, Cédric; Olié, Jean-Pierre; Le Gall, Didier; Beauchet, Olivier

    2012-04-01

    Suicide has been related to affective disorders. We hypothesized that suicide could be associated with cognitive inhibition deficit. Our study aimed to systematically review all published articles that examined the relation between cognitive inhibition deficit and suicidal behaviours (that is, suicide attempt or suicidal ideation) in patients with affective disorders. We performed an English and French MEDLINE and EMBASE search, ranging from 1970 to 2010, indexed under the MeSH terms of suicide, neuropsychology, neuropsychological tests, and executive function, combined with the following title and abstract terms: neuropsychological functions, executive functioning, and executive performance. Among the 164 selected studies, 9 observational studies met the selection criteria and were included in the final analysis. The number of participants ranged from 57 to 244 (28% to 66%, respectively, were men). Executive dysfunction was more frequently found among patients with suicidal behaviours. In particular, higher cognitive inhibition deficit was observed in depressed subjects with suicide behaviours, compared with depressed subjects without any suicidal behaviour. The results of the meta-analysis showed a higher impairment in inhibition score, according to the number of perseverations in the Wisconsin Card Sorting Test (Cohen d = 0.68) than in inhibition according to the time needed to perform the Trail-Making Test part B (d = 0.01) among patients with suicidal behaviour, compared with patients with no suicidal behaviour. This systematic review and meta-analysis showed a positive association between cognitive inhibition deficit and suicide attempts in patients with affective disorders. Future research should examine whether cognitive inhibition deficit precedes the suicidal behaviour.

  11. Cognitive disorders in children associated with urban vehicular emissions.

    PubMed

    Annavarapu, Ramesh Naidu; Kathi, Srujana

    2016-01-01

    This review introduces recent advances in an emerging research area that is focussed on studying the effect of exposure to vehicular emissions on cognition, with specific attention to children from urban environments. Today, air pollution is a global environmental issue, especially in urban environments, emitting particulate matter (PM), nitrogen dioxide (NO2), carbon monoxide (CO), volatile organic compounds (VOCs) and polycyclic aromatic hydrocarbons (PAHs) into the surroundings. The association of exposure to urban air pollution and cognitive disorders in children is a major cause of concern. We review recent findings associated with exposure to air pollutants and explained the potential mechanisms driving oxidative stress in living systems. An attempt has been made to investigate the cognitive effects of air pollutants leading to neurodegeneration, neurodysfunction, attention deficit/hypersensitivity deficiencies and autism in children. Accumulating evidence suggests that urban air pollution may have significant impact on central nervous system (CNS) of the developing brain.

  12. Cognitive behavioral therapy of obsessive-compulsive disorder

    PubMed Central

    Foa, Edna B.

    2010-01-01

    Until the mid-1960s, obsessive-compulsive disorder (OCD) was considered to be treatment-resistant, as both psychodynamic psychotherapy and medication had been unsuccessful in significantly reducing OCD symptoms. The first real breakthrough came in 1966 with the introduction of exposure and ritual prevention. This paper will discuss the cognitive behavioral conceptualizations that influenced the development of cognitive behavioral treatments for OCD. There will be a brief discussion of the use of psychodynamic psychotherapy and early behavioral therapy, neither of which produced successful outcomes with OCD. The main part of the paper will be devoted to current cognitive behavioral therapy (CBT) with an emphasis on variants of exposure and ritual or response prevention (EX/RP) treatments, the therapy that has shown the most empirical evidence of its efficacy. PMID:20623924

  13. Implicit cognitive processes in binge-eating disorder and obesity.

    PubMed

    Brauhardt, Anne; Rudolph, Almut; Hilbert, Anja

    2014-06-01

    Binge-eating disorder (BED) is characterized by recurrent binge eating episodes, associated eating disorder and general psychopathology, and commonly occurs in obese individuals. Explicit self-esteem and explicit weight bias have been linked to BED, while little is known about implicit cognitive processes such as implicit self-esteem and implicit weight bias. Obese participants with BED and an individually matched obese only group (OB) and normal weight control group (CG; each N = 26) were recruited from the community to examine group differences and associations in explicit and implicit self-esteem and weight bias, as well as the impact of implicit cognitive processes on global eating disorder psychopathology. Implicit cognitive processes were assessed using the Implicit Association Test. Significantly lower explicit self-esteem, as well as higher exposure to explicit weight bias, compared to CG and OB was found in the BED group. All groups showed positive implicit self-esteem, however, it was significantly lower in BED when compared to CG. BED and CG demonstrated equally high implicit weight bias whereas OB did not. Explicit and implicit measures were not significantly correlated. Global eating disorder psychopathology was predicted by explicit and implicit self-esteem. The results of the present study add to the importance of implicit self-esteem and implicit weight bias beyond explicit measures in BED, while both were previously shown to be associated with onset and maintenance of BED. In conclusion, implicit cognitive processes should be focused on in interventions for BED to investigate their impact on psychological treatments. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. The Impact of Obsessive Compulsive Personality Disorder on Cognitive Behaviour Therapy for Obsessive Compulsive Disorder.

    PubMed

    Gordon, Olivia M; Salkovskis, Paul M; Bream, Victoria

    2016-07-01

    It is often suggested that, in general, co-morbid personality disorders are likely to interfere with CBT based treatment of Axis I disorders, given that personality disorders are regarded as dispositional and are therefore considered less amenable to change than axis I psychiatric disorders. The present study aimed to investigate the impact of co-occurring obsessive-compulsive disorder (OCD) and obsessive-compulsive personality disorder (OCPD) on cognitive-behavioural treatment for OCD. 92 individuals with a diagnosis of OCD participated in this study. Data were drawn from measures taken at initial assessment and following cognitive-behavioural treatment at a specialist treatment centre for anxiety disorders. At assessment, participants with OCD and OCPD had greater overall OCD symptom severity, as well as doubting, ordering and hoarding symptoms relative to those without OCPD; however, participants with co-morbid OCD and OCPD demonstrated greater treatment gains in terms of OCD severity, checking and ordering than those without OCPD. Individuals with OCD and OCPD had higher levels of checking, ordering and overall OCD severity at initial assessment; however, at post-treatment they had similar scores to those without OCPD. The implications of these findings are discussed in the light of research on axis I and II co-morbidity and the impact of axis II disorders on treatment for axis I disorders.

  15. Psychotic-like cognitive biases in borderline personality disorder.

    PubMed

    Moritz, Steffen; Schilling, Lisa; Wingenfeld, Katja; Köther, Ulf; Wittekind, Charlotte; Terfehr, Kirsten; Spitzer, Carsten

    2011-09-01

    Whereas a large body of research has linked borderline personality disorder (BPD) with affective rather than psychotic disorders, BPD patients frequently display psychotic and psychosis-prone symptoms, respectively. The present study investigated whether cognitive biases implicated in the pathogenesis of psychotic symptoms, especially delusions, are also evident in BPD. A total of 20 patients diagnosed with BPD and 20 healthy controls were administered tasks measuring neuropsychological deficits (psychomotor speed, executive functioning) and cognitive biases (e.g., one-sided reasoning, jumping to conclusions, problems with intentionalizing). Whereas BPD patients performed similar to controls on standard neuropsychological tests, they showed markedly increased scores on four out of five subscales of the Cognitive Biases Questionnaire for Psychosis (CBQp) and displayed a one-sided attributional style on the revised Internal, Personal and Situational Attributions Questionnaire (IPSAQ-R) with a marked tendency to attribute events to themselves. The study awaits replication with larger samples, but we tentatively suggest that the investigation of psychosis-related cognitive biases may prove useful for the understanding and treatment of BPD. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Mnesic imbalance: a cognitive theory about autism spectrum disorders

    PubMed Central

    Romero-Munguía, Miguel Ángel

    2008-01-01

    Autism is characterized by impairments in social interaction, communicative capacity and behavioral flexibility. Some cognitive theories can be useful for finding a relationship between these irregularities and the biological mechanisms that may give rise to this disorder. Among such theories are mentalizing deficit, weak central coherence and executive dysfunction, but none of them has been able to explain all three diagnostic symptoms of autism. These cognitive disorders may be related among themselves by faulty learning, since several research studies have shown that the brains of autistic individuals have abnormalities in the cerebellum, which plays a role in procedural learning. In keeping with this view, one may postulate the possibility that declarative memory replaces faulty procedural memory in some of its functions, which implies making conscious efforts in order to perform actions that are normally automatic. This may disturb cognitive development, resulting in autism symptoms. Furthermore, this mnesic imbalance is probably involved in all autism spectrum disorders. In the present work, this theory is expounded, including preliminary supporting evidence. PMID:18925971

  17. The world is random: a cognitive perspective on perceived disorder

    PubMed Central

    Kotabe, Hiroki P.

    2014-01-01

    Research on the consequences of perceiving disorder is largely sociological and concerns broken windows theory, which states that signs of social disorder cause further social disorder. The predominant psychological explanations for this phenomenon are primarily social. In contrast, I propose a parsimonious cognitive model (“world-is-random” model; WIR) that may partly account for these effects. Basically, WIR proposes that perceiving disorder primes randomness-related concepts, which results in a reduction to one’s sense of personal control, which has diverse affective, judgmental, and behavioral consequences. I review recent developments on the psychological consequences of perceiving disorder and argue that WIR can explain all of these findings. I also cover select correlational findings from the sociological literature and explain how WIR can at least partly explain them. In a general discussion, I consider possible alternative psychological models and argue that they do not adequately explain the most recent psychological research on disorder. I then propose future directions which include determining whether perceiving disorder causes a “unique psychology” and delimiting boundary conditions. PMID:24982648

  18. 'Hot' cognition in major depressive disorder: a systematic review.

    PubMed

    Miskowiak, Kamilla W; Carvalho, Andre F

    2014-01-01

    Major depressive disorder (MDD) is associated with significant cognitive dysfunction in both 'hot' (i.e. emotion-laden) and 'cold' (non-emotional) domains. Here we review evidence pertaining to 'hot' cognitive changes in MDD. This systematic review searched the PubMed and PsycInfo computerized databases in May 2014 augmented by hand searches of reference lists. We included original articles in which MDD participants (or their healthy first-degree relatives) and a healthy control group were compared on standard measures of emotional processing or reward/ punishment processing as well as systematic reviews and meta-analyses. A total of 116 articles met the inclusion criteria of which 97 were original studies. Negative biases in perception, attention and memory for emotional information, and aberrant reward/punishment processing occur in MDD. Imbalanced responses to negative stimuli in a fronto-limbic network with hyper-activity in limbic and ventral prefrontal regions paired with hypo-activity of dorsal prefrontal regions subserve these abnormalities. A cross-talk of 'hot' and 'cold' cognition disturbances in MDD occurs. Disturbances in 'hot cognition' may also contribute to the perpetuation of negative emotional states in MDD. Limited success in the identification of susceptibility genes in MDD has led to great research interest in identifying vulnerability biomarkers or endophenotypes. Emerging evidence points to the persistence of 'hot' cognition dysfunction during remission and to subtle 'hot' cognition deficits in healthy relatives of patients with MDD. Taken together, these findings suggest that abnormalities in 'hot' cognition may constitute a candidate neurocognitive endophenotype for depression.

  19. Impact of childhood trauma on cognitive profile in bipolar disorder.

    PubMed

    Jiménez, Esther; Solé, Brisa; Arias, Bárbara; Mitjans, Marina; Varo, Cristina; Reinares, María; Bonnín, Caterina Del Mar; Ruíz, Victoria; Saiz, Pilar Alejandra; García-Portilla, M Paz; Burón, Patricia; Bobes, Julio; Amann, Benedikt L; Martínez-Arán, Anabel; Torrent, Carla; Vieta, Eduard; Benabarre, Antoni

    2017-08-01

    Bipolar Disorder (BD) is associated with cognitive impairment even during remission periods. Nonetheless, this impairment seems to adjust to different profiles of severity. Our aim was to examine the potential impact of childhood trauma (CT) on cognitive performance and, more specifically, on neurocognitive profile membership. Using a data-driven strategy, 113 euthymic bipolar patients were grouped according to their cognitive performance using a hierarchical clustering technique. Patients from the three resulting clusters, the so-called "low", "average", and "high performance" groups, were then compared in terms of main sociodemographic, clinical and functioning variables, including CT measures. One-way ANOVA, a chi-square test and partial correlations were used for this purpose, as appropriate. A multinomial logistic regression model was used to determine which variables contributed to neurocognitive clustering membership. Patients from the three neurocognitive clusters differed in terms of sociodemographic, clinical, functioning and CT variables. Scores on the Childhood Trauma Questionnaire (CTQ), especially on the physical negligence subscale, were also associated with a poor cognitive performance. The multinomial regression model indicated that CTQ total scores and the estimated intelligence quotient (IQ) significantly contributed to differentiation among the three neurocognitive groups. Our results confirmed that CT significantly impacts on cognitive performance during adulthood in BD. The data obtained suggest that a history of CT could act as a liability marker for cognitive impairment. A higher estimated IQ may act as a protective factor against cognitive decline in this group of patients. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  20. [Descriptive study of behavioural disorders in mild cognitive impairment].

    PubMed

    Baquero, M; Blasco, R; Campos-García, A; Garcés, M; Fages, E M; Andreu-Català, M

    Mild cognitive impairment (MCI) is defined as an abnormality in cognitive function not provoking a noticeable disability in activities of daily living in the affected person. In a group of patients with MCI, we propose to observe and to quantify the presence of behavioral disorders, using the neuropsychiatric inventory (NPI). NPI is a known instrument in evaluation of this kind of disorders in patients with dementia, and it is a semi structured interview with a relevant informer or relative to the patient. NPI was applied to a series of 100 cases (61 women and 39 men) of MCI, diagnosed as usual in our settings. Mean age was 74.3 +/- 10 years, and mean MEC (Spanish modified version of MMSE) 25.57 +/- 4.2 (over a maximum of 35 points). Most prevalent disorder was depression, in 36 % of cases, and other frequent findings were irritability (35%), anxiety (24%) and apathy (19%). In some cases, agitation (4%), abnormal motor behavior (3%) and delusions (1%) were detected. Hallucination, disinhibition and euphoria or elation were not detected in this series. Data show a certain similarity with occidental culture environment, globally considered. The presence of behavioral and psychological disorders in patients with MCI could be a marker for later development of dementia. NPI can be a usable tool when detection and evaluation of these symptoms is required.

  1. Sleep Quality Improvement During Cognitive Behavioral Therapy for Anxiety Disorders.

    PubMed

    Ramsawh, Holly J; Bomyea, Jessica; Stein, Murray B; Cissell, Shadha H; Lang, Ariel J

    2016-01-01

    Despite the ubiquity of sleep complaints among individuals with anxiety disorders, few prior studies have examined whether sleep quality improves during anxiety treatment. The current study examined pre- to posttreatment sleep quality improvement during cognitive behavioral therapy (CBT) for panic disorder (PD; n = 26) or generalized anxiety disorder (GAD; n = 24). Among sleep quality indices, only global sleep quality and sleep latency improved significantly (but modestly) during CBT. Sleep quality improvement was greater for treatment responders, but did not vary by diagnosis. Additionally, poor baseline sleep quality was independently associated with worse anxiety treatment outcome, as measured by higher intolerance of uncertainty. Additional intervention targeting sleep prior to or during CBT for anxiety may be beneficial for poor sleepers.

  2. Sleep Quality Improvement During Cognitive Behavioral Therapy for Anxiety Disorders

    PubMed Central

    Ramsawh, Holly J.; Bomyea, Jessica; Stein, Murray B.; Cissell, Shadha H.; Lang, Ariel J.

    2014-01-01

    Despite the ubiquity of sleep complaints among individuals with anxiety disorders, few prior studies have examined whether sleep quality improves during anxiety treatment. The current study examined pre- to post-treatment sleep quality improvement during cognitive behavioral therapy (CBT) for panic disorder (PD; n = 26) or generalized anxiety disorder (GAD; n = 24). Among sleep quality indices, only global sleep quality and sleep latency improved significantly (but modestly) during CBT. Sleep quality improvement was greater for treatment responders, but did not vary by diagnosis. Additionally, poor baseline sleep quality was independently associated with worse anxiety treatment outcome, as measured by higher intolerance of uncertainty. Additional intervention targeting sleep prior to or during CBT for anxiety may be beneficial for poor sleepers. PMID:26244485

  3. Cognitive and Emotion Regulation Change Processes in Cognitive Behavioural Therapy for Social Anxiety Disorder.

    PubMed

    O'Toole, Mia S; Mennin, Douglas S; Hougaard, Esben; Zachariae, Robert; Rosenberg, Nicole K

    2015-01-01

    The objective of the study was to investigate variables, derived from both cognitive and emotion regulation conceptualizations of social anxiety disorder (SAD), as possible change processes in cognitive behaviour therapy (CBT) for SAD. Several proposed change processes were investigated: estimated probability, estimated cost, safety behaviours, acceptance of emotions, cognitive reappraisal and expressive suppression. Participants were 50 patients with SAD, receiving a standard manualized CBT program, conducted in groups or individually. All variables were measured pre-therapy, mid-therapy and post-therapy. Lower level mediation models revealed that while a change in most process measures significantly predicted clinical improvement, only changes in estimated probability and cost and acceptance of emotions showed significant indirect effects of CBT for SAD. The results are in accordance with previous studies supporting the mediating role of changes in cognitive distortions in CBT for SAD. In addition, acceptance of emotions may also be a critical component to clinical improvement in SAD during CBT, although more research is needed on which elements of acceptance are most helpful for individuals with SAD. The study's lack of a control condition limits any conclusion regarding the specificity of the findings to CBT. Change in estimated probability and cost, and acceptance of emotions showed an indirect effect of CBT for SAD. Cognitive distortions appear relevant to target with cognitive restructuring techniques. Finding acceptance to have an indirect effect could be interpreted as support for contemporary CBT approaches that include acceptance-based strategies. Copyright © 2014 John Wiley & Sons, Ltd.

  4. Cognitive Remediation and Bias Modification Strategies in Mood and Anxiety Disorders.

    PubMed

    Gold, Alexandra K; Montana, Rebecca E; Sylvia, Louisa G; Nierenberg, Andrew A; Deckersbach, Thilo

    2016-12-01

    Cognitive impairments and biases, which are prevalent in patients with mood and anxiety disorders, can affect quality of life and functioning. Traditional treatments are only insufficiently addressing these impairments and biases. We review the cognitive impairments and biases present in these disorders as well as treatments targeting these domains. Interventions aimed at improving cognitive impairments and biases may help improve cognitive deficits and overall functioning in patients with mood and anxiety disorders. Direct comparisons of treatments for cognitive impairments or biases versus more traditional psychosocial interventions have produced diverse results. Overall, treatments for cognitive impairments and cognitive biases warrant additional study in clinical trials. Future research should explore cognitive remediation and cognitive bias modification adjunctive to psychosocial treatments to optimize patient outcomes in mood and anxiety disorders.

  5. Cognitive remediation therapy for mood disorders: rationale, early evidence, and future directions.

    PubMed

    Bowie, Christopher R; Gupta, Maya; Holshausen, Katherine

    2013-06-01

    People with mood disorders experience cognitive impairments that are predictive of functional disability. Cognitive remediation (CR) is an empirically validated intervention that is designed to remediate neurocognitive deficits and improve functioning. Although much of the focus of this treatment during the last decade has centred on attention deficit disorders, brain injury, and schizophrenia spectrum disorders, emerging evidence suggests that CR is an effective intervention for mood disorders and that these treatment effects translate into improvements in cognitive performance and possibly functioning. Our review aims to examine the profile and magnitude of cognitive impairments in mood disorders, review the evidence in support of CR for this population, and discuss future research directions in CR.

  6. Cognitive disorders after sporadic ecstasy use? A case report.

    PubMed

    Ruis, Carla; Postma, Albert; Bouvy, Willem; van der Ham, Ineke

    2015-01-01

    Memory problems and changes in hippocampal structures after chronic ecstasy use are well described in the literature. Cognitive problems after incidental ecstasy use are rare, and the few patients described in case reports returned to their normal cognitive level after a relative short period. FV is a 39-year-old man who used an ecstasy tablet in 2005. This resulted in severe confusion for a few days. The confusion was followed by persistent memory complaints and difficulties orientating in new surroundings. An extensive neuropsychological examination 7 years after the ecstasy use revealed a severe memory disorder. Furthermore, his performance on a virtual reality test of navigation showed serious problems navigating in new surroundings. In comparison with matched control subjects (Bayesian approach for single case studies) his scores were significantly impaired on several subtasks of the navigation test. On a magnetic resonance imaging (MRI) scan of the brain bilateral hippocampal atrophy and sclerosis were visible, comparable to previous MRI studies describing hippocampal damage following ecstasy ingestion. This case report describes persistent memory and navigation disorders after sporadic ecstasy use, supported by structural brain abnormalities seen on the MRI scan. These findings revive the debate on whether sporadic ecstasy use can cause persistent cognitive deficits.

  7. The Cognitive Psychopathology of Internet Gaming Disorder in Adolescence.

    PubMed

    King, Daniel L; Delfabbro, Paul H

    2016-11-01

    Adolescents are known to be an at-risk population for developing Internet gaming disorder (IGD). A recent clinical model has proposed that adolescents with IGD may endorse a unique set of maladaptive beliefs that underlie persistent and excessive involvement in Internet gaming activities. These include (a) beliefs about game reward value and tangibility, (b) maladaptive and inflexible rules about gaming behaviour, (c) over-reliance on gaming to meet self-esteem needs, and (d) gaming as a method of gaining social acceptance. A sample of 824 adolescents (402 male and 422 female) were recruited from multiple secondary schools and administered a survey that included measures of IGD symptomatology, problematic Internet gaming cognition, and psychological distress. The results showed that adolescents with IGD report significantly more maladaptive gaming beliefs than adolescents without IGD, including those who play Internet games for more than 30 h per week. The size of observed effects were large. The strong association between gaming cognitions and IGD symptoms still held after controlling for measures of gaming activity and psychological distress. These findings indicate that adolescents with IGD have distinct problematic thoughts about gaming, and highlight the importance of addressing these cognitions in therapeutic interventions for the disorder.

  8. Major mental disorders in Addis Ababa, Ethiopia. I. Schizophrenia, schizoaffective and cognitive disorders.

    PubMed

    Kebede, D; Alem, A

    1999-01-01

    We report here on a survey conducted in Addis Ababa between September and December of 1994 to estimate the prevalence and socio-demographic correlates of schizophrenia, schizoaffective, and severe cognitive disorders. An Amharic version of the CIDI was used to collect data from a random community sample of 1420 individuals aged 15 and above. Weighted lifetime and one-month prevalence were 0.4% and 0.3%, for schizophrenia, and 0.5% and 0.4% for schizoaffective disorders, respectively. The prevalence of severe cognitive disorders was found to be 2.6%. Multivariate logistic analysis showed that the risk of lifetime psychosis (schizophrenia, schizoaffective, bipolar disorders, and depressive episodes with psychotic symptoms) was significantly higher in the age group 25-44 years compared to the reference age group of 15-24 years: adjusted Odds Ratio and 95% confidence interval, OR (95% CI) = 2.41 (1.01, 5.74); it was also significantly higher in the never married group compared to those married: OR (95% CI) = 3.01 (1.08, 8.42). The risk was significantly lower in the employed compared to the unemployed: OR (95% CI) = 0.42 (0.18, 1.00). There was a statistically significant trend of increasing risk of severe cognitive disorders with increasing age. The trend was in the reverse direction for educational status, the risk decreasing significantly with increasing educational attainment.

  9. Empathic accuracy and cognition in schizotypal personality disorder.

    PubMed

    Ripoll, Luis H; Zaki, Jamil; Perez-Rodriguez, Maria Mercedes; Snyder, Rebekah; Strike, Kathryn Sloan; Boussi, Ayelet; Bartz, Jennifer A; Ochsner, Kevin N; Siever, Larry J; New, Antonia S

    2013-11-30

    Interpersonal dysfunction contributes to significant disability in the schizophrenia spectrum. Schizotypal Personality Disorder (SPD) is a schizophrenia-related personality demonstrating social cognitive impairment in the absence of frank psychosis. Past research indicates that cognitive dysfunction or schizotypy may account for social cognitive dysfunction in this population. We tested SPD subjects and healthy controls on the Empathic Accuracy (EA) paradigm and the Reading of the Mind in the Eyes Test (RMET), assessing the impact of EA on social support. We also explored whether EA differences could be explained by intelligence, working memory, trait empathy, or attachment avoidance. SPD subjects did not differ from controls in RMET, but demonstrated lower EA during negative valence videos, associated with lower social support. Dynamic, multimodal EA paradigms may be more effective at capturing interpersonal dysfunction than static image tasks such as RMET. Schizotypal severity, trait empathy, and cognitive dysfunction did not account for empathic dysfunction in SPD, although attachment avoidance is related to empathic differences. Empathic dysfunction for negative affect contributes to decreased social support in the schizophrenia spectrum. Future research may shed further light on potential links between attachment avoidance, empathic dysfunction, and social support.

  10. Cognitive Rehabilitation of Episodic Memory Disorders: From Theory to Practice

    PubMed Central

    Ptak, Radek; der Linden, Martial Van; Schnider, Armin

    2010-01-01

    Memory disorders are among the most frequent and most debilitating cognitive impairments following acquired brain damage. Cognitive remediation strategies attempt to restore lost memory capacity, provide compensatory techniques or teach the use of external memory aids. Memory rehabilitation has strongly been influenced by memory theory, and the interaction between both has stimulated the development of techniques such as spaced retrieval, vanishing cues or errorless learning. These techniques partly rely on implicit memory and therefore enable even patients with dense amnesia to acquire new information. However, knowledge acquired in this way is often strongly domain-specific and inflexible. In addition, individual patients with amnesia respond differently to distinct interventions. The factors underlying these differences have not yet been identified. Behavioral management of memory failures therefore often relies on a careful description of environmental factors and measurement of associated behavioral disorders such as unawareness of memory failures. The current evidence suggests that patients with less severe disorders benefit from self-management techniques and mnemonics whereas rehabilitation of severely amnesic patients should focus on behavior management, the transmission of domain-specific knowledge through implicit memory processes and the compensation for memory deficits with memory aids. PMID:20700383

  11. Cognitive control of gaze in bipolar disorder and schizophrenia

    PubMed Central

    Thakkar, Katharine N.; Schall, Jeffrey D.; Logan, Gordon D.; Park, Sohee

    2015-01-01

    The objective of the present study was to compare two components of executive functioning, response monitoring and inhibition in bipolar disorder (BP) and schizophrenia (SZ). The saccadic countermanding task is a translational paradigm optimized for detecting subtle abnormalities in response monitoring and response inhibition. We have previously reported countermanding performance abnormalities in SZ, but the degree to which these impairments are shared by other psychotic disorders is unknown. 18 BP, 17 SZ, and 16 demographically-matched healthy controls (HC) participated in a saccadic countermanding task. Performance on the countermanding task is approximated as a race between movement generation and inhibition processes; this model provides an estimate of the time needed to cancel a planned movement. Response monitoring was assessed by the reaction time (RT) adjustments based on trial history. Like SZ patients, BP patients needed more time to cancel a planned movement. The two patient groups had equivalent inhibition efficiency. On trial history-based RT adjustments, however, we found a trend towards exaggerated trial history-based slowing in SZ compared to BP. Findings have implications for understanding the neurobiology of cognitive control, for defining the etiological overlap between schizophrenia and bipolar disorder and for developing pharmacological treatments of cognitive impairments. PMID:25601802

  12. [Rethinking addictions: the cognitive paradigm and substance dependence disorder].

    PubMed

    Capece, José

    2008-01-01

    The aim of this task is to review some psychotherapeutic strategies used for the treatment of Substance Dependence Disorder. Different distorted beliefs, from the cognitive paradigm, which are usually assumed in our society, are studied here. These beliefs reveal difficulty in facing the drug problem, from the scientific knowledge based on evidence. Different problems are set up, such us the illness pattern, therapeutic alliance, treatment aims, unlawful acts, medication, ideologies and implications for the social interventions. Different strategies that have proved effectiveness are reviewed. Motivational Interview, Contingencies Management, Standard Cognitive Therapy and Harm Reduction have been pointed out. We come to an end with the recommendation to use the scientific knowledge for the treatment programs and preventive policies.

  13. Cognitive control adjustments and conflict adaptation in major depressive disorder.

    PubMed

    Clawson, Ann; Clayson, Peter E; Larson, Michael J

    2013-08-01

    Individuals with major depressive disorder (MDD) show alterations in the cognitive control function of conflict processing. We examined the influence of these deficits on behavioral and event-related potential (ERP) indices of conflict adaptation, a cognitive control process wherein previous-trial congruency modulates current-trial performance, in 55 individuals with MDD and 55 matched controls. ERPs were calculated while participants completed a modified flanker task. There were nonsignificant between-groups differences in response time, error rate, and N2 indices of conflict adaptation. Higher depressive symptom scores were associated with smaller mean N2 conflict adaptation scores for individuals with MDD and when collapsed across groups. Results were consistent when comorbidity and medications were analyzed. These findings suggest N2 conflict adaptation is associated with depressive symptoms rather than clinical diagnosis alone.

  14. Cognitive dysfunction in body dysmorphic disorder: new implications for nosological systems and neurobiological models.

    PubMed

    Jefferies-Sewell, Kiri; Chamberlain, Samuel R; Fineberg, Naomi A; Laws, Keith R

    2017-02-01

    Introduction Body dysmorphic disorder (BDD) is a debilitating disorder, characterized by obsessions and compulsions relating specifically to perceived appearance, and which has been newly classified within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Obsessive-Compulsive and Related Disorders grouping. Until now, little research has been conducted into the cognitive profile of this disorder.

  15. Out of my real body: cognitive neuroscience meets eating disorders

    PubMed Central

    Riva, Giuseppe

    2014-01-01

    Clinical psychology is starting to explain eating disorders (ED) as the outcome of the interaction among cognitive, socio-emotional and interpersonal elements. In particular two influential models—the revised cognitive-interpersonal maintenance model and the transdiagnostic cognitive behavioral theory—identified possible key predisposing and maintaining factors. These models, even if very influential and able to provide clear suggestions for therapy, still are not able to provide answers to several critical questions: why do not all the individuals with obsessive compulsive features, anxious avoidance or with a dysfunctional scheme for self-evaluation develop an ED? What is the role of the body experience in the etiology of these disorders? In this paper we suggest that the path to a meaningful answer requires the integration of these models with the recent outcomes of cognitive neuroscience. First, our bodily representations are not just a way to map an external space but the main tool we use to generate meaning, organize our experience, and shape our social identity. In particular, we will argue that our bodily experience evolves over time by integrating six different representations of the body characterized by specific pathologies—body schema (phantom limb), spatial body (unilateral hemi-neglect), active body (alien hand syndrome), personal body (autoscopic phenomena), objectified body (xenomelia) and body image (body dysmorphia). Second, these representations include either schematic (allocentric) or perceptual (egocentric) contents that interact within the working memory of the individual through the alignment between the retrieved contents from long-term memory and the ongoing egocentric contents from perception. In this view EDs may be the outcome of an impairment in the ability of updating a negative body representation stored in autobiographical memory (allocentric) with real-time sensorimotor and proprioceptive data (egocentric). PMID:24834042

  16. Cognitive Change Predicts Symptom Reduction With Cognitive Therapy for Posttraumatic Stress Disorder

    PubMed Central

    Kleim, Birgit; Grey, Nick; Wild, Jennifer; Nussbeck, Fridtjof W.; Stott, Richard; Hackmann, Ann; Clark, David M.; Ehlers, Anke

    2012-01-01

    Objective: There is a growing body of evidence for the effectiveness of trauma-focused cognitive behavior therapy (TF-CBT) for posttraumatic stress disorder (PTSD), but few studies to date have investigated the mechanisms by which TF-CBT leads to therapeutic change. Models of PTSD suggest that a core treatment mechanism is the change in dysfunctional appraisals of the trauma and its aftermath. If this is the case, then changes in appraisals should predict a change in symptoms. The present study investigated whether cognitive change precedes symptom change in Cognitive Therapy for PTSD, a version of TF-CBT. Method: The study analyzed weekly cognitive and symptom measures from 268 PTSD patients who received a course of Cognitive Therapy for PTSD, using bivariate latent growth modeling. Results: Results showed that (a) dysfunctional trauma-related appraisals and PTSD symptoms both decreased significantly over the course of treatment, (b) changes in appraisals and symptoms were correlated, and (c) weekly change in appraisals significantly predicted subsequent reduction in symptom scores (both corrected for the general decrease over the course of therapy). Changes in PTSD symptom severity did not predict subsequent changes in appraisals. Conclusions: The study provided preliminary evidence for the temporal precedence of a reduction in negative trauma-related appraisals in symptom reduction during trauma-focused CBT for PTSD. This supports the role of change in appraisals as an active therapeutic mechanism. PMID:23276122

  17. Cognitive change predicts symptom reduction with cognitive therapy for posttraumatic stress disorder.

    PubMed

    Kleim, Birgit; Grey, Nick; Wild, Jennifer; Nussbeck, Fridtjof W; Stott, Richard; Hackmann, Ann; Clark, David M; Ehlers, Anke

    2013-06-01

    There is a growing body of evidence for the effectiveness of trauma-focused cognitive behavior therapy (TF-CBT) for posttraumatic stress disorder (PTSD), but few studies to date have investigated the mechanisms by which TF-CBT leads to therapeutic change. Models of PTSD suggest that a core treatment mechanism is the change in dysfunctional appraisals of the trauma and its aftermath. If this is the case, then changes in appraisals should predict a change in symptoms. The present study investigated whether cognitive change precedes symptom change in Cognitive Therapy for PTSD, a version of TF-CBT. The study analyzed weekly cognitive and symptom measures from 268 PTSD patients who received a course of Cognitive Therapy for PTSD, using bivariate latent growth modeling. Results showed that (a) dysfunctional trauma-related appraisals and PTSD symptoms both decreased significantly over the course of treatment, (b) changes in appraisals and symptoms were correlated, and (c) weekly change in appraisals significantly predicted subsequent reduction in symptom scores (both corrected for the general decrease over the course of therapy). Changes in PTSD symptom severity did not predict subsequent changes in appraisals. The study provided preliminary evidence for the temporal precedence of a reduction in negative trauma-related appraisals in symptom reduction during trauma-focused CBT for PTSD. This supports the role of change in appraisals as an active therapeutic mechanism.

  18. Relationship between cognition, clinical and cognitive insight in psychotic disorders: a review and meta-analysis.

    PubMed

    Nair, Akshay; Palmer, Emma Claire; Aleman, André; David, Anthony S

    2014-01-01

    The neurocognitive theory of insight posits that poor insight in psychotic illnesses is related to cognitive deficits in cognitive self-appraisal mechanisms. In this paper we perform a comprehensive meta-analysis examining relationships between clinical insight and neurocognition in psychotic disorders. We have also completed a meta-analysis of studies examining 'cognitive insight', as measured by the Beck Cognitive Insight Scale (BCIS), and its relationship with neurocognitive function in patients with psychosis. The clinical insight analysis included data from 72 studies and a total population of 5429 patients. We found that insight in psychosis was significantly associated with total cognition (r=0.16, p<0.001), IQ (r=0.16, p<0.001), memory (r=0.13, p<0.001) and executive function (r=0.14, p<0.001). All of these correlations were stronger when examined in patients with schizophrenia only. In the BCIS analysis we included 7 studies and 466 patients in total. We found that no significant associations were found between the self-reflectiveness sub-component and neurocognition. By contrast there were significant correlations between the self-certainty subcomponent and memory (r=-0.23, p<0.001), IQ (r=-0.19, p<0.001) and total cognition (r=-0.14, p=0.01). We did not find evidence of significant publication bias in any analyses. Overall, our results indicate that there is a small but significant relationship between clinical insight, some aspects of cognitive insight and neurocognition. These findings reflect the complexity of the insight construct and indicate that while the neurocognitive model is important it is likely to be one of many which contribute to the understanding of this phenomenon.

  19. Disordered eating-related cognition and psychological flexibility as predictors of psychological health among college students.

    PubMed

    Masuda, Akihiko; Price, Matthew; Anderson, Page L; Wendell, Johanna W

    2010-01-01

    The present cross-sectional study investigated the relation among disordered eating-related cognition, psychological flexibility, and poor psychological outcomes among a nonclinical college sample. As predicted, conviction of disordered eating-related cognitions was positively associated with general psychological ill-health and emotional distress in interpersonal contexts. Disordered eating-related cognition was also inversely related to psychological flexibility, which was inversely related to poor psychological health and emotional distress in interpersonal contexts. The combination of disordered eating-related cognition and psychological flexibility accounted for the proportion of variance of these poor psychological outcomes greater than disordered eating-related cognition alone. Finally, psychological flexibility accounted for the proportion of variance of these negative psychological variables greater than did disordered eating-related cognition.

  20. Computer-supported cognitive behavioral treatment of anxiety disorders.

    PubMed

    Anderson, Page; Jacobs, Carli; Rothbaum, Barbara O

    2004-03-01

    This article reviews the empirical literature pertaining to the use of computer-supported cognitive-behavioral treatment of anxiety disorders, including palmtop computers, virtual reality exposure therapy, and personal computer software programs. The advantages and disadvantages unique to each type of technology are described. The review concludes with a discussion of ethical issues, barriers to the use of technology by clinicians, and suggestions for a process by which scientists and practitioners can conceptualize how technology can advance our understanding of anxiety and our dissemination of effective treatments.

  1. Cerebellar cognitive affective syndrome presented as severe borderline personality disorder.

    PubMed

    Pesic, Danilo; Peljto, Amir; Lukic, Biljana; Milovanovic, Maja; Svetozarevic, Snezana; Lecic Tosevski, Dusica

    2014-01-01

    An increasing number of findings confirm the significance of cerebellum in affecting regulation and early learning. Most consistent findings refer to association of congenital vermis anomalies with deficits in nonmotor functions of cerebellum. In this paper we presented a young woman who was treated since sixteen years of age for polysubstance abuse, affective instability, and self-harming who was later diagnosed with borderline personality disorder. Since the neurological and neuropsychological reports pointed to signs of cerebellar dysfunction and dysexecutive syndrome, we performed magnetic resonance imaging of brain which demonstrated partially developed vermis and rhombencephalosynapsis. These findings match the description of cerebellar cognitive affective syndrome and show an overlap with clinical manifestations of borderline personality disorder.

  2. Combined medication and cognitive therapy for generalized anxiety disorder.

    PubMed

    Crits-Christoph, Paul; Newman, Michelle G; Rickels, Karl; Gallop, Robert; Gibbons, Mary Beth Connolly; Hamilton, Jessica L; Ring-Kurtz, Sarah; Pastva, Amy M

    2011-12-01

    The current study assessed efficacy of combined cognitive behavioral therapy (CBT) and venlafaxine XR compared to venlafaxine XR alone in the treatment of generalized anxiety disorder (GAD) within settings where medication is typically offered as the treatment for this disorder. Patients with DSM-IV-diagnosed GAD who were recently enrolled in a long-term venlafaxine XR study were randomly offered (n=77), or not offered (n=40), the option of adding 12 sessions of CBT. Of those offered CBT, 33% (n=26) accepted and attended at least one treatment session. There were no differences between the combined treatment group and the medication only group on primary or secondary efficacy measures in any of the sample comparisons. Many patients who present in medical/psychopharmacology settings seeking treatment for GAD decline the opportunity to receive adjunctive treatment. Of those that receive CBT, there appears to be no additional benefit of combined treatment compared to venlafaxine XR alone.

  3. [A cognitive approach of the borderline personality disorder].

    PubMed

    Keegan, Eduardo

    The development of cognitive models and treatments for borderline personality disorder over the last two decades has been remarkable. This article presents the main ideas of the models developed by Aaron T. Beck and Arthur Freeman, Jeffrey Young and Marsha Linehan. These theories have generated psychotherapies that have proven their efficacy in controlled empirical studies in a difficult to treat population. The models of Beck Freeman and Young are based on the concept of schema. Linehan's dialectical behavior therapy is based on a biosocial transactional conception of the disorder. All these models emphasize the importance of negative experiences in early development. The article presents the structure of these treatments and describes their specific interventions.

  4. Combined Medication and Cognitive Therapy for Generalized Anxiety Disorder

    PubMed Central

    Crits-Christoph, Paul; Newman, Michelle G.; Rickels, Karl; Gallop, Robert; Gibbons, Mary Beth Connolly; Hamilton, Jessica L.; Ring-Kurtz, Sarah; Pastva, Amy M.

    2011-01-01

    The current study assessed efficacy of combined cognitive behavioral therapy (CBT) and venlafaxine XR compared to venlafaxine XR alone in the treatment of generalized anxiety disorder (GAD) within settings where medication is typically offered as the treatment for this disorder. Patients with DSM-IV–diagnosed GAD who were recently enrolled in a long-term venlafaxine XR study were randomly offered (n=77), or not offered (n=40), the option of adding 12 sessions of CBT. Of those offered CBT, 33% (n=26) accepted and attended at least one treatment session. There were no differences between the combined treatment group and the medication only group on primary or secondary efficacy measures in any of the sample comparisons. Many patients who present in medical/psychopharmacology settings seeking treatment for GAD decline the opportunity to receive adjunctive treatment. Of those that receive CBT, there appears to be no additional benefit of combined treatment compared to venlafaxine XR alone. PMID:21840164

  5. Cognitive Impairment in Bipolar Disorder and Schizophrenia: A Systematic Review

    PubMed Central

    Vöhringer, Paul A.; Barroilhet, Sergio A.; Amerio, Andrea; Reale, Maria Laura; Alvear, Katherine; Vergne, Derick; Ghaemi, S. Nassir

    2013-01-01

    Aims: Previous comparisons of cognitive decline among patients with bipolar disorder (BD) and schizophrenia (SZ) have found somehow quite similar profiles of deficits, but results have varied between studies. Therefore an extensive and thoughtful systematic review of the matter is warranted. Methods: Studies were found through systematic search (PubMed) following PRISMA guidelines. To be included, studies must have assessed the following cognitive functions: executive functions, memory, IQ, attention-concentration, and perceptuomotor function. In order to make comparison between the two entities, studies should include BD patients with operationally defined euthymia, schizophrenic patients in remission, and third group of healthy control patients. Comparisons were made after controlling for years of schooling and residual affective symptoms. Results: We found that overall both SZ and BD patients present deficits on all neurocognitive measures compared to healthy controls. In particular, SZ patients show more severe and pervasive cognitive deficits while BD patients present a milder and more confined impairment. In addition, evidence from the literature suggests that SZ and BD patients share a similar cognitive impairment profile with different degrees of deficits. Therefore, the difference between the two groups seems to be more quantitative (degree of deficit) rather than qualitative (profile), supporting a dimensional approach to the two clinical entities. Limitations of the present review includes the impossibility to control for effects of medication, varying time required for assessment across studies, illness diagnosis reliability, and course severity. Conclusion: Patients with BD might exhibit a cognitive impairment that could be similar to SZ in terms of their profile, although patients with SZ may have more severe and widespread impairments. PMID:23964248

  6. Sociotropic cognition and eating disordered attitudes and behavior in young adults.

    PubMed

    Pedlow, C Teal; Niemeier, Heather M

    2013-04-01

    Sociotropic cognition is a mindset characterized by a strong need for social approval and fear of interpersonal rejection. Sociotropic cognition has been associated with depression and health risk behavior in women, but few studies have specifically addressed eating disordered attitudes and behaviors, and studies including men are lacking. The purpose of the present study was to assess the influence of sociotropic cognition on eating-related attitudes and behaviors in men and women. Participants were N=362 undergraduate students (51% female; mean age=19.2±1.43) who completed measures of sociotropic cognition, depressed mood, eating disordered attitudes and behaviors, body shape satisfaction, and physical activity. Using hierarchical regression, the results demonstrated that sociotropic cognition was associated with greater dietary restraint, body shape, eating, and weight concerns, emotional eating, and global eating disordered score. Body shape dissatisfaction and emotional eating were found to mediate the relationship between sociotropic cognition and eating disordered behaviors. Sociotropic cognition appears to be an important predictor of body shape dissatisfaction and eating disordered behaviors in a non-clinical sample. Individuals high in sociotropic cognition may engage in eating disordered behavior in response to fears of social evaluation. These findings have implications for prevention and treatment of eating disorders. Cognitive-behavioral intervention strategies are suggested to reduce sociotropic cognition and its influence on eating disordered behavior.

  7. Contributions of cognitive inflexibility to eating disorder and social anxiety symptoms.

    PubMed

    Arlt, Jean; Yiu, Angelina; Eneva, Kalina; Taylor Dryman, M; Heimberg, Richard G; Chen, Eunice Y

    2016-04-01

    Eating disorders and social anxiety are highly co-occurring. These disorders share fears of social evaluation, possibly maintained by similar cognitive content and styles, including an inability to adapt or flexibly respond to unexpected conditions. However, the role of cognitive inflexibility in eating disorders in relation to social anxiety has not been explored. In this study, the link between eating disorder symptoms and cognitive inflexibility, while accounting for social anxiety, is examined. Participants (N=461) were undergraduates who completed the Detail and Flexibility Questionnaire 12-item Cognitive Rigidity subscale, the Eating Disorders Diagnostic Scale, and the Social Interaction Anxiety Scale. Eating disorder symptoms and social anxiety were both positively correlated with cognitive inflexibility. After controlling for social anxiety, the relationship between eating disorder symptoms and cognitive inflexibility remained robust. Further examination of cognitive inflexibility in eating disorders and comorbid social anxiety in clinical samples is warranted. We suggest future directions for examining cognitive inflexibility as a trans-diagnostic construct important to eating disorders and frequently comorbid disorders, consistent with NIMH Research Domain Criteria. Copyright © 2015. Published by Elsevier Ltd.

  8. Social Cognition in a Clinical Sample of Personality Disorder Patients.

    PubMed

    Ruiz-Tagle, Amparo; Costanzo, Elsa; De Achával, Delfina; Guinjoan, Salvador

    2015-01-01

    Social cognition was assessed in a clinical sample of personality disorder (PD) stable patients receiving ambulatory treatment (N = 17) and healthy matched controls (N = 17) using tests of recognition of emotions in faces and eyes, in a test of social faux pas and in theory of mind (ToM) stories. Results indicated that when compared with healthy controls, individuals with PD showed a clear tendency to obtain lower scoring in tasks assessing recognition of emotion in faces (T = -2.602, p = 0.014), eyes (T = -3.593, p = 0.001), ToM stories (T = -4.706, p = 0.000), and Faux pas (T = -2.227, p = 0.035). In the present pilot study, PD individuals with a normal cognitive efficiency showed an impaired performance at social cognition assessment including emotion recognition and ToM.

  9. Measurement of psychological disorders using cognitive diagnosis models.

    PubMed

    Templin, Jonathan L; Henson, Robert A

    2006-09-01

    Cognitive diagnosis models are constrained (multiple classification) latent class models that characterize the relationship of questionnaire responses to a set of dichotomous latent variables. Having emanated from educational measurement, several aspects of such models seem well suited to use in psychological assessment and diagnosis. This article presents the development of a new cognitive diagnosis model for use in psychological assessment--the DINO (deterministic input; noisy "or" gate) model--which, as an illustrative example, is applied to evaluate and diagnose pathological gamblers. As part of this example, a demonstration of the estimates obtained by cognitive diagnosis models is provided. Such estimates include the probability an individual meets each of a set of dichotomous Diagnostic and Statistical Manual of Mental Disorders (text revision [DSM-IV-TR]; American Psychiatric Association, 2000) criteria, resulting in an estimate of the probability an individual meets the DSM-IV-TR definition for being a pathological gambler. Furthermore, a demonstration of how the hypothesized underlying factors contributing to pathological gambling can be measured with the DINO model is presented, through use of a covariance structure model for the tetrachoric correlation matrix of the dichotomous latent variables representing DSM-IV-TR criteria.

  10. Dyslexia and dyscalculia: two learning disorders with different cognitive profiles.

    PubMed

    Landerl, Karin; Fussenegger, Barbara; Moll, Kristina; Willburger, Edith

    2009-07-01

    This study tests the hypothesis that dyslexia and dyscalculia are associated with two largely independent cognitive deficits, namely a phonological deficit in the case of dyslexia and a deficit in the number module in the case of dyscalculia. In four groups of 8- to 10-year-olds (42 control, 21 dyslexic, 20 dyscalculic, and 26 dyslexic/dyscalculic), phonological awareness, phonological and visual-spatial short-term and working memory, naming speed, and basic number processing skills were assessed. A phonological deficit was found for both dyslexic groups, irrespective of additional arithmetic deficits, but not for the dyscalculia-only group. In contrast, deficits in processing of symbolic and nonsymbolic magnitudes were observed in both groups of dyscalculic children, irrespective of additional reading difficulties, but not in the dyslexia-only group. Cognitive deficits in the comorbid dyslexia/dyscalculia group were additive; that is, they resulted from the combination of two learning disorders. These findings suggest that dyslexia and dyscalculia have separable cognitive profiles, namely a phonological deficit in the case of dyslexia and a deficient number module in the case of dyscalculia.

  11. Social Cognition in a Clinical Sample of Personality Disorder Patients

    PubMed Central

    Ruiz-Tagle, Amparo; Costanzo, Elsa; De Achával, Delfina; Guinjoan, Salvador

    2015-01-01

    Social cognition was assessed in a clinical sample of personality disorder (PD) stable patients receiving ambulatory treatment (N = 17) and healthy matched controls (N = 17) using tests of recognition of emotions in faces and eyes, in a test of social faux pas and in theory of mind (ToM) stories. Results indicated that when compared with healthy controls, individuals with PD showed a clear tendency to obtain lower scoring in tasks assessing recognition of emotion in faces (T = −2.602, p = 0.014), eyes (T = −3.593, p = 0.001), ToM stories (T = −4.706, p = 0.000), and Faux pas (T = −2.227, p = 0.035). In the present pilot study, PD individuals with a normal cognitive efficiency showed an impaired performance at social cognition assessment including emotion recognition and ToM. PMID:26074824

  12. Integrated cognitive behavioral therapy for patients with substance use disorder and comorbid ADHD: two case presentations.

    PubMed

    van Emmerik-van Oortmerssen, Katelijne; Vedel, Ellen; van den Brink, Wim; Schoevers, Robert A

    2015-06-01

    Two cases of integrated cognitive behavioral therapy (ICBT) for substance use disorder (SUD) and Attention Deficit Hyperactivity Disorder (ADHD) are presented illustrating that ICBT is a promising new treatment option. Copyright © 2015 Elsevier Ltd. All rights reserved.

  13. Micro-RNAs in cognition and cognitive disorders: Potential for novel biomarkers and therapeutics.

    PubMed

    Woldemichael, Bisrat T; Mansuy, Isabelle M

    2016-03-15

    Micro-RNAs (miRNAs) are small regulatory non-coding RNAs involved in the regulation of many biological functions. In the brain, they have distinct expression patterns depending on region, cell-type and developmental stage. Their expression profile is altered by neuronal activation in response to behavioral training or chemical/electrical stimulation. The dynamic changes in miRNA level regulate the expression of genes required for cognitive processes such as learning and memory. In addition, in cognitive dysfunctions such as dementias, expression levels of many miRNAs are perturbed, not only in brain areas affected by the pathology, but also in peripheral body fluids such as serum and cerebrospinal fluid. This presents an opportunity to utilize miRNAs as biomarkers for early detection and assessment of cognitive dysfunctions. Further, since miRNAs target many genes and pathways, they may represent key molecular signatures that can help understand the mechanisms of cognitive disorders and the development of potential therapeutic agents. Copyright © 2015 Elsevier Inc. All rights reserved.

  14. Guanfacine for the Treatment of Cognitive Disorders: A Century of Discoveries at Yale

    PubMed Central

    Arnsten, Amy F.T.; Jin, Lu E.

    2012-01-01

    The prefrontal cortex (PFC) is among the most evolved brain regions, contributing to our highest order cognitive abilities. It regulates behavior, thought, and emotion using working memory. Many cognitive disorders involve impairments of the PFC. A century of discoveries at Yale Medical School has revealed the neurobiology of PFC cognitive functions, as well as the molecular needs of these circuits. This work has led to the identification of therapeutic targets to treat cognitive disorders. Recent research has found that the noradrenergic α2A agonist guanfacine can improve PFC function by strengthening PFC network connections via inhibition of cAMP-potassium channel signaling in postsynaptic spines. Guanfacine is now being used to treat a variety of PFC cognitive disorders, including Tourette’s Syndrome and Attention Deficit Hyperactivity Disorder (ADHD). This article reviews the history of Yale discoveries on the neurobiology of PFC working memory function and the identification of guanfacine for treating cognitive disorders. PMID:22461743

  15. Cognition in schizophrenia and schizo-affective disorder: impairments that are more similar than different

    PubMed Central

    Owoso, A.; Carter, C. S.; Gold, J.M.; MacDonald, A.W.; Ragland, J.D.; Silverstein, S.M.; Strauss, M. E.; Barch, D. M.

    2014-01-01

    Background Cognition is increasingly being recognized as an important aspect of psychotic disorders and a key contributor to functional outcome. In the past, comparative studies have been performed in schizophrenia and schizo-affective disorder with regard to cognitive performance, but the results have been mixed and the cognitive measures used have not always assessed the cognitive deficits found to be specific to psychosis. A set of optimized cognitive paradigms designed by the Cognitive Neuroscience Test Reliability and Clinical Applications for Schizophrenia (CNTRACS) Consortium to assess deficits specific to schizophrenia was used to measure cognition in a large group of individuals with schizophrenia and schizo-affective disorder. Method A total of 519 participants (188 with schizophrenia, 63 with schizo-affective disorder and 268 controls) were administered three cognitive paradigms assessing the domains of goal maintenance in working memory, relational encoding and retrieval in episodic memory and visual integration. Results Across the three domains, the results showed no major quantitative differences between patient groups, with both groups uniformly performing worse than healthy subjects. Conclusions The findings of this study suggests that, with regard to deficits in cognition, considered a major aspect of psychotic disorder, schizophrenia and schizo-affective disorder do not demonstrate major significant distinctions. These results have important implications for our understanding of the nosological structure of major psychopathology, providing evidence consistent with the hypothesis that there is no natural distinction between cognitive functioning in schizophrenia and schizo-affective disorder. PMID:23522057

  16. Codex (cognitive disorders examination) for the detection of dementia and mild cognitive impairment.

    PubMed

    Larner, Andrew J

    2013-12-01

    Dementia is a major public health problem. Rapid and simple tests, easy to use for screening of dementia and mild cognitive impairment (MCI), are required. To examine the utility of Codex (cognitive disorders examination), a decision tree, for the detection of dementia and MCI. Codex was administered to 105 consecutive patients attending a memory clinic over a six month period. The study showed good sensitivity (0.81) and specificity (0.81) for Codex in identifying patients with dementia. The sensitivity and specificity were 0.68 and 0.90 respectively for the detection of MCI. Codex is a simple, quick and reliable test for the detection of dementia, but it is not sufficiently sensitive for the detection of MCI. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  17. Motor, emotional, and cognitive empathy in children and adolescents with autism spectrum disorder and conduct disorder.

    PubMed

    Bons, Danielle; van den Broek, Egon; Scheepers, Floor; Herpers, Pierre; Rommelse, Nanda; Buitelaar, Jan K; Buitelaaar, Jan K

    2013-04-01

    It is unclear which aspects of empathy are shared and which are uniquely affected in autism spectrum disorder (ASD) and conduct disorder (CD) as are the neurobiological correlates of these empathy impairments. The aim of this systematic review is to describe the overlap and specificity of motor, emotional, and cognitive aspects of empathy in children and adolescents with ASD or CD. Motor and cognitive empathy impairments are found in both ASD and CD, yet the specificity seems to differ. In ASD facial mimicry and emotion recognition may be impaired for all basic emotions, whereas in CD this is only the case for negative emotions. Emotional empathy and the role of attention to the eyes therein need further investigation. We hypothesize that impaired motor and cognitive empathy in both disorders are a consequence of lack of attention to the eyes. However, we hypothesize major differences in emotional empathy deficits between ASD and CD, probably due to emotional autonomic and amygdala hyper-responsivity in ASD versus hypo-responsivity in CD, both resulting in lack of attention to the eyes.

  18. Cognitions in bipolar affective disorder and unipolar depression: imagining suicide.

    PubMed

    Hales, Susie A; Deeprose, Catherine; Goodwin, Guy M; Holmes, Emily A

    2011-01-01

    Bipolar disorder has the highest rate of suicide of all the psychiatric disorders. In unipolar depression, individuals report vivid, affect-laden images of suicide or the aftermath of death (flashforwards to suicide) during suicidal ideation but this phenomenon has not been explored in bipolar disorder. Therefore the authors investigated and compared imagery and verbal thoughts related to past suicidality in individuals with bipolar disorder (n = 20) and unipolar depression (n = 20). The study used a quasi-experimental comparative design. The Structured Clinical Interview for DSM-IV was used to confirm diagnoses. Quantitative and qualitative data were gathered through questionnaire measures (e.g., mood and trait imagery use). Individual interviews assessed suicidal cognitions in the form of (i) mental images and (ii) verbal thoughts. All participants reported imagining flashforwards to suicide. Both groups reported greater preoccupation with these suicide-related images than with verbal thoughts about suicide. However, compared to the unipolar group, the bipolar group were significantly more preoccupied with flashforward imagery, rated this imagery as more compelling, and were more than twice as likely to report that the images made them want to take action to complete suicide. In addition, the bipolar group reported a greater trait propensity to use mental imagery in general. Suicidal ideation needs to be better characterized, and mental imagery of suicide has been a neglected but potentially critical feature of suicidal ideation, particularly in bipolar disorder. Our findings suggest that flashforward imagery warrants further investigation for formal universal clinical assessment procedures. © 2011 John Wiley and Sons A/S.

  19. Physical, Mental, and Social Catastrophic Cognitions as Prognostic Factors in Cognitive-Behavioral and Pharmacological Treatments for Panic Disorder

    ERIC Educational Resources Information Center

    Hicks, Thomas V.; Leitenberg, Harold; Barlow, David H.; Gorman, Jack M.; Shear, Katherine M.; Woods, Scott W.

    2005-01-01

    The authors explored the prognostic value of 3 different types of catastrophic cognitions in the treatment of panic disorder with and without mild-to-moderate agoraphobia using a sample of 143 participants who received either cognitive-behavioral therapy (CBT) or imipramine in a randomized controlled trial. Stronger fears of social catastrophes…

  20. Cognitive Reappraisal Self-Efficacy Mediates the Effects of Individual Cognitive-Behavioral Therapy for Social Anxiety Disorder

    ERIC Educational Resources Information Center

    Goldin, Philippe R.; Ziv, Michal; Jazaieri, Hooria; Werner, Kelly; Kraemer, Helena; Heimberg, Richard G.; Gross, James J.

    2012-01-01

    Objective: To examine whether changes in cognitive reappraisal self-efficacy (CR-SE) mediate the effects of individually administered cognitive-behavioral therapy (I-CBT) for social anxiety disorder (SAD) on severity of social anxiety symptoms. Method: A randomized controlled trial in which 75 adult patients (21-55 years of age; 53% male; 57%…

  1. Cognitive Changes During Prolonged Exposure versus Prolonged Exposure Plus Cognitive Restructuring in Female Assault Survivors with Posttraumatic Stress Disorder

    ERIC Educational Resources Information Center

    Foa, Edna B.; Rauch, Sheila A. M.

    2004-01-01

    The authors report on changes in cognitions related to posttraumatic stress disorder (PTSD) among 54 female survivors of sexual and nonsexual assault with chronic PTSD who completed either prolonged exposure alone or in combination with cognitive restructuring. Treatment included 9-12 weekly sessions, and assessment was conducted at pretreatment,…

  2. Cognitive Reappraisal Self-Efficacy Mediates the Effects of Individual Cognitive-Behavioral Therapy for Social Anxiety Disorder

    ERIC Educational Resources Information Center

    Goldin, Philippe R.; Ziv, Michal; Jazaieri, Hooria; Werner, Kelly; Kraemer, Helena; Heimberg, Richard G.; Gross, James J.

    2012-01-01

    Objective: To examine whether changes in cognitive reappraisal self-efficacy (CR-SE) mediate the effects of individually administered cognitive-behavioral therapy (I-CBT) for social anxiety disorder (SAD) on severity of social anxiety symptoms. Method: A randomized controlled trial in which 75 adult patients (21-55 years of age; 53% male; 57%…

  3. Physical, Mental, and Social Catastrophic Cognitions as Prognostic Factors in Cognitive-Behavioral and Pharmacological Treatments for Panic Disorder

    ERIC Educational Resources Information Center

    Hicks, Thomas V.; Leitenberg, Harold; Barlow, David H.; Gorman, Jack M.; Shear, Katherine M.; Woods, Scott W.

    2005-01-01

    The authors explored the prognostic value of 3 different types of catastrophic cognitions in the treatment of panic disorder with and without mild-to-moderate agoraphobia using a sample of 143 participants who received either cognitive-behavioral therapy (CBT) or imipramine in a randomized controlled trial. Stronger fears of social catastrophes…

  4. Effectiveness of meta-cognitive and cognitive-behavioral therapy in patients with major depressive disorder.

    PubMed

    Ashouri, Ahmad; Atef Vahid, Mohammad Kazem; Gharaee, Banafsheh; Rasoulian, Maryam

    2013-01-01

    The present study aimed to compare the effectiveness of metacognitive therapy (MCT) and cognitive-behavior therapy (CBT) in treating Iranian patients with major depressive disorder (MDD). Thirty three outpatients meeting DSM-IV-TR criteria for MDD without any other axis I and II disorders were randomly assigned to one of three treatment conditions, i.e. MCT, CBT and pharmacotherapy. The Beck Depression Inventory-II-Second Edition (BDI-II), Beck Anxiety Inventory (BAI), Ruminative Response Scale (RRS) and Dysfunctional Attitude Scale (DAS) were administered for pre-treatment, post-treatment and follow-up. Data were analyzed by repeated measures analysis of variance (ANOVA). Based on repeated measures ANOVA, all the participants demonstrated improvement in depression, anxiety, dysfunctional attitude and ruminative response. Based on percentage results, all the patients in MCT and CBT groups showed significant improvement at post-treatment phase. MCT and CBT were more effective than pharmacotherapy alone In treatment of MDD. None.

  5. Impact on Infants’ Cognitive Development of Antenatal Exposure to Iron Deficiency Disorder and Common Mental Disorders

    PubMed Central

    Tran, Thach Duc; Biggs, Beverley-Ann; Tran, Tuan; Simpson, Julie Anne; Hanieh, Sarah; Dwyer, Terence; Fisher, Jane

    2013-01-01

    Objectives The aim of this study was to examine the effects of antenatal exposure to iron deficiency anemia (IDA) and common mental disorders (CMD) on cognitive development of 6 months old infants in a developing country. Methods A prospective population-based study in a rural province in Vietnam, which enrolled pregnant women at 12–20 weeks gestation and followed them up with their infants until six months postpartum. Criteria for IDA were Hb <11 g/dL and serum ferritin <15 ng/mL. CMD symptoms were assessed by the Edinburgh Postnatal Depression Scale-Vietnam validation. Infant cognitive development was assessed by Bayley Scales of Infant and Toddler Development, 3rd Ed. Path analyses were performed to determine the direct and indirect, partly or fully mediated, causal effects of the antenatal exposures. Results A total of 497 pregnant women were recruited, of those 378 women provided complete data which were included in the analyses. Statistically significant direct adverse effects of persistent antenatal IDA (estimated difference of −11.62 points; 95% CI −23.01 to −0.22) and antenatal CMD (−4.80 points; 95% CI: −9.40 to −0.20) on infant Bayley cognitive scores at six months were found. Higher birthweight, household wealth, and self-rated sufficient supply of breastmilk were associated with higher cognitive scores. Maternal age >30 years and primiparity had an indirect adverse effect on infants’ Bayley cognitive scores. Conclusions These findings suggest that antenatal IDA and CMD both have adverse effects on child cognitive development, which if unrecognized and unaddressed are likely to be lasting. It is crucial that both these risks are considered by policy makers, clinicians, and researchers seeking to improve child cognitive function in developing countries. PMID:24086390

  6. Cognitive dysfunction in major depression and bipolar disorder: Assessment and treatment options.

    PubMed

    MacQueen, Glenda M; Memedovich, Katherine A

    2017-01-01

    Cognitive dysfunction is a recognized feature of mood disorders, including major depressive disorder (MDD) and bipolar disorder (BD). Cognitive impairment is associated with poor overall functional outcome and is therefore an important feature of illness to optimize for patients' occupational and academic outcomes. While generally people with BD appear to have a greater degree of cognitive impairment than those with MDD, direct comparisons of both patient groups within a single study are lacking. There are a number of methods for the assessment of cognitive function, but few are currently used in clinical practice. Current symptoms, past course of illness, clinical features, such as the presence of psychosis and comorbid conditions, may all influence cognitive function in mood disorders. Despite the general lack of assessment of cognitive function in clinical practice, clinicians are increasingly targeting cognitive symptoms as part of comprehensive treatment strategies. Novel pharmacological agents may improve cognitive function, but most studies of standard mood stabilizers, such as lithium and the anticonvulsants, have focused on whether or not the medications impair cognition. Non-pharmacological strategies, such as cognitive remediation and exercise, are increasingly studied in patients with mood disorders. Despite the growing interest in strategies to manage cognitive function, there is a paucity of high-quality trials examining either pharmacological or non-pharmacological modes of intervention.

  7. Cognitive vulnerability to bipolar disorder in offspring of parents with bipolar disorder.

    PubMed

    Pavlickova, Hana; Turnbull, Oliver; Bentall, Richard P

    2014-11-01

    Bipolar disorder is a highly heritable illness, with a positive family history robustly predictive of its onset. It follows that studying biological children of parents with bipolar disorder may provide information about developmental pathways to the disorder. Moreover, such studies may serve as a useful test of theories that attribute a causal role in the development of mood disorders to psychological processes. Psychological style (including self-esteem, coping style with depression, domain-specific risk-taking, sensation-seeking, sensitivity to reward and punishment, and hypomanic personality and cognition) was assessed in 30 offspring of bipolar parents and 30 children of well parents. Parents of both child groups completed identical assessments. Although expected differences between parents with bipolar disorder and well parents were detected (such as low self-esteem, increased rumination, high sensitivity to reward and punishment), offspring of bipolar parents were, as a group, not significantly different from well offspring, apart from a modest trend towards lower adaptive coping. When divided into affected and non-affected subgroups, both groups of index children showed lower novelty-seeking. Only affected index children showed lower self-esteem, increased rumination, sensitivity to punishment, and hypomanic cognitions. Notably, these processes were associated with symptoms of depression. Psychological abnormalities in index offspring were associated with having met diagnostic criteria for psychiatric illnesses and the presence of mood symptoms, rather than preceding them. Implications of the present findings for our understanding of the development of bipolar disorder, as well as for informing early interventions, are discussed. © 2014 The British Psychological Society.

  8. Treatment Efficacy: Cognitive-Communicative Disorders Resulting from Traumatic Brain Injury in Adults.

    ERIC Educational Resources Information Center

    Coelho, Carl A.; And Others

    1996-01-01

    This article discusses adults with brain injuries and resulting cognitive communicative disorders. The incidence of brain injuries, the effects of cognitive-communication disorders, the role of the speech-language pathologist, the benefits of treatment, and the effects of different treatments are discussed. Charts are included that summarize…

  9. Disordered Eating-Related Cognition and Psychological Flexibility as Predictors of Psychological Health among College Students

    ERIC Educational Resources Information Center

    Masuda, Akihiko; Price, Matthew; Anderson, Page L.; Wendell, Johanna W.

    2010-01-01

    The present cross-sectional study investigated the relation among disordered eating-related cognition, psychological flexibility, and poor psychological outcomes among a nonclinical college sample. As predicted, conviction of disordered eating-related cognitions was positively associated with general psychological ill-health and emotional distress…

  10. Disordered Eating-Related Cognition and Psychological Flexibility as Predictors of Psychological Health among College Students

    ERIC Educational Resources Information Center

    Masuda, Akihiko; Price, Matthew; Anderson, Page L.; Wendell, Johanna W.

    2010-01-01

    The present cross-sectional study investigated the relation among disordered eating-related cognition, psychological flexibility, and poor psychological outcomes among a nonclinical college sample. As predicted, conviction of disordered eating-related cognitions was positively associated with general psychological ill-health and emotional distress…

  11. Cognitive behavioral therapy in pharmacoresistant obsessive–compulsive disorder

    PubMed Central

    Vyskocilova, Jana; Prasko, Jan; Sipek, Jiri

    2016-01-01

    Background The aim of the study was to determine whether patients with obsessive–compulsive disorder (OCD) resistant to drug therapy may improve their condition using intensive, systematic cognitive behavioral therapy (CBT) lasting for 6 weeks, and whether it is possible to predict the therapeutic effect using demographic, clinical, and selected psychological characteristics at baseline. Methods Sixty-six OCD patients were included in the study, of which 57 completed the program. The diagnosis was confirmed using the structured Mini International Neuropsychiatric Interview. Patients were rated using the objective and subjective forms of the Yale–Brown Obsessive Compulsive Scale, objective and subjective forms of the Clinical Global Impression, Beck Anxiety Inventory, Beck Depression Inventory, Dissociative Experiences Scale, 20-item Somatoform Dissociation Questionnaire, and the Sheehan Disability Scale before their treatment, and with subjective Yale–Brown Obsessive Compulsive Scale, objective and subjective Clinical Global Impression, Beck Anxiety Inventory, and Beck Depression Inventory at the end of the treatment. Patients were treated with antidepressants and daily intensive group CBT for the 6-week period. Results During the 6-week intensive CBT program in combination with pharmacotherapy, there was a significant improvement in patients suffering from OCD resistant to drug treatment. There were statistically significantly decrease in the scores assessing the severity of OCD symptoms, anxiety, and depressive feelings. A lower treatment effect was achieved specifically in patients who 1) showed fewer OCD themes in symptomatology, 2) showed a higher level of somatoform dissociation, 3) had poor insight, and 4) had a higher initial level of overall severity of the disorder. Remission of the disorder was more likely in patients who had 1) good insight, 2) a lower initial level of anxiety, and 3) no comorbid depressive disorder. PMID:27042074

  12. Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder: Current Status and Working Hypotheses

    ERIC Educational Resources Information Center

    Vaidya, Chandan J.; Stollstorff, Melanie

    2008-01-01

    Cognitive neuroscience studies of Attention Deficit Hyperactivity Disorder (ADHD) suggest multiple loci of pathology with respect to both cognitive domains and neural circuitry. Cognitive deficits extend beyond executive functioning to include spatial, temporal, and lower-level "nonexecutive" functions. Atypical functional anatomy extends beyond…

  13. Cognitive Neuroscience of Attention Deficit Hyperactivity Disorder: Current Status and Working Hypotheses

    ERIC Educational Resources Information Center

    Vaidya, Chandan J.; Stollstorff, Melanie

    2008-01-01

    Cognitive neuroscience studies of Attention Deficit Hyperactivity Disorder (ADHD) suggest multiple loci of pathology with respect to both cognitive domains and neural circuitry. Cognitive deficits extend beyond executive functioning to include spatial, temporal, and lower-level "nonexecutive" functions. Atypical functional anatomy extends beyond…

  14. Rivastigmine for refractory REM behavior disorder in mild cognitive impairment.

    PubMed

    Brunetti, Valerio; Losurdo, Anna; Testani, Elisa; Lapenta, Leonardo; Mariotti, Paolo; Marra, Camillo; Rossini, Paolo Maria; Della Marca, Giacomo

    2014-03-01

    Mild Cognitive Impairment (MCI) and REM Behavior Disorder (RBD) are both associated with a degeneration of ponto-medullary cholinergic pathways. We conducted a placebo-controlled, cross-over pilot trial of Rivastigmine (RVT) in 25 consecutive patients with MCI, who presented RBD refractory to conventional first-line treatments (melatonin up to 5 mg/day and clonazepam up to 2 mg/day). RVT treatment was followed by a significant reduction of RBD episodes when compared with placebo. Our data suggest that, in MCI patients with RBD resistant to conventional therapies (muscle relaxants benzodiazepines or melatonin,) treatment with RVT may induce a reduction in the frequency of RBD episodes compared to placebo.

  15. Disorders of regulation of cognitive activity in autistic children.

    PubMed

    Adrien, J L; Martineau, J; Barthélémy, C; Bruneau, N; Garreau, B; Sauvage, D

    1995-06-01

    Infantile autism is a pervasive developmental disorder characterized by disturbances concerning not only the areas of socialization and communication ("aloneness") but also the ability to modify and change behavior ("need for sameness"). In most recent studies, various abnormal and deviant cognitive activities, such as the ability to regulate one's behavior, were considered as accounting for these signs. In this report, we examined the regulation of cognitive activity, from a developmental perspective in comparing autistic with mentally retarded children matched in a pairwise manner by global, verbal, and nonverbal developmental ages. All children were tested with tasks adapted from the Object Permanence Test which corresponds to Piaget's sensorimotor development Stages IV to VI. Results showed that autistic children had a pervasive difficulty in maintenance set, made more perseverative errors when the abstraction degree of task was higher, and were more variable in their behavioral strategies. Discussion is focused on the interests and limits of these tasks for the examination of regulation activity from diagnostic and developmental perspectives. Finally, interpretations about recent neuropsychological and neurophysiological works, and additional interdisciplinary studies are suggested.

  16. Cognitive-analytical therapy for a patient with functional neurological symptom disorder-conversion disorder (psychogenic myopia): A case study.

    PubMed

    Nasiri, Hamid; Ebrahimi, Amrollah; Zahed, Arash; Arab, Mostafa; Samouei, Rahele

    2015-05-01

    Functional neurological symptom disorder commonly presents with symptoms and defects of sensory and motor functions. Therefore, it is often mistaken for a medical condition. It is well known that functional neurological symptom disorder more often caused by psychological factors. There are three main approaches namely analytical, cognitive and biological to manage conversion disorder. Any of such approaches can be applied through short-term treatment programs. In this case, study a 12-year-old boy with the diagnosed functional neurological symptom disorder (psychogenic myopia) was put under a cognitive-analytical treatment. The outcome of this treatment modality was proved successful.

  17. Meta-Analysis of the Association between Tea Intake and the Risk of Cognitive Disorders

    PubMed Central

    Ma, Qing-Ping; Huang, Chen; Cui, Qiao-Yun; Yang, Ding-Jun; Sun, Kang; Chen, Xuan; Li, Xing-Hui

    2016-01-01

    Background Alzheimer’s disease is a common neurodegenerative disorder in elderly. This study was aimed to systematically evaluate the association between tea intake and the risk of cognitive disorders by meta-analysis. Methods and Findings PubMed, Embase and Wanfang databases were systematically searched and a total of 26 observational studies were included in this study. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were calculated and pooled by using fixed or random effects models according to the degree of heterogeneity. Results The overall pooled analysis indicated that tea intake could significantly reduce the risk of cognitive disorders (OR = 0.65, 95%CI = 0.58–0.73). Subgroup analyses were conducted based on study design, population, frequency of tea drinking and type of cognitive disorders. The results showed that tea drinking was significantly associated with the reduced incidence of cognitive disorders in all of subgroups based on study design and frequency of tea drinking. In particular, tea drinking was inversely associated with the risk of cognitive impairment (CoI), mild cognitive impairment (MCI), cognitive decline and ungrouped cognitive disorders. Moreover, for population subgroups, the significant association was only found in Chinese people. Conclusion Our study suggests that daily tea drinking is associated with decreased risk of CoI, MCI and cognitive decline in the elderly. However, the association between tea intake and Alzheimer’s disease remains elusive. PMID:27824892

  18. Meta-Analysis of the Association between Tea Intake and the Risk of Cognitive Disorders.

    PubMed

    Ma, Qing-Ping; Huang, Chen; Cui, Qiao-Yun; Yang, Ding-Jun; Sun, Kang; Chen, Xuan; Li, Xing-Hui

    2016-01-01

    Alzheimer's disease is a common neurodegenerative disorder in elderly. This study was aimed to systematically evaluate the association between tea intake and the risk of cognitive disorders by meta-analysis. PubMed, Embase and Wanfang databases were systematically searched and a total of 26 observational studies were included in this study. Odds ratios (ORs) and the corresponding 95% confidence intervals (CIs) were calculated and pooled by using fixed or random effects models according to the degree of heterogeneity. The overall pooled analysis indicated that tea intake could significantly reduce the risk of cognitive disorders (OR = 0.65, 95%CI = 0.58-0.73). Subgroup analyses were conducted based on study design, population, frequency of tea drinking and type of cognitive disorders. The results showed that tea drinking was significantly associated with the reduced incidence of cognitive disorders in all of subgroups based on study design and frequency of tea drinking. In particular, tea drinking was inversely associated with the risk of cognitive impairment (CoI), mild cognitive impairment (MCI), cognitive decline and ungrouped cognitive disorders. Moreover, for population subgroups, the significant association was only found in Chinese people. Our study suggests that daily tea drinking is associated with decreased risk of CoI, MCI and cognitive decline in the elderly. However, the association between tea intake and Alzheimer's disease remains elusive.

  19. Cognition enhancing or neuroprotective compounds for the treatment of cognitive disorders: why? when? which?

    PubMed

    Lockhart, Brian P; Lestage, Pierre J

    2003-01-01

    Neurodegenerative disorders such as Alzheimer's disease, Lewy-Body dementia, Parkinson's disease and cerebrovascular dementia result in an insidious cognitive and behavioural decline culminating in the development of severe dementia. Based on current population projections it has been estimated that by 2050 the number of individuals over 65 will increase to 1.1 billion worldwide and as a consequence, the number of cases of dementia to 37 million. Faced with such an enormous public health and socio-economic burden it is evident that the importance of therapeutic intervention aimed at either finding a cure or preventing disease progression cannot be overstated. The aim of the present paper is to present an overview, in the context of a brain aging continuum, at what stage cognition enhancing and/or neuroprotective intervention strategies aimed at stabilising and/or preventing neurodegenerative disease could demonstrate potential clinical benefit. In particular, the clinical identification of patients with mild cognitive impairment and age-associated memory impairment which may represent a 'transition' state between normal aging and dementia is discussed as a potential clinical population cohort targeted for early intervention in dementia. Considering the wide spectrum of cognitive and psychotic effects in dementia juxtaposed with the neuropathological evolution of the disease, it is clear that a variety of therapeutic intervention(s) will be required in order, to at the least, stabilise disease progression. Evidently, since Alzheimer's disease is by far the most prevalent form of dementia, and will undoubtedly serve as the benchmark for any future treatment of dementia, an update of current symptomatic and disease-modifying therapeutic approaches (cholinergic, glutamatergic, nootropics, beta-amyloid cascade inhibitors) will be reviewed.

  20. Deep sequencing reveals 50 novel genes for recessive cognitive disorders.

    PubMed

    Najmabadi, Hossein; Hu, Hao; Garshasbi, Masoud; Zemojtel, Tomasz; Abedini, Seyedeh Sedigheh; Chen, Wei; Hosseini, Masoumeh; Behjati, Farkhondeh; Haas, Stefan; Jamali, Payman; Zecha, Agnes; Mohseni, Marzieh; Püttmann, Lucia; Vahid, Leyla Nouri; Jensen, Corinna; Moheb, Lia Abbasi; Bienek, Melanie; Larti, Farzaneh; Mueller, Ines; Weissmann, Robert; Darvish, Hossein; Wrogemann, Klaus; Hadavi, Valeh; Lipkowitz, Bettina; Esmaeeli-Nieh, Sahar; Wieczorek, Dagmar; Kariminejad, Roxana; Firouzabadi, Saghar Ghasemi; Cohen, Monika; Fattahi, Zohreh; Rost, Imma; Mojahedi, Faezeh; Hertzberg, Christoph; Dehghan, Atefeh; Rajab, Anna; Banavandi, Mohammad Javad Soltani; Hoffer, Julia; Falah, Masoumeh; Musante, Luciana; Kalscheuer, Vera; Ullmann, Reinhard; Kuss, Andreas Walter; Tzschach, Andreas; Kahrizi, Kimia; Ropers, H Hilger

    2011-09-21

    Common diseases are often complex because they are genetically heterogeneous, with many different genetic defects giving rise to clinically indistinguishable phenotypes. This has been amply documented for early-onset cognitive impairment, or intellectual disability, one of the most complex disorders known and a very important health care problem worldwide. More than 90 different gene defects have been identified for X-chromosome-linked intellectual disability alone, but research into the more frequent autosomal forms of intellectual disability is still in its infancy. To expedite the molecular elucidation of autosomal-recessive intellectual disability, we have now performed homozygosity mapping, exon enrichment and next-generation sequencing in 136 consanguineous families with autosomal-recessive intellectual disability from Iran and elsewhere. This study, the largest published so far, has revealed additional mutations in 23 genes previously implicated in intellectual disability or related neurological disorders, as well as single, probably disease-causing variants in 50 novel candidate genes. Proteins encoded by several of these genes interact directly with products of known intellectual disability genes, and many are involved in fundamental cellular processes such as transcription and translation, cell-cycle control, energy metabolism and fatty-acid synthesis, which seem to be pivotal for normal brain development and function.

  1. Disordered eating cognitions and behaviours among slimming organization competition winners.

    PubMed

    Green, G C; Buckroyd, J

    2008-02-01

    Long-term success in weight loss treatments for obesity is elusive. The most widely used approach after diet books is slimming clubs. A percentage of members achieve dramatic and lasting weight losses. The study aimed to evaluate the prevalence of binge eating and unhealthy eating-related thought patterns among a group of highly successful weight losers. Sixty-five slimming competition winners self reported their weight history and eating habits in a semi-structured questionnaire. The Eating Disorders Examination Questionnaire (EDE-Q) and the Emotional Eating Scale (EES) were also administered. Despite substantial weight loss (mean = 38%, SD = 10%) and widespread maintenance of losses, participants evidenced high levels of dietary restraint and weight, shape and eating overconcern. Emotional eating levels were significantly higher than those seen in noneating disordered populations on two of three subscales. Seventy-one per cent also reported bingeing in the past 3 months. Commercial slimming organizations should engage with broader psychological and behavioural features of obesity, including bingeing and eating-related cognitive patterns.

  2. Cognitive variability in psychotic disorders: a cross-diagnostic cluster analysis.

    PubMed

    Lewandowski, K E; Sperry, S H; Cohen, B M; Ongür, D

    2014-11-01

    Cognitive dysfunction is a core feature of psychotic disorders; however, substantial variability exists both within and between subjects in terms of cognitive domains of dysfunction, and a clear 'profile' of cognitive strengths and weaknesses characteristic of any diagnosis or psychosis as a whole has not emerged. Cluster analysis provides an opportunity to group individuals using a data-driven approach rather than predetermined grouping criteria. While several studies have identified meaningful cognitive clusters in schizophrenia, no study to date has examined cognition in a cross-diagnostic sample of patients with psychotic disorders using a cluster approach. We aimed to examine cognitive variables in a sample of 167 patients with psychosis using cluster methods. Subjects with schizophrenia (n = 41), schizo-affective disorder (n = 53) or bipolar disorder with psychosis (n = 73) were assessed using a battery of cognitive and clinical measures. Cognitive data were analysed using Ward's method, followed by a K-means cluster approach. Clusters were then compared on diagnosis and measures of clinical symptoms, demographic variables and community functioning. A four-cluster solution was selected, including a 'neuropsychologically normal' cluster, a globally and significantly impaired cluster, and two clusters of mixed cognitive profiles. Clusters differed on several clinical variables; diagnoses were distributed amongst all clusters, although not evenly. Identification of groups of patients who share similar neurocognitive profiles may help pinpoint relevant neural abnormalities underlying these traits. Such groupings may also hasten the development of individualized treatment approaches, including cognitive remediation tailored to patients' specific cognitive profiles.

  3. Cognitive behavioural therapy for anxiety disorders in children and adolescents.

    PubMed

    James, A; Soler, A; Weatherall, R

    2005-10-19

    Childhood and adolescent anxiety disorders are relatively common, occurring in between 5-18% of all children and adolescents. They are associated with significant morbidity and impairment in social and academic functioning, and when persistent, there is a risk of depression, suicide attempts and substance abuse in adulthood. There is accumulating evidence for the efficacy of cognitive behavioural therapy (CBT), with a number of randomised controlled trials (RCTs) suggesting benefit. To determine whether CBT is an effective treatment for childhood and adolescent anxiety disorders in comparison to waiting list or attention controls. Search of the Cochrane Register of Controlled Trials and the Cochrane Depression, Anxiety and Neurosis Group Register, which includes relevant randomised controlled trials from the bibliographic databases - The Cochrane Library ( to January 2004), EMBASE, (1970-2004) MEDLINE (1970-2004) and PsycINFO (1970-2004). We also searched the references of all included studies and relevant textbooks, and contacted authors in order to identify further trials. . Each identified study was assessed for possible inclusion by two reviewers independently. Inclusion criteria consisted of randomised controlled trials of CBT versus waiting list/attention controls in children (more than six years of age) and adolescents (under the age of 19 years) with a DSM (Diagnostic Statistical Manual) or ICD (International Classification of Diseases) anxiety diagnosis; and excluding simple phobia, obsessive compulsive disorder and post-traumatic stress disorder. Each study was required to conform to the principles of CBT through use of a protocol and comprising at least eight sessions of CBT. The methodological quality of included trials was assessed by two reviewers independently. The dichotomous outcome of remission of anxiety diagnosis was pooled using relative risk (RR) with 95% confidence intervals. Means and standard deviations of anxiety symptom continuous scores

  4. Validity and reliability of the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) in Japanese patients with bipolar disorder.

    PubMed

    Toyoshima, Kuniyoshi; Fujii, Yutaka; Mitsui, Nobuyuki; Kako, Yuki; Asakura, Satoshi; Martinez-Aran, Anabel; Vieta, Eduard; Kusumi, Ichiro

    2017-08-01

    In Japan, there are currently no reliable rating scales for the evaluation of subjective cognitive impairment in patients with bipolar disorder. We studied the relationship between the Japanese version of the Cognitive Complaints in Bipolar Disorder Rating Assessment (COBRA) and objective cognitive assessments in patients with bipolar disorder. We further assessed the reliability and validity of the COBRA. Forty-one patients, aged 16-64, in a remission period of bipolar disorder were recruited from Hokkaido University Hospital in Sapporo, Japan. The COBRA (Japanese version) and Frankfurt Complaint Questionnaire (FCQ), the gold standard in subjective cognitive assessment, were administered. A battery of neuropsychological tests was employed to measure objective cognitive impairment. Correlations among the COBRA, FCQ, and neuropsychological tests were determined using Spearman's correlation coefficient. The Japanese version of the COBRA had high internal consistency, good retest reliability, and concurrent validity-as indicated by a strong correlation with the FCQ. A significant correlation was also observed between the COBRA and objective cognitive measurements of processing speed. These findings are the first to demonstrate that the Japanese version of the COBRA may be clinically useful as a subjective cognitive impairment rating scale in Japanese patients with bipolar disorder. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

  5. A measure of dysfunctional eating-related cognitions in people with psychotic disorders.

    PubMed

    Khazaal, Yasser; Billieux, Joël; Fresard, Emmanuelle; Huguelet, Philippe; Van der Linden, Martial; Zullino, Daniele

    2010-03-01

    Obesity and binge eating disorder are common in individuals with psychotic disorders. Eating and weight-related cognitions are known to influence eating behaviors. The study was designed to assess the psychometric properties of the Mizes Anorectic Cognitions Questionnaire (MAC-R) in patients with psychotic disorders. Binge eating disorder (BED), body mass index (BMI), the MAC-R and the three factor eating questionnaire (TFEQ) were assessed in 125 patients with a diagnosis of schizophrenia or schizoaffective disorder. Whereas the MAC-R has not acceptable psychometric properties, a brief version of the MAC-R (BMAC) has good psychometrical properties and is correlated with TFEQ and BMI. Binge eating disorder is also correlated to the Rigid Weight Regulation and Fear of Weight Gain subscale. The BMAC is a useful brief measure to assess eating and weight related cognitions in people with psychotic disorders.

  6. Omega 3 Fatty Acids: Novel Neurotherapeutic Targets for Cognitive Dysfunction in Mood Disorders and Schizophrenia?

    PubMed Central

    Knöchel, Christian; Voss, Martin; Grter, Florian; Alves, Gilberto S.; Matura, Silke; Sepanski, Beate; Stäblein, Michael; Wenzler, Sofia; Prvulovic, David; Carvalho, André F.; Oertel-Knöchel, Viola

    2015-01-01

    An increasing body of evidences from preclinical as well as epidemiological and clinical studies suggest a potential beneficial role of dietary intake of omega-3 fatty acids for cognitive functioning. In this narrative review, we will summarize and discuss recent findings from epidemiological, interventional and experimental studies linking dietary consumption of omega-3 fatty acids to cognitive function in healthy adults. Furthermore, affective disorders and schizophrenia (SZ) are characterized by cognitive dysfunction encompassing several domains. Cognitive dysfunction is closely related to impaired functioning and quality of life across these conditions. Therefore, the current review focues on the potential influence of omega-3 fatty acids on cognition in SZ and affective disorders. In sum, current data predominantly from mechanistic models and animal studies suggest that adjunctive omega-3 fatty acid supplementation could lead to improved cognitive functioning in SZ and affective disorders. However, besides its translational promise, evidence for clinical benefits in humans has been mixed. Notwithstanding evidences indicate that adjunctive omega-3 fatty acids may have benefit for affective symptoms in both unipolar and bipolar depression, to date no randomized controlled trial had evaluated omega-3 as cognitive enhancer for mood disorders, while a single published controlled trial suggested no therapeutic benefit for cognitive improvement in SZ. Considering the pleiotropic mechanisms of action of omega-3 fatty acids, the design of well-designed controlled trials of omega-3 supplementation as a novel, domain-specific, target for cognitive impairment in SZ and affective disorders is warranted. PMID:26467414

  7. Omega 3 Fatty Acids: Novel Neurotherapeutic Targets for Cognitive Dysfunction in Mood Disorders and Schizophrenia?

    PubMed

    Knöchel, Christian; Voss, Martin; Grüter, Florian; Alves, Gilberto S; Matura, Silke; Sepanski, Beate; Stäblein, Michael; Wenzler, Sofia; Prvulovic, David; Carvalho, André F; Oertel-Knöchel, Viola

    2015-01-01

    An increasing body of evidences from preclinical as well as epidemiological and clinical studies suggest a potential beneficial role of dietary intake of omega-3 fatty acids for cognitive functioning. In this narrative review, we will summarize and discuss recent findings from epidemiological, interventional and experimental studies linking dietary consumption of omega-3 fatty acids to cognitive function in healthy adults. Furthermore, affective disorders and schizophrenia (SZ) are characterized by cognitive dysfunction encompassing several domains. Cognitive dysfunction is closely related to impaired functioning and quality of life across these conditions. Therefore, the current review focues on the potential influence of omega-3 fatty acids on cognition in SZ and affective disorders. In sum, current data predominantly from mechanistic models and animal studies suggest that adjunctive omega-3 fatty acid supplementation could lead to improved cognitive functioning in SZ and affective disorders. However, besides its translational promise, evidence for clinical benefits in humans has been mixed. Notwithstanding evidences indicate that adjunctive omega-3 fatty acids may have benefit for affective symptoms in both unipolar and bipolar depression, to date no randomized controlled trial had evaluated omega-3 as cognitive enhancer for mood disorders, while a single published controlled trial suggested no therapeutic benefit for cognitive improvement in SZ. Considering the pleiotropic mechanisms of action of omega-3 fatty acids, the design of well-designed controlled trials of omega-3 supplementation as a novel, domain-specific, target for cognitive impairment in SZ and affective disorders is warranted.

  8. Gains in cognition through combined cognitive and physical training: the role of training dosage and severity of neurocognitive disorder

    PubMed Central

    Bamidis, Panagiotis D.; Fissler, Patrick; Papageorgiou, Sokratis G.; Zilidou, Vasiliki; Konstantinidis, Evdokimos I.; Billis, Antonis S.; Romanopoulou, Evangelia; Karagianni, Maria; Beratis, Ion; Tsapanou, Angeliki; Tsilikopoulou, Georgia; Grigoriadou, Eirini; Ladas, Aristea; Kyrillidou, Athina; Tsolaki, Anthoula; Frantzidis, Christos; Sidiropoulos, Efstathios; Siountas, Anastasios; Matsi, Stavroula; Papatriantafyllou, John; Margioti, Eleni; Nika, Aspasia; Schlee, Winfried; Elbert, Thomas; Tsolaki, Magda; Vivas, Ana B.; Kolassa, Iris-Tatjana

    2015-01-01

    Physical as well as cognitive training interventions improve specific cognitive functions but effects barely generalize on global cognition. Combined physical and cognitive training may overcome this shortcoming as physical training may facilitate the neuroplastic potential which, in turn, may be guided by cognitive training. This study aimed at investigating the benefits of combined training on global cognition while assessing the effect of training dosage and exploring the role of several potential effect modifiers. In this multi-center study, 322 older adults with or without neurocognitive disorders (NCDs) were allocated to a computerized, game-based, combined physical and cognitive training group (n = 237) or a passive control group (n = 85). Training group participants were allocated to different training dosages ranging from 24 to 110 potential sessions. In a pre-post-test design, global cognition was assessed by averaging standardized performance in working memory, episodic memory and executive function tests. The intervention group increased in global cognition compared to the control group, p = 0.002, Cohen’s d = 0.31. Exploratory analysis revealed a trend for less benefits in participants with more severe NCD, p = 0.08 (cognitively healthy: d = 0.54; mild cognitive impairment: d = 0.19; dementia: d = 0.04). In participants without dementia, we found a dose-response effect of the potential number and of the completed number of training sessions on global cognition, p = 0.008 and p = 0.04, respectively. The results indicate that combined physical and cognitive training improves global cognition in a dose-responsive manner but these benefits may be less pronounced in older adults with more severe NCD. The long-lasting impact of combined training on the incidence and trajectory of NCDs in relation to its severity should be assessed in future long-term trials. PMID:26300772

  9. Cognitive and Psychiatric Phenotypes of Movement Disorders in Children: A Systematic Review

    ERIC Educational Resources Information Center

    Ben-Pazi, Hilla; Jaworowski, Solomon; Shalev, Ruth S

    2011-01-01

    Aim: The cognitive and psychiatric aspects of adult movement disorders are well established, but specific behavioural profiles for paediatric movement disorders have not been delineated. Knowledge of non-motor phenotypes may guide treatment and determine which symptoms are suggestive of a specific movement disorder and which indicate medication…

  10. Affective disorders and cognitive failures: a comparison of seasonal and nonseasonal depression.

    PubMed

    Sullivan, Brianna; Payne, Tabitha W

    2007-11-01

    Seasonal depression shares certain common symptoms with nonseasonal depression; however, the two disorders have never been examined in a single study, to the authors' knowledge. The goal of this research was to examine the potential similarities in cognitive impairments in seasonal affective disorder and major depressive disorder in college students in the Midwest. Identification of affective disorders was based on participants' self-reported behavior and affect on the Beck Depression Inventory and the Seasonal Pattern Assessment Questionnaire. A group of 93 participants was assessed for major depressive disorder and seasonal affective disorder in late autumn and completed the Cognitive Failures Questionnaire for reported difficulties in everyday activities that correspond to problems with perception, attention, and memory retrieval. The results indicated that seasonal affective disorder was highly prevalent (28.0%), substantially more so than major depressive disorder (8.6%). Similar to previous research on major depressive disorder, gender differences were also evident among participants with seasonal affective disorder, with more women qualifying than men. Both affective disorders were associated with higher reports of cognitive failures in comparison to participants with no depressive symptoms. These results reveal that individuals with seasonal affective disorder showed cognitive impairments similar to those with nonseasonal depression.

  11. Cognitive and Psychiatric Phenotypes of Movement Disorders in Children: A Systematic Review

    ERIC Educational Resources Information Center

    Ben-Pazi, Hilla; Jaworowski, Solomon; Shalev, Ruth S

    2011-01-01

    Aim: The cognitive and psychiatric aspects of adult movement disorders are well established, but specific behavioural profiles for paediatric movement disorders have not been delineated. Knowledge of non-motor phenotypes may guide treatment and determine which symptoms are suggestive of a specific movement disorder and which indicate medication…

  12. Association of arterial hypertension and cognitive impairment in euthymic bipolar disorder.

    PubMed

    Hubenak, Jan; Tuma, Ivan; Bazant, Jan

    2015-01-01

    Cognitive impairment in euthymic phase of bipolar disorder has been documented in many studies. Several factors may contribute to such impairment, e.g. sedative medication, thyreopathy. Metabolic syndrome with its components represents another frequent condition found in bipolar disorder exerting probably adverse impact on cognition. Since it is treatable factor and current literature suggests possible connection with cognitive dysfunction, we aimed to explore such associations to identify promising targets of complex treatment. Forty euthymic bipolar patients have been enrolled. Their body and metabolic parameters were measured. Medical history data were collected. Cognition was evaluated using battery of tests. Neuropsychological performance was transformed into neurocognitive composite score. Cognition of subjects was compared dichotomously according to presence or absence of pathological body and metabolic parameters. Correlations of selected parameters and composite score were done. Low neurocognitive score was found in presence of hypertension, metabolic syndrome, abdominal obesity and hyperglycemia. Only connection of hypertension and cognitive score reached sufficient statistical power. Patients presenting hypertension performed worse in all tested domains of cognition when compared with normal blood pressure group. Subjects using lithium performed substantially worse in cognitive tests. However, in comparison with anticonvulsant group, lithium users had markedly longer disorder history as well as longer duration of thymoprofylaxis. No significant correlation of HDRS score, insulinemia or HOMA-IR was found. Despite relatively small sample size, noticeable association of hypertension and cognitive impairment was revealed. This might indicate possible way of enhancing cognition in bipolar disorder by treating elevated blood pressure.

  13. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence.

    PubMed

    Kaczkurkin, Antonia N; Foa, Edna B

    2015-09-01

    A large amount of research has accumulated on the efficacy and effectiveness of cognitive-behavioral therapy (CBT) for anxiety disorders including posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, social anxiety disorder, and specific phobia. The purpose of the current article is to provide an overview of two of the most commonly used CBT methods used to treat anxiety disorders (exposure and cognitive therapy) and to summarize and discuss the current empirical research regarding the usefulness of these techniques for each anxiety disorder. Additionally, we discuss the difficulties that arise when comparing active CBT treatments, and we suggest directions for future research. Overall, CBT appears to be both efficacious and effective in the treatment of anxiety disorders, but dismantling studies are needed to determine which specific treatment components lead to beneficial outcomes and which patients are most likely to benefit from these treatment components.

  14. Cognitive-behavioral therapy for anxiety disorders: an update on the empirical evidence

    PubMed Central

    Kaczkurkin, Antonia N.; Foa, Edna B.

    2015-01-01

    A large amount of research has accumulated on the efficacy and effectiveness of cognitive-behavioral therapy (CBT) for anxiety disorders including posttraumatic stress disorder, obsessive-compulsive disorder, panic disorder, generalized anxiety disorder, social anxiety disorder, and specific phobia. The purpose of the current article is to provide an overview of two of the most commonly used CBT methods used to treat anxiety disorders (exposure and cognitive therapy) and to summarize and discuss the current empirical research regarding the usefulness of these techniques for each anxiety disorder. Additionally, we discuss the difficulties that arise when comparing active CBT treatments, and we suggest directions for future research. Overall, CBT appears to be both efficacious and effective in the treatment of anxiety disorders, but dismantling studies are needed to determine which specific treatment components lead to beneficial outcomes and which patients are most likely to benefit from these treatment components. PMID:26487814

  15. Cognitive Function as a Trans-Diagnostic Treatment Target in Stimulant Use Disorders

    PubMed Central

    Sofuoglu, Mehmet; DeVito, Elise E.; Waters, Andrew J.; Carroll, Kathleen M.

    2016-01-01

    Stimulant use disorder is an important public health problem, with an estimated 2.1 million current users in the United States alone. No pharmacological treatments are approved by the U.S. Food and Drug Administration (FDA) for stimulant use disorder and behavioral treatments have variable efficacy and limited availability. Most individuals with stimulant use disorder have other comorbidities, most with overlapping symptoms and cognitive impairments. The goal of this article is to present a rationale for cognition as a treatment target in stimulant use disorder, and to outline potential treatment approaches. Rates of lifetime comorbid psychiatric disorders among people with stimulant use disorders are estimated at 65% - 73%, with the most common being mood disorders (13% - 64%) and anxiety disorders (21% - 50%), as well as non-substance induced psychotic disorders (under 10%). There are several models of addictive behavior, but the dual process model particularly highlights the relevance of cognitive impairments and biases to the development and maintenance of addiction. This model explains addictive behavior as a balance between automatic processes and executive control, which in turn are related to individual (genetics, comorbid disorders, psychosocial factors) and other (craving, triggers, drug use) factors. Certain cognitive impairments, such as attentional bias and approach bias, are most relevant to automatic processes, while sustained attention, response inhibition, and working memory are primarily related to executive control. These cognitive impairments and biases are also common in disorders frequently comorbid with stimulant use disorder, and predict poor treatment retention and clinical outcomes. As such, they may serve as feasible trans-diagnostic treatment targets. There are promising pharmacological, cognitive, and behavioral approaches that aim to enhance cognitive function. Pharmacotherapies target cognitive impairments associated with executive

  16. Emotional and cognitive social processes are impaired in Parkinson's disease and are related to behavioral disorders.

    PubMed

    Narme, Pauline; Mouras, Harold; Roussel, Martine; Duru, Cécile; Krystkowiak, Pierre; Godefroy, Olivier

    2013-03-01

    Parkinson's disease (PD) is associated with behavioral disorders that can affect social functioning but are poorly understood. Since emotional and cognitive social processes are known to be crucial in social relationships, impairment of these processes may account for the emergence of behavioral disorders. We used a systematic battery of tests to assess emotional processes and social cognition in PD patients and relate our findings to conventional neuropsychological data (especially behavioral disorders). Twenty-three PD patients and 46 controls (matched for age and educational level) were included in the study and underwent neuropsychological testing, including an assessment of the behavioral and cognitive components of executive function. Emotional and cognitive social processes were assessed with the Interpersonal Reactivity Index caregiver-administered questionnaire (as a measure of empathy), a facial emotion recognition task and two theory of mind (ToM) tasks. When compared with controls, PD patients showed low levels of empathy (p = .006), impaired facial emotion recognition (which persisted after correction for perceptual abilities) (p = .001), poor performance in a second-order ToM task (p = .008) that assessed both cognitive (p = .004) and affective (p = .03) inferences and, lastly, frequent dysexecutive behavioral disorders (in over 40% of the patients). Overall, impaired emotional and cognitive social functioning was observed in 17% of patients and was related to certain cognitive dysexecutive disorders. In terms of behavioral dysexecutive disorders, social behavior disorders were related to impaired emotional and cognitive social functioning (p = .04) but were independent of cognitive impairments. Emotional and cognitive social processes were found to be impaired in Parkinson's disease. This impairment may account for the emergence of social behavioral disorders. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  17. The second attention disorder? Sluggish cognitive tempo vs. attention-deficit/hyperactivity disorder: update for clinicians.

    PubMed

    Saxbe, Catherine; Barkley, Russell A

    2014-01-01

    Sluggish cognitive tempo (SCT) refers to an impairment of attention in hypoactive-appearing individuals that first presents in childhood. At this time, it exists only as a research entity that has yet to debut in official diagnostic taxonomies. However, it seems likely that a constellation of characteristic features of SCT may form the criteria for a newly defined childhood disorder in the foreseeable future, provided limitations in the extant findings can be addressed by future research. Most clinicians who assess and treat cases of attention- deficit/hyperactivity disorder (ADHD) have likely seen and treated someone who falls within the parameters for SCT. This article outlines the history of SCT and reviews the current understanding of the disorder, how it is distinguishable from and similar to other attention disorders, and what future directions research and treatment may take. Based on this review and their clinical experience, the authors conjecture that SCT is probably distinct from ADHD rather than being an ADHD subtype, although there is notable overlap with the ADHD predominantly inattentive and combined presentations.

  18. Implicit motives and cognitive variables: specific links to vulnerability for unipolar or bipolar disorder.

    PubMed

    Fuhr, Kristina; Hautzinger, Martin; Meyer, Thomas Daniel

    2014-01-30

    Cognitive variables contribute to the etiology of affective disorders. With the differentiation between explicit and implicit measures some studies have indicated underlying depressogenic schemata even in bipolar disorders. We tested for differences in implicit motives and cognitive variables between patients with remitted unipolar and bipolar disorder compared to controls and in a high-risk sample. Additionally we investigated whether affective symptoms relate to those variables. We cross-sectionally examined N=164 participants (53 with bipolar disorder, 58 with major depression, and 53 without affective disorders) and a high-risk sample (N=49) of adolescent children of either parents with unipolar or bipolar disorder or of healthy parents. The Multi-Motive-Grid was used to measure the implicit motives achievement, affiliation, and power, in addition to the cognitive measures of self-esteem, dysfunctional attitudes, and perfectionism. Unipolar and bipolar groups did not differ from healthy controls in implicit motives but showed higher scores in the cognitive factors. Adolescents at high risk for unipolar disorder showed lower scores in the power and achievement motives compared to adolescents at low risk. Subsyndromal depressive symptoms were related to the cognitive variables in both samples. Our results underline the importance of cognitive-behavioral treatment for both unipolar and bipolar disorder. © 2013 Published by Elsevier Ireland Ltd.

  19. Cognitive predictors of treatment response to bupropion and cognitive effects of bupropion in patients with major depressive disorder.

    PubMed

    Herrera-Guzmán, Ixchel; Gudayol-Ferré, Esteve; Lira-Mandujano, Jennifer; Herrera-Abarca, Jorge; Herrera-Guzmán, Daniel; Montoya-Pérez, Karina; Guardia-Olmos, Joan

    2008-07-15

    Cognitive effects of antidepressants and cognitive predictors of antidepressant treatment response are recent focuses of interest in the neuropsychology of depression. We studied the cognitive predictors of treatment response to bupropion and its neuropsychological effects in patients with major depressive disorder. Twenty subjects meeting the DSM-IV criteria for major depressive disorder were assessed with the Hamilton Depression Rating Scale and a neuropsychological battery. Subjects were medicated with 150 mg/day of bupropion sustained release for 8 weeks. At the end of the trial, 12 subjects were classified as responders to treatment and 8 were non-responders. Our findings suggest that low pretreatment measures of visual memory and low levels of mental processing speed are predictive of good response to bupropion. The cognitive effects of bupropion after the treatment showed that patients improved in visual memory measures and in mental processing speed. Our results suggest that cognitive predictors of treatment response to bupropion and cognitive effects of bupropion in patients with major depressive disorder could be closely related. These findings need to be replicated due to the exploratory nature of the present work.

  20. Differences in cognitive impairment between schizophrenia and bipolar disorder: Considering the role of heterogeneity.

    PubMed

    Bora, Emre

    2016-10-01

    Schizophrenia is associated with significant cognitive impairment. Bipolar disorder (BD) also presents with cognitive deficits that are similar to, albeit less severe, than those reported in schizophrenia. There has been controversy over whether selective deficits in social cognition or developmental trajectory of cognitive deficits can distinguish schizophrenia from BD. Also, available studies have not generally considered the potential effect of cognitive heterogeneity within the two disorders on between-group differences. The current review examines the evidence on the specificity of social cognitive deficits and early neurocognitive impairment to schizophrenia and explores the overall outcome of studies investigating within and cross-diagnosis cognitive heterogeneity in schizophrenia and BD. Current evidence does not support the specificity of social cognitive impairment to schizophrenia. Available studies also suggest that cognitive impairment in premorbid and early stages is evident not only in schizophrenia but also in many BD patients. Both schizophrenia and BD have a number of cognitive subgroups, including severe impairment, good functioning, and one or more selective or modest impairment clusters. While both disorders are represented in each cognitive subgroup, there are significant cross-diagnostic differences regarding prevalences of individuals belonging to the severe impairment and good functioning subgroups. Individuals with schizophrenia are much more likely to exhibit severe cognitive impairment than individuals with BD and good cognitive functioning is more often observed in BD patients than schizophrenia patients. Further identification of the neurobiological and genetic characteristics of the cognitive subgroups in major psychoses can improve the validity of diagnostic systems and can advance the development of personalized management approaches, including cognitive remediation.

  1. Impaired cognitive control over emotional material in euthymic bipolar disorder.

    PubMed

    Wolkenstein, Larissa; Kanske, Philipp; Bailer, Josef; Wessa, Michèle; Hautzinger, Martin; Joormann, Jutta

    2017-05-01

    Previous research suggests that bipolar disorder (BD) is characterized by deficits in cognitive control (CC). Impaired CC has been found in high-risk samples and is associated with the maintenance of BD symptoms. It remains unclear, however, whether BD is characterized by a general deficit in CC or by a deficit that is specifically related to the processing of emotional material. The sample consisted of 42 remitted bipolar patients and 39 healthy controls (HC). We examined whether BD individuals display impaired CC when confronted with negative as well as positive material using an arithmetic inhibition task that required inhibition of pictorial stimulus material. Whereas both groups showed difficulties in exerting CC over negative material, only BD individuals exhibited deficient CC over positive material. Even though we intended the negative and positive pictures in the arithmetic inhibition task to be similarly arousing, participants in the current study rated the negative compared to the positive pictures as more arousing. BD is associated with impaired CC when processing emotional - especially positive - stimuli even when patients are in remission. Possible implications of this deficit especially for emotion regulation are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  2. Emotion beliefs and cognitive behavioural therapy for social anxiety disorder.

    PubMed

    De Castella, Krista; Goldin, Philippe; Jazaieri, Hooria; Heimberg, Richard G; Dweck, Carol S; Gross, James J

    2015-01-01

    Despite strong support for the efficacy of cognitive behavioural therapy (CBT) for social anxiety disorder (SAD), little is known about mechanisms of change in treatment. Within the context of a randomized controlled trial of CBT, this study examined patients' beliefs about the fixed versus malleable nature of anxiety-their 'implicit theories'-as a key variable in CBT for SAD. Compared to waitlist (n = 29; 58% female), CBT (n = 24; 52% female) led to significantly lower levels of fixed beliefs about anxiety (Mbaseline = 11.70 vs. MPost = 7.08, d = 1.27). These implicit beliefs indirectly explained CBT-related changes in social anxiety symptoms (κ(2) = .28, [95% CI = 0.12, 0.46]). Implicit beliefs also uniquely predicted treatment outcomes when controlling for baseline social anxiety and other kinds of maladaptive beliefs (perceived social costs, perceived social self-efficacy, and maladaptive interpersonal beliefs). Finally, implicit beliefs continued to predict social anxiety symptoms at 12 months post-treatment. These findings suggest that changes in patients' beliefs about their emotions may play an important role in CBT for SAD.

  3. Modelling cognitive affective biases in major depressive disorder using rodents.

    PubMed

    Hales, Claire A; Stuart, Sarah A; Anderson, Michael H; Robinson, Emma S J

    2014-10-01

    Major depressive disorder (MDD) affects more than 10% of the population, although our understanding of the underlying aetiology of the disease and how antidepressant drugs act to remediate symptoms is limited. Major obstacles include the lack of availability of good animal models that replicate aspects of the phenotype and tests to assay depression-like behaviour in non-human species. To date, research in rodents has been dominated by two types of assays designed to test for depression-like behaviour: behavioural despair tests, such as the forced swim test, and measures of anhedonia, such as the sucrose preference test. These tests have shown relatively good predictive validity in terms of antidepressant efficacy, but have limited translational validity. Recent developments in clinical research have revealed that cognitive affective biases (CABs) are a key feature of MDD. Through the development of neuropsychological tests to provide objective measures of CAB in humans, we have the opportunity to use 'reverse translation' to develop and evaluate whether similar methods are suitable for research into MDD using animals. The first example of this approach was reported in 2004 where rodents in a putative negative affective state were shown to exhibit pessimistic choices in a judgement bias task. Subsequent work in both judgement bias tests and a novel affective bias task suggest that these types of assay may provide translational methods for studying MDD using animals. This review considers recent work in this area and the pharmacological and translational validity of these new animal models of CABs.

  4. Cannabis Use Disorders in Schizophrenia: Effects on Cognition and Symptoms

    PubMed Central

    DeRosse, Pamela; Kaplan, Alyson; Burdick, Katherine E.; Lencz, Todd; Malhotra, Anil K.

    2010-01-01

    Objective Despite the controversy surrounding the possible causal link between cannabis use and the onset of schizophrenia (SZ), data seeking to elucidate the effect of cannabis use disorders (CUD) on the clinical presentation of SZ have produced mixed results. Although several studies have suggested that CUD in patients with SZ may be associated with variation in cognitive function, clinical presentation and course of illness, the effects have been inconsistent. Methods We retrospectively ascertained a large cohort (N = 455) of SZ patients with either no history of a CUD (CUD−; N=280) or a history of CUD (CUD+; N=175). Groups were initially compared on key demographic variables including sex, race, age, age at onset of SZ, parental socioeconomic status, premorbid IQ, education level and global assessment of functioning. Covarying for any observed differences in demographic variables, we then compared groups on lifetime measures of psychotic symptoms as well as a brief battery of neurocognitive tests. Results Compared to the CUD− group the CUD+ group demonstrated significantly better performance on measures of processing speed (Trail Making Test A and B), verbal fluency (animal naming) and verbal learning and memory (California Verbal Learning Test). Moreover, the CUD+ group had better GAF scores than the CUD− group. Conclusions Collectively, these findings suggest that SZ patients with comorbid CUD may represent a higher functioning subgroup of SZ. Future prospective studies are needed to elucidate the nature of this relationship. PMID:20483565

  5. The Behavioral and Cognitive Executive Disorders of Stroke: The GREFEX Study

    PubMed Central

    Roussel, Martine; Martinaud, Olivier; Hénon, Hilde; Vercelletto, Martine; Bindschadler, Claire; Joseph, Pierre-Alain; Robert, Philippe; Labauge, Pierre; Godefroy, Olivier

    2016-01-01

    Background Many studies have highlighted the high prevalence of executive disorders in stroke. However, major uncertainties remain due to use of variable and non-validated methods. The objectives of this study were: 1) to characterize the executive disorder profile in stroke using a standardized battery, validated diagnosis criteria of executive disorders and validated framework for the interpretation of neuropsychological data and 2) examine the sensitivity of the harmonization standards protocol proposed by the National Institute of Neurological Disorders and Stroke and Canadian Stroke Network (NINDS-CSN) for the diagnosis of Vascular Cognitive Impairment. Methods 237 patients (infarct: 57; cerebral hemorrhage: 54; ruptured aneurysm of the anterior communicating artery (ACoA): 80; cerebral venous thrombosis (CVT): 46) were examined by using the GREFEX battery. The patients’ test results were interpreted with a validated framework derived from normative data from 780 controls. Results Dysexecutive syndrome was observed in 88 (55.7%; 95%CI: 48–63.4) out of the 156 patients with full cognitive and behavioral data: 40 (45.5%) had combined behavioral and cognitive syndromes, 29 (33%) had a behavioral disorder alone and 19 (21.6%) had a cognitive syndrome alone. The dysexecutive profile was characterized by prominent impairments of initiation and generation in the cognitive domain and by hypoactivity with disinterest and anticipation loss in the behavioral domain. Cognitive impairment was more frequent (p = 0.014) in hemorrhage and behavioral disorders were more frequent (p = 0.004) in infarct and hemorrhage. The harmonization standards protocol underestimated (p = 0.007) executive disorders in CVT or ACoA. Conclusions This profile of executive disorders implies that the assessment should include both cognitive tests and a validated inventory for behavioral dysexecutive syndrome. Initial assessment may be performed with a short cognitive battery, such as the

  6. Systematic review of the neural basis of social cognition in patients with mood disorders

    PubMed Central

    Cusi, Andrée M.; Nazarov, Anthony; Holshausen, Katherine; MacQueen, Glenda M.; McKinnon, Margaret C.

    2012-01-01

    Background This review integrates neuroimaging studies of 2 domains of social cognition — emotion comprehension and theory of mind (ToM) — in patients with major depressive disorder and bipolar disorder. The influence of key clinical and method variables on patterns of neural activation during social cognitive processing is also examined. Methods Studies were identified using PsycINFO and PubMed (January 1967 to May 2011). The search terms were “fMRI,” “emotion comprehension,” “emotion perception,” “affect comprehension,” “affect perception,” “facial expression,” “prosody,” “theory of mind,” “mentalizing” and “empathy” in combination with “major depressive disorder,” “bipolar disorder,” “major depression,” “unipolar depression,” “clinical depression” and “mania.” Results Taken together, neuroimaging studies of social cognition in patients with mood disorders reveal enhanced activation in limbic and emotion-related structures and attenuated activity within frontal regions associated with emotion regulation and higher cognitive functions. These results reveal an overall lack of inhibition by higher-order cognitive structures on limbic and emotion-related structures during social cognitive processing in patients with mood disorders. Critically, key variables, including illness burden, symptom severity, comorbidity, medication status and cognitive load may moderate this pattern of neural activation. Limitations Studies that did not include control tasks or a comparator group were included in this review. Conclusion Further work is needed to examine the contribution of key moderator variables and to further elucidate the neural networks underlying altered social cognition in patients with mood disorders. The neural networks underlying higher-order social cognitive processes, including empathy, remain unexplored in patients with mood disorders. PMID:22297065

  7. Systematic review of the neural basis of social cognition in patients with mood disorders.

    PubMed

    Cusi, Andrée M; Nazarov, Anthony; Holshausen, Katherine; Macqueen, Glenda M; McKinnon, Margaret C

    2012-05-01

    This review integrates neuroimaging studies of 2 domains of social cognition--emotion comprehension and theory of mind (ToM)--in patients with major depressive disorder and bipolar disorder. The influence of key clinical and method variables on patterns of neural activation during social cognitive processing is also examined. Studies were identified using PsycINFO and PubMed (January 1967 to May 2011). The search terms were "fMRI," "emotion comprehension," "emotion perception," "affect comprehension," "affect perception," "facial expression," "prosody," "theory of mind," "mentalizing" and "empathy" in combination with "major depressive disorder," "bipolar disorder," "major depression," "unipolar depression," "clinical depression" and "mania." Taken together, neuroimaging studies of social cognition in patients with mood disorders reveal enhanced activation in limbic and emotion-related structures and attenuated activity within frontal regions associated with emotion regulation and higher cognitive functions. These results reveal an overall lack of inhibition by higher-order cognitive structures on limbic and emotion-related structures during social cognitive processing in patients with mood disorders. Critically, key variables, including illness burden, symptom severity, comorbidity, medication status and cognitive load may moderate this pattern of neural activation. Studies that did not include control tasks or a comparator group were included in this review. Further work is needed to examine the contribution of key moderator variables and to further elucidate the neural networks underlying altered social cognition in patients with mood disorders. The neural networks under lying higher-order social cognitive processes, including empathy, remain unexplored in patients with mood disorders.

  8. The Behavioral and Cognitive Executive Disorders of Stroke: The GREFEX Study.

    PubMed

    Roussel, Martine; Martinaud, Olivier; Hénon, Hilde; Vercelletto, Martine; Bindschadler, Claire; Joseph, Pierre-Alain; Robert, Philippe; Labauge, Pierre; Godefroy, Olivier

    2016-01-01

    Many studies have highlighted the high prevalence of executive disorders in stroke. However, major uncertainties remain due to use of variable and non-validated methods. The objectives of this study were: 1) to characterize the executive disorder profile in stroke using a standardized battery, validated diagnosis criteria of executive disorders and validated framework for the interpretation of neuropsychological data and 2) examine the sensitivity of the harmonization standards protocol proposed by the National Institute of Neurological Disorders and Stroke and Canadian Stroke Network (NINDS-CSN) for the diagnosis of Vascular Cognitive Impairment. 237 patients (infarct: 57; cerebral hemorrhage: 54; ruptured aneurysm of the anterior communicating artery (ACoA): 80; cerebral venous thrombosis (CVT): 46) were examined by using the GREFEX battery. The patients' test results were interpreted with a validated framework derived from normative data from 780 controls. Dysexecutive syndrome was observed in 88 (55.7%; 95%CI: 48-63.4) out of the 156 patients with full cognitive and behavioral data: 40 (45.5%) had combined behavioral and cognitive syndromes, 29 (33%) had a behavioral disorder alone and 19 (21.6%) had a cognitive syndrome alone. The dysexecutive profile was characterized by prominent impairments of initiation and generation in the cognitive domain and by hypoactivity with disinterest and anticipation loss in the behavioral domain. Cognitive impairment was more frequent (p = 0.014) in hemorrhage and behavioral disorders were more frequent (p = 0.004) in infarct and hemorrhage. The harmonization standards protocol underestimated (p = 0.007) executive disorders in CVT or ACoA. This profile of executive disorders implies that the assessment should include both cognitive tests and a validated inventory for behavioral dysexecutive syndrome. Initial assessment may be performed with a short cognitive battery, such as the harmonization standards protocol. However

  9. Cognitive Remediation: Potential Novel Brain-Based Treatment for Bipolar Disorder in Children and Adolescents

    PubMed Central

    Dickstein, Daniel P.; Cushman, Grace K.; Kim, Kerri L.; Weissman, Alexandra B.; Wegbreit, Ezra

    2015-01-01

    Bipolar disorder (BD) is among the most impairing psychiatric disorders affecting children and adolescents, despite our best psychopharmacological and psychotherapeutic treatments. Cognitive remediation, defined as a behavioral intervention designed to improve cognitive functions so as to reduce psychiatric illness, is an emerging brain-based treatment approach that has thus far not been studied in pediatric BD. The present article reviews the basic principles of cognitive remediation, describes what is known about cognitive remediation in psychiatric disorders, and delineates potential brain/behavior alterations implicated in pediatric BD that might be targets for cognitive remediation. Emerging data shows that cognitive remediation may be useful in children and adults with schizophrenia, ADHD, and anxiety disorders, and in adults with BD. Potential targets for cognitive remediation in pediatric BD include face processing, response inhibition, frustration, and cognitive flexibility. Further study is warranted to determine if cognitive remediation for these targets, or others, may serve as a novel, brain-based treatment for pediatric BD. PMID:26135596

  10. [Psychological Treatments for Borderline Personality Disorder: A Review of Cognitive-Behavioral Oriented Therapies].

    PubMed

    Marques, Sofia; Barrocas, Daniel; Rijo, Daniel

    2017-04-28

    Borderline personality disorder is the most common personality disorder, with a global prevalence rate between 1.6% and 6%. It is characterized by affective disturbance and impulsivity, which lead to a high number of self-harm behaviors and great amount of health services use. International guidelines recommend psychotherapy as the primary treatment for borderline personality disorder. This paper reviews evidence about the effects and efficacy of cognitive-behavioral oriented psychological treatments for borderline personality disorder. A literature review was conducted in Medline and PubMed databases, using the following keywords: borderline personality disorder, cognitive-behavioral psychotherapy and efficacy. Sixteen randomized clinical trials were evaluate in this review, which analyzed the effects of several cognitive-behavioral oriented psychotherapeutic interventions, namely dialectical behavioral therapy, cognitive behavioral therapy, schema-focused therapy and manual-assisted cognitive therapy. All above stated treatments showed clinical beneficial effects, by reducing borderline personality disorder core pathology and associated general psychopathology, as well as by reducing the severity and frequency of self-harm behaviors, and by improving the overall social, interpersonal and global adjustment. Dialectical behavioral therapy and schema-focused therapy also caused a soaring remission rate of diagnostic borderline personality disorder criteria of 57% and 94%, respectively. Although there were differences between the psychotherapeutic interventions analysed in this review, all showed clinical benefits in the treatment of borderline personality disorder. Dialectical behavioral therapy and schema-focused therapy presented the strongest scientific data documenting their efficacy, but both interventions are integrative cognitive-behavioral therapies which deviate from the traditional cognitive-behavioral model. In summary, the available studies support

  11. Cognitive-behavioral models of social anxiety disorder.

    PubMed

    Roth, D A; Heimberg, R G

    2001-12-01

    In 1985, Liebowitz et al labeled SAD the "neglected anxiety disorder." Clearly, times have changed. Although it took 10 years after this pronouncement for the first cognitive-behavioral model of SAD to be introduced, a great deal of research has been carried out and a great deal has been learned since then. The core features of these models seem to hold a great deal of validity. Perhaps the greatest "learning curve" has been seen in work done on the processing of the self as social object, a component of both cognitive-behavioral models of SAD. A great deal of empiric evidence now suggests that people with SAD see themselves as they believe they are seen by others. Unfortunately, their perception of how they are seen by others is often grossly distorted, likely contributing to the distress they feel about social situations and their concomitant avoidance of them. Recent work by Hirsch and Mathews has gone so far as to suggest that people with the disorder may not attend at all to social information while social events are ongoing but rather may judge them later based on preexisting notions about themselves as social beings. In Rapee and Heimberg's model, preferential allocation of attentional resources is emphasized, and this has been another great area of progress over the past few years. While people with SAD may be hypervigilant to social threat in their environments, once they find it, they tend to divert their attention away from it--as has been most clearly demonstrated in the studies of processing of facial expressions. The data suggest that both angry and happy faces may be perceived as threatening and attention is diverted as a means of avoiding them--again having important implications for social behavior and for maintenance of the disorder over time. Important strides have also been made in understanding judgment biases in SAD. Studies on this issue have suggested that individuals with the disorder see positive social outcomes as unlikely and see

  12. Functional impairment and cognitive performance in mood disorders: A community sample of young adults.

    PubMed

    Reyes, Amanda N; Cardoso, Taiane A; Jansen, Karen; Mondin, Thaíse C; Souza, Luciano D M; Magalhães, Pedro V S; Kapczinski, Flavio; Silva, Ricardo A

    2017-05-01

    The aim of this study was to compare the global functioning and cognitive performance in a community sample of young adults with mood disorders versus community controls. This was a cross-sectional study nested in a cohort study with a community sample. Data was collected from February 2012 to June 2014; specifically, at a mean of five years after the first phase, all young adults were invited to participate in a re-evaluation. Mini International Neuropsychiatric Interview - PLUS (MINI-PLUS) was used for the diagnosis of mood disorders. The Functional Assessment Short Test (FAST) and the Montreal Cognitive Assessment (MoCA) were used to assess the global functioning, and cognitive performance, respectively. Were included 1258 subjects. Functional impairment was greater in subjects with bipolar disorder when compared to community controls, and there were no differences between major depressive disorder and community controls. There were no significant differences in cognitive performance between young adults with mood disorders when compared to community controls. Functional impairment is a marker for bipolar disorder in young adults; however, gross cognitive impairment assessed by a screening test is not, possibly because cognition is impaired in more advanced stages of the disorder.

  13. Factors Influencing Self-Assessment of Cognition and Functioning in Bipolar Disorder: A Preliminary Study

    PubMed Central

    Harvey, Philip D.; Paschall, Gayla; Depp, Colin

    2015-01-01

    Introduction Self-assessment deficits are common in schizophrenia and span multiple aspects of functioning, including awareness of symptoms, and the ability to assess objective levels of cognitive deficits and everyday functioning. While impaired awareness of illness in bipolar disorder during symptomatic periods is well understood, awareness of disability and cognitive deficits has been less well studied. Methods In this pilot study, 30 patients with a lifetime history of bipolar 1 disorder and current bipolar depression completed performance-based tests of cognition and functional capacity and self reported their opinions of their cognitive abilities, everyday functioning, and symptoms. High contact clinicians also provided impressions of the patients’ cognitive performance and everyday functioning. Results Clinician impressions of cognition and everyday functioning were correlated with the results of the performance-based assessments, whereas the patient self-reports of cognition and functioning were uncorrelated both with their own performance and with the clinician impressions. However, severity of depressive symptoms was correlated with self-reports of functioning in cognitive and functional domains, but not with either performance-based data or clinician impressions of cognition or functioning. Conclusions Depression appears to be a factor affecting self-assessment in bipolar disorder and reports of cognition and functioning were minimally related to objective information and clinician impressions. Symptoms of mania were minimal and not correlated with performance-based assessments or clinician impressions. PMID:26057868

  14. The impact of neuroscience on society: cognitive enhancement in neuropsychiatric disorders and in healthy people.

    PubMed

    Sahakian, Barbara J; Bruhl, Annette B; Cook, Jennifer; Killikelly, Clare; Savulich, George; Piercy, Thomas; Hafizi, Sepehr; Perez, Jesus; Fernandez-Egea, Emilio; Suckling, John; Jones, Peter B

    2015-09-19

    In addition to causing distress and disability to the individual, neuropsychiatric disorders are also extremely expensive to society and governments. These disorders are both common and debilitating and impact on cognition, functionality and wellbeing. Cognitive enhancing drugs, such as cholinesterase inhibitors and methylphenidate, are used to treat cognitive dysfunction in Alzheimer's disease and attention deficit hyperactivity disorder, respectively. Other cognitive enhancers include specific computerized cognitive training and devices. An example of a novel form of cognitive enhancement using the technological advancement of a game on an iPad that also acts to increase motivation is presented. Cognitive enhancing drugs, such as methylphenidate and modafinil, which were developed as treatments, are increasingly being used by healthy people. Modafinil not only affects 'cold' cognition, but also improves 'hot' cognition, such as emotion recognition and task-related motivation. The lifestyle use of 'smart drugs' raises both safety concerns as well as ethical issues, including coercion and increasing disparity in society. As a society, we need to consider which forms of cognitive enhancement (e.g. pharmacological, exercise, lifelong learning) are acceptable and for which groups (e.g. military, doctors) under what conditions (e.g. war, shift work) and by what methods we would wish to improve and flourish.

  15. The impact of neuroscience on society: cognitive enhancement in neuropsychiatric disorders and in healthy people

    PubMed Central

    Sahakian, Barbara J.; Bruhl, Annette B.; Cook, Jennifer; Killikelly, Clare; Savulich, George; Piercy, Thomas; Hafizi, Sepehr; Perez, Jesus; Fernandez-Egea, Emilio; Suckling, John; Jones, Peter B.

    2015-01-01

    In addition to causing distress and disability to the individual, neuropsychiatric disorders are also extremely expensive to society and governments. These disorders are both common and debilitating and impact on cognition, functionality and wellbeing. Cognitive enhancing drugs, such as cholinesterase inhibitors and methylphenidate, are used to treat cognitive dysfunction in Alzheimer's disease and attention deficit hyperactivity disorder, respectively. Other cognitive enhancers include specific computerized cognitive training and devices. An example of a novel form of cognitive enhancement using the technological advancement of a game on an iPad that also acts to increase motivation is presented. Cognitive enhancing drugs, such as methylphenidate and modafinil, which were developed as treatments, are increasingly being used by healthy people. Modafinil not only affects ‘cold’ cognition, but also improves ‘hot’ cognition, such as emotion recognition and task-related motivation. The lifestyle use of ‘smart drugs' raises both safety concerns as well as ethical issues, including coercion and increasing disparity in society. As a society, we need to consider which forms of cognitive enhancement (e.g. pharmacological, exercise, lifelong learning) are acceptable and for which groups (e.g. military, doctors) under what conditions (e.g. war, shift work) and by what methods we would wish to improve and flourish. PMID:26240429

  16. Cognitive Disruptions in Stress-Related Psychiatric Disorders: A Role for Corticotropin Releasing Factor (CRF)

    PubMed Central

    Bangasser, Debra A.; Kawasumi, Yushi

    2015-01-01

    Stress is a potential etiology contributor to both post-traumatic stress disorders (PTSD) and major depression. One stress-related neuropeptide that is hypersecreted in these disorders is corticotropin releasing factor (CRF). Dysregulation of CRF has long been linked to the emotion and mood symptoms that characterize PTSD and depression. However, the idea that CRF also mediates the cognitive disruptions observed in patients with these disorders has received less attention. Here we review literature indicating that CRF can alter cognitive functions. Detailed are anatomical studies revealing that CRF is poised to modulate regions required for learning and memory. We also describe preclinical behavioral studies that demonstrate CRF’s ability to alter fear conditioning, impair memory consolidation, and alter a number of executive functions, including attention and cognitive flexibility. The implications of these findings for the etiology and treatment of the cognitive impairments observed in stress-related psychiatric disorders are described. PMID:25888454

  17. Behavioral, Cognitive, and Pharmacological Treatments of Panic Disorder with Agoraphobia: Critique and Synthesis.

    ERIC Educational Resources Information Center

    Michelson, Larry K.; Marchione, Karen

    1991-01-01

    Examines theoretical, methodologic, and research issues as well as strengths, limitations, and possible interactions pertaining to behavioral, cognitive, and pharmacological treatments of panic disorder with agoraphobia. Compares attrition, outcome, and maintenance effects and presents composite indices of significant improvement, endstate…

  18. Risk of Adverse Cognitive or Behavioral Conditions and Psychiatric Disorders

    NASA Technical Reports Server (NTRS)

    Slack, Kelley J.; Schneiderman, Jason S.; Leveton, Lauren B.; Whitmire, Alexandra M.; Picano, James J.

    2015-01-01

    The NASA commitment to human space flight includes continuing to fly astronauts on the ISS until it is decommissioned as well as possibly returning astronauts to the moon or having astronauts venture to an asteroid or Mars. As missions leave low Earth orbit and explore deeper space, BHP supports and conducts research to enable a risk posture that considers the risk of adverse cognitive or behavioral conditions and psychiatric disorders “acceptable given mitigations,” for pre-, in, and post-flight.The Human System Risk Board (HSRB) determines the risk of various mission scenarios using a likelihood (per person per year) by consequences matrix examining those risks across two categories—long term health and operational (within mission). Colors from a stoplight signal are used by HSRB and quickly provide a means of assessing overall perceived risk for a particular mission scenario. Risk associated with the current six month missions on the ISS are classified as “accepted with monitoring” while planetary missions, such as a mission to Mars, are recognized to be a “red” risk that requires mitigation to ensure mission success.Currently, the HSRB deems that the risk of adverse cognitive or behavioral conditions and psychiatric outcomes requires mitigation for planetary missions owing to long duration isolation and radiation exposure (see Table 1). While limited research evidence exists from spaceflight, it is well known anecdotally that the shift from the two week shuttle missions to the six month ISS missions renders the psychological stressors of space as more salient over longer duration missions. Shuttle astronauts were expected just to tolerate any stressors that arose during their mission and were successful at doing so (Whitmire et al, 2013). While it is possible to deal with stressors such as social isolation and to live with incompatible crewmembers for two weeks on shuttle, “ignoring it” is much less likely to be a successful coping mechanism

  19. Reduced Efficiency and Capacity of Cognitive Control in Autism Spectrum Disorder.

    PubMed

    Mackie, Melissa-Ann; Fan, Jin

    2016-03-01

    Cognitive control constrains mental operations to prioritize information that reaches conscious awareness and is essential to flexible, adaptive behavior under conditions of uncertainty. Cognitive control can be compromised by neurodevelopmental disorders such as autism spectrum disorder (ASD), which is characterized by the presence of social and communicative deficits, and restricted interests/repetitive behaviors. Although prior investigations have attempted to elucidate the nature of cognitive control in ASD, whether there is an underlying information processing deficit associated with cognitive control remains unclear. This study challenged cognitive control in 15 high-functioning adults with ASD and 15 typically developing (TD) controls using three novel tasks designed to systematically manipulate uncertainty. We aimed to investigate the efficiency of cognitive control in sequential information processing, cognitive control of nonsequential information processing across a range of cognitive loads and cognitive control capacity under time constraint. Results demonstrated that the ASD group performed less efficiently on sequential and nonsequential information processing, and had reduced cognitive control capacity under time constraint relative to the TD group. These findings suggest that inefficient cognitive control of information processing may be a fundamental deficit in ASD.

  20. Gender Differences in the Maintenance of Response to Cognitive Behavior Therapy for Posttraumatic Stress Disorder

    ERIC Educational Resources Information Center

    Felmingham, Kim L.; Bryant, Richard A.

    2012-01-01

    Objective: To examine potential differential responses in men and women to cognitive behavior therapy for posttraumatic stress disorder (PTSD). Method: Fifty-two men and 56 women diagnosed with PTSD participated in randomized controlled trials of cognitive behavior therapy for PTSD. Participants were randomly allocated to either (a) exposure-only…

  1. [Cognitive disorders and adult grade II and III gliomas: analysis of a series of 15 patients].

    PubMed

    Le Rhun, E; Delbeuck, X; Devos, P; Pasquier, F; Dubois, F

    2009-06-01

    Correlated with better follow-up of gliomas, cognitive disorders are increasingly studied. The aim of this study was to describe the cognitive disorders presented by these patients at baseline, before any treatment, and to evaluate the relations between cognitive disorders and return to work. A detailed neuropsychological evaluation was administrated to 15 newly diagnosed patients with a grade II or III glial tumor before any treatment. Patients also completed the quality of life and depression scales. All patients in our study presented with at least one failed cognitive domain during the detailed examination, while the scores on the MMSE scale were within the norm. The most deteriorated functions were divided attention and episodic verbal and nonverbal memory. Moreover, a significant link was found between the number of failed cognitive functions and quality of life. Cognitive disorders are frequent with glial tumors and impact patients' quality of life. Simple tests of global cognitive status are not sufficient to detect cognitive difficulties in these patients. Consequently, detailed and adapted neuropsychological assessment is necessary, especially to detect deteriorated problems with memory, divided attention, or processing speed in this population.

  2. Brief Report: Cognitive Flexibility in Autism Spectrum Disorders: A Quantitative Review

    ERIC Educational Resources Information Center

    Leung, Rachel C.; Zakzanis, Konstantine K.

    2014-01-01

    Impairments in cognitive flexibility have been used to characterize the neuropsychological presentation of persons with autism spectrum disorders (ASDs). Previous studies have yielded mixed results. Our objective was to systematically review the sensitivity of cognitive flexibility measures in ASD using quantitative methods employed by…

  3. Cognitive-Behavioral Treatments for Anxiety and Phobic Disorders in Children and Adolescents: A Review

    ERIC Educational Resources Information Center

    King, Neville J.; Heyne, David; Ollendick, Thomas H.

    2005-01-01

    This article provides an overview of cognitive-behavioural strategies used in the treatment of child-anxiety problems, emphasizing the need for exposure and caregiver involvement. Most of the paper focuses on developments in empirically supported cognitive-behavioral intervention protocols for generalized anxiety disorder, separation anxiety…

  4. Cognitive-Behavioural Intervention for People with Intellectual Disability and Anxiety Disorders

    ERIC Educational Resources Information Center

    Dagnan, Dave; Jahoda, Andrew

    2006-01-01

    Background: Distinct cognitive models and treatments have been developed for people without intellectual disability with a wide range of anxiety disorders. However, these have not been reported as applied to people with intellectual disabilities. In fact, much of the cognitive therapy literature for people with intellectual disabilities does not…

  5. Mediated Moderation in Combined Cognitive Behavioral Therapy versus Component Treatments for Generalized Anxiety Disorder

    ERIC Educational Resources Information Center

    Newman, Michelle G.; Fisher, Aaron J.

    2013-01-01

    Objective: This study examined (a) duration of generalized anxiety disorder (GAD) as a moderator of cognitive behavioral therapy (CBT) versus its components (cognitive therapy and self-control desensitization) and (b) increases in dynamic flexibility of anxious symptoms during the course of psychotherapy as a mediator of this moderation. Degree of…

  6. Should Sluggish Cognitive Tempo Symptoms Be Included in the Diagnosis of Attention-Deficit/hyperactivity Disorder?

    ERIC Educational Resources Information Center

    Todd, Richard D.; Rasmussen, Erik R.; Wood, Catherine; Levy, Florence; Hay, David A.

    2004-01-01

    Objective: To determine the impact of including sluggish cognitive tempo items on the factor and latent class structure of attention-deficit/hyperactivity disorder (ADHD) subtypes in boys and girls. Method: Parent report of two sluggish cognitive tempo items on a population-based sample of 1,430 female twins and 1,414 male twins were analyzed…

  7. Cognitive Behavioral Therapy and the Treatment of Posttraumatic Stress Disorder: Where Counseling and Neuroscience Meet

    ERIC Educational Resources Information Center

    Makinson, Ryan A.; Young, J. Scott

    2012-01-01

    There is increasing evidence to support the biological basis of mental disorders. Subsequently, understanding the neurobiological context from which mental distress arises can help counselors appropriately apply cognitive behavioral therapy and other well-researched cognitive interventions. The purpose of this article is to describe the…

  8. COX-2 gene expression is correlated with cognitive function in recurrent depressive disorder.

    PubMed

    Gałecki, Piotr; Talarowska, Monika; Bobińska, Kinga; Szemraj, Janusz

    2014-02-28

    Cyclooxygenase-2(COX-2) may be a key inflammatory enzyme involved in recurrent depressive disorder(rDD). In rDD group, COX-2 expression were higher and significant correlations occurred between COX-2 expression and cognitive functions. In controls there was no significant association between analysed variables. Thus, the COX-2 enzyme may be important for cognitive functioning in rDD.

  9. Cognitive Enhancement Therapy for Adults with Autism Spectrum Disorder: Results of an 18-Month Feasibility Study

    ERIC Educational Resources Information Center

    Eack, Shaun M.; Greenwald, Deborah P.; Hogarty, Susan S.; Bahorik, Amber L.; Litschge, Maralee Y.; Mazefsky, Carla A.; Minshew, Nancy J.

    2013-01-01

    Adults with autism experience significant impairments in social and non-social information processing for which few treatments have been developed. This study conducted an 18-month uncontrolled trial of Cognitive Enhancement Therapy (CET), a comprehensive cognitive rehabilitation intervention, in 14 verbal adults with autism spectrum disorder to…

  10. The Uses of Cognitive Training Technologies in the Treatment of Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Wass, Sam V.; Porayska-Pomsta, Kaska

    2014-01-01

    In this review, we focus on research that has used technology to provide cognitive training--i.e. to improve performance on some measurable aspect of behaviour--in individuals with autism spectrum disorders. We review technology-enhanced interventions that target three different cognitive domains: (a) emotion and face recognition, (b) language and…

  11. Gender Differences in the Maintenance of Response to Cognitive Behavior Therapy for Posttraumatic Stress Disorder

    ERIC Educational Resources Information Center

    Felmingham, Kim L.; Bryant, Richard A.

    2012-01-01

    Objective: To examine potential differential responses in men and women to cognitive behavior therapy for posttraumatic stress disorder (PTSD). Method: Fifty-two men and 56 women diagnosed with PTSD participated in randomized controlled trials of cognitive behavior therapy for PTSD. Participants were randomly allocated to either (a) exposure-only…

  12. Can the Components of a Cognitive Model Predict the Severity of Generalized Anxiety Disorder?

    ERIC Educational Resources Information Center

    Dugas, Michel J.; Savard, Pierre; Gaudet, Adrienne; Turcotte, Julie; Laugesen, Nina; Robichaud, Melisa; Francis, Kylie; Koerner, Naomi

    2007-01-01

    Over the past decade, a number of well-controlled studies have supported the validity of a cognitive model of generalized anxiety disorder (GAD) that has four main components: intolerance of uncertainty, positive beliefs about worry, negative problem orientation, and cognitive avoidance. Although these studies have shown that the model components…

  13. Mediated Moderation in Combined Cognitive Behavioral Therapy versus Component Treatments for Generalized Anxiety Disorder

    ERIC Educational Resources Information Center

    Newman, Michelle G.; Fisher, Aaron J.

    2013-01-01

    Objective: This study examined (a) duration of generalized anxiety disorder (GAD) as a moderator of cognitive behavioral therapy (CBT) versus its components (cognitive therapy and self-control desensitization) and (b) increases in dynamic flexibility of anxious symptoms during the course of psychotherapy as a mediator of this moderation. Degree of…

  14. Cognitive-Behavioral Treatments for Anxiety and Phobic Disorders in Children and Adolescents: A Review

    ERIC Educational Resources Information Center

    King, Neville J.; Heyne, David; Ollendick, Thomas H.

    2005-01-01

    This article provides an overview of cognitive-behavioural strategies used in the treatment of child-anxiety problems, emphasizing the need for exposure and caregiver involvement. Most of the paper focuses on developments in empirically supported cognitive-behavioral intervention protocols for generalized anxiety disorder, separation anxiety…

  15. Cognitive Enhancement Therapy for Adults with Autism Spectrum Disorder: Results of an 18-Month Feasibility Study

    ERIC Educational Resources Information Center

    Eack, Shaun M.; Greenwald, Deborah P.; Hogarty, Susan S.; Bahorik, Amber L.; Litschge, Maralee Y.; Mazefsky, Carla A.; Minshew, Nancy J.

    2013-01-01

    Adults with autism experience significant impairments in social and non-social information processing for which few treatments have been developed. This study conducted an 18-month uncontrolled trial of Cognitive Enhancement Therapy (CET), a comprehensive cognitive rehabilitation intervention, in 14 verbal adults with autism spectrum disorder to…

  16. What Difference Does It Make? Implicit, Explicit and Complex Social Cognition in Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Schaller, Ulrich M.; Rauh, Reinhold

    2017-01-01

    We tested social cognition abilities of adolescents with autism spectrum disorders (ASD) and neurotypically developed peers (NTD). A multi-faceted test-battery including facial emotion categorization (FEC), classical false belief tasks (FBT), and complex social cognition (SC), yielded significantly lower accuracy rates for FEC and complex SC tasks…

  17. Cognitive Inflexibility and Frontal-Cortical Activation in Pediatric Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Britton, Jennifer C.; Rauch, Scott L.; Rosso, Isabelle M.; Killgore, William D. S.; Price, Lauren M.; Ragan, Jennifer; Chosak, Anne; Hezel, Dianne M.; Pine, Daniel S.; Leibenluft, Ellen; Pauls, David L.; Jenike, Michael A.; Stewart, S. Evelyn

    2010-01-01

    Objective: Deficits in cognitive flexibility and response inhibition have been linked to perturbations in cortico-striatal-thalamic circuitry in adult obsessive-compulsive disorder (OCD). Although similar cognitive deficits have been identified in pediatric OCD, few neuroimaging studies have been conducted to examine its neural correlates in the…

  18. Aspects of Piaget's cognitive developmental psychology and neurobiology of psychotic disorders - an integrative model.

    PubMed

    Gebhardt, Stefan; Grant, Phillip; von Georgi, Richard; Huber, Martin T

    2008-09-01

    Psychological, neurobiological and neurodevelopmental approaches have frequently been used to provide pathogenic concepts on psychotic disorders. However, aspects of cognitive developmental psychology have hardly been considered in current models. Using a hypothesis-generating approach an integration of these concepts was conducted. According to Piaget (1896-1980), assimilation and accommodation as forms of maintenance and modification of cognitive schemata represent fundamental processes of the brain. In general, based on the perceived input stimuli, cognitive schemata are developed resulting in a conception of the world, the realistic validity and the actuality of which is still being controlled and modified by cognitive adjustment processes. In psychotic disorders, however, a disproportion of environmental demands and the ability to activate required neuronal adaptation processes occurs. We therefore hypothesize a failure of the adjustment of real and requested output patterns. As a consequence autonomous cognitive schemata are generated, which fail to adjust with reality resulting in psychotic symptomatology. Neurobiological, especially neuromodulatory and neuroplastic processes play a central role in these perceptive and cognitive processes. In conclusion, integration of cognitive developmental psychology into the existing pathogenic concepts of psychotic disorders leads to interesting insights into basic disease mechanisms and also guides future research in the cognitive neuroscience of such disorders.

  19. Can the Components of a Cognitive Model Predict the Severity of Generalized Anxiety Disorder?

    ERIC Educational Resources Information Center

    Dugas, Michel J.; Savard, Pierre; Gaudet, Adrienne; Turcotte, Julie; Laugesen, Nina; Robichaud, Melisa; Francis, Kylie; Koerner, Naomi

    2007-01-01

    Over the past decade, a number of well-controlled studies have supported the validity of a cognitive model of generalized anxiety disorder (GAD) that has four main components: intolerance of uncertainty, positive beliefs about worry, negative problem orientation, and cognitive avoidance. Although these studies have shown that the model components…

  20. Implications of Neuroscientific Evidence for the Cognitive Models of Post-Traumatic Stress Disorder

    ERIC Educational Resources Information Center

    Cruwys, Tegan; O'Kearney, Richard

    2008-01-01

    Brewin's dual representation theory, Ehlers and Clark's cognitive appraisal model, and Dalgleish's schematic, propositional, analogue and associative representational systems model are considered in the light of recent evidence on the neural substrates of post-traumatic stress disorder (PTSD). The models' proposals about the cognitive mechanism of…

  1. Brief Report: Cognitive Flexibility in Autism Spectrum Disorders: A Quantitative Review

    ERIC Educational Resources Information Center

    Leung, Rachel C.; Zakzanis, Konstantine K.

    2014-01-01

    Impairments in cognitive flexibility have been used to characterize the neuropsychological presentation of persons with autism spectrum disorders (ASDs). Previous studies have yielded mixed results. Our objective was to systematically review the sensitivity of cognitive flexibility measures in ASD using quantitative methods employed by…

  2. Should Sluggish Cognitive Tempo Symptoms Be Included in the Diagnosis of Attention-Deficit/hyperactivity Disorder?

    ERIC Educational Resources Information Center

    Todd, Richard D.; Rasmussen, Erik R.; Wood, Catherine; Levy, Florence; Hay, David A.

    2004-01-01

    Objective: To determine the impact of including sluggish cognitive tempo items on the factor and latent class structure of attention-deficit/hyperactivity disorder (ADHD) subtypes in boys and girls. Method: Parent report of two sluggish cognitive tempo items on a population-based sample of 1,430 female twins and 1,414 male twins were analyzed…

  3. Implications of Neuroscientific Evidence for the Cognitive Models of Post-Traumatic Stress Disorder

    ERIC Educational Resources Information Center

    Cruwys, Tegan; O'Kearney, Richard

    2008-01-01

    Brewin's dual representation theory, Ehlers and Clark's cognitive appraisal model, and Dalgleish's schematic, propositional, analogue and associative representational systems model are considered in the light of recent evidence on the neural substrates of post-traumatic stress disorder (PTSD). The models' proposals about the cognitive mechanism of…

  4. Cognitive Behavioral Therapy and the Treatment of Posttraumatic Stress Disorder: Where Counseling and Neuroscience Meet

    ERIC Educational Resources Information Center

    Makinson, Ryan A.; Young, J. Scott

    2012-01-01

    There is increasing evidence to support the biological basis of mental disorders. Subsequently, understanding the neurobiological context from which mental distress arises can help counselors appropriately apply cognitive behavioral therapy and other well-researched cognitive interventions. The purpose of this article is to describe the…

  5. Cognitive Inflexibility and Frontal-Cortical Activation in Pediatric Obsessive-Compulsive Disorder

    ERIC Educational Resources Information Center

    Britton, Jennifer C.; Rauch, Scott L.; Rosso, Isabelle M.; Killgore, William D. S.; Price, Lauren M.; Ragan, Jennifer; Chosak, Anne; Hezel, Dianne M.; Pine, Daniel S.; Leibenluft, Ellen; Pauls, David L.; Jenike, Michael A.; Stewart, S. Evelyn

    2010-01-01

    Objective: Deficits in cognitive flexibility and response inhibition have been linked to perturbations in cortico-striatal-thalamic circuitry in adult obsessive-compulsive disorder (OCD). Although similar cognitive deficits have been identified in pediatric OCD, few neuroimaging studies have been conducted to examine its neural correlates in the…

  6. The Uses of Cognitive Training Technologies in the Treatment of Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Wass, Sam V.; Porayska-Pomsta, Kaska

    2014-01-01

    In this review, we focus on research that has used technology to provide cognitive training--i.e. to improve performance on some measurable aspect of behaviour--in individuals with autism spectrum disorders. We review technology-enhanced interventions that target three different cognitive domains: (a) emotion and face recognition, (b) language and…

  7. Cognitive Disorders and Syntactical Deficiencies in the Inmate Populations of Federal Penitentiaries in Canada.

    ERIC Educational Resources Information Center

    Koopman, P. R. S.

    A study examined cognitive disorders and syntactical deficiencies in the inmate populations of federal penitentiaries in Canada. The focus of the study was on the relationship between language development and cognitive ability. During the study, a total of 240 inmates from prisons throughout Canada were given hour-long interviews in which they…

  8. Difference of perceptions and evaluation of cognitive dysfunction in major depressive disorder patients across psychiatrists internationally

    PubMed Central

    Hammi, Emna El; Samp, Jennifer; Rémuzat, Cécile; Auray, Jean-Paul; Lamure, Michel; Aballéa, Samuel; Kooli, Amna; Akhras, Kasem

    2014-01-01

    Background: Many studies have suggested that major depressive disorder (MDD) is often associated with cognitive dysfunction. Despite this, guidance addressing assessment of cognitive dysfunction in MDD is lacking. The aim of this study was to examine psychiatrists’ perceptions and evaluation of cognitive dysfunction in routine practice in MDD patients across different countries. Method: A total of 61 psychiatrists in the US, Germany, France, Spain, Hong Kong, and Australia participated in an online survey about perceptions of cognitive dysfunction in MDD patients, evaluation of cognition and instruments used in cognitive evaluation. Results: Most psychiatrists reportedly relied on patient history interviews for cognitive evaluation (83% in France and approximately 60% in the USA, Germany, Australia and Hong Kong). The remainder used a cognitive instrument or a combination of cognitive instrument and patient history interview for assessment. Of those using instruments for cognitive assessment, only nine named instruments that were appropriate for cognitive evaluation. The remainder reported other clinical measures not intended for cognitive evaluation. Conclusions: Overall, psychiatrists in routine clinical practice value the assessment of cognitive in MDD. However, there is a lack of standardization in these assessments and misconceptions regarding proper assessment. PMID:24490027

  9. Cognitive Hypnotherapy for Accessing and Healing Emotional Injuries for Anxiety Disorders.

    PubMed

    Alladin, Assen

    2016-07-01

    Although anxiety disorders on the surface may appear simple, they often represent complex problems that are compounded by underlying factors. For these reasons, treatment of anxiety disorders should be individualized. This article describes cognitive hypnotherapy, an individual comprehensive treatment protocol that integrates cognitive, behavioral, mindfulness, psychodynamic, and hypnotic strategies in the management of anxiety disorders. The treatment approach is based on the self-wounds model of anxiety disorders, which provides the rationale for integrating diverse strategies in the psychotherapy for anxiety disorders. Due to its evidence-based and integrated nature, the psychotherapy described here provides accuracy, efficacy, and sophistication in the formulation and treatment of anxiety disorders. This model can be easily adapted to the understanding and treatment of other emotional disorders.

  10. Temporal patterns of change in panic disorder during cognitive behaviour therapy: an Indian study.

    PubMed

    Manjula, M; Prasadarao, P S D V; Kumaraiah, V; Raguram, R

    2014-09-01

    CBT has been proven to be effective in the treatment of panic disorder; however, attempts to study the process of change are limited. The study evaluated the temporal patterns of change in the panic symptoms, cognitions, behaviours, and anxiety sensitivity in subjects with panic disorder being treated with CBT. Thirty subjects with panic disorder were allocated to two groups: Cognitive Behaviour Therapy (CBT, n = 15) and Behaviour Therapy (BT, n = 15). Assessments were carried out weekly for five consecutive weeks using the Semi-Structured Interview Schedule, the Anxiety Sensitivity Index, the Agoraphobic Cognitions Questionnaire, and the Texas Panic Attack Record Form. The CBT group received comprehensive CBT and the BT group received psycho-education and Applied Relaxation. Following intervention the change was continuous and gradual on all the variables in the CBT group and the scores reduced to a functional range after 4-5 weeks of therapy. Such a change was not evident in the BT group. Significant change was evident in cognitive domains following the introduction of the exposure and cognitive restructuring within the CBT group. Both cognitive and behavioural techniques contributed to the overall change. CBT had an impact on the cognitive domains and significant changes were evident corresponding to the addition of cognitive restructuring and exposure techniques in the 3rd to 5th week. Both cognitive and behavioural components are therefore crucial for overall improvement to occur.

  11. The relationship between cognitive function and quality of life in euthymic Chinese patients with bipolar disorder.

    PubMed

    Xiao, Lin; Gao, Yulin; Zhang, Lili; Chen, Peiyun; Sun, Xiaojia

    2016-12-30

    This study aimed to identify the relationship between cognitive function and quality of life (QOL) in Chinese patients with bipolar disorder (BD) in the remission stage, by adopting disease-specific instruments. The remission stage was assessed using the Hamilton Depression Rating Scale (HAMD) and the Bech-Rafaelsen Mania Rating Scale (BRMS). One hundred euthymic bipolar patients and 115 healthy controls completed the "cognitive complaints in bipolar disorder rating assessment"(COBRA), Montreal Cognitive Assessment scale (MoCA), and "Brief version of Quality of Life in Bipolar Disorder" (Bref QOL.BD), which were used to assess the subjective cognitive function, objective cognitive function, and QOL, respectively. Compared to the healthy controls, the patient group had significantly lower total scores on both MoCA and Brief QOL.BD, and higher total score of COBRA. After controlling the influence of mood symptoms (HAMD and BRMS), both objective (MoCA) and subjective (COBRA) cognitive function could predict QOL significantly when entered either separately or simultaneously into hierarchical multiple regression models. When entered simultaneously, cognitive function explained 21% of the variance in QOL. The findings indicated that both objective and subjective cognitive function could influence QOL in euthymic bipolar patients, so continuous cognitive-improving interventions could help euthymic bipolar patients improve their QOL. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  12. What Cognitive Behavioral Techniques Do Therapists Report Using when Delivering Cognitive Behavioral Therapy for the Eating Disorders?

    ERIC Educational Resources Information Center

    Waller, Glenn; Stringer, Hannah; Meyer, Caroline

    2012-01-01

    Objective: Clinicians commonly "drift" away from using proven therapeutic techniques. This study examined the degree to which such drift occurs among cognitive behavioral therapy (CBT) clinicians working with a specific clinical population--adults with eating disorders. Method: The study used a correlational design. The participants were…

  13. What Cognitive Behavioral Techniques Do Therapists Report Using when Delivering Cognitive Behavioral Therapy for the Eating Disorders?

    ERIC Educational Resources Information Center

    Waller, Glenn; Stringer, Hannah; Meyer, Caroline

    2012-01-01

    Objective: Clinicians commonly "drift" away from using proven therapeutic techniques. This study examined the degree to which such drift occurs among cognitive behavioral therapy (CBT) clinicians working with a specific clinical population--adults with eating disorders. Method: The study used a correlational design. The participants were…

  14. Modelling cognitive affective biases in major depressive disorder using rodents

    PubMed Central

    Hales, Claire A; Stuart, Sarah A; Anderson, Michael H; Robinson, Emma S J

    2014-01-01

    Major depressive disorder (MDD) affects more than 10% of the population, although our understanding of the underlying aetiology of the disease and how antidepressant drugs act to remediate symptoms is limited. Major obstacles include the lack of availability of good animal models that replicate aspects of the phenotype and tests to assay depression-like behaviour in non-human species. To date, research in rodents has been dominated by two types of assays designed to test for depression-like behaviour: behavioural despair tests, such as the forced swim test, and measures of anhedonia, such as the sucrose preference test. These tests have shown relatively good predictive validity in terms of antidepressant efficacy, but have limited translational validity. Recent developments in clinical research have revealed that cognitive affective biases (CABs) are a key feature of MDD. Through the development of neuropsychological tests to provide objective measures of CAB in humans, we have the opportunity to use ‘reverse translation’ to develop and evaluate whether similar methods are suitable for research into MDD using animals. The first example of this approach was reported in 2004 where rodents in a putative negative affective state were shown to exhibit pessimistic choices in a judgement bias task. Subsequent work in both judgement bias tests and a novel affective bias task suggest that these types of assay may provide translational methods for studying MDD using animals. This review considers recent work in this area and the pharmacological and translational validity of these new animal models of CABs. Linked Articles This article is part of a themed section on Animal Models in Psychiatry Research. To view the other articles in this section visit http://dx.doi.org/10.1111/bph.2014.171.issue-20 PMID:24467454

  15. Cognitive retraining for organizational impairment in obsessive-compulsive disorder.

    PubMed

    Buhlmann, Ulrike; Deckersbach, Thilo; Engelhard, Iris; Cook, Laura M; Rauch, Scott L; Kathmann, Norbert; Wilhelm, Sabine; Savage, Cary R

    2006-11-15

    Individuals with obsessive-compulsive disorder (OCD) have difficulties in organizing information during encoding associated with subsequent memory impairments. This study was designed to investigate whether impairments in organization in individuals with OCD can be alleviated with cognitive training. Thirty-five OCD subjects and 36 controls copied and recalled the Rey-Osterrieth Complex Figure Test (RCFT) [Osterrieth, P.A., 1944. Le test de copie d'une figure complexe: Contribution a l'étude de la perception et de la memoire (The test of copying a complex figure: A contribution to the study of perception and memory). Archive de Psychologie 30, 286-350.] before being randomly assigned to a training or non-training condition. The training condition was designed to improve the ability to organize complex visuospatial information in a meaningful way. The intervention phase was followed by another copy and recall trial of the RCFT. Both OCD and control subjects who underwent training improved more in organization and memory than subjects who did not receive organizational training, providing evidence that the training procedure was effective. OCD subjects improved more in organizational during encoding than control subjects, irrespective of whether or not they had received training. This suggests that organization impairment in OCD affects primarily the ability to spontaneously utilize strategies when faced with complex, ambiguous information but that the ability to implement such strategies when provided with additional trials is preserved. These findings support a distinction in OCD between failure to utilize a strategy and incapacity to implement a strategy.

  16. Attention deficit/hyperactivity disorder symptoms moderate cognition and behavior in children with autism spectrum disorders.

    PubMed

    Yerys, Benjamin E; Wallace, Gregory L; Sokoloff, Jennifer L; Shook, Devon A; James, Joette D; Kenworthy, Lauren

    2009-12-01

    Recent estimates suggest that 31% of children with autism spectrum disorders (ASD) meet diagnostic criteria for attention deficit/hyperactivity disorder (ADHD), and another 24% of children with ASD exhibit subthreshold clinical ADHD symptoms. Presence of ADHD symptoms in the context of ASD could have a variety of effects on cognition, autistic traits, and adaptive/maladaptive behaviors including: exacerbating core ASD impairments; adding unique impairments specific to ADHD; producing new problems unreported in ASD or ADHD; having no clear impact; or producing some combination of these scenarios. Children with ASD and co-morbid ADHD symptoms (ASD+ADHD; n = 21), children with ASD without ADHD (ASD; n = 28), and a typically developing control group (n = 21) were included in the study; all groups were matched on age, gender-ratio, IQ, and socioeconomic status. Data were collected on verbal and spatial working memory, response inhibition, global executive control (EC), autistic traits, adaptive functioning, and maladaptive behavior problems. In this sample, the presence of ADHD symptoms in ASD exacerbated impairments in EC and adaptive behavior and resulted in higher autistic trait, and externalizing behavior ratings. ADHD symptoms were also associated with greater impairments on a lab measure of verbal working memory. These findings suggest that children with ASD+ADHD symptoms present with exacerbated impairments in some but not all domains of functioning relative to children with ASD, most notably in adaptive behavior and working memory. Therefore, ADHD may moderate the expression of components of the ASD cognitive and behavioral phenotype, but ASD+ADHD may not represent an etiologically distinct phenotype from ASD alone.

  17. Attention deficit/hyperactivity disorder symptoms moderate cognition and behavior in children with autism spectrum disorders

    PubMed Central

    Yerys, Benjamin E.; Wallace, Gregory L.; Sokoloff, Jennifer L.; Shook, Devon A.; James, Joette D.; Kenworthy, Lauren

    2010-01-01

    Recent estimates suggest that over 30% of children with autism spectrum disorders (ASD) meet diagnostic criteria for attention deficit/hyperactivity disorder (ADHD), and another 20% of children with ASD exhibit subthreshold clinical ADHD symptoms. Presence of ADHD symptoms in the context of ASD could have a variety of effects on cognition, autistic traits, and adaptive/maladaptive behaviors including: exacerbating core ASD impairments; adding unique impairments specific to ADHD; producing new problems unreported in ASD or ADHD; having no clear impact; or producing some combination of these scenarios. Children with ASD and co-morbid ADHD symptoms (ASD+ADHD; n=21), children with ASD without ADHD (ASD; n=28), and a typically developing control group (n=21) were included in the study; all groups were matched on age, gender-ratio, IQ, and socioeconomic status. Data were collected on verbal and spatial working memory, response inhibition, global executive control, autistic traits, adaptive functioning, and maladaptive behavior problems. In this sample, the presence of ADHD symptoms in ASD exacerbated impairments in executive control and adaptive behavior and resulted in higher autistic trait, and externalizing behavior ratings. ADHD symptoms were also associated with greater impairments on a lab measure of verbal working memory. These findings suggest that children with ASD+ADHD symptoms present with exacerbated impairments in some but not all domains of functioning relative to children with ASD, most notably in adaptive behavior and working memory. Therefore, ADHD may moderate the expression of components of the ASD cognitive and behavioral phenotype, but ASD+ADHD may not represent an etiologically distinct phenotype from ASD alone. PMID:19998356

  18. The effect of comorbid major depressive disorder or bipolar disorder on cognitive behavioral therapy for social anxiety disorder.

    PubMed

    Fracalanza, Katie; McCabe, Randi E; Taylor, Valerie H; Antony, Martin M

    2014-06-01

    Major depressive disorder (MDD) and bipolar disorder (BD) commonly co-occur in individuals with social anxiety disorder (SAD), yet whether these comorbidities influence the outcomes of cognitive behavioral therapy (CBT) for SAD is unclear. The present study examined the degree to which individuals with SAD and comorbid MDD (SAD+MDD; n=76), comorbid BD (SAD+BD; n=19), a comorbid anxiety disorder (SAD+ANX; n=27), or no comorbid diagnoses (SAD+NCO; n=41) benefitted from CBT for SAD. Individuals were screened using the Structured Clinical Interview for DSM-IV and then completed the Social Phobia Inventory and the Depression Anxiety Stress Scales before and after 12-weeks of group CBT for SAD. At pretreatment the SAD+MDD and SAD+BD groups reported higher social anxiety symptoms than the SAD+ANX and SAD+NCO groups. All groups reported large and significant improvement in social anxiety with CBT. However, at posttreatment the SAD+MDD and SAD+BD groups continued to have higher social anxiety symptoms than the SAD+NCO group, and the SAD+ANX group did not differ in social anxiety symptoms from any group. The sample also showed small and statistically significant improvement in depressive symptoms with CBT for SAD. Information about medication was not collected in the present study, and we did not assess the long-term effects of CBT. Our results suggest that CBT for SAD is an effective treatment even in the presence of comorbid mood disorders in the short-term, although extending the course of treatment may be helpful for this population and should be investigated in future research. Copyright © 2014 Elsevier B.V. All rights reserved.

  19. Does disturbance of self underlie social cognition deficits in schizophrenia and other psychotic disorders?

    PubMed

    Nelson, Barnaby; Sass, Louis A; Thompson, Andrew; Yung, Alison R; Francey, Shona M; Amminger, G Paul; McGorry, Patrick D

    2009-05-01

    Although the different approaches to psychosis research have made significant advances in their own fields, integration between the approaches is often lacking. This paper attempts to integrate a strand of cognitive research in psychotic disorders (specifically, social cognition research) with phenomenological accounts of schizophrenia and other psychotic disorders. The paper is a critical investigation of phenomenological models of disturbed selfhood in schizophrenia in relation to cognitive theories of social cognition in psychotic disorders. We argue that disturbance of the basic sense of self, as articulated in the phenomenological literature, may underlie the social cognition difficulties present in psychotic disorders. This argument is based on phenomenological thinking about self-presence ('ipseity') being the primary or most basic ground for the intentionality of consciousness - that is, the directedness of consciousness towards others and the world. A disruption in this basic ground of conscious life has a reverberating effect through other areas of cognitive and social functioning. We propose three routes whereby self-disturbance may compromise social cognition, including dissimilarity, disruption of lived body and disturbed mental coherence. If this model is supported, then social cognition difficulties may be thought of as a secondary index or marker of the more primary disturbance of self in psychotic disorders. Further empirical work examining the relationship between cognitive and phenomenological variables may be of value in identifying risk markers for psychosis onset, thus contributing to early intervention efforts, as well as in clarifying the essential psychopathological features of schizophrenia and other psychotic disorders. © 2009 The Authors. Journal compilation © 2009 Blackwell Publishing Asia Pty Ltd.

  20. Can multiple sclerosis as a cognitive disorder influence patients' dreams?

    PubMed

    Moghadasi, Abdorreza Naser; Owji, Mahsa

    2013-01-01

    Dream should be considered as a kind of cognitive ability that is formed parallel to other cognitive capabilities like language. On the other hand, multiple sclerosis (MS) is a complex disease that can involve different aspects of our cognition. Therefore, MS may influence patients' dreams. In fact, we do not know what the importance of dream is in MS, but further studies may introduce dream and dreaming as a sign of improvement or progression in MS disease.

  1. Can multiple sclerosis as a cognitive disorder influence patients’ dreams?

    PubMed Central

    Owji, Mahsa

    2013-01-01

    Dream should be considered as a kind of cognitive ability that is formed parallel to other cognitive capabilities like language. On the other hand, multiple sclerosis (MS) is a complex disease that can involve different aspects of our cognition. Therefore, MS may influence patients’ dreams. In fact, we do not know what the importance of dream is in MS, but further studies may introduce dream and dreaming as a sign of improvement or progression in MS disease. PMID:24250908

  2. Systematic review of appropriate cognitive assessment instruments used in clinical trials of schizophrenia, major depressive disorder and bipolar disorder.

    PubMed

    Bakkour, Nadia; Samp, Jennifer; Akhras, Kasem; El Hammi, Emna; Soussi, Imen; Zahra, Fatma; Duru, Gérard; Kooli, Amna; Toumi, Mondher

    2014-05-30

    Cognitive dysfunction is increasingly recognized as a symptom in mental conditions including schizophrenia, major depressive disorder (MDD), and bipolar disorder (BPD). Despite the many available cognitive assessment instruments, consensus is lacking on their appropriate use in clinical trials. We conducted a systematic literature review in Embase, PubMed/Medline and PsychINFO to identify appropriate cognitive function instruments for use in clinical trials of schizophrenia, MDD, and BPD. Instruments were identified from the articles. Instruments and articles were excluded if they did not address schizophrenia, MDD, or BPD. Instrument appropriateness was further assessed by the criteria of the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative: test-retest reliability, utility, relationship to functional status, potential changeability to pharmacological agents, and tolerability and practicality for clinical trials. The database search yielded 173 articles describing 150 instruments used to assess cognitive function. Seventeen additional instruments were identified through Google and clinicaltrials.gov. Among all these, only 30 (18%) were deemed appropriate for use in the diseases of interest. Of these, 27 were studied in schizophrenia, one in MDD and two in BPD. These findings suggest the need for careful selection of appropriate cognitive assessment instruments, as not all may be valid in these disorders.

  3. Age-Dependent Pleiotropy Between General Cognitive Function and Major Psychiatric Disorders.

    PubMed

    Hill, W David; Davies, Gail; Liewald, David C; McIntosh, Andrew M; Deary, Ian J

    2016-08-15

    General cognitive function predicts psychiatric illness across the life course. This study examines the role of pleiotropy in explaining the link between cognitive function and psychiatric disorder. We used two large genome-wide association study data sets on cognitive function-one from older age, n = 53,949, and one from childhood, n = 12,441. We also used genome-wide association study data on educational attainment, n = 95,427, to examine the validity of its use as a proxy phenotype for cognitive function. Using a new method, linkage disequilibrium regression, we derived genetic correlations, free from the confounding of clinical state between psychiatric illness and cognitive function. We found a genetic correlation of .711 (p = 2.26e-12) across the life course for general cognitive function. We also showed a positive genetic correlation between autism spectrum disorder and cognitive function in childhood (rg = .360, p = .0009) and for educational attainment (rg = .322, p = 1.37e-5) but not in older age. In schizophrenia, we found a negative genetic correlation between older age cognitive function (rg = -.231, p = 3.81e-12) but not in childhood or for educational attainment. For Alzheimer's disease, we found negative genetic correlations with childhood cognitive function (rg = -.341, p = .001), educational attainment (rg = -.324, p = 1.15e-5), and with older age cognitive function (rg = -.324, p = 1.78e-5). The pleiotropy exhibited between cognitive function and psychiatric disorders changed across the life course. These age-dependent associations might explain why negative selection has not removed variants causally associated with autism spectrum disorder or schizophrenia. Copyright © 2016 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  4. Emotional power of music in patients with memory disorders: clinical implications of cognitive neuroscience.

    PubMed

    Samson, Séverine; Dellacherie, Delphine; Platel, Hervé

    2009-07-01

    By adapting methods of cognitive psychology to neuropsychology, we examined memory and familiarity abilities in music in relation to emotion. First we present data illustrating how the emotional content of stimuli influences memory for music. Second, we discuss recent findings obtained in patients with two different brain disorders (medically intractable epilepsy and Alzheimer's disease) that show relatively spared memory performance for music, despite severe verbal memory disorders. Studies on musical memory and its relation to emotion open up paths for new strategies in cognitive rehabilitation and reinstate the importance of examining interactions between cognitive and clinical neurosciences.

  5. Clinical Advances in Geriatric Psychiatry: A Focus on Prevention of Mood and Cognitive Disorders.

    PubMed

    Eyre, Harris; Baune, Bernhard; Lavretsky, Helen

    2015-09-01

    The world population is aging at a rate unprecedented in human history, placing substantial pressure on health systems across the world along with concurrent rises in chronic diseases. In particular, rates of cognitive disorders and late-life affective disorders are expected to increase. In tandem with aging, there are robust predictions suggesting that rates of age-related cognitive decline and dementia, and geriatric depression, will increase, with serious consequences. Clearly innovative prevention and treatment strategies are needed. This article reviews the latest promising clinical advances that hold promise for assisting the prevention and treatment of depression, cognitive decline, and dementia. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. A meta-analysis on the impact of psychiatric disorders and maltreatment on cognition.

    PubMed

    Masson, Marjolaine; East-Richard, Caroline; Cellard, Caroline

    2016-02-01

    Few studies have attempted to describe the range of cognitive impairments in individuals with psychiatric disorders who experienced maltreatment as children. The aims of this meta-analysis were to establish the impact of maltreatment and psychiatric disorders on cognition, and to examine the change in impact from childhood to adulthood. Twelve publications from 1970 to 2013 were included, with the following inclusion criteria: (a) individuals with a psychiatric disorder who experienced maltreatment, (b) use of at least 1 standardized neuropsychological measure, and (c) use of a control group without any psychiatric disorder or mistreatment. The majority of studies (10/12) were about posttraumatic stress disorder. Several effect sizes were calculated (Hedge's g) according to the cognitive domains. The results of the meta-analysis demonstrate that the combination of psychiatric disorders and childhood maltreatment has a negative impact on global cognitive performance, with a moderate effect size (g = -0.59). The most affected cognitive domains for individuals aged 7- to 18-years-old were visual episodic memory (g = -0.97), executive functioning (g = -0.90), and intelligence (g = -0.68). For individuals over the age of 18-years-old, the most affected cognitive domains were verbal episodic memory (g = -0.77), visuospatial/problem solving (g = -0.73), and attention (g = -0.72). The impact of maltreatment and psychiatric disorders was greater in children than in adults (slope = 0.008, p < .002). The results suggest that exposure to maltreatment and the presence of psychiatric disorders have a broad impact on cognition, with specific neuropsychological profile. PsycINFO Database Record (c) 2016 APA, all rights reserved.

  7. Efficacy and Utility of Computer-Assisted Cognitive Behavioural Therapy for Anxiety Disorders

    ERIC Educational Resources Information Center

    Przeworski, Amy; Newman, Michelle G.

    2006-01-01

    Despite the efficacy of cognitive behavioural treatment for anxiety disorders, more than 70% of individuals with anxiety disorders go untreated every year. This is partially due to obstacles to treatment including limited access to mental health services for rural residents, the expense of treatment and the inconvenience of attending weekly…

  8. Dual Cognitive and Biological Correlates of Anxiety in Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Hollocks, Matthew J.; Pickles, Andrew; Howlin, Patricia; Simonoff, Emily

    2016-01-01

    Young people with autism spectrum disorder (ASD) have a high prevalence (~40 %) of anxiety disorders compared to their non-ASD peers. It is unclear whether cognitive and biological processes associated with anxiety in ASD are analogous to anxiety in typically developing (TD) populations. In this study 55 boys with ASD (34 with a co-occurring…

  9. Counseling College Women Experiencing Eating Disorder Not Otherwise Specified: A Cognitive Behavior Therapy Model

    ERIC Educational Resources Information Center

    Choate, Laura H.

    2010-01-01

    Eating disorder not otherwise specified (EDNOS; American Psychiatric Association, 2000) is, by far, the most common eating disorder that college counseling professionals encounter among their female clients. Empirical evidence and best practice guidelines support use of cognitive behavior therapy (CBT) with women experiencing EDNOS. This article…

  10. Cognitive-Behavioral Therapy for Anxiety in Children Diagnosed with Autism Spectrum Disorders: Modification Trends

    ERIC Educational Resources Information Center

    Moree, Brittany N.; Davis, Thompson E., III

    2010-01-01

    Anxiety disorders have been found to be highly comorbid with autism spectrum disorders (ASDs). Even so, the identification and dissemination of empirically supported treatments for anxiety in adults or children who have ASD has lagged behind the larger evidence-based trend. This review examines the efficacy of cognitive-behavioral therapy as a…

  11. Sleep Disruption as a Correlate to Cognitive and Adaptive Behavior Problems in Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Taylor, Matthew A.; Schreck, Kimberly A.; Mulick, James A.

    2012-01-01

    Sleep problems associated with autism spectrum disorders (ASD) have been well documented, but less is known about the effects of sleep problems on day-time cognitive and adaptive performance in this population. Children diagnosed with autism or pervasive developmental disorder-not otherwise specified (PDD-NOS) (N = 335) from 1 to 10 years of age…

  12. Specificity of Treatment Effects: Cognitive Therapy and Relaxation for Generalized Anxiety and Panic Disorders

    ERIC Educational Resources Information Center

    Siev, Jedidiah; Chambless, Dianne L.

    2007-01-01

    The aim of this study was to address claims that among bona fide treatments no one is more efficacious than another by comparing the relative efficacy of cognitive therapy (CT) and relaxation therapy (RT) in the treatment of generalized anxiety disorder (GAD) and panic disorder without agoraphobia (PD). Two fixed-effects meta-analyses were…

  13. Cognitive Behavioral Therapy for Anxiety in Children with Autism Spectrum Disorders: A Randomized, Controlled Trial

    ERIC Educational Resources Information Center

    Wood, Jeffrey J.; Drahota, Amy; Sze, Karen; Har, Kim; Chiu, Angela; Langer, David A.

    2009-01-01

    Background: Children with autism spectrum disorders often present with comorbid anxiety disorders that cause significant functional impairment. This study tested a modular cognitive behavioral therapy (CBT) program for children with this profile. A standard CBT program was augmented with multiple treatment components designed to accommodate or…

  14. Neurobiological Circuits Regulating Attention, Cognitive Control, Motivation, and Emotion: Disruptions in Neurodevelopmental Psychiatric Disorders

    ERIC Educational Resources Information Center

    Arnsten, Amy F. T.; Rubia, Katya

    2012-01-01

    Objective: This article aims to review basic and clinical studies outlining the roles of prefrontal cortical (PFC) networks in the behavior and cognitive functions that are compromised in childhood neurodevelopmental disorders and how these map into the neuroimaging evidence of circuit abnormalities in these disorders. Method: Studies of animals,…

  15. Sleep Disruption as a Correlate to Cognitive and Adaptive Behavior Problems in Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Taylor, Matthew A.; Schreck, Kimberly A.; Mulick, James A.

    2012-01-01

    Sleep problems associated with autism spectrum disorders (ASD) have been well documented, but less is known about the effects of sleep problems on day-time cognitive and adaptive performance in this population. Children diagnosed with autism or pervasive developmental disorder-not otherwise specified (PDD-NOS) (N = 335) from 1 to 10 years of age…

  16. Cognitive Profiling in Chinese Developmental Dyslexia with Attention-Deficit/Hyperactivity Disorders

    ERIC Educational Resources Information Center

    Chan, Won Shing Raymond; Hung, Se Fong; Liu, Suet Nga; Lee, Cheuk Kiu Kathy

    2008-01-01

    The cognitive profiles of children with Developmental Reading Disorder (RD) and Attention-Deficit/Hyperactivity Disorders (ADHD) have been extensively studied in alphabetic language communities. Deficits in phonological processing and rapid naming have been implicated as core features of RD although whether the latter is a deficit specific to RD…

  17. Specificity of Treatment Effects: Cognitive Therapy and Relaxation for Generalized Anxiety and Panic Disorders

    ERIC Educational Resources Information Center

    Siev, Jedidiah; Chambless, Dianne L.

    2007-01-01

    The aim of this study was to address claims that among bona fide treatments no one is more efficacious than another by comparing the relative efficacy of cognitive therapy (CT) and relaxation therapy (RT) in the treatment of generalized anxiety disorder (GAD) and panic disorder without agoraphobia (PD). Two fixed-effects meta-analyses were…

  18. Dual Cognitive and Biological Correlates of Anxiety in Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Hollocks, Matthew J.; Pickles, Andrew; Howlin, Patricia; Simonoff, Emily

    2016-01-01

    Young people with autism spectrum disorder (ASD) have a high prevalence (~40 %) of anxiety disorders compared to their non-ASD peers. It is unclear whether cognitive and biological processes associated with anxiety in ASD are analogous to anxiety in typically developing (TD) populations. In this study 55 boys with ASD (34 with a co-occurring…

  19. Neurobiological Circuits Regulating Attention, Cognitive Control, Motivation, and Emotion: Disruptions in Neurodevelopmental Psychiatric Disorders

    ERIC Educational Resources Information Center

    Arnsten, Amy F. T.; Rubia, Katya

    2012-01-01

    Objective: This article aims to review basic and clinical studies outlining the roles of prefrontal cortical (PFC) networks in the behavior and cognitive functions that are compromised in childhood neurodevelopmental disorders and how these map into the neuroimaging evidence of circuit abnormalities in these disorders. Method: Studies of animals,…

  20. [Neuropsychological aspects of delusional disorders. Characteristic attributional style or cognitive deficit?].

    PubMed

    Bömmer, I; Brüne, M

    2007-07-01

    "Pure" delusional disorders are clinically rare, and the neuropsychology of such disorders is poorly understood. Whereas "deficit" models suggest a cognitive impairment accounting for the incorrigible fixation of false beliefs, cognitive models propose the existence of a characteristic attributional style in patients to stabilise a fragile self. The cognitive flexibility and attributional style of 21 patients diagnosed with delusional disorder according to ICD-10 were compared with a group of healthy controls paralleled for age, sex, education, and intelligence. Patients with delusional disorders made more errors and more perseverative errors in the Wisconsin Card Sorting Test compared with controls. However, these differences were only significant in patients with a comorbid depression. In contrast to earlier studies, patients with delusional disorders did not attribute negative events to external or personal causes more often than healthy controls, but partly tended to show a depressive attributional style. Our results do not support either a cognitive deficit in patients with delusional disorders or a characteristic attributional style. In terms of treatment recommendations, a thorough diagnosis of comorbid depressive disorders in patients with delusional disorders is warranted.

  1. Children with Anxiety Disorders: Use of a Cognitive Behavioral Therapy Model within a Social Milieu

    ERIC Educational Resources Information Center

    Kearny, Regina; Pawlukewicz, Justine; Guardino, Mary

    2014-01-01

    Because anxiety is the most common mental health disorder diagnosed in children, early intervention is crucial for fundamental coping. Although cognitive-behavioral therapy (CBT) is the preferred treatment method for this affective disorder, instruction for children needs to be specific for them to successfully acquire and implement essential CBT…

  2. Cognitive Processing Therapy for Acute Stress Disorder Resulting from an Anti-Gay Assault

    ERIC Educational Resources Information Center

    Kaysen, Debra; Lostutter, Ty W.; Goines, Marie A.

    2005-01-01

    This case study describes Cognitive Processing Therapy (CPT) with a 30-year-old gay man with symptoms of acute stress disorder (ASD) following a recent homophobic assault. Treatment addressed assault-related posttraumatic stress disorder symptoms and depressive symptoms. Also addressed were low self-esteem, helplessness, and high degrees of…

  3. Cognitive Dysfunction Is Worse among Pediatric Patients with Bipolar Disorder Type I than Type II

    ERIC Educational Resources Information Center

    Schenkel, Lindsay S.; West, Amy E.; Jacobs, Rachel; Sweeney, John A.; Pavuluri, Mani N.

    2012-01-01

    Background: Impaired profiles of neurocognitive function have been consistently demonstrated among pediatric patients with bipolar disorder (BD), and may aid in the identification of endophenotypes across subtypes of the disorder. This study aims to determine phenotypic cognitive profiles of patients with BD Type I and II. Methods: Subjects (N =…

  4. Counseling College Women Experiencing Eating Disorder Not Otherwise Specified: A Cognitive Behavior Therapy Model

    ERIC Educational Resources Information Center

    Choate, Laura H.

    2010-01-01

    Eating disorder not otherwise specified (EDNOS; American Psychiatric Association, 2000) is, by far, the most common eating disorder that college counseling professionals encounter among their female clients. Empirical evidence and best practice guidelines support use of cognitive behavior therapy (CBT) with women experiencing EDNOS. This article…

  5. Cognitive Dysfunction Is Worse among Pediatric Patients with Bipolar Disorder Type I than Type II

    ERIC Educational Resources Information Center

    Schenkel, Lindsay S.; West, Amy E.; Jacobs, Rachel; Sweeney, John A.; Pavuluri, Mani N.

    2012-01-01

    Background: Impaired profiles of neurocognitive function have been consistently demonstrated among pediatric patients with bipolar disorder (BD), and may aid in the identification of endophenotypes across subtypes of the disorder. This study aims to determine phenotypic cognitive profiles of patients with BD Type I and II. Methods: Subjects (N =…

  6. Cognitive-Behavioral Therapy for Anxiety in Children Diagnosed with Autism Spectrum Disorders: Modification Trends

    ERIC Educational Resources Information Center

    Moree, Brittany N.; Davis, Thompson E., III

    2010-01-01

    Anxiety disorders have been found to be highly comorbid with autism spectrum disorders (ASDs). Even so, the identification and dissemination of empirically supported treatments for anxiety in adults or children who have ASD has lagged behind the larger evidence-based trend. This review examines the efficacy of cognitive-behavioral therapy as a…

  7. Cognitive Behavioral Therapy for Anxiety in Children with Autism Spectrum Disorders: A Randomized, Controlled Trial

    ERIC Educational Resources Information Center

    Wood, Jeffrey J.; Drahota, Amy; Sze, Karen; Har, Kim; Chiu, Angela; Langer, David A.

    2009-01-01

    Background: Children with autism spectrum disorders often present with comorbid anxiety disorders that cause significant functional impairment. This study tested a modular cognitive behavioral therapy (CBT) program for children with this profile. A standard CBT program was augmented with multiple treatment components designed to accommodate or…

  8. Cognitive behavioral therapy in anxiety disorders: current state of the evidence.

    PubMed

    Otte, Christian

    2011-01-01

    A plethora of studies have examined the efficacy and effectiveness of cognitive-behavioral therapy (CBT) for adult anxiety disorders. In recent years, several meta-analyses have been conducted to quantitatively review the evidence of CBT for anxiety disorders, each using different inclusion criteria for studies, such as use of control conditions or type of study environment. This review aims to summarize and to discuss the current state of the evidence regarding CBT treatment for panic disorder, generalized anxiety disorder, social anxiety disorder, obsessive-compulsive disorder, and post-traumatic stress disorder. Overall, CBT demonstrates both efficacy in randomized controlled trials and effectiveness in naturalistic settings in the treatment of adult anxiety disorders. However, due to methodological issues, the magnitude of effect is currently difficult to estimate. In conclusion, CBT appears to be both efficacious and effective in the treatment of anxiety disorders, but more high-quality studies are needed to better estimate the magnitude of the effect.

  9. Cognitive phenotype and psychiatric disorder in 22q11.2 deletion syndrome: A review.

    PubMed

    Biswas, Asit B; Furniss, Frederick

    2016-01-01

    The behavioural phenotype of 22q11.2 deletion syndrome syndrome (22q11DS), one of the most common human multiple anomaly syndromes, frequently includes intellectual disability (ID) together with high risk of diagnosis of psychotic disorders including schizophrenia. Candidate cognitive endophenotypes include problems with retrieval of contextual information from memory and in executive control and focussing of attention. 22q11DS may offer a model of the relationship between ID and risk of psychiatric disorder. This paper reviews research on the relationship between the cognitive phenotype and the development of psychiatric disorders in 22q11DS. Aspects of cognitive function including verbal I.Q., visual memory, and executive function, are associated with mental health outcome in people with 22q11DS. This relationship may result from a common neurobiological basis for the cognitive difficulties and psychiatric disorders. Some of the cognitive difficulties experienced by people with 22q11DS, especially in attention, memory retrieval, and face processing, may, however, in themselves constitute risk factors for development of hallucinations and paranoid delusions. Future research into factors leading to psychiatric disorder in people with 22q11DS should include assessment of social and psychological factors including life events, symptoms associated with trauma, attachment, and self-esteem, which together with cognitive risk factors may mediate mental health outcome. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. CSF neuroinflammatory biomarkers in bipolar disorder are associated with cognitive impairment.

    PubMed

    Rolstad, Sindre; Jakobsson, Joel; Sellgren, Carl; Isgren, Anniella; Ekman, Carl Johan; Bjerke, Maria; Blennow, Kaj; Zetterberg, Henrik; Pålsson, Erik; Landén, Mikael

    2015-08-01

    Persistent cognitive impairment in the euthymic state of bipolar disorder is increasingly recognized. Mounting evidence also suggests an association between neuroinflammation and cognitive dysfunction. The purpose of this study was to test if cerebrospinal fluid (CSF) markers of neuroinflammation could account for cognitive impairment in bipolar disorder. Hierarchical linear regression models were applied to account for performance in five cognitive domains using CSF neuroinflammatory biomarkers as predictors in patients with bipolar disorder type I and II (N=78). The associations between these biomarkers and cognition were further tested in healthy age- and sex-matched controls (N=86). In patients with bipolar disorder, the CSF biomarkers accounted for a significant proportion of the variance in executive functions (42.8%, p=<.0005) independently of age, medication, disease status, and bipolar subtype. The microglial marker YKL-40 had a high impact (beta=-.99), and was the only biomarker that contributed individually. CSF biomarkers were not associated with cognitive performance in healthy controls. The CSF neuroinflammation biomarker YKL-40 is associated with executive performance in euthymic bipolar disorder, but not in healthy controls.

  11. Subtle cognitive dysfunction in nonaffected siblings of individuals affected by nonpsychotic disorders.

    PubMed

    Weiser, Mark; Reichenberg, Abraham; Kravitz, Efrat; Lubin, Gad; Shmushkevich, Moti; Glahn, David C; Gross, Raz; Rabinowitz, Jonathan; Noy, Shlomo; Davidson, Michael

    2008-03-15

    Previous studies have reported that as a group, individuals affected by psychotic and nonpsychotic disorders perform below norms on cognitive tests. Other studies have indicated that unaffected siblings of individuals affected by psychotic disorders also perform below norms on the same tests. We investigated cognitive performance on a large, population-based sample of individuals, affected at the time of testing by nonpsychotic disorders, and their unaffected siblings. Subjects were taken from a population-based cohort of 523,375, 16- to 17-year-old male adolescents who had been assessed by the Israeli Draft Board. Cognitive test scores were examined in sib-pairs discordant for nonpsychotic (n = 19,489) and psychotic (n = 888) disorders and compared with 224,082 individuals from sibships with no evidence of mental illness. There appears to be a gradient in cognitive performance (worst to best) from individuals currently affected by psychotic illnesses (Cohen's d = -.82), followed by individuals currently affected by nonpsychotic illness (Cohen's d = -.58), unaffected siblings of individuals affected by psychotic illness (Cohen's d = -.37), unaffected siblings of individuals affected by nonpsychotic illness (Cohen's d = -.27), and members of sibships with no evidence of mental illness. Unaffected siblings of both psychotic and nonpsychotic individuals from multiple affected sibships (more then one affected sibling) had worse cognitive test scores compared with unaffected siblings from simplex sibships (only one affected sibling). The results support, but do not prove, the notion that cognitive impairment in psychiatric disorders is familial and cuts across diagnostic entities.

  12. Attachment and social cognition in borderline personality disorder: Specificity in relation to antisocial and avoidant personality disorders.

    PubMed

    Beeney, Joseph E; Stepp, Stephanie D; Hallquist, Michael N; Scott, Lori N; Wright, Aidan G C; Ellison, William D; Nolf, Kimberly A; Pilkonis, Paul A

    2015-07-01

    Theory and research point to the role of attachment difficulties in borderline personality disorder (BPD). Attachment insecurity is believed to lead to chronic problems in social relationships, attributable, in part, to impairments in social cognition, which comprise maladaptive mental representations of self, others, and self in relation to others. However, few studies have attempted to identify social-cognitive mechanisms that link attachment insecurity to BPD and to assess whether such mechanisms are specific to the disorder. For the present study, empirically derived indices of mentalization, self-other boundaries, and identity diffusion were tested as mediators between attachment style and personality disorder symptoms. In a cross-sectional structural equation model, mentalization and self-other boundaries mediated the relationship between attachment anxiety and BPD. Mentalization partially mediated the relationship between attachment anxiety and antisocial personality disorder (PD) symptoms, and self-other boundaries mediated the relationship between attachment anxiety.

  13. What's the Worry with Social Anxiety? Comparing Cognitive Processes in Children with Generalized Anxiety Disorder and Social Anxiety Disorder.

    PubMed

    Hearn, Cate S; Donovan, Caroline L; Spence, Susan H; March, Sonja; Holmes, Monique C

    2016-12-05

    Social anxiety disorder (SAD) in children is often comorbid with generalized anxiety disorder (GAD). We investigated whether worry, intolerance of uncertainty, beliefs about worry, negative problem orientation and cognitive avoidance, that are typically associated with GAD, are present in children with SAD. Participants included 60 children (8-12 years), matched on age and gender. Groups included children: with primary GAD and without SAD (GAD); with primary SAD and without GAD (SAD); and without an anxiety disorder (NAD). GAD and SAD groups scored significantly higher than the NAD group on worry, intolerance of uncertainty, negative beliefs about worry and negative problem orientation, however, they did not score differently from each other. Only the GAD group scored significantly higher than the NAD group on cognitive avoidance. These findings further understanding of the structure of SAD and suggest that the high comorbidity between SAD and GAD may be due to similar underlying processes within the disorders.

  14. Targeting Prefrontal Cortical Systems for Drug Development: Potential Therapies for Cognitive Disorders

    PubMed Central

    Arnsten, Amy F.T.; Wang, Min

    2016-01-01

    Medications to treat cognitive disorders are increasingly needed, yet researchers have had few successes in this challenging arena. Cognitive abilities in primates arise from highly evolved N-methyl-d-aspartate (NMDA) receptor circuits in layer III of the dorsolateral prefrontal cortex. These circuits have unique modulatory needs that can differ from the layer V neurons that predominate in rodents, but they offer multiple therapeutic targets. Cognitive improvement often requires low doses that enhance the pattern of information held in working memory, whereas higher doses can produce nonspecific changes that obscure information. Identifying appropriate doses for clinical trials may be helped by assessments in monkeys and by flexible, individualized dose designs. The use of guanfacine (Intuniv) for prefrontal cortical disorders was based on research in monkeys, supporting this approach. Coupling our knowledge of higher primate circuits with the powerful methods now available in drug design will help create effective treatments for cognitive disorders. PMID:26738476

  15. How culture shapes social cognition deficits in mental disorders: A review.

    PubMed

    Koelkebeck, Katja; Uwatoko, Teruhisa; Tanaka, Jiro; Kret, Mariska Esther

    2017-04-01

    Social cognitive skills are indispensable for successful communication with others. Substantial research has determined deficits in these abilities in patients with mental disorders. In neurobiological development and continuing into adulthood, cross-cultural differences in social cognition have been demonstrated. Moreover, symptomatic patterns in mental disorders may vary according to the cultural background of an individual. Cross-cultural studies can thus help in understanding underlying (biological) mechanisms and factors that influence behavior in health and disease. In addition, studies that apply novel paradigms assessing the impact of culture on cognition may benefit and advance neuroscience research. In this review, the authors give an overview of cross-cultural research in the field of social cognition in health and in mental disorders and provide an outlook on future research directions, taking a neuroscience perspective.

  16. The prevalence, measurement, and treatment of the cognitive dimension/domain in major depressive disorder.

    PubMed

    McIntyre, Roger S; Xiao, Holly X; Syeda, Kahlood; Vinberg, Maj; Carvalho, Andre F; Mansur, Rodrigo B; Maruschak, Nadia; Cha, Danielle S

    2015-07-01

    Insufficient outcomes amongst adults with major depressive disorder (MDD) provide the impetus to identify and refine therapeutic targets that are most critical to outcome from patient, provider, and societal perspectives. Towards this aim, a pivotal shift towards the transnosological domain, cognition, is occurring in the study of MDD and other brain disorders. This paper aims to provide a framework for conceptualizing and prioritizing cognitive function amongst adults with MDD with a particular view to provide a conceptual framework for research and clinical priorities. We also summarize extant data pertaining to psychotropic effects, notably antidepressants, on the cognitive dimension/domain. This narrative review was based on articles identified through a PubMed/MEDLINE search of all English-language articles published between January 1966 and October 2014. The search words were major depressive disorder, depression, unipolar depression, cognition, cognitive dysfunction, cognitive deficit, and cognitive function. The search was supplemented with a manual review of relevant references. The selection of articles for inclusion in this review was based on overall methodological quality as well as on their pertinence to informing the framework described herein. Cognitive dysfunction in MDD is a discrete domain subserved by discrete yet overlapping substrates. There is a need to provide a glossary of terms commonly employed in the cognition literature for consensus as to the appropriate screening, measurement, and monitoring tools. The guiding principle of measurement-based care should include systematic assessment and measurement of cognition in subpopulations with MDD, as a tactic to improve outcome. Relatively few treatment strategies have demonstrated efficacy specifically for the cognitive domain in MDD. The antidepressant vortioxetine has replicated evidence of specific pro-cognitive effects in adults with MDD across multiple subdomains of cognitive function

  17. Cognitive Styles in High-Functioning Adolescents with Autistic Disorder.

    ERIC Educational Resources Information Center

    Teunisse, Jan-Pieter; Cools, Alexander R.; van Spaendonck, Karel P. M.; Aerts, Francisca H. T. M.; Berger, Hans J. C.

    2001-01-01

    A study investigated the operationalization, the identification, and the prevalence of weak central coherence and poor cognitive shifting in 35 high-functioning adolescents with autism. Weak central coherence and poor cognitive shifting did not appear to be related to measures of symptom severity, social understanding, and social competence.…

  18. The role of cognition in child development and disorder.

    PubMed

    Rutter, M

    1987-03-01

    The role of cognition in child development is reviewed with respect to the role of cognitive processing and cognitive deficits. Cognitive processing is discussed with respect to the self-system; the effects of psychosocial experiences; risk, vulnerability and protective mechanisms; vulnerability to depression; aetiology and treatment of depression. Cognitive deficits are discussed with respect to the socio-emotional consequences of language delay and reading difficulties; hyperkinetic/attentional deficit syndromes; schizophrenia; and autism. It is concluded that the ways in which we appraise our life circumstances and the ways in which we react to experiences of all kinds are greatly influenced by how we think about ourselves and our environment. Biases and distortions in such cognitive processing may be associated with social and emotional malfunction. These biases may derive from earlier experiences, from intensive temperamental styles, or from deficits in the ability to process incoming information. The further study of cognitive processing and cognitive deficits is likely to be rewarding and helpful for clinical practice.

  19. Cognitive Therapy for Obsessive-Compulsive Disorder: A Case Example

    ERIC Educational Resources Information Center

    Chosak, Anne; Marques, Luana; Fama, Jeanne; Renaud, Stefanie; Wilhelm, Sabine

    2009-01-01

    Cognitive therapy for OCD is an empirically validated alternative to the more widely used and validated behavioral therapy for OCD. The cognitive approach is based on the premise that belief systems contribute importantly to the development and maintenance of all types of OCD. By identifying and challenging maladaptive thoughts, beliefs, and core…

  20. Cognitive Therapy for Obsessive-Compulsive Disorder: A Case Example

    ERIC Educational Resources Information Center

    Chosak, Anne; Marques, Luana; Fama, Jeanne; Renaud, Stefanie; Wilhelm, Sabine

    2009-01-01

    Cognitive therapy for OCD is an empirically validated alternative to the more widely used and validated behavioral therapy for OCD. The cognitive approach is based on the premise that belief systems contribute importantly to the development and maintenance of all types of OCD. By identifying and challenging maladaptive thoughts, beliefs, and core…

  1. Evaluation of the benefits of exercise on cognition in major depressive disorder.

    PubMed

    Greer, Tracy L; Furman, Jennifer L; Trivedi, Madhukar H

    2017-07-06

    Cognitive impairment is increasingly recognized as a significant symptom in patients with major depressive disorder (MDD). While exercise is already recommended in many treatment guidelines for patients with MDD and has been shown to improve cognition in other disorders (e.g., Alzheimer's, Parkinson's, schizophrenia), limited research is available evaluating the effect of exercise on cognition in MDD. We provide a narrative review of existing literature regarding the effect(s) of exercise on cognition across several neurodegenerative and psychiatric diseases, and particularly in MDD, with specific emphasis on study design and methodology that may impair adequate synthesis of the results. We also describe mechanisms by which exercise may improve cognition in depression and other brain disorders. Of existing studies with MDD, data are equivocal, as some are supportive of improved cognition, whereas others demonstrate no benefit. Several limitations were noted, including insufficiently-powered designs, variability in interventions examined (e.g., aerobic, anaerobic, mind-body) or control groups, lack of attention to the status of baseline cognitive impairment, and/or heterogeneity across outcome measures and clinical characteristics. While preliminary results suggest the potential for exercise as a beneficial treatment or augmentation strategy for impaired cognition in MDD, the aforementioned limitations necessitate further investigation. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. A meta-analytic review of adult cognitive-behavioral treatment outcome across the anxiety disorders.

    PubMed

    Norton, Peter J; Price, Esther C

    2007-06-01

    The efficacy of cognitive behavioral treatments (CBT) for anxiety in adults has been supported by multiple meta-analyses. However, most have focused on only 1 diagnosis, thereby disallowing diagnostic comparisons. This study examined the efficacy of CBT across the anxiety disorders. One hundred eight trials of CBT for an anxiety disorder met study criteria. Cognitive therapy and exposure therapy alone, in combination, or combined with relaxation training, were efficacious across the anxiety disorders, with no differential efficacy for any treatment components for any specific diagnoses. However, when comparing across diagnoses, outcomes for generalized anxiety disorder and posttraumatic stress disorder were superior to those for social anxiety disorder, but no other differences emerged. CBT effects were superior to those for no-treatment and expectancy control treatments, although tentative evidence suggested equal effects of CBT when compared with relaxation-only treatments.

  3. A Review of the Role of Social Cognition in Major Depressive Disorder

    PubMed Central

    Weightman, Michael James; Air, Tracy Michele; Baune, Bernhard Theodor

    2014-01-01

    Background: Social cognition – the ability to identify, perceive, and interpret socially relevant information – is an important skill that plays a significant role in successful interpersonal functioning. Social cognitive performance is recognized to be impaired in several psychiatric conditions, but the relationship with major depressive disorder is less well understood. The aim of this review is to characterize the current understanding of: (i) the different domains of social cognition and a possible relationship with major depressive disorder, (ii) the clinical presentation of social cognition in acute and remitted depressive states, and (iii) the effect of severity of depression on social cognitive performance. Methods: Electronic databases were searched to identify clinical studies investigating social cognition in a major depressive disorder population, yielding 31 studies for this review. Results: Patients with major depressive disorder appear to interpret social cognitive stimuli differently to healthy controls: depressed individuals may interpret emotion through a mood-congruent bias and have difficulty with cognitive theory of mind tasks requiring interpretation of complex mental states. Social cognitive performance appears to be inversely associated with severity of depression, whilst the bias toward negative emotions persists even in remission. Some deficits may normalize following effective pharmacotherapy. Conclusions: The difficulties with social interaction observed in major depressive disorder may, at least in part, be due to an altered ability to correctly interpret emotional stimuli and mental states. These features seem to persist even in remission, although some may respond to intervention. Further research is required in this area to better understand the functional impact of these findings and the way in which targeted therapy could aid depressed individuals with social interactions. PMID:25566100

  4. A Randomized Clinical Trial of Cognitive Enhancement Therapy for Adults with Autism Spectrum Disorders

    DTIC Science & Technology

    2012-10-01

    Enhancement Therapy for Adults with Autism Spectrum Disorders PRINCIPAL INVESTIGATOR: Nancy J. Minshew, M.D. & Shaun M. Each, Ph.D...Therapy for Adults with Autism Spectrum Disorders 5a. CONTRACT NUMBER 5b. GRANT NUMBER W81XWH-11-1-0665 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR...controlled trial of Cognitive Enhancement Therapy (CET) in 54 verbal adults with autism spectrum disorders and assessing the efficacy of this approach

  5. Cognitive Mediators of Treatment for Social Anxiety Disorder: Comparing Acceptance and Commitment Therapy and Cognitive-Behavioral Therapy

    PubMed Central

    Niles, Andrea N.; Burklund, Lisa J.; Arch, Joanna J.; Lieberman, Matthew D.; Saxbe, Darby; Craske, Michelle G.

    2016-01-01

    Objective To assess the relationship between session-by-session mediators and treatment outcomes in traditional cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for social anxiety disorder. Method Session-by-session changes in negative cognitions (a theorized mediator of CBT) and experiential avoidance (a theorized mediator of ACT) were assessed in 50 adult outpatients randomized to CBT (n = 25) or ACT (n = 25) for DSM-IV social anxiety disorder. Results Multilevel modeling analyses revealed significant nonlinear decreases in the proposed mediators in both treatments, with ACT showing steeper decline than CBT at the beginning of treatment and CBT showing steeper decline than ACT at the end of treatment. Curvature (or the nonlinear effect) of experiential avoidance during treatment significantly mediated posttreatment social anxiety symptoms and anhedonic depression in ACT, but not in CBT, with steeper decline of the Acceptance and Action Questionnaire at the beginning of treatment predicting fewer symptoms in ACT only. Curvature of negative cognitions during both treatments predicted outcome, with steeper decline of negative cognitions at the beginning of treatment predicting lower posttreatment social anxiety and depressive symptoms. Conclusions Rate of change in negative cognitions at the beginning of treatment is an important predictor of change across both ACT and CBT, whereas rate of change in experiential avoidance at the beginning of treatment is a mechanism specific to ACT. PMID:25022777

  6. Cognitive mediators of treatment for social anxiety disorder: comparing acceptance and commitment therapy and cognitive-behavioral therapy.

    PubMed

    Niles, Andrea N; Burklund, Lisa J; Arch, Joanna J; Lieberman, Matthew D; Saxbe, Darby; Craske, Michelle G

    2014-09-01

    To assess the relationship between session-by-session mediators and treatment outcomes in traditional cognitive-behavioral therapy (CBT) and acceptance and commitment therapy (ACT) for social anxiety disorder. Session-by-session changes in negative cognitions (a theorized mediator of CBT) and experiential avoidance (a theorized mediator of ACT) were assessed in 50 adult outpatients randomized to CBT (n=25) or ACT (n=25) for DSM-IV social anxiety disorder. Multilevel modeling analyses revealed significant nonlinear decreases in the proposed mediators in both treatments, with ACT showing steeper decline than CBT at the beginning of treatment and CBT showing steeper decline than ACT at the end of treatment. Curvature (or the nonlinear effect) of experiential avoidance during treatment significantly mediated posttreatment social anxiety symptoms and anhedonic depression in ACT, but not in CBT, with steeper decline of the Acceptance and Action Questionnaire at the beginning of treatment predicting fewer symptoms in ACT only. Curvature of negative cognitions during both treatments predicted outcome, with steeper decline of negative cognitions at the beginning of treatment predicting lower posttreatment social anxiety and depressive symptoms. Rate of change in negative cognitions at the beginning of treatment is an important predictor of change across both ACT and CBT, whereas rate of change in experiential avoidance at the beginning of treatment is a mechanism specific to ACT. Copyright © 2014. Published by Elsevier Ltd.

  7. [Cognitive functions of children with attention deficit/hyperactivity disorder].

    PubMed

    Liu, Yuxin; Wang, Yufeng

    2002-03-25

    To investigate the features of cognitive function in children with attention deficit/hyperactivity disorder (ADHD). Wechsler Intelligence Scale for Children-RC, Wechsler Memory Scale (WMS), Number Cancellation Test, Ravin's Standard Progressive Matrices, and Stroop test were conducted among 60 7 approximately 12-year-old children diagnosed with ADHD and 60 children matched by age, sex, and maternal education level. The verbal intelligence quotient, performance IQ, full scale IQ, verbal comprehension IQ, perceptual organization IQ, and freedom from distractibility IQ of the ADHD CHILDREN were 104 +/- 13, 98 +/- 14, 102 +/- 13, 100 +/- 15, and 102 +/- 15, all less than those of the controls (112 +/- 11, 108 +/- 13, 112 +/- 12, 111 +/- 12, 107 +/- 13, and 116 +/- 13, all P < 0.01). The scores of long-term memory, short-term memory, immediate memory, memory quotient, and reverse digit span in the children with ADHD were 40 +/- 7, 58 +/- 12, 7 +/- 3, 95 +/- 15, and 4.2 +/- 1.7 respectively, all less than those in the controls (49 +/- 5, 63 +/- 10, 8.4 +/- 3.0, 109 +/- 12.5, and 5.0 +/- 1.4 respectively, all P < 0.05). Number cancellation test showed significantly lower total score and higher error rate in ADHD children than in the controls (51.5 and 76.4 VS 77.3 and 38.0, both P = 0.000). In Stroop test, the ADHD children spent more time for all the four parts, had to make more effort to eliminate the interference of word meaning, and made more errors in the C and D parts. The average standard score of Raven's Standard Progressive Matrices was 4.0 +/- 1.5, significantly higher than that in the controls (2.7 +/- 1.2, P = 0.000). The levels of intelligence, memory, and attention in ADHD children are lower that those in normal children. ADHD children have deficiency in executive functions, such as selective inhibition, working memory and plan implementation.

  8. Changes in cognitive symptoms after a buspirone-melatonin combination treatment for Major Depressive Disorder.

    PubMed

    Targum, Steven D; Wedel, Pamela C; Fava, Maurizio

    2015-09-01

    Cognitive deficits are often associated with acute depressive episodes and contribute to the functional impairment seen in patients with Major Depressive Disorder (MDD). Many patients sustain residual cognitive deficits after treatment that may be independent of the core MDD disorder. We tracked changes in cognitive deficits relative to antidepressant treatment response using the patient self-rated Massachusetts General Hospital Cognitive and Physical Functioning Questionnaire (MGH-CPFQ) during a 6-week, double-blind trial of a combination antidepressant treatment (buspirone 15 mg with melatonin-SR 3 mg) versus buspirone (15 mg) monotherapy versus placebo in MDD patients with acute depressive episodes. The CPFQ includes distinct cognitive and physical functioning dimension subscales. Treatment response was determined using the Inventory of Depressive Symptomatology (IDSc30). Treatment responders improved significantly more on the total CPFQ than non-responders (p < 0.0001) regardless of treatment assignment. The cognitive dimension of the CPFQ score favored the combination treatment over the other two groups (ANCOVA: p = 0.050). Among the treatment non-responders, the effect size for the CPFQ cognitive dimension was 0.603 favoring the combination treatment over the over two groups and 0.113 for the CPFQ physical dimension. These preliminary findings suggest that a combination of buspirone with melatonin may benefit cognitive function distinct from mood symptoms and that some aspects of cognition may be specific targets for treatment within a population of patients with MDD.

  9. Cognitive disorders in pediatric medulloblastoma: what neuroimaging has to offer.

    PubMed

    Hoang, Duc Ha; Pagnier, Anne; Guichardet, Karine; Dubois-Teklali, Fanny; Schiff, Isabelle; Lyard, Geneviève; Cousin, Emilie; Krainik, Alexandre

    2014-08-01

    Medulloblastomas are the most common malignant childhood brain tumors arising in the posterior fossa. Treatment improvements for these tumors have meant that there are a greater number of survivors, but this long-term patient survival has increased the awareness of resulting neurocognitive deficits. Impairments in attention, memory, executive functions, and intelligence quotient demonstrate that the cerebellum likely plays a significant role in numerous higher cognitive functions such as language, cognitive, and emotional functions. In addition, children with medulloblastoma not only have cerebellar lesions but also brain white matter damages due to radiation and chemotherapy. Functional neuroimaging, a noninvasive method with many advantages, has become the standard tool in clinical and cognitive neuroscience research. By reviewing functional neuroimaging studies, this review aims to clarify the role of the cerebellum in cognitive function and explain more clearly cognitive sequelae due to polytherapy in children with medulloblastoma. This review suggests that the posterior cerebellar lobes are crucial to maintaining cognitive performance. Clinical investigations could help to better assess the involvement of these lobes in cognitive functions.

  10. Cognitive Deficits as a Mediator of Poor Occupational Function in Remitted Major Depressive Disorder Patients

    PubMed Central

    Woo, Young Sup; Rosenblat, Joshua D.; Kakar, Ron; Bahk, Won-Myong; McIntyre, Roger S.

    2016-01-01

    Cognitive deficits in major depressive disorder (MDD) patients have been described in numerous studies. However, few reports have aimed to describe cognitive deficits in the remitted state of MDD and the mediational effect of cognitive deficits on occupational outcome. The aim of the current review is to synthesize the literature on the mediating and moderating effects of specific domains of cognition on occupational impairment among people with remitted MDD. In addition, predictors of cognitive deficits found to be vocationally important will be examined. Upon examination of the extant literature, attention, executive function and verbal memory are areas of consistent impairment in remitted MDD patients. Cognitive domains shown to have considerable impact on vocational functioning include deficits in memory, attention, learning and executive function. Factors that adversely affect cognitive function related to occupational accommodation include higher age, late age at onset, residual depressive symptoms, history of melancholic/psychotic depression, and physical/psychiatric comorbidity, whereas higher levels of education showed a protective effect against cognitive deficit. Cognitive deficits are a principal mediator of occupational impairment in remitted MDD patients. Therapeutic interventions specifically targeting cognitive deficits in MDD are needed, even in the remitted state, to improve functional recovery, especially in patients who have a higher risk of cognitive deficit. PMID:26792035

  11. Lower cognitive functioning as a predictor of weight gain in bipolar disorder: a 12-month study.

    PubMed

    Bond, D J; Torres, I J; Lee, S S; Kozicky, J-M; Silveira, L E; Dhanoa, T; Lam, R W; Yatham, L N

    2017-03-01

    In cross-sectional studies, elevated body mass index (BMI) is associated with cognitive impairment in bipolar disorder (BD). We investigated the direction of this association by prospectively examining changes in BMI and cognition. We measured BMI and performance in six cognitive domains over 12 months in 80 adolescent and young adult BD patients and 46 healthy comparison subjects (HS). Ninety-three percent of patients received pharmacotherapy and 84% were euthymic. We used repeated-measures ancova and longitudinal mixed models to investigate whether (i) higher BMI and increasing BMI over time predicted lower subsequent cognitive functioning, and (ii) lower cognitive functioning and changes in cognition predicted increasing BMI. Neither baseline BMI nor BMI change predicted lower cognitive functioning. Lower baseline scores in attention, verbal memory, working memory, and a composite measure of global cognition predicted increasing BMI in patients and HS. In patients, lower cognitive functioning remained associated with increasing BMI when clinical and treatment variables were adjusted for. Improvement in working memory predicted a smaller subsequent BMI increase in patients. Lower cognitive functioning in specific domains predicts increasing BMI in patients with BD and healthy young adults. Targeting cognition may be important for minimizing weight gain in BD. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Five-year follow-up of cognitive impairment in older adults with bipolar disorder.

    PubMed

    Schouws, Sigfried N T M; Comijs, Hannie C; Dols, Annemieke; Beekman, Aartjan T F; Stek, Max L

    2016-03-01

    To date, cognitive impairment has been thought to be an integral part of bipolar disorder. In clinical staging models, cognitive impairment is one of the hallmarks to define the clinical stage and it plays an important role in identifying the risk factors for progression to later stages of the illness. It is important to examine neurocognitive performance over longer periods to test the hypothesis of neuroprogression of bipolar disorder. A comprehensive neuropsychological test battery was applied at baseline and five years later to 56 euthymic older outpatients with bipolar disorder (mean age = 68.35 years, range: 60-90 years) and to a demographically matched sample of 44 healthy subjects. A group-by-time repeated measures multivariate analysis of variance was performed to measure changes over time for the two groups. The impact of baseline illness characteristics on the intra-individual change in neurocognitive performance within the bipolar disorder group was studied by using logistic regression analysis. At baseline and at follow-up, patients with bipolar disorder performed worse on all neurocognitive measures compared to the matched healthy subjects. However, there was no significant group-by-time interaction between the patients with bipolar disorder and the comparison group. Although older patients with bipolar disorder had worse cognitive function than healthy subjects, they did not have greater cognitive decline over a five-year period. The change in acquired cognitive impairment of patients with bipolar disorder might parallel the cognitive development as seen in normal aging. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Cognitive Behavioral Treatment for Childhood Anxiety Disorders: Long-Term Effects on Anxiety and Secondary Disorders in Young Adulthood

    ERIC Educational Resources Information Center

    Saavedra, Lissette M.; Silverman, Wendy K.; Morgan-Lopez, Antonio A.; Kurtines, William M.

    2010-01-01

    Background: The present study's aim was to examine the long-term effects (8 to 13 years post-treatment; M = 9.83 years; SD = 1.71) of the most widely used treatment approaches of exposure-based cognitive behavioral treatment for phobic and anxiety disorders in children and adolescents (i.e., group treatment and two variants of individual…

  14. Cognitive Behavioral Treatment for Childhood Anxiety Disorders: Long-Term Effects on Anxiety and Secondary Disorders in Young Adulthood

    ERIC Educational Resources Information Center

    Saavedra, Lissette M.; Silverman, Wendy K.; Morgan-Lopez, Antonio A.; Kurtines, William M.

    2010-01-01

    Background: The present study's aim was to examine the long-term effects (8 to 13 years post-treatment; M = 9.83 years; SD = 1.71) of the most widely used treatment approaches of exposure-based cognitive behavioral treatment for phobic and anxiety disorders in children and adolescents (i.e., group treatment and two variants of individual…

  15. The Management of Cognitive Impairment in Bipolar Disorder: Current Status and Perspectives

    PubMed Central

    Sanches, Marsal; Bauer, Isabelle E.; Galvez, Juan F.; Zunta-Soares, Giovana B.; Soares, Jair C.

    2014-01-01

    Bipolar disorder (BD) is associated with important cognitive deficits that persist during the periods of remission. Although these deficits seem to play an important role in the functional impairment experienced by bipolar patients, evidence regarding their clinical management is scant. We revised the databases PubMed, MEDLINE, and clinicaltrials.gov, searching for studies focusing on the pharmacological and nonpharmacological treatment of cognitive deficits among bipolar patients. In addition, a manual search of bibliographical cross-references was performed. Currently, there is no Food and Drug Administration–approved pharmacological agent for the management of cognitive deficits in BD. A number of agents have been tested in the treatment of cognitive deficits in BD, with mixed results. Nonpharmacological interventions, such as cognitive remediation and noninvasive brain stimulation techniques, seem promising, but their role has not yet been properly explored among bipolar patients. Additional studies, aiming at evaluating the efficacy of interventions combining cognitive rehabilitation and biological treatments, are highly desirable. PMID:25383489

  16. Correlates of cognitive flexibility in veterans seeking treatment for posttraumatic stress disorder.

    PubMed

    Keith, Jessica; Velezmoro, Rodrigo; O'Brien, Carol

    2015-04-01

    This study examined the association between cognitive flexibility and variables that may be associated with treatment outcome for 579 veterans seeking Veterans Health Administration treatment for posttraumatic stress disorder (PTSD) secondary to combat or sexual trauma. Factors associated with severity of PTSD (level of PTSD symptoms and guilt cognitions) and with PTSD prognosis (posttraumatic growth and optimistic expectations for the future) were examined. Regression analyses revealed that cognitive flexibility was associated with lower levels of PTSD symptoms and fewer guilt cognitions. Cognitive flexibility was positively associated with posttraumatic growth and optimistic expectations for the future, even when controlling for PTSD severity. These results suggest that interventions designed to increase cognitive flexibility in veterans may be a worthwhile adjunct to treatment for PTSD as we continue efforts to improve treatment outcomes.

  17. [Cognitive predictors of social improvement in adolescents with autism spectrum-disorders].

    PubMed

    Teunisse, J P; Krebbers, F T T; Palmen, A; van der Sijde, A; Aerts, F H T M; Mommersteeg, M C J; Berger, H J C

    2007-01-01

    In an earlier study published in this journal (Berger e.a. 2002) it was shown that the cognitive styles 'weak central coherence' and 'poor cognitive shifting' are common in autism spectrum disorders, but tests have revealed that the styles do not apply to every member of the patient group. This finding could have consequences for the course of treatment. To find out if the cognitive styles of autistic patients can predict whether their social functioning will improve after three years of treatment we conducted a follow-up study in which we examined 44 non-retarded adolescents with an autism spectrum disorder who were receiving residential treatment. On the basis of factor scores awarded in an extensive battery of neuropsychological tests, we formed subgroups of patients with weak versus strong central coherence and cognitive shifting. Then analyses of variance were used to discover whether the subgroups were predictors of changes in three aspects of social functioning: autistic symptoms, social intelligence and social competence. We found a small but significant gain in all the social domains. However, there were clear individual differences in the degree of improvement. Cognitive shifting was found to be a predictor of a clinically meaningful improvement in social competence. The correlation found between cognitive shifting and social competence indicates that patients with an autism spectrum disorder should be given different forms of treatment that take differences in cognitive style into account.

  18. A Role for Cognitive Rehabilitation in Increasing the Effectiveness of Treatment for Alcohol Use Disorders

    PubMed Central

    Bates, Marsha E.; Buckman, Jennifer F.; Nguyen, Tam T.

    2013-01-01

    Neurocognitive impairments are prevalent in persons seeking treatment for alcohol use disorders (AUDs). These impairments and their physical, social, psychological and occupational consequences vary in severity across persons, much like those resulting from traumatic brain injury; however, due to their slower course of onset, alcohol-related cognitive impairments are often overlooked both within and outside of the treatment setting. Evidence suggests that cognitive impairments can impede treatment goals through their effects on treatment processes. Although some recovery of alcohol-related cognitive impairments often occurs after cessation of drinking (time-dependent recovery), the rate and extent of recovery is variable across cognitive domains and individuals. Following a long hiatus in scientific interest, a new generation of research aims to facilitate treatment process and improve AUD treatment outcomes by directly promoting cognitive recovery (experience-dependent recovery). This review updates knowledge about the nature and course of cognitive and brain impairments associated with AUD, including cognitive effects of adolescent AUD. We summarize current evidence for indirect and moderating relationships of cognitive impairment to treatment outcome, and discuss how advances in conceptual frameworks of brain-behavior relationships are fueling the development of novel AUD interventions that include techniques for cognitive remediation. Emerging evidence suggests that such interventions can be effective in promoting cognitive recovery in persons with AUD and other substance use disorders, and potentially increasing the efficacy of AUD treatments. Finally, translational approaches based on cognitive science, neurophysiology, and neuroscience research are considered as promising future directions for effective treatment development that includes cognitive rehabilitation. PMID:23412885

  19. Sudden gains in exposure-focused cognitive-behavioral group therapy for panic disorder.

    PubMed

    Nogueira-Arjona, Raquel; Santacana, Martí; Montoro, María; Rosado, Silvia; Guillamat, Roser; Vallès, Vicenç; Fullana, Miquel A

    2017-05-11

    In the context of psychological treatment, a sudden gain is a large and enduring improvement in symptom severity that occurs between two single therapy sessions. The influence of sudden gains on long-term outcomes and functional impairment in anxiety disorders is not well understood, and little is known with regard to panic disorder in particular. In addition, previous research on patients with anxiety disorders has produced inconsistent results regarding the relationship between sudden gains and cognitive change. We examined the incidence of sudden gains in a large sample (n = 116) of panic disorder patients undergoing exposure-focused cognitive-behavioral group therapy, and compared panic severity, functional impairment, and cognitive change in patients with and without sudden gains at posttreatment and 6-month follow-up. Participants who experienced sudden gains displayed lower levels of panic severity and functional impairment at posttreatment and 6-month follow-up than those who did not experience sudden gains. However, we observed no difference in cognitive changes between groups, either at posttreatment or at follow-up. Our results demonstrate that the beneficial effects of sudden gains on therapeutic outcomes not only extend to long-term and functional outcome measures but are also evident in less cognitive (i.e., exposure-focused) forms of psychological treatment. Sudden gains are common in panic disorder patients undergoing exposure-based cognitive-behavioral group therapy. Sudden gains during exposure-focused therapy are linked to greater improvement in panic disorder severity and functional impairment. The positive impact of sudden gains on panic disorder severity and functional impairment is maintained in the long term. Copyright © 2017 John Wiley & Sons, Ltd.

  20. Pattern of cognitive impairment in older veterans with posttraumatic stress disorder evaluated at a memory disorders clinic.

    PubMed

    Scott Mackin, R; Lesselyong, Julia A; Yaffe, Kristine

    2012-06-01

    We determined the pattern of clinically significant cognitive impairment (CI) among older veterans with posttraumatic stress disorder (PTSD) evaluated in a memory disorders clinic. Data were collected from 19 ethnically diverse veterans. Cognitive functioning in six domains (verbal learning, memory, attention, language, executive functioning, and information processing speed) was assessed. The majority of veterans (57%) demonstrated CI on a measure of single trial list learning, 44% exhibited CI on short delay memory for lists, and 31% exhibited CI in long delay memory for lists. CI on measures of memory for stories (14%) and executive functioning (6%) were less common, and none of the participants demonstrated CI on measures of attention, language, or information processing speed. CI on measures of single trial list learning and memory for lists are common in older patients with PTSD evaluated in a memory disorders clinic and are likely to contribute to functional deficits. Copyright © 2011 John Wiley & Sons, Ltd.

  1. Cognitive profiles in euthymic patients with bipolar disorders: results from the FACE-BD cohort.

    PubMed

    Roux, Paul; Raust, Aurélie; Cannavo, Anne Sophie; Aubin, Valérie; Aouizerate, Bruno; Azorin, Jean-Michel; Bellivier, Frank; Belzeaux, Raoul; Bougerol, Thierry; Cussac, Iréna; Courtet, Philippe; Etain, Bruno; Gard, Sébastien; Job, Sophie; Kahn, Jean-Pierre; Leboyer, Marion; Olié, Emilie; Henry, Chantal; Passerieux, Christine

    2017-03-01

    Although cognitive deficits are a well-established feature of bipolar disorders (BD), even during periods of euthymia, little is known about cognitive phenotype heterogeneity among patients with BD. We investigated neuropsychological performance in 258 euthymic patients with BD recruited via the French network of expert centers for BD. We used a test battery assessing six domains of cognition. Hierarchical cluster analysis of the cross-sectional data was used to determine the optimal number of subgroups and to assign each patient to a specific cognitive cluster. Subsequently, subjects from each cluster were compared on demographic, clinical functioning, and pharmacological variables. A four-cluster solution was identified. The global cognitive performance was above normal in one cluster and below normal in another. The other two clusters had a near-normal cognitive performance, with above and below average verbal memory, respectively. Among the four clusters, significant differences were observed in estimated intelligence quotient and social functioning, which were lower for the low cognitive performers compared to the high cognitive performers. These results confirm the existence of several distinct cognitive profiles in BD. Identification of these profiles may help to develop profile-specific cognitive remediation programs, which might improve functioning in BD. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Pathways between neurocognition, social cognition and emotion regulation in bipolar disorder.

    PubMed

    Van Rheenen, T E; Meyer, D; Rossell, S L

    2014-11-01

    Converging evidence suggests that in bipolar disorder (BD), social cognition and emotion regulation are affected by the capacity for effective neurocognitive function. Adaptive emotion regulation may also rely on intact social cognition, and it is possible that social cognition acts as a mediator in its relationship with neurocognition. We aimed to address this hypothesis by explicitly examining interrelationships among neurocognition, social cognition and emotion regulation in an out-patient sample meeting criteria for a DSM-IV-TR diagnosis of BD compared with controls. Fifty-one BD patients and 52 healthy controls completed a battery of tests assessing neurocognition, social cognition (emotion perception and theory of mind) and emotion regulation. Path analysis revealed that in BD, neurocognition was associated with social cognition, but social cognition was not associated with emotion regulation as expected. In contrast, a component of social cognition was found to mediate the relationship between neurocognition and emotion regulation in healthy controls. These findings highlight differences in the pattern of associations between neurocognition, social cognition and emotion regulation across BD patients and controls. In the present data, these results appear to indicate that neurocognitive and social cognitive abilities generally operate in isolation from emotion regulation in BD. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  3. Examination of the Content Specificity of Posttraumatic Cognitions in Combat Veterans With Posttraumatic Stress Disorder.

    PubMed

    Raab, Phillip A; Mackintosh, Margaret-Anne; Gros, Daniel F; Morland, Leslie A

    2015-01-01

    Cognitive theories have proposed the idea of content specificity, which holds that emotional disorders are associated with unique sets of negative cognitions. The existent research exploring the content specificity related to posttraumatic stress disorder (PTSD) and depression is sparse, and research is especially needed in veteran samples. The purpose of this study was to examine the associations of PTSD symptom clusters and comorbid depressive symptoms with posttraumatic cognitions. This study was cross-sectional in design, and the sample consisted of data from 150 male combat veterans with PTSD drawn from the baseline assessments of a large clinical trial. Analyses involved a series of separate and simultaneous linear regressions to examine the unique associations of comorbid depressive symptoms and PTSD symptom clusters with posttraumatic cognitions, as well as post hoc analyses to examine the mediational role of comorbid depressive symptoms. Findings demonstrated that posttraumatic negative cognitions about the self and self-blame were most strongly associated with comorbid depressive symptoms and the depression-related PTSD numbing cluster. Comorbid depressive symptoms also partially mediated nearly all the relationships between posttraumatic cognitions and PTSD symptom clusters. The findings of this study suggest that posttraumatic cognitions about the self and self-blame are not specific to PTSD but rather are more strongly related to symptoms of depression and negative affect. The results also suggest a potential pathway from posttraumatic cognitions to PTSD through the partially mediating influence of comorbid depression, and highlight the need to assess and treat comorbid depression in veterans with PTSD.

  4. Nicotinic receptor mechanisms and cognition in normal states and neuropsychiatric disorders

    PubMed Central

    Sacco, Kristi A.; Bannon, Katie L.; George, Tony P.

    2005-01-01

    Cigarette smoking rates in the American population are approximately 23%, whereas rates of smoking in clinical and population studies of individuals with neuropsychiatric disorders are typically two- to four-fold higher. Studies conducted in a variety of neuropsychiatric populations [e.g. attention-deficit hyperactivity disorder (ADHD), Alzheimer’s disease, schizophrenia] have collectively suggested that nicotine may be efficacious in remediating selected cognitive deficits associated with these disorders, thus providing a framework for understanding the specific vulnerability of these patients to smoking initiation and maintenance. However, the specific gain in cognitive performance produced by nicotine administration in healthy subjects with normal cognitive function is less clear. This article reviews our current understanding of central nicotinic acetylcholine receptor (nAChRs) systems in normal and neuropsychiatric disease states and, specifically, their role with respect to cognitive dysfunction and clinical symptoms in several specific neuropsychiatric populations, including ADHD, Alzheimer’s disease, Parkinson’s disease, Tourette’s Disorder, schizophrenia and affective disorders. The potential benefits of nicotinic agents for therapeutic use in neuropsychiatric disorders is discussed, as well as directions for further research in this area. PMID:15582913

  5. Systematic review of efficacy of cognitive behaviour therapies in childhood and adolescent depressive disorder

    PubMed Central

    Harrington, Richard; Whittaker, Jane; Shoebridge, Philip; Campbell, Fiona

    1998-01-01

    Objective: To determine whether cognitive behaviour therapy is an effective treatment for childhood and adolescent depressive disorder. Design: Systematic review of six randomised trials comparing the efficacy of cognitive behaviour therapy with inactive interventions in subjects aged 8 to 19 years with depressive disorder. Main outcome measure: Remission from depressive disorder. Results: The rate of remission from depressive disorder was higher in the therapy group (129/208; 62%) than in the comparison group (61/168; 36%). The pooled odds ratio was 3.2 (95% confidence interval 1.9 to 5.2), suggesting a significant benefit of active treatment. Most studies, however, were based on relatively mild cases of depression and were of only moderate quality. Conclusions: Cognitive behaviour therapy may be of benefit for depressive disorder of moderate severity in children and adolescents. It cannot, however, yet be recommended for severe depression. Definitive large trials will be required to determine whether the results of this systematic review are reliable. Key messages Depressive disorders are a common problem in child psychiatric clinics, but a recent systematic review found that tricyclic medication was of unproved benefit This systematic review identified six randomised trials of a psychological treatment—cognitive behaviour therapy—in subjects aged 8 to 19 years with depressive disorder The results seemed to show that cognitive behaviour therapy is an effective treatment for depressive disorder of moderate severity Because of the small number of trials available for this quantitative analysis definitive large trials will be required to determine whether the present results are reliable PMID:9596592

  6. Spectrum of cognitive disorders in idiopathic normal pressure hydrocephalus

    PubMed Central

    Picascia, Marta; Minafra, Brigida; Zangaglia, Roberta; Gracardi, Luciana; Pozzi, Nicolò Gabriele; Sinforiani, Elena; Pacchetti, Claudio

    2016-01-01

    Summary Idiopathic normal pressure hydrocephalus (iNPH) is a syndrome characterized by ventricular dilation accompanied by a progressive triad of a gait disturbance, “dementia” and incontinence. We retrospectively evaluated cognitive profile, and its relationship with disease variables, in 64 iNPH patients. The iNPH group performed significantly worse than the control group on all neuropsychological tests, except for verbal memory (within the normal range). The patients were subdivided into four groups: group 1 (42%: global cognitive impairment); group 2 (24%: frontosubcortical dysfunction); group 3 (17%: isolated deficit of a single cognitive domain); group 4 (17%: no cognitive impairment). Group 1 was older, with a significantly longer disease duration and more severe motor disease, while groups 3 and 4 were younger and presented milder motor impairment and a shorter disease duration. These data suggest parallel progression of cognitive and motor impairment in iNPH; early shunt surgery might prevent the development, in older age, of dementia in these patients. PMID:27678207

  7. The kynurenine pathway as a therapeutic target in cognitive and neurodegenerative disorders

    PubMed Central

    Stone, Trevor W; Darlington, L Gail

    2013-01-01

    Understanding the neurochemical basis for cognitive function is one of the major goals of neuroscience, with a potential impact on the diagnosis, prevention and treatment of a range of psychiatric and neurological disorders. In this review, the focus will be on a biochemical pathway that remains under-recognized in its implications for brain function, even though it can be responsible for moderating the activity of two neurotransmitters fundamentally involved in cognition – glutamate and acetylcholine. Since this pathway – the kynurenine pathway of tryptophan metabolism – is induced by immunological activation and stress, it also stands in a unique position to mediate the effects of environmental factors on cognition and behaviour. Targeting the pathway for new drug development could, therefore, be of value not only for the treatment of existing psychiatric conditions, but also for preventing the development of cognitive disorders in response to environmental pressures. PMID:23647169

  8. Dementia and cognitive disorder identified at a forensic psychiatric examination - a study from Sweden.

    PubMed

    Ekström, Anette; Kristiansson, Marianne; Björkstén, Karin Sparring

    2017-09-18

    Few studies have addressed the relationship between dementia and crime. We conducted a study of persons who got a primary or secondary diagnosis of dementia or cognitive disorder in a forensic psychiatric examination. In Sweden, annually about 500 forensic psychiatric examinations are carried out. All cases from 2008 to 2010 with the diagnoses dementia or cognitive disorder were selected from the database of the Swedish National Board of Forensic Medicine. Out of 1471 cases, there were 54 cases of dementia or cognitive disorder. Case files were scrutinized and 17 cases of dementia and 4 cases of cognitive disorder likely to get a dementia diagnosis in a clinical setting were identified and further studied. There were 18 men and 3 women; Median age 66 (n = 21; Range 35-77) years of age. Eleven men but no women had a previous criminal record. There were a total of 38 crimes, mostly violent, committed by the 21 persons. The crimes were of impulsive rather that pre-meditated character. According to the forensic psychiatric diagnoses, dementia was caused by cerebrovascular disorder (n = 4), alcohol or substance abuse (n = 3), cerebral haemorrhage and alcohol (n = 1), head trauma and alcohol (n = 2), Alzheimer's disease (n = 2), Parkinson's disease (n = 1), herpes encephalitis (n = 1) and unspecified (3). Out of four persons diagnosed with cognitive disorder, one also had delusional disorder and another one psychotic disorder and alcohol dependence. An alcohol-related diagnosis was established in ten cases. There were only two cases of Dementia of Alzheimer's type, one of whom also had alcohol intoxication. None was diagnosed with a personality disorder. All but one had a history of somatic or psychiatric comorbidity like head traumas, stroke, other cardio-vascular disorders, epilepsy, depression, psychotic disorders and suicide attempts. In this very ill group, the suggested verdict was probation in one case and different forms of care in the remaining

  9. A pilot study of cognitive behaviour therapy for panic disorder augmented by panic surfing.

    PubMed

    Lamplugh, Claire; Berle, David; Milicevic, Denise; Starcevic, Vladan

    2008-01-01

    This pilot study reports the outcome of cognitive behaviour therapy for panic disorder augmented by panic surfing. This treatment approach encourages acceptance of feelings rather than control of symptoms and anxiety, at the same time also targeting catastrophic misinterpretations, bodily vigilance and safety-seeking behaviours. Eighteen participants completed a brief group treatment for panic disorder incorporating psychoeducation, panic surfing, interoceptive exposure, graded exposure and cognitive restructuring. Significant improvements occurred over the course of this treatment and were maintained at a 1-month follow-up. Results suggest that cognitive behaviour therapy augmented by panic surfing may be effective in the treatment of panic disorder, but there is a need for controlled studies and investigation of the relative contribution of its various components.

  10. Evaluation of a cognitive psychophysiological model for management of tic disorders: an open trial.

    PubMed

    O'Connor, Kieron; Lavoie, Marc; Blanchet, Pierre; St-Pierre-Delorme, Marie-Ève

    2016-07-01

    Tic disorders, in particular chronic tic disorder and Tourette syndrome, affect about 1% of the population. The current treatment of choice is pharmacological or behavioural, addressing tics or the premonitory urges preceding tic onset. The current study reports an open trial evaluating the effectiveness of a cognitive psychophysiological treatment addressing Tourette-specific sensorimotor activation processes rather than the tic. Forty-nine people with Tourette syndrome and 36 people with chronic tics completed 10 weeks of individual cognitive psychophysiological therapy. Outcome measures included two tic severity scales and psychosocial measures. Post-treatment both groups had significantly improved on the tic scales with strong effect sizes across tic locations and complex and simple tics, maintained at 6-month follow-up with further change in perfectionism and self-esteem. The cognitive psychophysiological approach targeting underlying sensorimotor processes rather than tics in Tourette's and chronic tic disorder reduced symptoms with a large effect size. © The Royal College of Psychiatrists 2016.

  11. Cognitive functioning in patients with affective disorders and schizophrenia: a meta-analysis.

    PubMed

    Stefanopoulou, Evgenia; Manoharan, Andiappan; Landau, Sabine; Geddes, John R; Goodwin, Guy; Frangou, Sophia

    2009-01-01

    There is considerable evidence for cognitive dysfunction in schizophrenia and affective disorders, but the pattern of potential similarities or differences between diagnostic groups remains uncertain. The objective of this study was to conduct a quantitative review of studies on cognitive performance in schizophrenia and affective disorders. Relevant articles were identified through literature search in major databases for the period between January 1980 and December 2005. Meta-analytic treatment of the original studies revealed widespread cognitive deficits in patients with schizophrenia and affective disorders in intellectual ability and speed of information processing, in encoding and retrieval, rule discovery and in response generation and response inhibition. Differences between diagnostic groups were quantitative rather than qualitative.

  12. Cognitive Profiles of Adults with Asperger's Disorder, High-Functioning Autism, and Pervasive Developmental Disorder Not Otherwise Specified Based on the WAIS-III

    ERIC Educational Resources Information Center

    Kanai, Chieko; Tani, Masayuki; Hashimoto, Ryuichiro; Yamada, Takashi; Ota, Haruhisa; Watanabe, Hiromi; Iwanami, Akira; Kato, Nobumasa

    2012-01-01

    Little is known about the cognitive profiles of high-functioning Pervasive Developmental Disorders (PDD) in adults based on the Wechsler Intelligence Scale III (WAIS-III). We examined cognitive profiles of adults with no intellectual disability (IQ greater than 70), and in adults with Asperger's disorder (AS; n = 47), high-functioning autism (HFA;…

  13. Cognitive Profiles of Adults with Asperger's Disorder, High-Functioning Autism, and Pervasive Developmental Disorder Not Otherwise Specified Based on the WAIS-III

    ERIC Educational Resources Information Center

    Kanai, Chieko; Tani, Masayuki; Hashimoto, Ryuichiro; Yamada, Takashi; Ota, Haruhisa; Watanabe, Hiromi; Iwanami, Akira; Kato, Nobumasa

    2012-01-01

    Little is known about the cognitive profiles of high-functioning Pervasive Developmental Disorders (PDD) in adults based on the Wechsler Intelligence Scale III (WAIS-III). We examined cognitive profiles of adults with no intellectual disability (IQ greater than 70), and in adults with Asperger's disorder (AS; n = 47), high-functioning autism (HFA;…

  14. Computational Neuropsychiatry – Schizophrenia as a Cognitive Brain Network Disorder

    PubMed Central

    Dauvermann, Maria R.; Whalley, Heather C.; Schmidt, André; Lee, Graham L.; Romaniuk, Liana; Roberts, Neil; Johnstone, Eve C.; Lawrie, Stephen M.; Moorhead, Thomas W. J.

    2014-01-01

    Computational modeling of functional brain networks in fMRI data has advanced the understanding of higher cognitive function. It is hypothesized that functional networks mediating higher cognitive processes are disrupted in people with schizophrenia. In this article, we review studies that applied measures of functional and effective connectivity to fMRI data during cognitive tasks, in particular working memory fMRI studies. We provide a conceptual summary of the main findings in fMRI data and their relationship with neurotransmitter systems, which are known to be altered in individuals with schizophrenia. We consider possible developments in computational neuropsychiatry, which are likely to further our understanding of how key functional networks are altered in schizophrenia. PMID:24723894

  15. Impact of emotion on cognition in trauma survivors: what is the role of posttraumatic stress disorder?

    PubMed

    Mueller-Pfeiffer, C; Martin-Soelch, C; Blair, J R; Carnier, A; Kaiser, N; Rufer, M; Schnyder, U; Hasler, G

    2010-10-01

    Cognitive theories of anxiety disorders postulate an increased attentional bias to environmental cues associated with threat that underlies the exaggerated fear response. The role of trauma, which may represent strong competitive advantage for attention, remains unclear. We investigated the influence of trauma exposure and the presence of anxiety/stress disorders on the impact of emotional distractors on cognitive performance. Fourteen trauma-exposed subjects with PTSD, 12 trauma-exposed subjects with anxiety disorders other than PTSD, 12 trauma-exposed healthy subjects and 19 non-trauma-exposed healthy controls participated in this study. The impact of emotion on cognition was determined by the Affective Stroop task that measures the effect of irrelevant emotional distractors on the speed of operant responding. The speed of cognitive performance was significantly reduced in the presence of negative distractors versus neutral or positive distractors in subjects with PTSD, while there was no significant influence of the distractor type on performance in the other diagnostic groups (diagnosis-by-distractor type interaction, p<0.001). While negative distractors induced the same levels of anxiety and depersonalization in subjects with PTSD and subjects with other anxiety disorders, distractor-induced depersonalization was associated with slowing of cognitive performance in PTSD (p=0.02) but not in other groups. Different types of anxiety disorders in the non-PTSD group might reduce the selectivity of the results; some subjects received medication possibly impacting on their cognitive functioning. The cognitive impairments in the presence of negative distractors specifically found in PTSD call for research into novel psychotherapeutic approaches, e.g. attentional training, for PTSD. Copyright 2010 Elsevier B.V. All rights reserved.

  16. The effect of overweight/obesity on cognitive function in euthymic individuals with bipolar disorder.

    PubMed

    Yim, C Y; Soczynska, J K; Kennedy, S H; Woldeyohannes, H O; Brietzke, E; McIntyre, R S

    2012-04-01

    Persistent impairment in cognitive function has been described in euthymic individuals with bipolar disorder. Collective work indicates that obesity is associated with reduced cognitive function in otherwise healthy individuals. This sub-group post-hoc analysis preliminarily explores and examines the association between overweight/obesity and cognitive function in euthymic individuals with bipolar disorder. Euthymic adults with DSM-IV-TR-defined bipolar I or II disorder were enrolled. Subjects included in this post-hoc analysis (n=67) were divided into two groups (normal weight, body mass index [BMI] of 18.5-24.9 kg/m2; overweight/obese, BMI ≥ 25.0 kg/m2). Demographic and clinical information were obtained at screening. At baseline, study participants completed a comprehensive cognitive battery to assess premorbid IQ, verbal learning and memory, attention and psychomotor processing speed, executive function, general intellectual abilities, recollection and habit memory, as well as self-perceptions of cognitive failures. BMI was negatively correlated with attention and psychomotor processing speed as measured by the Digit Symbol Substitution Test (P<0.01). Overweight and obese bipolar individuals had a significantly lower score on the verbal fluency test when compared to normal weight subjects (P<0.05). For all other measures of cognitive function, non-significant trends suggesting a negative association with BMI were observed, with the exception of measures of executive function (i.e., trail making test B) and recollection memory (i.e., process-dissociation task). Notwithstanding the post-hoc methodology and relatively small sample size, the results of this study suggest a possible negative effect of overweight/obesity on cognitive function in euthymic individuals with bipolar disorder. Taken together, these data provide the impetus for more rigorous evaluation of the mediational role of overweight/obesity (and other medical co-morbidity) on cognitive function in

  17. Caffeine intake from coffee or tea and cognitive disorders: a meta-analysis of observational studies.

    PubMed

    Kim, Young-Seok; Kwak, Sang Mi; Myung, Seung-Kwon

    2015-01-01

    Observational epidemiological studies such as cross-sectional, case-control, and cohort studies have reported inconsistent findings regarding the association between caffeine intake from coffee or tea and the risk of cognitive disorders such as dementia, Alzheimer's disease, cognitive impairment, and cognitive decline. We searched PubMed and EMBASE in September 2014. Three evaluators independently extracted and reviewed articles, based on predetermined selection criteria. Out of 293 articles identified through the search and bibliographies of relevant articles, 20 epidemiological studies from 19 articles, which involved 31,479 participants (8,398 in six cross-sectional studies, 4,601 in five case-control studies, and 19,918 in nine cohort studies), were included in the final analysis. The pooled odds ratio (OR) or relative risk (RR) of caffeine intake from coffee or tea for cognitive disorders (dementia, Alzheimer's disease, cognitive impairment, and cognitive decline) was 0.82 (95% confidence interval [CI], 0.67-1.01, I² = 63.2%) in a random-effects meta-analysis. In the subgroup meta-analysis by caffeine sources, the summary OR or RR of coffee intake was 0.83 (95% CI, 0.70-0.98; I² = 44.8%). However, in the subgroup meta-analysis by study design, the summary estimates (RR or OR) of coffee intake for cognitive disorders were 0.70 (95% CI, 0.50-0.98; I² = 42.0%) for cross-sectional studies, 0.82 (95% CI, 0.55-1.24; I² = 33.4%) for case-control studies, and 0.90 (95% CI, 0.59-1.36; I² = 60.0%) for cohort studies. This meta-analysis found that caffeine intake from coffee or tea was not associated with the risk of cognitive disorders.

  18. Introduction to the special section on cognitive bias modification in emotional disorders.

    PubMed

    Koster, Ernst H W; Fox, Elaine; MacLeod, Colin

    2009-02-01

    Cognitive models of anxiety disorders and unipolar depression have postulated that selective information processing plays an important role in the development and maintenance of emotional psychopathology. Cognitive bias modification (CBM) procedures have recently been developed to test this theoretical claim. The purpose of this special section is to introduce the central ideas underlying CBM and to bring together the research that exemplifies the theoretical and clinical potential of the CBM approach.

  19. Improving the Understanding of the Link between Cognition and Functional Capacity in Schizophrenia and Bipolar Disorder

    PubMed Central

    Moore, Raeanne C.; Harmell, Alexandrea L.; Harvey, Philip D.; Bowie, Christopher R.; Depp, Colin A.; Pulver, Ann E.; McGrath, John A; Patterson, Thomas L.; Cardenas, Veronica; Wolyniec, Paula; Thornquist, Mary H.; Luke, James R.; Palmer, Barton W.; Jeste, Dilip V.; Mausbach, Brent T.

    2015-01-01

    OBJECTIVE Deficits in cognitive functioning are related to functional disability in people with serious mental illness. Measures of functional capacity are commonly used as a proxy for functional disabilities for cognitive remediation programs, and robust linear relationships between functional capacity and cognitive deficits are frequently observed. This study aimed to determine whether a curvilinear relationship better approximates the association between cognitive functioning and functional capacity. METHOD Two independent samples were studied. Study 1: Participants with schizophrenia (n=435) and bipolar disorder (n=390) aged 18–83 completed a neuropsychological battery and a performance-based measure of functional capacity. Study 2: 205 participants with schizophrenia (age range=39–72) completed a brief neuropsychological screening battery and a performance-based measure of functional capacity. For both studies, linear and quadratic curve estimations were conducted with cognitive performance predicting functional capacity scores. RESULTS Significant linear and quadratic trends were observed for both studies. Study 1: In both the schizophrenia and bipolar participants, when cognitive composite z-scores were >0 (indicating normal to above normal performance), cognition was not related to functional capacity. Study 2: When neuropsychological screening battery z-scores were >−1 (indicating low average to average performance), cognition was not related to functional capacity. CONCLUSIONS These results illustrate that in cognitively normal adults with serious mental illness, the relationship between cognitive function and functional capacity is relatively weak. These findings may aid clinicians and researchers determine who may optimally benefit from cognitive remediation programs, with greater benefits possibly being achieved for individuals with cognitive deficits relative to individuals with normal cognition. PMID:26427917

  20. Social cognition mediates the relation between attachment schemas and posttraumatic stress disorder.

    PubMed

    Venta, Amanda; Hatkevich, Claire; Mellick, William; Vanwoerden, Salome; Sharp, Carla

    2017-01-01

    A social-cognitive perspective on posttraumatic stress disorder (PTSD) has been proposed and posits that impaired social cognition, rooted in attachment insecurity, plays a role in the development of PTSD. Support for the role of impaired social cognition in PTSD has been found in adults, but the social-cognitive perspective on PTSD has not been examined in adolescents. This study sought to explore differences in social cognition and PTSD on the basis of attachment security, and it examined social cognition as a mediator in the relation between attachment security and PTSD and with regard to PTSD symptom change during inpatient treatment. We recruited 142 adolescents from an inpatient psychiatric hospital, where adolescents and their parents completed assessments at admission and discharge. Adolescents with a secure attachment demonstrated better social-cognitive skills than did those with an insecure attachment. Social cognition mediated the relation between adolescents' maternal attachment representations and PTSD at admission across 3 self- and parent-report measures. Social cognition also mediated the relation between adolescents' maternal attachment representations at admission and PTSD treatment outcome. This study provides the 1st support for the application of Sharp, Fonagy, and Allen's (2012) social-cognitive perspective of PTSD to adolescents by showing a link between clinically significant symptoms of PTSD and attachment security through social-cognitive impairment. Findings indicate that improvement in PTSD during medium-stay inpatient treatment is partially driven by baseline attachment security and social-cognitive abilities, highlighting the potential of social-cognitive skills as important targets of clinical intervention among adolescents with PTSD. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. Childhood IQ and adult mental disorders: a test of the cognitive reserve hypothesis.

    PubMed

    Koenen, Karestan C; Moffitt, Terrie E; Roberts, Andrea L; Martin, Laurie T; Kubzansky, Laura; Harrington, HonaLee; Poulton, Richie; Caspi, Avshalom

    2009-01-01

    Cognitive reserve has been proposed as important in the etiology of neuropsychiatric disorders. However, tests of the association between premorbid IQ and adult mental disorders other than schizophrenia have been limited and inconclusive. The authors tested the hypothesis that low childhood IQ is associated with increased risk and severity of adult mental disorders. Participants were members of a representative 1972-1973 birth cohort of 1,037 males and females in Dunedin, New Zealand, who were followed up to age 32 with 96% retention. WISC-R IQ was assessed at ages 7, 9, and 11. Research diagnoses of DSM mental disorders were made at ages 18, 21, 26, and 32. Lower childhood IQ was associated with increased risk of developing schizophrenia spectrum disorder, adult depression, and adult anxiety. Lower childhood IQ was also associated with greater comorbidity and with persistence of depression; the association with persistence of generalized anxiety disorder was nearly significant. Higher childhood IQ predicted increased risk of adult mania. Lower cognitive reserve, as reflected by childhood IQ, is an antecedent of several common psychiatric disorders and also predicts persistence and comorbidity. Thus, many patients who seek mental health treatment may have lower cognitive ability; this should be considered in prevention and treatment planning.

  2. Cognitive, affective, and behavioral characteristics of mothers with anxiety disorders in the context of child anxiety disorder.

    PubMed

    Creswell, Cathy; Apetroaia, Adela; Murray, Lynne; Cooper, Peter

    2013-02-01

    Parental emotional distress, particularly high maternal anxiety, is one of the most consistent predictors of child anxiety treatment outcome. In order to identify the cognitive, affective, and behavioral parenting characteristics of mothers of children with anxiety disorders who themselves have an anxiety disorder, we assessed the expectations, appraisals, and behaviors of 88 mothers of anxious children (44 mothers who were not anxious [NONANX] and 44 mothers with a current anxiety disorder [ANX]) when interacting with their 7-12-year-old children. There were no observed differences in anxiety and avoidance among children of ANX and NONANX mothers, but, compared with NONANX mothers, ANX mothers held more negative expectations, and they differed on observations of intrusiveness, expressed anxiety, warmth, and the quality of the relationship. Associations were moderated by the degree to which children expressed anxiety during the tasks. Maternal-reported negative emotions during the task significantly mediated the association between maternal anxiety status and the observed quality of the relationship. These findings suggest that maternal anxiety disorder is associated with reduced tolerance of children's negative emotions. This may interfere with the maintenance of a positive, supportive mother-child interaction under conditions of stress and, as such, this may impede optimum treatment outcomes. The findings identify potential cognitive, affective, and behavioral targets to improve treatment outcomes for children with anxiety disorders in the context of a current maternal anxiety disorder. 2013 APA, all rights reserved

  3. Aerobic exercise to improve cognitive function in adults with neurological disorders: a systematic review.

    PubMed

    McDonnell, Michelle N; Smith, Ashleigh E; Mackintosh, Shylie F

    2011-07-01

    To evaluate whether aerobic exercise improves cognition in adults diagnosed with neurologic disorders. The Cochrane Central Register of Controlled Clinical Trials, MEDLINE, CINAHL, PubMed, EMBASE, PEDro, AMED, SPORTDiscus, PsycINFO, ERIC, and Google Scholar, with the last search performed in December 2010. We included controlled clinical trials and randomized controlled trials with adults diagnosed with a neurologic disorder. Studies were included if they compared a control group with a group involved in an aerobic exercise program to improve cardiorespiratory fitness and if they measured cognition as an outcome. Two reviewers independently extracted data and methodologic quality of the included trials. From the 67 trials reviewed, a total of 7 trials, involving 249 participants, were included. Two trials compared the effectiveness of yoga and aerobic exercise in adults with multiple sclerosis. Two trials evaluated the effect of exercise on patients with dementia, and 2 trials evaluated the effectiveness of exercise to improve cognition after traumatic brain injury. One trial studied the effect of a cycling program in people with chronic stroke. Lack of commonality between measures of cognition limited meta-analyses. Results from individual studies show that aerobic exercise improved cognition in people with dementia, improved attention and cognitive flexibility in patients with traumatic brain injury, improved choice reaction time in people with multiple sclerosis, and enhanced motor learning in people with chronic stroke. There is limited evidence to support the use of aerobic exercise to improve cognition in adults with neurologic disorders. Of the 67 studies retrieved, less than half included cognition as an outcome, and few studies continued the aerobic exercise program long enough to be considered effective. Further studies investigating the effect of aerobic exercise interventions on cognition in people with neurologic conditions are required. Copyright

  4. Assessing Cognitive Function in Bipolar Disorder: Challenges and Recommendations for Clinical Trial Design

    PubMed Central

    Burdick, Katherine E.; Ketter, Terence A.; Goldberg, Joseph F.; Calabrese, Joseph R.

    2015-01-01

    OBJECTIVE Neurocognitive impairment in schizophrenia has been recognized for more than a century. In contrast, only recently have significant neurocognitive deficits been recognized in bipolar disorder. Converging data suggest the importance of cognitive problems in relation to quality of life in bipolar disorder, highlighting the need for treatment and prevention efforts targeting cognition in bipolar patients. Future treatment trials targeting cognitive deficits will be met with methodological challenges due to the inherent complexity and heterogeneity of the disorder, including significant diagnostic comorbidities, the episodic nature of the illness, frequent use of polypharmacy, cognitive heterogeneity, and a lack of consensus regarding measurement of cognition and outcome in bipolar patients. Guidelines for use in designing future trials are needed. PARTICIPANTS The members of the consensus panel (each of the bylined authors) were selected based upon their expertise in bipolar disorder. Dr. Burdick is a neuropsychologist who has studied cognition in this illness for 15 years; Drs. Ketter, Calabrese, and Goldberg each bring considerable expertise in the treatment of bipolar disorder both within and outside of controlled clinical trials. This consensus statement was derived from work together at scientific meetings (e.g. symposium presention at the 2014 Annual meeting of the American Society of Clinical Psychopharmacology, among others) and ongoing discussions by conference call. With the exception of the public presentations on this topic, these meetings were closed to outside participants. EVIDENCE A literature review was undertaken by the authors to identify illness-specific challenges relevant to the design and conduct of treatment trials targeting neurocognition in bipolar disorder. Expert opinion from each of the authors guided the consensus recommendations. CONSENSUS PROCESS Consensus recommendations, reached by unanimous opinion of the authors, are

  5. Relationship of cognitive function and adjustment difficulties among children and adolescents with dissociative disorder

    PubMed Central

    Ranjan, Rajeev; Mehta, Manju; Sagar, Rajesh; Sarkar, Siddharth

    2016-01-01

    Background and Aims: Although it has been suggested that children and adolescents with dissociative disorder have some cognitive deficits, the association of these cognitive impairments with adjustment difficulties has not been evaluated. The present study aimed to assess the relationship between cognitive functioning and adjustment difficulties in children and adolescents with dissociative disorder. Methods: This cross-sectional, descriptive assessment was carried out in the outpatient setting of child and adolescent psychiatric service in a tertiary care hospital. Fifty newly diagnosed children and adolescents with dissociative disorder were included. The cognitive functions were assessed by varied neuropsychological tests, and Bell's adjustment inventory was used for assessing various domains of adjustment. Results: The mean age of the sample which comprised 40% males was 13.0 (±2.4) years. The mean intelligence quotient (IQ) of the sample was 90.6. Impairment in cognitive test was maximum for verbal working memory followed by sustained attention, visual learning and memory, and verbal retention and recall. Adjustment difficulties were greatest in the domains of self, followed by domains of health, school, and family. Significant association was found between the IQ and adjustment in school; visual learning and memory and adjustments in school and overall adjustment; and sustained attention and adjustment of health. Conclusions: Dissociative children have poor cognitive ability which may be related to poor adjustment scores. PMID:27114655

  6. Aberrant Expression of Histone Deacetylases 4 in Cognitive Disorders: Molecular Mechanisms and a Potential Target

    PubMed Central

    Wu, Yili; Hou, Fei; Wang, Xin; Kong, Qingsheng; Han, Xiaolin; Bai, Bo

    2016-01-01

    Histone acetylation is a major mechanism of chromatin remodeling, contributing to epigenetic regulation of gene transcription. Histone deacetylases (HDACs) are involved in both physiological and pathological conditions by regulating the status of histone acetylation. Although histone deacetylase 4 (HDAC4), a member of the HDAC family, may lack HDAC activity, it is actively involved in regulating the transcription of genes involved in synaptic plasticity, neuronal survival, and neurodevelopment by interacting with transcription factors, signal transduction molecules and HDAC3, another member of the HDAC family. HDAC4 is highly expressed in brain and its homeostasis is crucial for the maintenance of cognitive function. Accumulated evidence shows that HDAC4 expression is dysregulated in several brain disorders, including neurodegenerative diseases and mental disorders. Moreover, cognitive impairment is a characteristic feature of these diseases. It indicates that aberrant HDAC4 expression plays a pivotal role in cognitive impairment of these disorders. This review aims to describe the current understanding of HDAC4’s role in the maintenance of cognitive function and its dysregulation in neurodegenerative diseases and mental disorders, discuss underlying molecular mechanisms, and provide an outlook into targeting HDAC4 as a potential therapeutic approach to rescue cognitive impairment in these diseases. PMID:27847464

  7. Homework Adherence and Cognitive Behaviour Treatment Outcome for Children and Adolescents with Anxiety Disorders.

    PubMed

    Arendt, Kristian; Thastum, Mikael; Hougaard, Esben

    2016-03-01

    Homework assignments are considered an essential component for a successful outcome of cognitive behavioural therapy for youths with anxiety disorders. However, only two studies have examined the association between homework adherence and outcome of cognitive behavioural therapy for youths with anxiety disorders. The study examined the association between homework adherence and treatment outcome following a generic group cognitive behaviour treatment program (Cool Kids) for anxiety disordered youths and their parents. The treatment program was completed by 98 children and adolescents (ages 7-16). Homework adherence was measured as time spent doing homework assignments between each session, reported by youths as well as parents. Outcome criteria consisted of youth-reported anxiety symptoms and clinician rated severity of primary anxiety diagnosis at posttreatment and 3-month follow-up. Results did not support an association between homework adherence and treatment outcome when controlling for pretreatment severity. The study found no convincing evidence that homework adherence predicted outcome of cognitive behavioural therapy for youths with anxiety disorders. Reasons for divergent findings on homework adherence in cognitive behavioural therapy for youths compared to adults are discussed.

  8. Similar changes in cognitions following cognitive-behavioral therapy or escitalopram for major depressive disorder: Implications for mechanisms of change.

    PubMed

    Farabaugh, Amy; Fisher, Lauren; Nyer, Maren; Holt, Daphne; Cohen, Mariana; Baer, Lee; Shapero, Benjamin G; Huz, Ilana; Cardoos, Amber; Fava, Maurizio; Alpert, Jonathan E

    2015-05-01

    Psychosocial treatments and medications both have been shown to be effective in treating major depressive disorder. We hypothesized that cognitive-behavioral therapy (CBT) would outperform medication on measures of cognitive change. We randomized depressed individuals to 12 weeks of CBT (n = 15) or escitalopram (n = 11). In an intent-to-treat analysis (n = 26), we conducted a repeated measures analysis of variance to examine changes in depressive symptoms (ie, 17-item Hamilton Depression Rating Scale, Beck Depression Inventory), anhedonia (ie, Snaith-Hamilton Pleasure Scale), cognitive measures (ie, Dysfunctional Attitudes Scale, Automatic Thoughts Questionnaire, Perceived Stress Scale), and quality of life (ie, Quality of Life Enjoyment and Satisfaction Questionnaire) at 4 time points: baseline, week 4, week 8, and week 12. Treatment for both groups started at baseline, and patients received either 12 weeks of individual CBT or 12 weeks of escitalopram with flexible dosing (10 to 20 mg). Collapsing the escitalopram and CBT groups, there were statistically significant pre-post changes on all outcome measures. However, there were no statistically significant differences between treatment groups on any of the outcome measures, including cognitive measures across time points. Our results suggest that both CBT and escitalopram have similar effects across a variety of domains and that, in contrast to our a priori hypothesis, CBT and escitalopram were associated with comparable changes on cognitive measures.

  9. Measurement of Psychological Disorders Using Cognitive Diagnosis Models

    ERIC Educational Resources Information Center

    Templin, Jonathan L.; Henson, Robert A.

    2006-01-01

    Cognitive diagnosis models are constrained (multiple classification) latent class models that characterize the relationship of questionnaire responses to a set of dichotomous latent variables. Having emanated from educational measurement, several aspects of such models seem well suited to use in psychological assessment and diagnosis. This article…

  10. Cognitive and Neural Correlates of Aging in Autism Spectrum Disorder

    DTIC Science & Technology

    2016-07-01

    Bayesian networks, machine learning 16. SECURITY CLASSIFICATION OF: 17. LIMITATION OF ABSTRACT 18. NUMBER OF PAGES 19a. NAME OF RESPONSIBLE PERSON...methods, we will use innovative machine learning and sparse Bayesian networks to combine structure, function, cognition, and symptom profiles to

  11. Dyslexia and Dyscalculia: Two Learning Disorders with Different Cognitive Profiles

    ERIC Educational Resources Information Center

    Landerl, Karin; Fussenegger, Barbara; Moll, Kristina; Willburger, Edith

    2009-01-01

    This study tests the hypothesis that dyslexia and dyscalculia are associated with two largely independent cognitive deficits, namely a phonological deficit in the case of dyslexia and a deficit in the number module in the case of dyscalculia. In four groups of 8- to 10-year-olds (42 control, 21 dyslexic, 20 dyscalculic, and 26…

  12. Measurement of Psychological Disorders Using Cognitive Diagnosis Models

    ERIC Educational Resources Information Center

    Templin, Jonathan L.; Henson, Robert A.

    2006-01-01

    Cognitive diagnosis models are constrained (multiple classification) latent class models that characterize the relationship of questionnaire responses to a set of dichotomous latent variables. Having emanated from educational measurement, several aspects of such models seem well suited to use in psychological assessment and diagnosis. This article…

  13. Cognitive-Behavioral Treatment of Late-Life Anxiety Disorders.

    ERIC Educational Resources Information Center

    Gorenstein, Ethan E.; Papp, Lazlo A.

    In the absence of data, pharmacotherapy with benzodiazepines has become the mainstay of anxiety management in the elderly population. However, the use of benzodiazepines in the elderly has many problems. Elderly persons are more sensitive to anti-anxiety medications and are subject to a variety of increased risks, including cognitive impairment,…

  14. Agnosia, apraxia, callosal disconnection and other specific cognitive disorders.

    PubMed

    Acciarresi, Monica

    2012-01-01

    Cortical function deficits have long been studied by anatomoclinic correlations. Recent functional imaging studies have allowed scientists to better understand which cerebral areas and which networks are involved in cognitive function deficit. This chapter will review the current knowledge on agnosia, apraxia and callosal disconnection syndromes.

  15. Dyslexia and Dyscalculia: Two Learning Disorders with Different Cognitive Profiles

    ERIC Educational Resources Information Center

    Landerl, Karin; Fussenegger, Barbara; Moll, Kristina; Willburger, Edith

    2009-01-01

    This study tests the hypothesis that dyslexia and dyscalculia are associated with two largely independent cognitive deficits, namely a phonological deficit in the case of dyslexia and a deficit in the number module in the case of dyscalculia. In four groups of 8- to 10-year-olds (42 control, 21 dyslexic, 20 dyscalculic, and 26…

  16. [Efficacy of cognitive behavioral therapy in the treatment of mood and anxiety disorders in adults].

    PubMed

    Sighvatsson, Magnús Blöndahl; Kristjánsdottir, Hafrún; Sigurdsson, Engibert; Sigurdsson, Jón Fridrik

    2011-11-01

    Cognitive behavioral therapy (CBT) represents that form of psychotherapy which has most research data to build on in the treatment of mood and anxiety disorders for adults. In this review we will introduce CBT and present the results of pertinent outcome research. Efficacy at the end of treatment is discussed, as well as long term effectiveness and the efficacy of combined treatment with medication and CBT. In addition, we discuss the pros and cons of group CBT compared to CBT in individual format, and comorbidity of mental disorders. According to this review CBT is efficacious for major depressive disorder, generalized anxiety disorder, panic disorder, post-traumatic stress disorder, obsessive compulsive disorder, social phobia and specific phobia. Efficacy of CBT is equal to or better than efficacy of drugs in the treatment of the above disorders, but there is less access to CBT. Longterm effectiveness of CBT appears to be good, but research on combined treatment is yet in its infancy and conclusions are premature on its place in treatment. Key words: Cognitive behavioral therapy, psychotropic treatment, efficacy, long-term effects, combined treatment, mental disorders, adults.

  17. Resting EEG theta activity predicts cognitive performance in attention-deficit hyperactivity disorder.

    PubMed

    Hermens, Daniel F; Soei, Eleonore X C; Clarke, Simon D; Kohn, Michael R; Gordon, Evian; Williams, Leanne M

    2005-04-01

    Quantitative electroencephalography has contributed significantly to elucidating the neurobiologic mechanisms of attention-deficit hyperactivity disorder. The most consistent and robust electroencephalographic disturbance in attention-deficit hyperactivity disorder has been abnormally increased theta band during resting conditions. Separate research using attention-demanding tests has elucidated cognitive disturbances that differentiate attention-deficit hyperactivity disorder. This study attempts to integrate electroencephalographic and neuropsychological indices to determine whether cognitive performance is specifically related to increased theta. Theta activity was recorded during a resting condition for 46 children/adolescents with attention-deficit hyperactivity disorder and their sex- and age-matched control subjects. Accuracy and reaction time during an auditory oddball and a visual continuous performance test were then recorded. Compared with control subjects, the attention-deficit hyperactivity disorder group manifested significantly increased (primarily left) frontal theta. Furthermore, the attention-deficit hyperactivity disorder group scored significantly delayed reaction time and decreased accuracy in both tasks. Correlation analysis revealed a significant relationship between frontal (primarily left) theta and oddball accuracy for the attention-deficit hyperactivity disorder group compared with a significant relationship between posterior (primarily right) theta and reaction time in the continuous performance test for the control group. These results indicate that spatial neurophysiologic deficits in attention-deficit hyperactivity disorder may be related to disturbances in signal detection. This observation has important implications for the role of trait-like biologic deficits in attention-deficit hyperactivity disorder predicting performance in information processing.

  18. Efficacy of exposure versus cognitive therapy in anxiety disorders: systematic review and meta-analysis

    PubMed Central

    2011-01-01

    Background There is growing evidence of the effectiveness of Cognitive Behavioural Therapy (CBT) for a wide range of psychological disorders. There is a continued controversy about whether challenging maladaptive thoughts rather than use of behavioural interventions alone is associated with the greatest efficacy. However little is known about the relative efficacy of various components of CBT. This review aims to compare the relative efficacy of Cognitive Therapy (CT) versus Exposure (E) for a range of anxiety disorders using the most clinically relevant outcome measures and estimating the summary relative efficacy by combining the studies in a meta-analysis. Methods Psych INFO, MEDLINE and EMBASE were searched from the first available year to May 2010. All randomised controlled studies comparing the efficacy of exposure with cognitive therapy were included. Odds ratios (OR) or standardised means' differences (Hedges' g) for the most clinically relevant primary outcomes were calculated. Outcomes of the studies were grouped according to specific disorders and were combined in meta-analyses exploring short-term and long-term outcomes. Results 20 Randomised Controlled Trials with (n = 1,308) directly comparing the efficacy of CT and E in anxiety disorders were included in the meta-analysis. No statistically significant difference in the relative efficacy of CT and E was revealed in Post Traumatic Stress Disorder (PTSD), in Obsessive Compulsive Disorder (OCD) and in Panic Disorder (PD). There was a statistically significant difference favouring CT versus E in Social Phobia both in the short-term (Z = 3.72, p = 0.0002) and the long-term (Z = 3.28, p = 0.001) outcomes. Conclusions On the basis of extant literature, there appears to be no evidence of differential efficacy between cognitive therapy and exposure in PD, PTSD and OCD and strong evidence of superior efficacy of cognitive therapy in social phobia PMID:22185596

  19. Lifetime cannabis use and cognition in patients with schizophrenia spectrum disorders and their unaffected siblings.

    PubMed

    Sánchez-Torres, Ana M; Basterra, Virginia; Rosa, Araceli; Fañanás, Lourdes; Zarzuela, Amalia; Ibáñez, Berta; Peralta, Víctor; Cuesta, Manuel J

    2013-12-01

    The relationship between cannabis and cognitive performance is controversial. While both acute administration and long-term cannabis use impair cognitive performance in healthy subjects, several studies have shown improved cognitive outcomes in patients with schizophrenia spectrum disorders who use cannabis. The aim of this study was to determine the relationship between lifetime cannabis use, as assessed longitudinally over 10 years of follow-up in a sample of 42 patients and 35 of their unaffected siblings, and current cognitive performance. Forty-two healthy control subjects were assessed at follow-up with the same instruments. Stepwise linear regression revealed a negative effect of longitudinal cannabis use on performance in a social cognition task in the patient group. In the sibling group, lifetime cannabis use had a negative effect on processing speed and declarative memory performance. In the control group, cannabis use per se did not predict cognitive performance; however, when adding lifetime tobacco use to the model, we found a negative association between lifetime cannabis and tobacco use and processing speed and social cognition performance. Moreover, a lower IQ associated with current cannabis use predicted worse attentional performance in the control group. The differential pattern of associations between cannabis use and cognitive performance in patients compared with siblings and controls can be explained by the negative impact of illness on cognition.

  20. Cognitive Dysfunction in Major Depressive Disorder. A Translational Review in Animal Models of the Disease

    PubMed Central

    Darcet, Flavie; Gardier, Alain M.; Gaillard, Raphael; David, Denis J.; Guilloux, Jean-Philippe

    2016-01-01

    Major Depressive Disorder (MDD) is the most common psychiatric disease, affecting millions of people worldwide. In addition to the well-defined depressive symptoms, patients suffering from MDD consistently complain about cognitive disturbances, significantly exacerbating the burden of this illness. Among cognitive symptoms, impairments in attention, working memory, learning and memory or executive functions are often reported. However, available data about the heterogeneity of MDD patients and magnitude of cognitive symptoms through the different phases of MDD remain difficult to summarize. Thus, the first part of this review briefly overviewed clinical studies, focusing on the cognitive dysfunctions depending on the MDD type. As animal models are essential translational tools for underpinning the mechanisms of cognitive deficits in MDD, the second part of this review synthetized preclinical studies observing cognitive deficits in different rodent models of anxiety/depression. For each cognitive domain, we determined whether deficits could be shared across models. Particularly, we established whether specific stress-related procedures or unspecific criteria (such as species, sex or age) could segregate common cognitive alteration across models. Finally, the role of adult hippocampal neurogenesis in rodents in cognitive dysfunctions during MDD state was also discussed. PMID:26901205

  1. Cognitive impairments and predominant polarity in bipolar disorder: a cross-sectional study.

    PubMed

    Belizario, Gabriel Okawa; Gigante, Alexandre Duarte; de Almeida Rocca, Cristiana Castanho; Lafer, Beny

    2017-12-01

    Bipolar disorder (BD) patients exhibit cognitive impairments during euthymic states. Studies suggest that manic episodes may be correlated to cognitive impairments. The present study investigated the relationship between predominant polarity and the cognitive deficits frequently detected in bipolar patients. We hypothesize that mania predominant polarity (MPP) patients should exhibit greater cognitive impairments in comparison to depressive (DPP) and indefinite predominant polarity (IPP) patients and healthy control (HC) individuals. The study evaluated 55 euthymic BD patients, type I and II, and 31 HCs. Patients were divided into 3 groups: MPP (n = 17), DPP (n = 22), and IPP (n = 16), and compared regarding demographic and clinical variables, and performance on a 7-test neuropsychological battery. MPP patients demonstrated greater cognitive impairments in alternating attention, verbal fluency, and delayed memory in comparison to DPP, IPP, and HC. Compared to HC, IPP patients exhibit cognitive deficits in verbal fluency and alternating attention and DPP patients solely in verbal fluency. Furthermore, DPP patients did not exhibit, in none of the seven neuropsychological tests, significant poorer performances than MPP or IPP patients, although having significant more episodes than MPP patients. MPP patients exhibit increased cognitive impairments in comparison to DPP, IPP, and HC subjects. Manic episodes may play an important role in the development of cognitive deficits and thus, in potential neuroprogression. Predominant polarity may be an important specifier for predicting future cognitive impairments.

  2. Neural correlates of cognitive control in gambling disorder: a systematic review of fMRI studies.

    PubMed

    Moccia, Lorenzo; Pettorruso, Mauro; De Crescenzo, Franco; De Risio, Luisa; di Nuzzo, Luigi; Martinotti, Giovanni; Bifone, Angelo; Janiri, Luigi; Di Nicola, Marco

    2017-07-01

    Decreased cognitive control over the urge to be involved in gambling activities is a core feature of Gambling Disorder (GD). Cognitive control can be differentiated into several cognitive sub-processes pivotal in GD clinical phenomenology, such as response inhibition, conflict monitoring, decision-making, and cognitive flexibility. This article aims to systematically review fMRI studies, which investigated the neural mechanisms underlying diminished cognitive control in GD. We conducted a comprehensive literature search and collected neuropsychological and neuroimaging data investigating cognitive control in GD. We included a total of 14 studies comprising 499 individuals. Our results indicate that impaired activity in prefrontal cortex may account for decreased cognitive control in GD, contributing to the progressive loss of control over gambling urges. Among prefrontal regions, orbital and ventromedial areas seem to be a possible nexus for sensory integration, value-based decision-making and emotional processing, thus contributing to both motivational and affective aspects of cognitive control. Finally, we discussed possible therapeutic approaches aimed at the restoration of cognitive control in GD, including pharmacological and brain stimulation treatments. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Cognitive Dysfunction in Major Depressive Disorder. A Translational Review in Animal Models of the Disease.

    PubMed

    Darcet, Flavie; Gardier, Alain M; Gaillard, Raphael; David, Denis J; Guilloux, Jean-Philippe

    2016-02-17

    Major Depressive Disorder (MDD) is the most common psychiatric disease, affecting millions of people worldwide. In addition to the well-defined depressive symptoms, patients suffering from MDD consistently complain about cognitive disturbances, significantly exacerbating the burden of this illness. Among cognitive symptoms, impairments in attention, working memory, learning and memory or executive functions are often reported. However, available data about the heterogeneity of MDD patients and magnitude of cognitive symptoms through the different phases of MDD remain difficult to summarize. Thus, the first part of this review briefly overviewed clinical studies, focusing on the cognitive dysfunctions depending on the MDD type. As animal models are essential translational tools for underpinning the mechanisms of cognitive deficits in MDD, the second part of this review synthetized preclinical studies observing cognitive deficits in different rodent models of anxiety/depression. For each cognitive domain, we determined whether deficits could be shared across models. Particularly, we established whether specific stress-related procedures or unspecific criteria (such as species, sex or age) could segregate common cognitive alteration across models. Finally, the role of adult hippocampal neurogenesis in rodents in cognitive dysfunctions during MDD state was also discussed.

  4. Mechanisms of change in cognitive therapy for major depressive disorder in the community mental health setting.

    PubMed

    Crits-Christoph, Paul; Gallop, Robert; Diehl, Caroline K; Yin, Seohyun; Gibbons, Mary Beth Connolly

    2017-06-01

    This study examined the relation of change in theory-relevant cognitive variables to depressive symptom change over the course of cognitive therapy, as well as the specificity of change mechanisms to cognitive therapy as compared with dynamic therapy. There were 237 adult outpatients who were randomized to either cognitive (n = 119) or dynamic (n = 118) therapy for major depressive disorder in a community mental health setting. Assessments of compensatory skills (Ways of Responding Community Version and Self-Report Version), dysfunctional attitudes (Dysfunctional Attitudes Scale), and depressogenic schemas (Psychological Distance Scaling Task) were obtained at baseline and months 1, 2, and 5 following baseline. Primary outcome was measured using the Hamilton Rating Scale for Depression. Across both therapy conditions, change in all 3 cognitive domains was associated with concurrent change in depressive symptoms. After controlling for other cognitive variables, increased interconnectedness of the positive achievement-related schema was significantly associated with concurrent symptom change in cognitive (rp = .26, p < .001) but not dynamic therapy (rp = .08, p = .29). Increases in positive compensatory skills were associated with subsequent change in depressive symptoms in cognitive therapy (rp = -.36, p = .003), but not in dynamic therapy (rp = .11, p = .386). Results provide support for the compensatory skills model of cognitive therapy (CT) within a community mental health setting. Additional research is necessary to understand other possible mechanisms of change in CT in the community setting. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  5. Attachment and Social Cognition in borderline personality disorder: specificity in relation to antisocial and avoidant personality disorders

    PubMed Central

    Beeney, Joseph E.; Stepp, Stephanie D.; Hallquist, Michael N.; Scott, Lori N.; Wright, Aidan G.C.; Ellison, William D.; Nolf, Kimberly A.; Pilkonis, Paul A

    2014-01-01

    Theory and research point to the role of attachment difficulties in borderline personality disorder (BPD). Attachment insecurity is believed to lead to chronic problems in social relationships, due, in part, to impairments in social cognition, which comprise maladaptive mental representations of self, others, and self in relation to others. However, few studies have attempted to identify social cognitive mechanisms that link attachment insecurity to BPD and to assess whether such mechanisms are specific to the disorder. For the present study, empirically derived indices of mentalization, self-other boundaries, and identity diffusion were tested as mediators between attachment style and personality disorder symptoms. In a cross-sectional structural equation model, mentalization and self-other boundaries mediated the relationship between attachment anxiety and BPD. Mentalization partially mediated the relationship between attachment anxiety and antisocial personality disorder (PD) symptoms, and self-other boundaries mediated the relationship between attachment anxiety and avoidant PD symptoms. The findings support theories that insecure attachment is associated with difficulties in social cognition and that a distinctive pattern of impairment characterizes BPD. PMID:25705979

  6. [Sluggish cognitive tempo: symptoms of predominantly inattentive attention deficit hyperactivity disorder or a new clinical entity?].

    PubMed

    Capdevila-Brophy, C; Artigas-Pallarés, J; Obiols-Llandrich, J E

    2006-02-13

    The attention deficit/hyperactivity disorder (ADHD) is an heterogeneous entity with three accepted subtypes. This article reviews changes in the diagnostic criteria and controversies around the ADHD subtypes. We review the sluggish cognitive tempo, construct which has been associated with the ADHD predominantly inattentive subtype. We illustrate this construct through examining clinical cases that manifest 'sluggish cognitive tempo' symptoms. This article raises questions such as the utility of the sluggish cognitive tempo in the diagnosis of ADHD predominantly inattentive, and the possibility that it is a clinical entity not described up to the present date.

  7. Post-traumatic stress disorder: cognitive hypnotherapy, mindfulness, and acceptance-based treatment approaches.

    PubMed

    Lynn, Steven Jay; Malakataris, Anne; Condon, Liam; Maxwell, Reed; Cleere, Colleen

    2012-04-01

    In this article, we describe how cognitive hypnotherapy can be used in conjunction with evidence-based practices for the treatment of post-traumatic stress disorder (PTSD). We review cognitive-behavioral interventions for PTSD, including mindfulness and acceptance-based approaches, and contend that (a) empirical support for the use of hypnosis in treating a variety of conditions is considerable; (b) hypnosis is fundamentally a cognitive-behavioral intervention; (c) psychological interventions with a firm footing in cognitive-behavioral therapy (CBT) are well-suited to treat the symptoms of PTSD; and (d) hypnosis can be a useful adjunct to evidence-based cognitive-behavioral approaches, including mindfulness and acceptance-based interventions, for treating PTSD.

  8. Childhood Maltreatment and Development of Substance Use Disorders: A Review and a Model of Cognitive Pathways.

    PubMed

    Edalati, Hanie; Krank, Marvin D

    2016-12-01

    Exposure to childhood maltreatment (CM) is associated with increased risk for developing substance use disorders (SUDs). CM exerts negative effects on cognitive abilities including intellectual performance, memory, attention, and executive function. Parallel cognitive impairments have been observed in SUDs. Hence, limited studies have examined the mediating effect of cognitive impairments in the relationship between CM and SUDs. In addition, most studies used concurrent self-report assessments in adult populations. Longitudinal studies that investigated the long-term consequences of CM on psychopathology, including SUDs, throughout childhood, adolescence, and adulthood are rare. Thus, the underlying developmental pathways between CM and SUDs are not clearly understood. In this article, we review the evidence that cognitive impairments mediate, at least in part, the relationship between CM and development of SUDs and propose a model that explains how CM increases the risk for SUDs through the development of a cognitive framework of vulnerability. © The Author(s) 2015.

  9. Involvement of Neuroinflammation during Brain Development in Social Cognitive Deficits in Autism Spectrum Disorder and Schizophrenia.

    PubMed

    Nakagawa, Yutaka; Chiba, Kenji

    2016-09-01

    Development of social cognition, a unique and high-order function, depends on brain maturation from childhood to adulthood in humans. Autism spectrum disorder (ASD) and schizophrenia have similar social cognitive deficits, although age of onset in each disorder is different. Pathogenesis of these disorders is complex and contains several features, including genetic risk factors, environmental risk factors, and sites of abnormalities in the brain. Although several hypotheses have been postulated, they seem to be insufficient to explain how brain alterations associated with symptoms in these disorders develop at distinct developmental stages. Development of ASD appears to be related to cerebellar dysfunction and subsequent thalamic hyperactivation in early childhood. By contrast, schizophrenia seems to be triggered by thalamic hyperactivation in late adolescence, whereas hippocampal aberration has been possibly initiated in childhood. One of the possible culprits is metal homeostasis disturbances that can induce dysfunction of blood-cerebrospinal fluid barrier. Thalamic hyperactivation is thought to be induced by microglia-mediated neuroinflammation and abnormalities of intracerebral environment. Consequently, it is likely that the thalamic hyperactivation triggers dysregulation of the dorsolateral prefrontal cortex for lower brain regions related to social cognition. In this review, we summarize the brain aberration in ASD and schizophrenia and provide a possible mechanism underlying social cognitive deficits in these disorders based on their distinct ages of onset. Copyright © 2016 by The American Society for Pharmacology and Experimental Therapeutics.

  10. Cognitive functioning and deep transcranial magnetic stimulation (DTMS) in major psychiatric disorders: A systematic review.

    PubMed

    Kedzior, Karina Karolina; Gierke, Lioba; Gellersen, Helena Marie; Berlim, Marcelo T

    2016-04-01

    Deep transcranial magnetic stimulation (DTMS) is a non-invasive brain stimulation method mostly utilised in the treatment of major depression. The aim of the current study was to systematically review the literature on the cognitive effects of DTMS applied with the H-coil system in major psychiatric disorders. Following a literature search in PsycInfo and PubMed (any time to December 2015), 13 out of 32 studies on DTMS and cognitive functioning were included in the current review. Three studies included 38 healthy participants, eight studies included 158 unipolar or bipolar depression patients and two studies included 45 schizophrenia patients. Low-frequency DTMS (1-3 sessions) had little effect on cognitive functioning in healthy participants. The most consistent cognitive and clinical improvements were reported in the short-term (after 20 daily sessions of high-frequency DTMS with H1-coil) in studies with major depression patients. There was also a trend towards a short-term cognitive and clinical improvement in studies with schizophrenia patients. High-frequency DTMS might improve cognitive functioning and alleviate clinical symptoms in the short-term, particularly in major depression. However, this conclusion is based on data from mostly uncontrolled, open-label studies with patients receiving concurrent antidepressants or antipsychotics. Randomised, sham-controlled trials are needed to investigate the magnitude of the cognitive outcomes of DTMS in the short-term and beyond the daily stimulation phase in major psychiatric disorders.

  11. Negative cognitive styles synergistically predict suicidal ideation in bipolar spectrum disorders: a 3-year prospective study.

    PubMed

    Stange, Jonathan P; Hamilton, Jessica L; Burke, Taylor A; Kleiman, Evan M; O'Garro-Moore, Jared K; Seligman, Nicole D; Abramson, Lyn Y; Alloy, Lauren B

    2015-03-30

    Rates of suicidal ideation and behavior are extremely high in bipolar spectrum disorders (BSDs). However, relatively little work has evaluated potentially synergistic relationships between cognitive and emotion-regulatory processes proposed by theoretical models of suicidality in BSDs. The present study evaluated whether negative cognitive style and subtypes of rumination would exacerbate the impact of self-criticism on suicidal ideation in a prospective study of individuals with BSDs. Seventy-two young adults with BSDs (bipolar II, bipolar NOS, or cyclothymia) completed diagnostic interviews and trait measures of self-criticism, negative cognitive style, and brooding and reflective rumination at a baseline assessment. The occurrence of suicidal ideation was assessed as part of diagnostic interviews completed every 4 months for an average of 3 years of follow-up. Negative cognitive style and reflective rumination strengthened the association between self-criticism and the prospective occurrence of suicidal ideation across follow-up. Individuals with high levels of self-criticism in conjunction with negative cognitive style or reflective rumination were most likely to experience the onset of suicidal ideation. Self-criticism may work synergistically with negative cognitive style and rumination to confer risk for suicidal ideation in bipolar spectrum disorders. These results support theoretical models of suicidality in BSDs and indicate that evaluating and understanding negative cognitive styles may help to identify individuals who are at risk of suicide.

  12. [Disturbances of social cognition in schizophrenia and bipolar disorder--similarities and differences].

    PubMed

    Bodnar, Anna; Andrzejewska, Marta; Rybakowski, Janusz

    2014-01-01

    In the first part of the article, two aspects of social cognition, such as the Theory of Mind (ToM), i.e. the ability to infer about mental and affective states of other people, having both cognitive and perceptive aspects as well as empathy, i.e. the ability to understand other person's perspective and take an emotional response of the observer to the affective state of the other person, were presented. Next, research on social cognition in schizophrenia and bipolar disorder (BD) has been reviewed, and the disturbances, observed in these two illnesses were compared, with particular emphasis on studies investigating social cognition in both schizophrenia and BD. The results of studies show that ToM disturbances occur both in schizophrenia and BD patients, however, in schizophrenia they are of greater severity. As for empathy, patients with schizophrenia have significant disturbances of recognizing emotions, as well as of cognitive and affective empathy. Patients with BD do not have abnormalities in cognitive empathy, have lesser disturbances of emotion recognition disorder compared with schizophrenia and show a connection between disturbances of affective empathy and the course of the disease (time period after manic or depressive episode). Further exploration of these issues seems important in order to determine to what extent the disturbances of social cognition can influence social and professional life of patients. It is also a potential area for therapeutic interventions supportive to pharmacotherapy.

  13. [Cognitive Profiles of Preschool Children with Developmental Coordination Disorders and ADHD].

    PubMed

    Jascenoka, Julia; Korsch, Franziska; Petermann, Franz; Petermann, Ulrike

    2015-01-01

    Cognitive Profiles of Preschool Children with Developmental Coordination Disorders and ADHD Studies confirm that developmental coordination disorders (DCD) are often accompanied by ADHD. It is important to know why children with combined disorders show a special profile in a common intelligence test (WPPSI-III). For this purpose, the WPPSI-III results of a total of 125 children aged five to six years with diagnosed isolated DCD, isolated ADHD, combined disorders and a normative sample were compared. Children with isolated ADHD showed the best cognitive profile. Children of all three diagnosis subgroups presented significantly poorer abilities in all WPPSI-III scales than the normative sample. In comparison with preschoolers showing isolated ADHD, children with DCD and ADHD have a significant lower Processing Speed Quotient.

  14. Longitudinal changes in cognition in early Parkinson's disease patients with REM sleep behavior disorder.

    PubMed

    Chahine, L M; Xie, S X; Simuni, T; Tran, B; Postuma, R; Amara, A; Oertel, W H; Iranzo, A; Scordia, C; Fullard, M; Linder, C; Purri, R; Darin, A; Rennert, L; Videnovic, A; Del Riva, P; Weintraub, D

    2016-06-01

    Cognitive decline is common in Parkinson's disease (PD), and identifying patients at highest risk for it is essential. We aimed to examine the effect of possible REM sleep behavior disorder (pRBD) on rate of cognitive decline in early PD, for both global cognition and in specific cognitive domains. Parkinson's Progression Markers Initiative (PPMI) is a multi-site, international study of PD patients untreated at enrollment. pRBD was assessed with the REM sleep behavior disorder questionnaire (RBDSQ). Global cognition was assessed at baseline and annually using the Montreal Cognitive Assessment (MoCA) and a cognitive battery. Linear mixed effects models were used to examine the relationship between pRBD (RBDSQ≥6) and rate of change in cognitive variables. Age, sex, years of education, and baseline motor and cognitive scores were included as covariates. The baseline sample consisted of 423 individuals with PD, mean age 61.7 years and 65.5% male. Data was available on 389, 366, and 196 participants at 1-year, 2-year, and 3-year follow-up respectively. Possible RBD occurred in 108 (25.5%) at baseline. In multivariate analyses, baseline RBD was associated with greater annual rate of decline in MoCA score (β = -0.34, 95%CI -0.54, -0.13, p < 0.001), Symbol Digit Modalities Test (β = -0.69, 95%CI -1.3, -0.09, p = 0.024), and Hopkins Verbal Learning Test-Revised, delayed free recall (β = -0.21, 95%CI -0.41, -0.013, p = 0.037). Possible RBD is common in early PD and predicts future cognitive decline, particularly in attention and memory domains. Copyright © 2016. Published by Elsevier Ltd.

  15. The Role of Working Memory for Cognitive Control in Anorexia Nervosa versus Substance Use Disorder.

    PubMed

    Brooks, Samantha J; Funk, Sabina G; Young, Susanne Y; Schiöth, Helgi B

    2017-01-01

    Prefrontal cortex executive functions, such as working memory (WM) interact with limbic processes to foster impulse control. Such an interaction is referred to in a growing body of publications by terms such as cognitive control, cognitive inhibition, affect regulation, self-regulation, top-down control, and cognitive-emotion interaction. The rising trend of research into cognitive control of impulsivity, using various related terms reflects the importance of research into impulse control, as failure to employ cognitions optimally may eventually result in mental disorder. Against this background, we take a novel approach using an impulse control spectrum model - where anorexia nervosa (AN) and substance use disorder (SUD) are at opposite extremes - to examine the role of WM for cognitive control. With this aim, we first summarize WM processes in the healthy brain in order to frame a systematic review of the neuropsychological, neural and genetic findings of AN and SUD. In our systematic review of WM/cognitive control, we found n = 15 studies of AN with a total of n = 582 AN and n = 365 HC participants; and n = 93 studies of SUD with n = 9106 SUD and n = 3028 HC participants. In particular, we consider how WM load/capacity may support the neural process of excessive epistemic foraging (cognitive sampling of the environment to test predictions about the world) in AN that reduces distraction from salient stimuli. We also consider the link between WM and cognitive control in people with SUD who are prone to 'jumping to conclusions' and reduced epistemic foraging. Finally, in light of our review, we consider WM training as a novel research tool and an adjunct to enhance treatment that improves cognitive control of impulsivity.

  16. Assessment of subjective and objective cognitive function in bipolar disorder: Correlations, predictors and the relation to psychosocial function.

    PubMed

    Demant, Kirsa M; Vinberg, Maj; Kessing, Lars V; Miskowiak, Kamilla W

    2015-09-30

    Cognitive dysfunction is prevalent in bipolar disorder (BD). However, the evidence regarding the association between subjective cognitive complaints, objective cognitive performance and psychosocial function is sparse and inconsistent. Seventy seven patients with bipolar disorder who presented cognitive complaints underwent assessment of objective and subjective cognitive function and psychosocial functioning as part of their participation in two clinical trials. We investigated the association between global and domain-specific objective and subjective cognitive function and between global cognitive function and psychosocial function. We also identified clinical variables that predicted objective and subjective cognitive function and psychosocial functioning. There was a correlation between global subjective and objective measures of cognitive dysfunction but not within the individual cognitive domains. However, the correlation was weak, suggesting that cognitive complaints are not an assay of cognition per se. Self-rated psychosocial difficulties were associated with subjective (but not objective) cognitive impairment and both subjective cognitive and psychosocial difficulties were predicted by depressive symptoms. Our findings indicate that adequate assessment of cognition in the clinical treatment of BD and in drug trials targeting cognition requires implementation of not only subjective measures but also of objective neuropsychological tests. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  17. Meta-Cognitions in Tourette Syndrome, Tic Disorders, and Body-Focused Repetitive Disorder

    PubMed Central

    O’Connor, Kieron; St-Pierre-Delorme, Marie-Ève; Leclerc, Julie; Lavoie, Marc; Blais, Mélodie T

    2014-01-01

    Objective To explore if self-reported presence of thinking about tics or body-focused repetitive behaviours (BFRBs; gests) are direct triggers of tic or gest onset in 3 groups: Tourette syndrome (TS; n =18), persistent chronic tic disorders (TDs; n = 42), and a comparison group with BFRB (n = 36). Method: The 3 groups completed a thinking about tics inventory, listing 22 items derived from clinician consensus that asked whether thoughts always, sometimes, or never exclusively triggered tic onset. Other questionnaires measured mood, perfectionism, impulsivity, premonitory urge, and self-rated tension. Sixty-three participants completed the inventory twice, and the inventory was completed pre- and post-behavioural intervention by a further 54. Results: The ranking of the thoughts reported as likely to trigger tics or gests was positively correlated across TD and BFRB groups. Exploratory principal components analysis of a reduced 12-item set (the thinking about tics inventory) in TS and TD groups revealed that such thoughts could be grouped into 3 separate subscales: thoughts about the interference of tics or gests, thoughts anticipating tics or gests, and thoughts about whether the person has permission to perform the tic or the gest. The 3 sets of subscales showed good and acceptable internal consistency and overall score showed good test–retest reliability, suggesting thoughts about tics or gests are robust and measurable. The subscales correlated with impulsivity, tic or behaviour severity, and ratings of frequency decreased post-behavioural treatment. Conclusions: Thinking about tics or gests is reported as triggering tics or gests in both TD and BFRB, and meta-cognition seems independent of premonitory sensations and relates to distinct clinical characteristics in each clinical group. PMID:25161066

  18. Meta-cognitions in tourette syndrome, tic disorders, and body-focused repetitive disorder.

    PubMed

    O'Connor, Kieron; St-Pierre-Delorme, Marie-Ève; Leclerc, Julie; Lavoie, Marc; Blais, Mélodie T

    2014-08-01

    To explore if self-reported presence of thinking about tics or body-focused repetitive behaviours (BFRBs; gests) are direct triggers of tic or gest onset in 3 groups: Tourette syndrome (TS; n =18), persistent chronic tic disorders (TDs; n = 42), and a comparison group with BFRB (n = 36). The 3 groups completed a thinking about tics inventory, listing 22 items derived from clinician consensus that asked whether thoughts always, sometimes, or never exclusively triggered tic onset. Other questionnaires measured mood, perfectionism, impulsivity, premonitory urge, and self-rated tension. Sixty-three participants completed the inventory twice, and the inventory was completed pre- and post-behavioural intervention by a further 54. The ranking of the thoughts reported as likely to trigger tics or gests was positively correlated across TD and BFRB groups. Exploratory principal components analysis of a reduced 12-item set (the thinking about tics inventory) in TS and TD groups revealed that such thoughts could be grouped into 3 separate subscales: thoughts about the interference of tics or gests, thoughts anticipating tics or gests, and thoughts about whether the person has permission to perform the tic or the gest. The 3 sets of subscales showed good and acceptable internal consistency and overall score showed good test-retest reliability, suggesting thoughts about tics or gests are robust and measurable. The subscales correlated with impulsivity, tic or behaviour severity, and ratings of frequency decreased post-behavioural treatment. Thinking about tics or gests is reported as triggering tics or gests in both TD and BFRB, and meta-cognition seems independent of premonitory sensations and relates to distinct clinical characteristics in each clinical group.

  19. Motor-Cognitive Dual-Task Training in Neurologic Disorders: A Systematic Review

    PubMed Central

    Fritz, NE; Cheek, FM; Nichols-Larsen, DS

    2015-01-01

    Background and Purpose Deficits in motor-cognitive dual-tasks (e.g., walking while talking) are common in individuals with neurological conditions. This review was conducted to determine the effectiveness of motor-cognitive dual-task training (DTT) compared to usual care on mobility and cognition in individuals with neurologic disorders. Methods Databases searched were Biosis, CINAHL, ERIC, PsychInfo, EBSCO Psychological & Behavioral, PubMed, Scopus, and Web of Knowledge. Eligibility criteria were studies of adults with neurologic disorders that included DTT and outcomes of gait or balance were included. Fourteen studies met inclusion criteria. Participants were individuals with brain injury, Parkinson’s disease (PD) and Alzheimer’s disease (AD). Intervention protocols included cued walking, cognitive tasks paired with gait, balance, and strength training and virtual reality or gaming. Quality of the included trials was evaluated with a standardized rating scale of clinical relevance. Results Results show that DTT improves single-task gait velocity and stride length in PD and AD, dual-task gait velocity and stride length in PD, AD and brain injury, and may improve balance and cognition in PD and AD. The inclusion criteria limited the diagnostic groups included. Discussion and Conclusions The range of training protocols and outcome assessments in available studies limited comparison of the results across studies. Improvement of dual-task ability in individuals with neurologic disorders holds potential for improving gait, balance and cognition. Motor-cognitive dual-task deficits in individuals with neurologic disorders may be amenable to training. Video Abstract available for additional insights from the authors (See Supplemental Digital Content). PMID:26079569

  20. Anhedonia and cognitive function in adults with MDD: results from the International Mood Disorders Collaborative Project.

    PubMed

    McIntyre, Roger S; Woldeyohannes, Hanna O; Soczynska, Joanna K; Maruschak, Nadia A; Wium-Andersen, Ida K; Vinberg, Maj; Cha, Danielle S; Lee, Yena; Xiao, Holly X; Gallaugher, Laura Ashley; Dale, Roman M; Alsuwaidan, Mohammad T; Mansur, Rodrigo B; Muzina, David J; Carvalho, Andre F; Jerrell, Jeanette M; Kennedy, Sidney H

    2016-10-01

    Cognitive dysfunction is common in major depressive disorder (MDD) and a critical determinant of health outcome. Anhedonia is a criterion item toward the diagnosis of a major depressive episode (MDE) and a well-characterized domain in MDD. We sought to determine the extent to which variability in self-reported cognitive function correlates with anhedonia. A post hoc analysis was conducted using data from (N=369) participants with a Diagnostic and Statistical Manual of Mental Disorders, 4th Edition, Text Revision (DSM-IV-TR)-defined diagnosis of MDD who were enrolled in the International Mood Disorders Collaborative Project (IMDCP) between January 2008 and July 2013. The IMDCP is a collaborative research platform at the Mood Disorders Psychopharmacology Unit, University of Toronto, Toronto, Canada, and the Cleveland Clinic, Cleveland, Ohio. Measures of cognitive function, anhedonia, and depression severity were analyzed using linear regression equations. A total of 369 adults with DSM-IV-TR-defined MDD were included in this analysis. Self-rated cognitive impairment [ie, as measured by the Adult ADHD Self-Report Scale (ASRS)] was significantly correlated with a proxy measure of anhedonia (r=0.131, p=0.012). Moreover, total depression symptom severity, as measured by the total Montgomery-Åsberg Depression Rating Scale (MADRS) score, was also significantly correlated with self-rated measures of cognitive dysfunction (r=0.147, p=0.005). The association between anhedonia and self-rated cognitive dysfunction remained significant after adjusting for illness severity (r=0.162, p=0.007). These preliminary results provide empirical data for the testable hypothesis that anhedonia and self-reported cognitive function in MDD are correlated yet dissociable domains. The foregoing observation supports the hypothesis of overlapping yet discrete neurobiological substrates for these domains.

  1. Meta-Analysis of Milk Consumption and the Risk of Cognitive Disorders

    PubMed Central

    Wu, Lei; Sun, Dali

    2016-01-01

    The association between milk intake and cognitive disorders has been investigated in several epidemiological studies, but the findings are still conflicting. No quantitative assessment has been performed to evaluate the potential relationship of milk intake and cognitive disorders. From the inception to October 2016, the PubMed and the Embase databases were searched for observational studies reporting the association of milk consumption and cognitive disorders (Alzheimer’s disease, dementia, and cognitive decline/impairment). A generic inverse-variance random-effects method was used to pool the Odds Ratios (ORs) and corresponding 95% confidence intervals (CIs) for the highest compared with the lowest level of milk intake. Subgroup and meta-regression analyses were used to assess the heterogeneity between subgroups. We identified seven articles involving a total of 10,941 participants. The highest level of milk consumption was significantly associated with a decreased risk of cognitive disorders, and the pooled OR (95% CI) was 0.72 (0.56, 0.93), with evidence of significant heterogeneity (I2 = 64%, p = 0.001). Subgroup analysis indicated that the association was more pronounced in ischemic stroke patients based on a single study. Furthermore, the inverse association between milk intake and cognitive disorders was limited to Asian subjects, and the African populations showed an intermediate non-significant trend. Although we have obtained a significant association, an established relationship cannot be drawn due to the study limitation. Large prospective studies are needed to quantify the potential dose-response patterns of milk intake and to explore the association in populations with different characteristics. PMID:27999380

  2. Integrated Cognitive Behavioral Therapy for Comorbid Cannabis Use and Anxiety Disorders

    PubMed Central

    Buckner, Julia D.; Ecker, Anthony H.; Beighley, Jennifer S.; Zvolensky, Michael J.; Schmidt, Norman B.; Shah, Sonia M.; Carroll, Kathleen M.

    2016-01-01

    Cannabis use disorders (CUDs) co-occur with anxiety disorders at high rates, presumably because some individuals with anxiety disorders may rely on cannabis to manage anxiety. Motivation enhancement therapy (MET) combined with cognitive-behavioral therapy (CBT) is an efficacious intervention for CUD, yet outcomes are worse for patients with elevated anxiety. The integration of MET-CBT with False Safety Behavior Elimination Treatment (FSET) may be useful with anxious CUD patients, as the use of cannabis to manage anxiety can be targeted as a false safety behavior. Here, we describe the integrated treatment and the successful use of it among two patients—one with CUD and comorbid social anxiety disorder (SAD) and one with CUD and comorbid SAD and generalized anxiety disorder. Data support the feasibility of this integrated treatment as a viable approach to the treatment of CUD and comorbid anxiety disorders. Future controlled trials are now warranted to further evaluate the intervention. PMID:28603457

  3. Integrated Cognitive Behavioral Therapy for Comorbid Cannabis Use and Anxiety Disorders.

    PubMed

    Buckner, Julia D; Ecker, Anthony H; Beighley, Jennifer S; Zvolensky, Michael J; Schmidt, Norman B; Shah, Sonia M; Carroll, Kathleen M

    2016-02-01

    Cannabis use disorders (CUDs) co-occur with anxiety disorders at high rates, presumably because some individuals with anxiety disorders may rely on cannabis to manage anxiety. Motivation enhancement therapy (MET) combined with cognitive-behavioral therapy (CBT) is an efficacious intervention for CUD, yet outcomes are worse for patients with elevated anxiety. The integration of MET-CBT with False Safety Behavior Elimination Treatment (FSET) may be useful with anxious CUD patients, as the use of cannabis to manage anxiety can be targeted as a false safety behavior. Here, we describe the integrated treatment and the successful use of it among two patients-one with CUD and comorbid social anxiety disorder (SAD) and one with CUD and comorbid SAD and generalized anxiety disorder. Data support the feasibility of this integrated treatment as a viable approach to the treatment of CUD and comorbid anxiety disorders. Future controlled trials are now warranted to further evaluate the intervention.

  4. Using the Brief Assessment of Cognition in Schizophrenia (BACS) to assess cognitive impairment in older patients with schizophrenia and bipolar disorder.

    PubMed

    Cholet, Jennyfer; Sauvaget, Anne; Vanelle, Jean-Marie; Hommet, Caroline; Mondon, Karl; Mamet, Jean-Philippe; Camus, Vincent

    2014-05-01

    A growing body of evidence suggests that impairment in cognitive functioning is an important clinical feature of both schizophrenia and bipolar disorder, and that these cognitive alterations worsen with age. Although cognitive assessments are increasingly becoming a part of research and clinical practice in schizophrenia, a standardized and easily administered test battery for elderly patients with bipolar disorder is still lacking. The Brief Assessment of Cognition in Schizophrenia (BACS) captures those domains of cognition that are the most severely affected in patients with schizophrenia and the most strongly correlated with functional outcome. The primary aim of our study was to investigate the clinical usefulness of the BACS in assessing cognitive functioning in elderly euthymic patients with bipolar disorder, and to compare their cognitive profile to that of elderly patients with schizophrenia. Elderly euthymic patients with bipolar disorder or schizophrenia were assessed using the BACS and a standard cognitive test battery. Fifty-seven elderly patients (aged 60 years and older) with bipolar disorder (n = 42) or schizophrenia (n = 15) were invited to participate. All of the patients were assessed by the BACS as being cognitively impaired. The patients with bipolar disorder scored significantly higher on the global scale and the verbal memory and attention sub-scores of the BACS than the patients with schizophrenia. The BACS appears to be a feasible and informative cognitive assessment tool for elderly patients with bipolar disorder. We believe that these preliminary results merit further investigation. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. A Placebo-Controlled Adjunctive Trial of Pramipexole in Patients with Bipolar Disorder: Targeting Cognitive Dysfunction

    PubMed Central

    Burdick, Katherine E.; Braga, Raphael J; Nnadi, Charles U.; Shaya, Yaniv; Stearns, Walter H.; Malhotra, Anil K.

    2015-01-01

    Objective Patients with bipolar disorder suffer from significant cognitive impairment which contributes directly to functional disability in bipolar patients, yet few studies have targeted these symptoms for treatment and the optimal study design remains unclear. We evaluated the effects of the dopamine D2/D3 receptor agonist, pramipexole, on cognition in bipolar disorder. Methods 50 DSM-IV stable bipolar I outpatients enrolled in an 8-week, double-blind, randomized, placebo-controlled cognitive enhancement trial. Patients completed neurocognitive testing at baseline and at week 8. Symptoms and side effects were monitored weekly. Results Forty-five patients completed the study [Placebo (n=24); Pramipexole (n=21)] and groups were well-matched on demographic and clinical features. Primary cognitive analyses were negative; however, secondary analyses revealed some interesting results which serve to highlight several important methodological issues. Subsyndromal mood symptoms at baseline had a significant influence on the degree of improvement due to active drug, with strictly euthymic patients faring best. In addition, the degree of baseline cognitive impairment was also an important factor in treatment response. Conclusions Although largely interpreted as a negative cognitive enhancement trial, our data suggest a potentially beneficial effect of pramipexole on some aspects of cognition in a subgroup patients with bipolar disorder. These data highlight the importance of rigorous subject selection for cognitive trials in bipolar illness. Future studies will be necessary to determine the possible clinical and functional implications of these results. This trial was registered at http://www.clinicaltrials.gov/ with the identifier: NCT00597896. PMID:22152405

  6. The histamine H3 receptor: an attractive target for the treatment of cognitive disorders

    PubMed Central

    Esbenshade, T A; Browman, K E; Bitner, R S; Strakhova, M; Cowart, M D; Brioni, J D

    2008-01-01

    The histamine H3 receptor, first described in 1983 as a histamine autoreceptor and later shown to also function as a heteroreceptor that regulates the release of other neurotransmitters, has been the focus of research by numerous laboratories as it represents an attractive drug target for a number of indications including cognition. The purpose of this review is to acquaint the reader with the current understanding of H3 receptor localization and function as a modulator of neurotransmitter release and its effects on cognitive processes, as well as to provide an update on selected H3 antagonists in various states of preclinical and clinical advancement. Blockade of centrally localized H3 receptors by selective H3 receptor antagonists has been shown to enhance the release of neurotransmitters such as histamine, ACh, dopamine and norepinephrine, among others, which play important roles in cognitive processes. The cognitive-enhancing effects of H3 antagonists across multiple cognitive domains in a wide number of preclinical cognition models also bolster confidence in this therapeutic approach for the treatment of attention deficit hyperactivity disorder, Alzheimer's disease and schizophrenia. However, although a number of clinical studies examining the efficacy of H3 receptor antagonists for a variety of cognitive disorders are currently underway, no clinical proof of concept for an H3 receptor antagonist has been reported to date. The discovery of effective H3 antagonists as therapeutic agents for the novel treatment of cognitive disorders will only be accomplished through continued research efforts that further our insights into the functions of the H3 receptor. PMID:18469850

  7. The histamine H3 receptor: an attractive target for the treatment of cognitive disorders.

    PubMed

    Esbenshade, T A; Browman, K E; Bitner, R S; Strakhova, M; Cowart, M D; Brioni, J D

    2008-07-01

    The histamine H3 receptor, first described in 1983 as a histamine autoreceptor and later shown to also function as a heteroreceptor that regulates the release of other neurotransmitters, has been the focus of research by numerous laboratories as it represents an attractive drug target for a number of indications including cognition. The purpose of this review is to acquaint the reader with the current understanding of H3 receptor localization and function as a modulator of neurotransmitter release and its effects on cognitive processes, as well as to provide an update on selected H3 antagonists in various states of preclinical and clinical advancement. Blockade of centrally localized H3 receptors by selective H3 receptor antagonists has been shown to enhance the release of neurotransmitters such as histamine, ACh, dopamine and norepinephrine, among others, which play important roles in cognitive processes. The cognitive-enhancing effects of H3 antagonists across multiple cognitive domains in a wide number of preclinical cognition models also bolster confidence in this therapeutic approach for the treatment of attention deficit hyperactivity disorder, Alzheimer's disease and schizophrenia. However, although a number of clinical studies examining the efficacy of H3 receptor antagonists for a variety of cognitive disorders are currently underway, no clinical proof of concept for an H3 receptor antagonist has been reported to date. The discovery of effective H3 antagonists as therapeutic agents for the novel treatment of cognitive disorders will only be accomplished through continued research efforts that further our insights into the functions of the H3 receptor.

  8. Cognitive and Neural Aspects of Information Processing in Major Depressive Disorder: An Integrative Perspective

    PubMed Central

    Foland-Ross, Lara C.; Gotlib, Ian H.

    2012-01-01

    Researchers using experimental paradigms to examine cognitive processes have demonstrated that Major Depressive Disorder (MDD) is associated not with a general deficit in cognitive functioning, but instead with more specific anomalies in the processing of negatively valenced material. Indeed, cognitive theories of depression posit that negative biases in the processing of information play a critical role in influencing the onset, maintenance, and recurrence of depressive episodes. In this paper we review findings from behavioral studies documenting that MDD is associated with specific difficulties in attentional disengagement from negatively valenced material, with tendencies to interpret information in a negative manner, with deficits in cognitive control in the processing of negative material, and with enhanced memory for negative material. To gain a better understanding of the neurobiological basis of these abnormalities, we also examine findings from functional neuroimaging studies of depression and show that dysfunction in neural systems that subserve emotion processing, inhibition, and attention may underlie and contribute to the deficits in cognition that have been documented in depressed individuals. Finally, we briefly review evidence from studies of children who are at high familial risk for depression that indicates that abnormalities in cognition and neural function are observable before the onset of MDD and, consequently, may represent a risk factor for the development of this disorder. By integrating research from cognitive and neural investigations of depression, we can gain a more comprehensive understanding not only of how cognitive and biological factors interact to affect the onset, maintenance, and course of MDD, but also of how such research can aid in the development of targeted strategies for the prevention and treatment of this debilitating disorder. PMID:23162521

  9. Personality dysfunction is the cause of recurrent non-cognitive mental disorder: a testable hypothesis.

    PubMed

    Tyrer, Peter

    2015-02-01

    The objective of this study is to examine the evidence for a new hypothesis explaining the relationship between personality and mental state disorders. At present, the attribution of personality disorder as a primary diagnosis only applies to patients who are antisocial, and particularly regarded as psychopathic, as in these patients, the mental state disorder that are associated are regarded in many respects as atypical and not representative of other mental disorders. The case is made in this paper that personality dysfunction lies behind the persistence of all non-cognitive mental disorders and that our failure to recognise this follows from our collective refusal to assess personality status early in life. Narrative review of relevant literature, which is limited as personality status is not often assessed early in life. Support is adduced that personality dysfunction lies behind the persistence of all non-cognitive mental disorders (i.e. those that are not specifically neurodevelopmental and linked to cognitive impairment). The potential importance of this hypothesis is presented with regard to treatment and management strategy, emphasising that without specific intervention for personality dysfunction, many patients are destined for persistent morbidity. Copyright © 2014 John Wiley & Sons, Ltd.

  10. Does the Vigilance-Avoidance Gazing Behavior of Children with Separation Anxiety Disorder Change after Cognitive-Behavioral Therapy?

    ERIC Educational Resources Information Center

    In-Albon, Tina; Schneider, Silvia

    2012-01-01

    Cognitive biases are of interest in understanding the development of anxiety disorders. They also play a significant role during psychotherapy, where cognitive biases are modified in order to break the vicious cycle responsible for maintaining anxiety disorders. In a previous study, the vigilance-avoidance pattern was shown in children with…

  11. Cognitive-Behavioral Therapy for Anxiety in Youth with an Autism Spectrum Disorder: A Follow-Up Study

    ERIC Educational Resources Information Center

    Selles, Robert R.; Arnold, Elysse B.; Phares, Vicky; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.

    2015-01-01

    Cognitive-behavioral therapy for anxiety in youth with an autism spectrum disorder appears efficacious; however, maintenance of treatment gains has not yet been studied. Using a sample of 32 youth who had benefited at least minimally from a past trial of cognitive-behavioral therapy for anxiety in autism spectrum disorder, this study assessed…

  12. Cognitive-Behavioral Therapy for Anxiety in Youth with an Autism Spectrum Disorder: A Follow-Up Study

    ERIC Educational Resources Information Center

    Selles, Robert R.; Arnold, Elysse B.; Phares, Vicky; Lewin, Adam B.; Murphy, Tanya K.; Storch, Eric A.

    2015-01-01

    Cognitive-behavioral therapy for anxiety in youth with an autism spectrum disorder appears efficacious; however, maintenance of treatment gains has not yet been studied. Using a sample of 32 youth who had benefited at least minimally from a past trial of cognitive-behavioral therapy for anxiety in autism spectrum disorder, this study assessed…

  13. Does the Vigilance-Avoidance Gazing Behavior of Children with Separation Anxiety Disorder Change after Cognitive-Behavioral Therapy?

    ERIC Educational Resources Information Center

    In-Albon, Tina; Schneider, Silvia

    2012-01-01

    Cognitive biases are of interest in understanding the development of anxiety disorders. They also play a significant role during psychotherapy, where cognitive biases are modified in order to break the vicious cycle responsible for maintaining anxiety disorders. In a previous study, the vigilance-avoidance pattern was shown in children with…

  14. Closed-Loop Rehabilitation of Age-Related Cognitive Disorders

    PubMed Central

    Mishra, Jyoti; Gazzaley, Adam

    2015-01-01

    Cognitive deficits are common in older adults, as a result of both the natural aging process and neurodegenerative disease. Although medical advancements have successfully prolonged the human lifespan, the challenge of remediating cognitive aging remains. The authors discuss the current state of cognitive therapeutic interventions and then present the need for development and validation of more powerful neurocognitive therapeutics. They propose that the next generation of interventions be implemented as closed-loop systems that target specific neural processing deficits, incorporate quantitative feedback to the individual and clinician, and are personalized to the individual’s neurocognitive capacities using real-time performance-adaptive algorithms. This approach should be multimodal and seamlessly integrate other treatment approaches, including neurofeedback and transcranial electrical stimulation. This novel approach will involve the generation of software that engages the individual in an immersive and enjoyable game-based interface, integrated with advanced biosensing hardware, to maximally harness plasticity and assure adherence. Introducing such next-generation closed-loop neurocognitive therapeutics into the mainstream of our mental health care system will require the combined efforts of clinicians, neuroscientists, bioengineers, software game developers, and industry and policy makers working together to meet the challenges and opportunities of translational neuroscience in the 21st century. PMID:25520029

  15. A comparative study of cognitive deficits in patients with delusional disorder and paranoid schizophrenia.

    PubMed

    Grover, Sandeep; Nehra, Ritu; Bhateja, Gaurav; Kulhara, Parmanand; Kumar, Suresh

    2011-07-01

    Very few studies have evaluated the neurocognitive functions of patients with persistent delusional disorder. To study the neurocognitive profile of patients with delusional disorder and compare it with those of patients with paranoid schizophrenia and healthy control subjects. Attention concentration, executive functions, memory, and IQ were assessed in 20 patients with delusional disorder and were compared with 20 patients with paranoid schizophrenia and 20 healthy controls. All three groups were matched on age, sex, and level of education. The two patient groups were also matched on duration of illness. In general, patients with delusional disorder performed worst than healthy controls and patients with paranoid schizophrenia performed in between the other two groups. Compared with healthy controls, both patients with delusional disorder and patients with paranoid schizophrenia were significantly impaired on different tests of attention and visual learning and memory. Compared with patients with paranoid schizophrenia, patients with delusional disorder had more impairment different tests of attention, visual learning and memory, verbal working memory, and executive functions. Patients with delusional disorder exhibit cognitive dysfunctions that are very similar to schizophrenia, but are more severe in intensity. The resemblance of cognitive profiles suggests that the two disorders may have similar etiological basis.

  16. A comparative study of cognitive deficits in patients with delusional disorder and paranoid schizophrenia

    PubMed Central

    Grover, Sandeep; Nehra, Ritu; Bhateja, Gaurav; Kulhara, Parmanand; Kumar, Suresh

    2011-01-01

    Background: Very few studies have evaluated the neurocognitive functions of patients with persistent delusional disorder. Aim: To study the neurocognitive profile of patients with delusional disorder and compare it with those of patients with paranoid schizophrenia and healthy control subjects. Materials and Methods: Attention concentration, executive functions, memory, and IQ were assessed in 20 patients with delusional disorder and were compared with 20 patients with paranoid schizophrenia and 20 healthy controls. All three groups were matched on age, sex, and level of education. The two patient groups were also matched on duration of illness. Results: In general, patients with delusional disorder performed worst than healthy controls and patients with paranoid schizophrenia performed in between the other two groups. Compared with healthy controls, both patients with delusional disorder and patients with paranoid schizophrenia were significantly impaired on different tests of attention and visual learning and memory. Compared with patients with paranoid schizophrenia, patients with delusional disorder had more impairment different tests of attention, visual learning and memory, verbal working memory, and executive functions. Conclusion: Patients with delusional disorder exhibit cognitive dysfunctions that are very similar to schizophrenia, but are more severe in intensity. The resemblance of cognitive profiles suggests that the two disorders may have similar etiological basis. PMID:23271865

  17. [Cognitive, linguistic, motoric, and social deficits in schoolstarters with behavioral disorders].

    PubMed

    Korsch, Franziska; Petermann, Ulrike; Schmidt, Sören; Petermann, Franz

    2013-01-01

    Studies show that ADHD, conduct disorders, and anxiety disorders are clinical disorders mostly diagnosed in schoolstarters. The preschool medical examination in Bremen was therefore extended by behavioral screenings. Based on their screening results from the SEU (health examination for school entry) 2011 in Bremen, 67 preschoolers were tested for behavioral disorders. Subsequently, children with behavioral or emotional symptoms (N = 56) were compared to symptomfree controls (N = 52) for their cognitive, motoric, linguistic, and social-emotional development. Psychosocial health was obtained through external assessment by the parents and kindergarten teachers. Results of the WPPSI-III, M-ABC-2, and ET 6-6 were included in the analysis. 32 children met the criteria for behavioral disorders. Children with behavioral or emotional symptoms showed significant lower scores on tests measuring cognitive, motoric, linguistic and emotional development compared to controls. Results suggest that there is necessity to screen all preschoolers for behavioral disorders before entering school. Because children with clinical or subclinical behavioral disorders showed major developmental deficits compared to children without behavioral symptoms, it is essential to conduct a multiple assessment on children with suspected behavioral disorders to ensure early developmental support and adequate interventional programs.

  18. Subtypes of mild cognitive impairment among the elderly with major depressive disorder in remission.

    PubMed

    Yeh, Yi-Chun; Tsang, Hin-Yeung; Lin, Pao-Yen; Kuo, Yu-Ting; Yen, Cheng-Fang; Chen, Cheng-Chung; Liu, Gin-Chung; Chen, Cheng-Sheng

    2011-11-01

    Cognitive impairment in remitted late-life depression varies and might be associated with greater risk of dementia in some individuals. This study aimed to classify the subtypes of mild cognitive impairment (MCI) in late-life major depressive disorder in remission and to examine their clinical correlates and structural magnetic resonance imaging (MRI) features. Elderly patients with major depressive disorder in remission and elderly comparisons were examined by a comprehensive battery of cognitive tasks. Proposed diagnostic criteria were used for MCI classification, and the degree of brain atrophy and white matter hyperintensity on MRI were evaluated. We found information-processing speed and memory were independent cognitive domains associated with late-life remitted major depressive disorder. Of the study cohort, 52.3% met the definition of MCI, including 28.5% with amnestic MCI (aMCI) and 23.8% with nonamnestic MCI (naMCI). A clinical correlate of aMCI was the late-onset of disorder (OR = 4.76; 95% CI = 1.57, 14.40) and of naMCI was a higher score on the Framingham stroke risk scale (OR = 1.39; 95% CI = 1.12, 1.72). The odds ratio of highest quartile of ventricular atrophy for aMCI compared to the comparisons was 3.65 (95% CI = 1.22, 10.96). The central cognitive impairments among the elderly with major depressive disorder in remission were memory and information-processing speed, and over half of the subjects met the MCI diagnostic criteria. Different risk factors existed for the subtypes of aMCI and naMCI. Later-age onset of first episode and ventricular atrophy were associated with aMCI, whereas vascular risk factor were associated with naMCI. We suggest there were different pathogeneses between aMCI and naMCI in late-life major depressive disorder.

  19. Behavioral response inhibition in psychotic disorders: diagnostic specificity, familiality and relation to generalized cognitive deficit.

    PubMed

    Ethridge, Lauren E; Soilleux, Melanie; Nakonezny, Paul A; Reilly, James L; Hill, S Kristian; Keefe, Richard S E; Gershon, Elliot S; Pearlson, Godfrey D; Tamminga, Carol A; Keshavan, Matcheri S; Sweeney, John A

    2014-11-01

    Difficulty inhibiting context-inappropriate behavior is a common deficit in psychotic disorders. The diagnostic specificity of this impairment, its familiality, and its degree of independence from the generalized cognitive deficit associated with psychotic disorders remain to be clarified. Schizophrenia, schizoaffective and bipolar patients with history of psychosis (n=523), their available first-degree biological relatives (n=656), and healthy participants (n=223) from the multi-site B-SNIP study completed a manual Stop Signal task. A nonlinear mixed model was used to fit logistic curves to success rates on Stop trials as a function of parametrically varied Stop Signal Delay. While schizophrenia patients had greater generalized cognitive deficit than bipolar patients, their deficits were similar on the Stop Signal task. Further, only bipolar patients showed impaired inhibitory control relative to healthy individuals after controlling for generalized cognitive deficit. Deficits accounted for by the generalized deficit were seen in relatives of schizophrenia and schizoaffective patients, but not in relatives of bipolar patients. In clinically stable patients with psychotic bipolar disorder, impaired inhibitory behavioral control was a specific cognitive impairment, distinct from the generalized neuropsychological impairment associated with psychotic disorders. Thus, in bipolar disorder with psychosis, a deficit in inhibitory control may contribute to risk for impulsive behavior. Because the deficit was not familial in bipolar families and showed a lack of independence from the generalized cognitive deficit in schizophrenia spectrum disorders, it appears to be a trait related to illness processes rather than one tracking familial risk factors. Copyright © 2014 Elsevier B.V. All rights reserved.

  20. Adult reversal of cognitive phenotypes in neurodevelopmental disorders.

    PubMed

    Silva, Alcino J; Ehninger, Dan

    2009-06-01

    Recent findings in mice suggest that it is possible to reverse certain neurodevelopmental disorders in adults. Changes in development, previously thought to be irreparable in adults, were believed to underlie the neurological and psychiatric phenotypes of a range of common mental health problems with a clear developmental component. As a consequence, most researchers have focused their efforts on understanding the molecular and cellular processes that alter development with the hope that early intervention could prevent the emergent pathology. Unexpectedly, several different animal model studies published recently, including animal models of autism, suggest that it may be possible to reverse neurodevelopmental disorders in adults: Addressing the underlying molecular and cellular deficits in adults could in several cases dramatically improve the neurocognitive phenotypes in these animal models. The findings reviewed here provide hope to millions of individuals afflicted with a wide range of neurodevelopmental disorders, including autism, since they suggest that it may be possible to treat or even cure them in adults.

  1. Common Cognitive Deficits in Children with Attention-Deficit/Hyperactivity Disorder and Autism: Working Memory and Visual-Motor Integration

    ERIC Educational Resources Information Center

    Englund, Julia A.; Decker, Scott L.; Allen, Ryan A.; Roberts, Alycia M.

    2014-01-01

    Cognitive deficits in working memory (WM) are characteristic features of Attention-Deficit/Hyperactivity Disorder (ADHD) and autism. However, few studies have investigated cognitive deficits using a wide range of cognitive measures. We compared children with ADHD ("n" = 49) and autism ("n" = 33) with a demographically matched…

  2. Common Cognitive Deficits in Children with Attention-Deficit/Hyperactivity Disorder and Autism: Working Memory and Visual-Motor Integration

    ERIC Educational Resources Information Center

    Englund, Julia A.; Decker, Scott L.; Allen, Ryan A.; Roberts, Alycia M.

    2014-01-01

    Cognitive deficits in working memory (WM) are characteristic features of Attention-Deficit/Hyperactivity Disorder (ADHD) and autism. However, few studies have investigated cognitive deficits using a wide range of cognitive measures. We compared children with ADHD ("n" = 49) and autism ("n" = 33) with a demographically matched…

  3. Bipolar disorder with comorbid anxiety disorders: impact of comorbidity on treatment outcome in cognitive-behavioral therapy and psychoeducation.

    PubMed

    Hawke, Lisa D; Velyvis, Vytas; Parikh, Sagar V

    2013-01-01

    Comorbid anxiety disorders are extremely prevalent in bipolar disorder (BD) and have substantial impact on the course of illness. Limited evidence regarding treatment factors has led to a renewal of research efforts examining both the impact of treatments on comorbid anxiety and the impact of comorbid anxiety on treatments. The current study examines the impact of comorbid anxiety disorders on response to two psychosocial interventions for BD. A sample of 204 patients with BD took part in the study. Of them, 41.7% had a comorbid anxiety disorder. All participants received either individual cognitive-behavioral therapy or group psychoeducation for BD. Evaluations included complete pretreatment and 18-month follow-up assessments of mood and anxiety symptoms, functioning, medication compliance, dysfunctional attitudes, and coping style. Outcome was compared based on the presence or absence of a comorbid anxiety disorder. The participants with comorbid anxiety disorders ranked more severe than those without on several measures. Despite more severe illness characteristics, the magnitude of their treatment gains was equivalent or superior to that of the participants without anxiety disorders on a variety of outcome measures. Although the treatments did not specifically target the anxiety disorder, the participants made significant improvements in anxiety symptoms. Despite greater illness severity, patients with comorbid anxiety disorders can make substantial gains from psychosocial interventions targeting BD. Even in the presence of an anxiety disorder, they are able to attend to the content of the psychosocial treatments and apply it to better manage their condition. The presence of a comorbid anxiety disorder should not be considered a deterrent to offering BD-focused psychosocial treatments.

  4. Effects of cortisol on cognition in major depressive disorder, posttraumatic stress disorder and borderline personality disorder - 2014 Curt Richter Award Winner.

    PubMed

    Wingenfeld, Katja; Wolf, Oliver T

    2015-01-01

    Stress hormones influence a wide range of cognitive functions, including memory performance and executive function. It is well established that glucocorticoids enhance memory consolidation but impair memory retrieval. While most of the effects have been attributed to glucocorticoid receptors (GR), the importance of mineralocorticoid receptors (MR) has been also emphasized. Dysfunctions in hypothalamic-pituitary-adrenal (HPA) axis have been reported for several mental disorders. While major depressive disorder (MDD) as well as borderline personality disorder (BPD) seem to be characterized by enhanced cortisol release in concert with a reduced feedback sensitivity of the HPA axis, in posttraumatic stress disorder (PTSD) a contrary picture has been reported. Despite the fact that altered GR function has been discussed for these disorders only very few studies have investigated the effects of glucocorticoids on cognitive performance in these patients so far. In a series of studies, we investigated the effects of glucocorticoids on cognition (i.e. declarative memory, working memory and response inhibition) in different mental disorders such as MDD, PTSD and BPD. While in patients with MDD cortisol administration failed to effect memory retrieval, patients with PTSD and BPD showed enhanced rather than impaired memory retrieval after cortisol administration. These results indicate an altered sensitivity to cortisol in these disorders. Results from one of our recent studies in the field of social cognition underline the importance of the MR. We found that emotional empathy was enhanced through stimulation of the MR via fludrocortisone in healthy participants and women with BPD. This review aims to integrate these findings and discuss potential mechanisms and implications.

  5. Disrupted reward circuits is associated with cognitive deficits and depression severity in major depressive disorder.

    PubMed

    Gong, Liang; Yin, Yingying; He, Cancan; Ye, Qing; Bai, Feng; Yuan, Yonggui; Zhang, Haisan; Lv, Luxian; Zhang, Hongxing; Xie, Chunming; Zhang, Zhijun

    2017-01-01

    Neuroimaging studies have demonstrated that major depressive disorder (MDD) patients show blunted activity responses to reward-related tasks. However, whether abnormal reward circuits affect cognition and depression in MDD patients remains unclear. Seventy-five drug-naive MDD patients and 42 cognitively normal (CN) subjects underwent a resting-state functional magnetic resonance imaging scan. The bilateral nucleus accumbens (NAc) were selected as seeds to construct reward circuits across all subjects. A multivariate linear regression analysis was employed to investigate the neural substrates of cognitive function and depression severity on the reward circuits in MDD patients. The common pathway underlying cognitive deficits and depression was identified with conjunction analysis. Compared with CN subjects, MDD patients showed decreased reward network connectivity that was primarily located in the prefrontal-striatal regions. Importantly, distinct and common neural pathways underlying cognition and depression were identified, implying the independent and synergistic effects of cognitive deficits and depression severity on reward circuits. This study demonstrated that disrupted topological organization within reward circuits was significantly associated with cognitive deficits and depression severity in MDD patients. These findings suggest that in addition to antidepressant treatment, normalized reward circuits should be a focus and a target for improving depression and cognitive deficits in MDD patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. The relationship between Impulse Control Disorders and cognitive dysfunctions in Parkinson's Disease: a meta-analysis.

    PubMed

    Santangelo, Gabriella; Raimo, Simona; Barone, Paolo

    2017-02-24

    Impulse Control Disorders (ICD) are associated with impairment in cognitive flexibility and cortical inhibition. In Parkinson's Disease (PD) the relationship between ICD and cognitive dysfunctions is still unclear: some studies found different cognitive profiles between Parkinsonians with and without ICD, whereas others did not. Moreover, findings from studies on ICD in PD are conflicting on which cognitive function is altered. A meta-analysis of 34 studies was performed to shed light on relationship between ICD and cognitive dysfunctions and to reveal the cognitive function compromised in Parkinsonians with ICD. Data were analyzed in global cognitive functioning, memory, executive functions, attention/working memory, language, and visuospatial functions. Significant relationship between ICD and dysfunction of abstraction ability/concept formation, set-shifting, visuospatial/constructional abilities and decision-making was found. These findings suggested that people affected by PD with specific frontal dysfunctions are more vulnerable to develop ICD when they take antiparkinsonian drug. Evaluation of specific cognitive functions in routine clinical practice might help to detect those people with PD susceptible to ICD before treating them with antiparkinsonian drugs.

  7. Investigating cognitive flexibility as a potential mechanism of mindfulness in Generalized Anxiety Disorder.

    PubMed

    Lee, Jonathan K; Orsillo, Susan M

    2014-03-01

    Research suggests mindfulness-based treatments may enhance efficacy of CBT for Generalized Anxiety Disorder (GAD). One hypothesized mechanism of mindfulness is cognitive flexibility; however, research findings to date are mixed as to a) whether cognitive inflexibility represents a characteristic of GAD, and b) whether mindfulness impacts cognitive flexibility. It is proposed that limitations in study methodology may partially account for these mixed findings. The present study investigated cognitive flexibility as a potential mechanism of mindfulness in a sample with elevated GAD symptoms using a modified emotional Stroop switching task while attempting to control for limitations of previous research. The purpose of the study was: 1) to explore cognitive inflexibility as a potential characteristic of GAD, and 2) to examine whether a brief mindfulness induction has measurable impact on cognitive flexibility. A total of 66 participants (53 with elevated GAD symptoms, and 13 non-anxious) were randomized to a mindful-breathing, music-assisted relaxation, or thought wandering condition prior to completing an emotional Stroop and emotional Stroop switching task. Results suggest that GAD may be characterized by an inflexible style of responding, and exposure to mindfulness and relaxation result in partial improvements in cognitive flexibility. Limitations of this study include small sample size, brief induction period, and use of an analog sample. The present findings suggest that mindfulness may be associated with partial improvement in cognitive flexibility. Copyright © 2013 Elsevier Ltd. All rights reserved.

  8. Season-independent cognitive deficits in seasonal affective disorder and their relation to depressive symptoms.

    PubMed

    Hjordt, Liv Vadskjær; Stenbæk, Dea Siggaard; Ozenne, Brice; Mc Mahon, Brenda; Hageman, Ida; Hasselbalch, Steen Gregers; Knudsen, Gitte Moos

    2017-11-01

    Although cognitive impairments are common in depressed individuals, it is unclear which aspects of cognition are affected and whether they represent state or trait features of depression. We here exploited a naturalistic model, namely the seasonal fluctuations in depressed status in individuals with Seasonal Affective Disorder (SAD), to study depression-related cognition, longitudinally. Twenty-nine medication-free individuals diagnosed with winter-SAD and 30 demographically matched healthy controls with no seasonality symptoms completed the Letter-number Sequencing task (LNS), the Symbol Digit Modalities Test (SDMT) and the Simple Reaction Time (SRT) twice; in summer and in winter. Compared to controls, SAD individuals showed significant season-independent impairments in tasks measuring working memory (LNS), cognitive processing speed (SDMT) and motor speed (SRT). In SAD individuals, cognitive processing speed was significantly negatively associated with the seasonal change in SAD depressive symptoms. We present novel evidence that in SAD individuals, working memory, cognitive processing- and motor speed is not only impaired in the winter but also in the summer. This suggests that certain cognitive impairments are SAD traits. Furthermore, impairments in cognitive processing speed appear to be related to depressive symptoms in SAD. Reduced processing speed may thus constitute a SAD vulnerability trait marker. Copyright © 2017 Elsevier B.V. All rights reserved.

  9. Relationship of Cognition to Clinical Response in First-Episode Schizophrenia Spectrum Disorders

    PubMed Central

    Trampush, Joey W.; Lencz, Todd; DeRosse, Pamela; John, Majnu; Gallego, Juan A.; Petrides, Georgios; Hassoun, Youssef; Zhang, Jian-Ping; Addington, Jean; Kellner, Charles H.; Tohen, Mauricio; Burdick, Katherine E.; Goldberg, Terry E.; Kane, John M.; Robinson, Delbert G.; Malhotra, Anil K.

    2015-01-01

    First-episode schizophrenia (FES) spectrum disorders are associated with pronounced cognitive dysfunction across all domains. However, less is known about the course of cognitive functioning, following the first presentation of psychosis, and the relationship of cognition to clinical course during initial treatment. The present longitudinal study examined the magnitude of neurocognitive impairment, using the MATRICS Consensus Cognitive Battery, in patients experiencing their first episode of psychosis at baseline and after 12 weeks of randomized antipsychotic treatment with either aripiprazole or risperidone. At baseline, FES patients evidenced marked impairments in cognitive functioning. Notably, performance on the mazes task of planning and reasoning significantly predicted the likelihood of meeting stringent criteria for positive symptom remission during the first 12 weeks of the trial. Performance on indices of general cognitive function, working memory, and verbal learning improved over time, but these improvements were mediated by improvements in both positive and negative symptoms. We did not detect any differential effects of antipsychotic medication assignment (aripiprazole vs risperidone) on cognitive functioning. Our results suggest that a brief paper-and-pencil measure reflecting planning/reasoning abilities may index responsivity to antipsychotic medication. However, improvements in cognitive functioning over time were related to clinical symptom improvement, reflecting “pseudospecificity.” PMID:26409223

  10. A new computerized cognitive and social cognition training specifically designed for patients with schizophrenia/schizoaffective disorder in early stages of illness: A pilot study.

    PubMed

    Fernandez-Gonzalo, Sol; Turon, Marc; Jodar, Merce; Pousa, Esther; Hernandez Rambla, Carla; García, Rebeca; Palao, Diego

    2015-08-30

    People with schizophrenia/schizoaffective disorders at early stages of the illness present cognitive and social cognition deficits that have a great impact in functional outcomes. Cognitive Remediation Therapy (CRT) has demonstrated consistent effect in cognitive performance, symptoms and psychosocial functioning. However, any CRT intervention or social cognition training have been specifically designed for patients in the early stages of psychosis. The aim of this pilot study is to assess the efficacy of a new computerized cognitive and social cognition program for patients with schizophrenia/schizoaffective disorder with recent diagnosis. A comprehensive assessment of clinical, social and non-social cognitive and functional measures was carried out in 53 randomized participants before and after the 4-months treatment. Significant results were observed in Spatial Span Forwards, Immediate Logical Memory and Pictures of Facial Affect (POFA) total score. None of these results were explained by medication, premorbid social functioning or psychopathological symptoms. No impact of the intervention was observed in other cognitive and social cognition outcome neither in clinical and functional outcomes. This new computerized intervention may result effective ameliorating visual attention, logical memory and emotional processing in patients in the early stages of schizophrenia/schizoaffective disorder.

  11. Relationship between maladaptive cognitions about sleep and recovery in patients with borderline personality disorder.

    PubMed

    Plante, David T; Frankenburg, Frances R; Fitzmaurice, Garrett M; Zanarini, Mary C

    2013-12-30

    Borderline personality disorder (BPD) has been associated with maladaptive cognitive processes including dysfunctional attitudes and a negative attribution style. Comorbid insomnia affects the course of multiple psychiatric disorders, and has been associated with the absence of recovery from BPD. Because dysfunctional beliefs and attitudes are common among patients with insomnia, the purpose of this study was to evaluate the association between maladaptive sleep-related cognitions and recovery status (symptomatic remission plus good concurrent psychosocial functioning) in patients with BPD. Two hundred and twenty three BPD patients participating in the McLean Study of Adult Development (MSAD) were administered the Dysfunctional Beliefs and Attitudes about Sleep questionnaire (DBAS-16) as part of the 16-year follow-up wave. Maladaptive sleep cognitions were compared between recovered (n=105) and non-recovered (n=118) BPD participants, in analyses that adjusted for age, sex, depression, anxiety, and primary sleep disorders. Results demonstrated that non-recovered BPD patients had significantly more severe maladaptive sleep-related cognitions as measured by the overall DBAS-16 score. These results demonstrate an association between dysfunctional beliefs and attitudes about sleep and recovery status among BPD patients. Further research is warranted to evaluate treatments targeted towards maladaptive sleep-related cognitions, and their subsequent effects on the course of BPD. © 2013 Published by Elsevier Ireland Ltd.

  12. Pharmacological cognitive enhancement: treatment of neuropsychiatric disorders and lifestyle use by healthy people.

    PubMed

    Sahakian, Barbara J; Morein-Zamir, Sharon

    2015-04-01

    Neuropsychiatric disorders typically manifest as problems with attentional biases, aberrant learning, dysfunctional reward systems, and an absence of top-down cognitive control by the prefrontal cortex. In view of the cost of common mental health disorders, in terms of distress to the individual and family in addition to the financial cost to society and governments, new developments for treatments that address cognitive dysfunction should be a priority so that all members of society can flourish. Cognitive enhancing drugs, such as cholinesterase inhibitors and methylphenidate, are used as treatments for the cognitive symptoms of Alzheimer's disease and attention deficit hyperactivity disorder. However, these drugs and others, including modafinil, are being increasingly used by healthy people for enhancement purposes. Importantly for ethical and safety reasons, the drivers for this increasing lifestyle use of so-called smart drugs by healthy people should be considered and discussions must occur about how to ensure present and future pharmacological cognitive enhancers are used for the benefit of society.

  13. Mindfulness-based cognitive behavior therapy in patients with anxiety disorders: a case series.

    PubMed

    Sharma, Mahendra P; Mao, Angelina; Sudhir, Paulomi M

    2012-07-01

    The present study is aimed at evaluating the effectiveness of a Mindfulness-Based Cognitive Behavior Therapy (MBCBT) for reducing cognitive and somatic anxiety and modifying dysfunctional cognitions in patients with anxiety disorders. A single case design with pre- and post-assessment was adopted. Four patients meeting the specified inclusion and exclusion criteria were recruited for the study. Three patients received a primary diagnosis of generalized anxiety disorder (GAD), while the fourth patient was diagnosed with Panic Disorder. Patients were assessed on the Cognitive and Somatic Anxiety Questionnaire (CSAQ), Penn State Worry Questionnaire (PSWQ), Hamilton's Anxiety Inventory (HAM-A), and Dysfunctional Attitudes Scale. The therapeutic program consisted of education regarding nature of anxiety, training in different versions of mindfulness meditation, cognitive restructuring, and strategies to handle worry, such as, worry postponement, worry exposure, and problem solving. A total of 23 sessions over four to six weeks were conducted for each patient. The findings of the study are discussed in light of the available research, and implications and limitations are highlighted along with suggestions for future research.

  14. Pregnancy-associated hypertensive disorders and adult cognitive function among Danish conscripts.

    PubMed

    Ehrenstein, Vera; Rothman, Kenneth J; Pedersen, Lars; Hatch, Elizabeth E; Sørensen, Henrik Toft

    2009-10-15

    The authors examined the association of gestational hypertensive disorders (hypertension, preeclampsia, eclampsia) with adult cognitive function among men born in 1978-1983 in a well-defined geographic area of northern Denmark. Data from the Danish Medical Birth Registry, the Danish National Registry of Patients, and draft board records were linked. Cognitive function was measured at conscription by using the Boerge Prien group intelligence test. Test scores were converted to the conventional IQ scale (mean = 100 (standard deviation, 15)). Low cognitive function was defined as IQ <85. Of the 17,457 men who underwent intelligence testing, 891 (5.1%) were born after a pregnancy involving hospitalization for a gestational hypertensive disorder. Compared with conscripts born after normotensive pregnancy, conscripts exposed to maternal gestational hypertension had an adjusted prevalence ratio for low cognitive function of 1.34 (95% confidence interval (CI): 1.01, 1.77). For those exposed to mild preeclampsia and severe preeclampsia/eclampsia, adjusted prevalence ratios were 1.34 (95% CI: 1.09, 1.65) and 1.10 (95% CI: 0.48, 2.51), respectively. The corresponding adjusted mean differences in IQ scores were -2.0 (95% CI: -4.0, 0.0), -3.2 (95% CI: -4.7, -1.8), and -2.0 (95% CI: -7.2, 3.2). In this study, prenatal exposure to gestational hypertensive disorders was associated with slightly reduced adult cognitive performance among male conscripts.

  15. Deconstructing Bipolar Disorder and Schizophrenia: A cross-diagnostic cluster analysis of cognitive phenotypes.

    PubMed

    Lee, Junghee; Rizzo, Shemra; Altshuler, Lori; Glahn, David C; Miklowitz, David J; Sugar, Catherine A; Wynn, Jonathan K; Green, Michael F

    2017-02-01

    Bipolar disorder (BD) and schizophrenia (SZ) show substantial overlap. It has been suggested that a subgroup of patients might contribute to these overlapping features. This study employed a cross-diagnostic cluster analysis to identify subgroups of individuals with shared cognitive phenotypes. 143 participants (68 BD patients, 39 SZ patients and 36 healthy controls) completed a battery of EEG and performance assessments on perception, nonsocial cognition and social cognition. A K-means cluster analysis was conducted with all participants across diagnostic groups. Clinical symptoms, functional capacity, and functional outcome were assessed in patients. A two-cluster solution across 3 groups was the most stable. One cluster including 44 BD patients, 31 controls and 5 SZ patients showed better cognition (High cluster) than the other cluster with 24 BD patients, 35 SZ patients and 5 controls (Low cluster). BD patients in the High cluster performed better than BD patients in the Low cluster across cognitive domains. Within each cluster, participants with different clinical diagnoses showed different profiles across cognitive domains. All patients are in the chronic phase and out of mood episode at the time of assessment and most of the assessment were behavioral measures. This study identified two clusters with shared cognitive phenotype profiles that were not proxies for clinical diagnoses. The finding of better social cognitive performance of BD patients than SZ patients in the Lowe cluster suggest that relatively preserved social cognition may be important to identify disease process distinct to each disorder. Copyright © 2016 Elsevier B.V. All rights reserved.

  16. The Role of Working Memory for Cognitive Control in Anorexia Nervosa versus Substance Use Disorder

    PubMed Central

    Brooks, Samantha J.; Funk, Sabina G.; Young, Susanne Y.; Schiöth, Helgi B.

    2017-01-01

    Prefrontal cortex executive functions, such as working memory (WM) interact with limbic processes to foster impulse control. Such an interaction is referred to in a growing body of publications by terms such as cognitive control, cognitive inhibition, affect regulation, self-regulation, top-down control, and cognitive–emotion interaction. The rising trend of research into cognitive control of impulsivity, using various related terms reflects the importance of research into impulse control, as failure to employ cognitions optimally may eventually result in mental disorder. Against this background, we take a novel approach using an impulse control spectrum model – where anorexia nervosa (AN) and substance use disorder (SUD) are at opposite extremes – to examine the role of WM for cognitive control. With this aim, we first summarize WM processes in the healthy brain in order to frame a systematic review of the neuropsychological, neural and genetic findings of AN and SUD. In our systematic review of WM/cognitive control, we found n = 15 studies of AN with a total of n = 582 AN and n = 365 HC participants; and n = 93 studies of SUD with n = 9106 SUD and n = 3028 HC participants. In particular, we consider how WM load/capacity may support the neural process of excessive epistemic foraging (cognitive sampling of the environment to test predictions about the world) in AN that reduces distraction from salient stimuli. We also consider the link between WM and cognitive control in people with SUD who are prone to ‘jumping to conclusions’ and reduced epistemic foraging. Finally, in light of our review, we consider WM training as a novel research tool and an adjunct to enhance treatment that improves cognitive control of impulsivity.

  17. Brief parent-child group therapy for childhood anxiety disorders: a developmental perspective on cognitive-behavioral group treatment.

    PubMed

    Ben-Amitay, Galit; Rosental, Batya; Toren, Paz

    2010-01-01

    The use of cognitive-behavioral group psychotherapy in treating childhood anxiety disorders has become widespread. This paper examines the dynamic processes underlying cognitive-behavioral group treatment for children with anxiety disorders and for their parents, with particular focus on the process of separation-individuation. Both children and their parents were empowered through processes of sub-grouping and thus helped to differentiate and separate. We consider this parallel dynamic process an important factor that can enhance cognitive-behavioral treatment.

  18. Inflammation as a neurobiological substrate of cognitive impairment in bipolar disorder: Evidence, pathophysiology and treatment implications.

    PubMed

    Rosenblat, Joshua D; Brietzke, Elisa; Mansur, Rodrigo B; Maruschak, Nadia A; Lee, Yena; McIntyre, Roger S

    2015-12-01

    Bipolar disorder (BD) has been associated with cognitive impairment during depressed, manic and euthymic periods. Inflammation has been shown to be involved in the pathophysiology of BD and cognitive impairment. For this systematic review, the MEDLINE/PubMed, Embase, Google Scholar and ClinicalTrials.gov databases were searched for relevant articles assessing the association between cognitive function and inflammatory markers in BD subjects. A discussion of potential mechanisms and therapeutic implications is also included to provide further context to the subject matter. Eight studies, including a total of 555 BD subjects, assessing the association between cognitive function and inflammatory markers were identified. Cognitive dysfunction was associated with elevated levels of pro-inflammatory markers YKL40, IL-6, sCD40L, IL-1Ra, hsCRP and TNF-α. Mechanistically, elevation in inflammatory cytokines alters monoamine levels leading to cognitive and affective dysfunction. Neuro-inflammation, manifesting as microglial activation, leads to increased oxidative stress, pathologic synaptic pruning and impaired neuroplasticity in key brain regions sub-serving mood and cognition. Immune dysfunction also activates the hypothalamic-pituitary-adrenal (HPA) axis leading to hypercortisolemia and metabolic dysfunction, further promoting neuronal dysfunction. Anti-inflammatory agents are therefore currently being investigated in the treatment of BD and appear to exert an antidepressant effect; however, cognitive outcomes have yet to be reported. Several studies suggest that immune dysfunction is associated with cognitive impairment in BD. Several neurobiological pathways have been identified whereby immune dysfunction may promote cognitive impairment in BD. Future investigations of anti-inflammatory agents targeting cognitive function as a treatment outcome are merited. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Genomic Copy Number Variation in Disorders of Cognitive Development

    ERIC Educational Resources Information Center

    Morrow, Eric M.

    2010-01-01

    Objective: To highlight recent discoveries in the area of genomic copy number variation in neuropsychiatric disorders including intellectual disability, autism, and schizophrenia. To emphasize new principles emerging from this area, involving the genetic architecture of disease, pathophysiology, and diagnosis. Method: Review of studies published…

  20. Genomic Copy Number Variation in Disorders of Cognitive Development

    ERIC Educational Resources Information Center

    Morrow, Eric M.

    2010-01-01

    Objective: To highlight recent discoveries in the area of genomic copy number variation in neuropsychiatric disorders including intellectual disability, autism, and schizophrenia. To emphasize new principles emerging from this area, involving the genetic architecture of disease, pathophysiology, and diagnosis. Method: Review of studies published…

  1. Hearing Disorder and Cognitive Function of Individuals with Down Syndrome.

    ERIC Educational Resources Information Center

    Libb, J. Wesley; And Others

    1985-01-01

    The relationship between hearing disorder and performance on intelligence tests among 28 children and young adults with Down Syndrome was investigated. Performance on intelligence tests by individuals with abnormal tympanograms was inferior to that of individuals with normal tympanograms. Hearing sensitivity measures were uncorrelated to…

  2. Motor and Cognitive Performance Differences between Children with and without Developmental Coordination Disorder (DCD)

    ERIC Educational Resources Information Center

    Asonitou, Katerina; Koutsouki, Dimitra; Kourtessis, Thomas; Charitou, Sofia

    2012-01-01

    The current study adopts the PASS theory of information processing to investigate the probable differences in specific motor and cognitive abilities between children with and without developmental coordination disorder (DCD). Participants were 108 5- and 6-year-old preschoolers (54 children with DCD and 54 children without DCD). The Movement…

  3. Effect of Cognitive Behavioral Therapy for Anxiety Disorders on Quality of Life: A Meta-Analysis

    PubMed Central

    Hofmann, Stefan G.; Wu, Jade Q.; Boettcher, Hannah

    2014-01-01

    OBJECTIVE Although cognitive-behavioral therapy is effective for treating anxiety disorders, little is known about its effect on quality of life. To conduct a meta-analysis of cognitive-behavioral therapy for anxiety disorders on quality of life, we searched for relevant studies in PubMed, PsycINFO and the Cochrane Library, and conducted manual searches. METHOD The search identified 44 studies that included 59 CBT trials, totaling 3,326 participants receiving cognitive-behavioral therapy for anxiety disorders. We estimated the controlled and within-group random effects of the treatment changes on quality of life. RESULTS The pre-post within-group and controlled effect sizes were moderately strong, Hedges’ g = 0.54 and Hedges’ g = 0.56, respectively. Improvements were greater for physical and psychological domains of quality of life than for environmental and social domains. The overall effect sizes decreased with publication year and increased with treatment duration. Face-to-face treatments delivered individually and in groups produced significantly higher effect sizes than internet-delivered treatments. CONCLUSION Cognitive-behavioral therapy for anxiety disorders is moderately effective for improving quality of life, especially in physical and psychological domains. Internet-delivered treatments are less effective in improving quality of life than face-to-face treatments. PMID:24447006

  4. Revisiting Cognitive and Adaptive Functioning in Children and Adolescents with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Matthews, Nicole L.; Pollard, Elena; Ober-Reynolds, Sharman; Kirwan, Janet; Malligo, Amanda; Smith, Christopher J.

    2015-01-01

    Profiles of performance on the Stanford Binet Intelligence Scales (SB5) and Vineland Adaptive Behavior Scales (VABS) were examined in 73 children and adolescents with autism spectrum disorder. SB5 cognitive profiles were observed to be similar between participants with and without early language delay, but different between participants with and…

  5. The Additive Benefit of Hypnosis and Cognitive-Behavioral Therapy in Treating Acute Stress Disorder

    ERIC Educational Resources Information Center

    Bryant, Richard A.; Moulds, Michelle L.; Guthrie, Rachel M.; Nixon, Reginald D. V.

    2005-01-01

    This research represents the first controlled treatment study of hypnosis and cognitive- behavioral therapy (CBT) of acute stress disorder (ASD). Civilian trauma survivors (N = 87) who met criteria for ASD were randomly allocated to 6 sessions of CBT, CBT combined with hypnosis (CBT-hypnosis), or supportive counseling (SC). CBT comprised exposure,…

  6. Child-Therapist Alliance and Clinical Outcomes in Cognitive Behavioral Therapy for Child Anxiety Disorders

    ERIC Educational Resources Information Center

    Chiu, Angela W.; McLeod, Bryce D.; Har, Kim; Wood, Jeffrey J.

    2009-01-01

    Background: Few studies have examined the link between child-therapist alliance and outcome in manual-guided cognitive behavioral therapy (CBT) for children diagnosed with anxiety disorders. This study sought to clarify the nature and strength of this relation. Methods: The Therapy Process Observational Coding System for Child…

  7. Nonverbal and Verbal Cognitive Discrepancy Profiles in Autism Spectrum Disorders: Influence of Age and Gender

    ERIC Educational Resources Information Center

    Ankenman, Katy; Elgin, Jenna; Sullivan, Katherine; Vincent, Logan; Bernier, Raphael

    2014-01-01

    Research suggests that discrepant cognitive abilities are more common in children with autism spectrum disorder (ASD) and may indicate an important ASD endophenotype. The current study examined the frequency of IQ discrepancy profiles (nonverbal IQ greater than verbal IQ [NVIQ greater than VIQ], verbal IQ greater than nonverbal IQ [VIQ greater…

  8. Stability and Change in the Cognitive and Adaptive Behaviour Scores of Preschoolers with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Flanagan, Helen E.; Smith, Isabel M.; Vaillancourt, Tracy; Duku, Eric; Szatmari, Peter; Bryson, Susan; Fombonne, Eric; Mirenda, Pat; Roberts, Wendy; Volden, Joanne; Waddell, Charlotte; Zwaigenbaum, Lonnie; Bennett, Teresa; Elsabbagh, Mayada; Georgiades, Stelios

    2015-01-01

    We examined the stability of cognitive and adaptive behaviour standard scores in children with autism spectrum disorder (ASD) between diagnosis and school entry approximately age 6. IQ increased 18 points in 2-year-olds, 12 points in 3-year-olds, and 9 points in 4-year-olds (N = 281). Adaptive behaviour scores increased 4 points across age groups…

  9. Cognitive-Behavioral Family Treatment of Childhood Obsessive-Compulsive Disorder: A Controlled Trial.

    ERIC Educational Resources Information Center

    Barrett, Paula; Healy-Farrell, Lara; March, John S.

    2004-01-01

    Objective: To evaluate the relative efficacy of (1) individual cognitive-behavioral family-based therapy (CBFT); (2) group CBFT; and (3) a waitlist control group in the treatment of childhood obsessive-compulsive disorder (OCD). Method: This study, conducted at a university clinic in Brisbane, Australia, involved 77 children and adolescents with…

  10. Two-Day, Intensive Cognitive-Behavioral Therapy for Panic Disorder: A Case Study

    ERIC Educational Resources Information Center

    Deacon, Brett

    2007-01-01

    Cognitive-behavioral therapy (CBT) is a highly effective treatment for panic disorder. However, few patients have access to this treatment, particularly those living in rural areas. In a pilot study, the author previously described the efficacy of a 2-day, intensive, exposure-based CBT intervention that was developed for the purpose of delivering…

  11. Impact of Cognitive-Behavioral Treatment on Quality of Life in Panic Disorder Patients.

    ERIC Educational Resources Information Center

    Telch, Michael J.; And Others

    1995-01-01

    Patients (n=156) meeting criteria for panic disorder with agoraphobia were randomly assigned to group cognitive-behavioral treatment (CBT) or a delayed-treatment control. Compared with the control group, CBT-treated patients showed significant reductions in impairment that were maintained at follow-up. Anxiety and phobic avoidance were…

  12. Family Cognitive Behavioral Therapy for Children and Adolescents with Clinical Anxiety Disorders

    ERIC Educational Resources Information Center

    Bogels, Susan M.; Siqueland, Lynne

    2006-01-01

    Objective: A family cognitive-behavioral therapy for children and adolescents ages 8 to 18 years with clinical anxiety disorders was developed and evaluated. Method: Seventeen families were measured before and after waitlist, after treatment, and at 3-month and 1-year follow-up. Results: No children changed their diagnostic status during waitlist,…

  13. Changes in Posttraumatic Stress Disorder and Depressive Symptoms during Cognitive Processing Therapy: Evidence for Concurrent Change

    ERIC Educational Resources Information Center

    Liverant, Gabrielle I.; Suvak, Michael K.; Pineles, Suzanne L.; Resick, Patricia A.

    2012-01-01

    Objective: Trauma-focused psychotherapies reduce both posttraumatic stress disorder (PTSD) and co-occurring depression. However, little is known about the relationship between changes in PTSD and depression during treatment. This study examined the association between changes in PTSD and depression during the course of cognitive processing therapy…

  14. Sex Differences in Cognitive Domains and Their Clinical Correlates in Higher-Functioning Autism Spectrum Disorders

    ERIC Educational Resources Information Center

    Bolte, Sven; Duketis, Eftichia; Poustka, Fritz; Holtmann, Martin

    2011-01-01

    Despite the skewed sex ratio, few studies have addressed possible cognitive sex differences in autism spectrum disorders (ASDs). This study compared visual attention to detail (ATTD) and selected executive functions (EF) in 35 males and 21 females with higher-functioning ASD and unaffected sibling controls. Females with ASD outperformed males on…

  15. Is Talent in Autism Spectrum Disorders Associated with a Specific Cognitive and Behavioural Phenotype?

    ERIC Educational Resources Information Center

    Bennett, Emily; Heaton, Pamela

    2012-01-01

    Parents of 125 children, adolescents and young adults with autism spectrum disorders completed a newly developed questionnaire aimed at identifying cognitive and behavioural characteristics associated with savant skills in this group. Factors distinguishing skilled individuals were then further investigated in case studies of three individuals…

  16. The Additive Benefit of Hypnosis and Cognitive-Behavioral Therapy in Treating Acute Stress Disorder

    ERIC Educational Resources Information Center

    Bryant, Richard A.; Moulds, Michelle L.; Guthrie, Rachel M.; Nixon, Reginald D. V.

    2005-01-01

    This research represents the first controlled treatment study of hypnosis and cognitive- behavioral therapy (CBT) of acute stress disorder (ASD). Civilian trauma survivors (N = 87) who met criteria for ASD were randomly allocated to 6 sessions of CBT, CBT combined with hypnosis (CBT-hypnosis), or supportive counseling (SC). CBT comprised exposure,…

  17. Stability and Change in the Cognitive and Adaptive Behaviour Scores of Preschoolers with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Flanagan, Helen E.; Smith, Isabel M.; Vaillancourt, Tracy; Duku, Eric; Szatmari, Peter; Bryson, Susan; Fombonne, Eric; Mirenda, Pat; Roberts, Wendy; Volden, Joanne; Waddell, Charlotte; Zwaigenbaum, Lonnie; Bennett, Teresa; Elsabbagh, Mayada; Georgiades, Stelios

    2015-01-01

    We examined the stability of cognitive and adaptive behaviour standard scores in children with autism spectrum disorder (ASD) between diagnosis and school entry approximately age 6. IQ increased 18 points in 2-year-olds, 12 points in 3-year-olds, and 9 points in 4-year-olds (N = 281). Adaptive behaviour scores increased 4 points across age groups…

  18. Nonverbal and Verbal Cognitive Discrepancy Profiles in Autism Spectrum Disorders: Influence of Age and Gender

    ERIC Educational Resources Information Center

    Ankenman, Katy; Elgin, Jenna; Sullivan, Katherine; Vincent, Logan; Bernier, Raphael

    2014-01-01

    Research suggests that discrepant cognitive abilities are more common in children with autism spectrum disorder (ASD) and may indicate an important ASD endophenotype. The current study examined the frequency of IQ discrepancy profiles (nonverbal IQ greater than verbal IQ [NVIQ greater than VIQ], verbal IQ greater than nonverbal IQ [VIQ greater…

  19. Revisiting Cognitive and Adaptive Functioning in Children and Adolescents with Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    Matthews, Nicole L.; Pollard, Elena; Ober-Reynolds, Sharman; Kirwan, Janet; Malligo, Amanda; Smith, Christopher J.

    2015-01-01

    Profiles of performance on the Stanford Binet Intelligence Scales (SB5) and Vineland Adaptive Behavior Scales (VABS) were examined in 73 children and adolescents with autism spectrum disorder. SB5 cognitive profiles were observed to be similar between participants with and without early language delay, but different between participants with and…

  20. [The Effectiveness of Cognitive Behavioral Therapy, Medication, or Combined Treatment For Child Hood Anxiety Disorders].

    PubMed

    Sevi Tok, Emine Sevinç; Arkar, Haluk; Bildik, Tezan

    2016-01-01

    The aims of this study were to evaluate the effectiveness of the Fear Hunter cognitive behavioral therapy program, which was developed for the treatment of childhood anxiety disorders, and to compare its effectiveness with standard medication treatment. A total of 46 participants (aged 8 to 12) that applied to the Ege University, Faculty of Medicine, Child and Adolescent Psychiatry clinic and had a diagnosis of anxiety disorder were recruited for the study. The participants were randomly assigned to cognitive behavioral therapy (CBT), standard drug treatment (ST), or combined treatment (CBT+ ST) groups according to the order of application. Subjects were evaluated using pretest, posttest and 3 months follow-up measurements. The participants were assessed by the researcher using The Screen for Child Anxiety Related Emotional Disorders (SCARED), The Children's Negative Cognitive Errors Questionnaire (CNCEQ), Health Related Quality of Life in Children (Kid-KINDL), and Children's Depression Inventory (CDI). The results of repeated measures ANOVA showed that, although general anxiety scores of all treatment conditions significantly decreased at posttest and follow up, a combination of two therapies (CBT+ST) had a significantly superior response rate. Moreover, all treatment conditions including CBT (CBT+ST and CBT) were superior to ST in terms of negative cognitive errors, quality of life, and depression. It is thought that The Fear Hunter Therapy Program is an effective treatment technique because; it provides significant improvement in the primary and secondary symptoms (e.g. quality of life, depression, negative automatic thoughts) of childhood anxiety disorders.