Computerized tabletop games as a form of a video game training for old-old

This research aimed at investigating the utility of a computerized version of a cognitively stimulating activity as a video game intervention for elderly. The study focused on the effect of a 6-week extensive practice intervention on aspects of cognitive functioning (vigilance, working memory (WM), inhibition, reasoning) of old-old participants (N = 29), randomly assigned to trained or active control group. The difference between groups was in the content of the extended video game practice – cognitively complex card game for trained and computerized version of a simple dice-game of chance for control participants. A pretest, posttest and a 4-month follow-up measurement was conducted. Results revealed improvements in both groups, except for improved reasoning found only in trained participants. These results suggest that: (1) improvements are dependent on the complexity of the program, (2) cognitively stimulating activity are a valid training procedure for old-old, (3) novelty of computer use is an important factor in determining training efficacy.     

An ecological approach to cognitive enhancement: Complex motor training

Cognitive training has received a lot of attention recently, yielding findings that can be conflicting and controversial. In this paper, we present a novel approach to cognitive training based on complex motor activities. In a randomized controlled design, participants were assigned to one of three conditions: aerobic exercise, working memory training or designed sport — an intervention specifically tailored to include both physical and cognitive demands. After training for eight weeks, the designed sport group showed the largest gains in all cognitive measures, illustrating the efficacy of complex motor activities to enhance cognition. Designed sport training also revealed impressive health benefits, namely decreased heart rate and blood pressure. In this period of skepticism over the efficacy of computerized cognitive training, we discuss the potential of ecological interventions targeting both cognition and physical fitness, and propose some possible applications.     

Cognitive Remediation in Schizophrenia

Cognitive deficits are routinely evident in schizophrenia, and are of sufficient magnitude to influence functional outcomes in work, social functioning and illness management. Cognitive remediation is an evidenced-based non-pharmacological treatment for the neurocognitive deficits seen in schizophrenia. Narrowly defined, cognitive remediation is a set of cognitive drills or compensatory interventions designed to enhance cognitive functioning, but from the vantage of the psychiatric rehabilitation field, cognitive remediation is a therapy which engages the patient in learning activities that enhance the neurocognitive skills relevant to their chosen recovery goals. Cognitive remediation programs vary in the extent to which they reflect these narrow or broader perspectives but six meta-analytic studies report moderate range effect sizes on cognitive test performance, and daily functioning. Reciprocal interactions between baseline ability level, the type of instructional techniques used, and motivation provide some explanatory power for the heterogeneity in patient response to cognitive remediation.     

Dopamine, working memory, and training induced plasticity: implications for developmental research

Cognitive deficits and particularly deficits in working memory (WM) capacity are common features in neuropsychiatric disorders. Understanding the underlying mechanisms through which WM capacity can be improved is therefore of great importance. Several lines of research indicate that dopamine plays an important role not only in WM function but also for improving WM capacity. For example, pharmacological interventions acting on the dopaminergic system, such as methylphenidate, improve WM performance. In addition, behavioral interventions for improving WM performance in the form of intensive computerized training have recently been associated with changes in dopamine receptor density. These two different means of improving WM performance--pharmacological and behavioral--are thus associated with similar biological mechanisms in the brain involving dopaminergic systems. This article reviews some of the evidence for the role of dopamine in WM functioning, in particular concerning the link to WM development and cognitive plasticity. Novel data are presented showing that variation in the dopamine transporter gene (DAT1) influences improvements in WM and fluid intelligence in preschool-age children following cognitive training. Our results emphasize the importance of the role of dopamine in determining cognitive plasticity.     

Efficacy of Cognitive Rehabilitation Therapies for Mild Cognitive Impairment (MCI) in Older Adults: Working Toward a Theoretical Model and Evidence-Based Interventions

To evaluate the efficacy of cognitive rehabilitation therapies (CRTs) for mild cognitive impairment (MCI). Our review revealed a need for evidence-based treatments for MCI and a lack of a theoretical rehabilitation model to guide the development and evaluation of these interventions. We have thus proposed a theoretical rehabilitation model of MCI that yields key intervention targets–cognitive compromise, functional compromise, neuropsychiatric symptoms, and modifiable risk and protective factors known to be associated with MCI and dementia. Our model additionally defines specific cognitive rehabilitation approaches that may directly or indirectly target key outcomes–restorative cognitive training, compensatory cognitive training, lifestyle interventions, and psychotherapeutic techniques. Fourteen randomized controlled trials met inclusion criteria and were reviewed. Studies markedly varied in terms of intervention approaches and selected outcome measures and were frequently hampered by design limitations. The bulk of the evidence suggested that CRTs can change targeted behaviors in individuals with MCI and that CRTs are associated with improvements in objective cognitive performance, but the pattern of effects on specific cognitive domains was inconsistent across studies. Other important outcomes (i.e., daily functioning, quality of life, neuropsychiatric symptom severity) were infrequently assessed across studies. Few studies evaluated long-term outcomes or the impact of CRTs on conversion rates from MCI to dementia or normal cognition. Overall, results from trials are promising but inconclusive. Additional well-designed and adequately powered trials are warranted and required before CRTs for MCI can be considered evidence-based.     

An experimental investigation of daytime monitoring for sleep-related threat in primary insomnia

An experimental manipulation was conducted to test the hypothesis that monitoring for sleep-related threat during the day triggers a cycle of cognitive processes that includes increased negative thinking, increased use of safety behaviours, increased perceived impairment in functioning, and increased self-reported sleepiness. Forty-seven individuals with primary insomnia were randomly assigned to a monitoring group (instructed to monitor their body sensations), a no-monitoring group (instructed to distract from their body sensations), or a no-instruction group. The manipulations to monitor or not monitor were administered immediately on waking and participants were asked to continue the manipulation throughout the experimental day. The monitoring group reported more negative thoughts, the use of more safety behaviours, and more sleepiness during the day relative to the no-instruction group. These findings offer support to a recent cognitive model, which identifies daytime monitoring for sleep-related threat as a key factor in the maintenance of the daytime distress and difficulty functioning in chronic insomnia.     

Does cognitive flexibility training enhance subjective mental functioning in healthy older adults?

Declining cognitive abilities in older adults can contribute to significant changes in socioemotional health and substantially reduce their perception of well-being. Whereas much attention has been dedicated to creating cognitive training programs to improve cognitive health in old age, there is little emphasis on the consequences of such interventions for subjective mental functioning. We created a randomized controlled trial in which we evaluated the effects of an adaptive computerized cognitive flexibility training. Healthy older adults (60–80 years old) were assigned to one of three conditions (frequent or infrequent switching or active control group) and performed 58 half-hour sessions within a period of 12 weeks. We measured effects on subjective cognitive failures and executive dysfunctioning, everyday functioning, depressive symptoms, anxiety, and quality of life, before, and after training. Additionally, participants’ proxies rated their cognitive failures and executive dysfunctioning. Subjective cognitive failures and executive dysfunctioning improved 4 weeks posttraining in all groups, although effect sizes were low (?_p² = .058 and .079, respectively) and there were no differences between groups (all p’s > .38). No significant changes in subjective reports were seen directly after training, which was the case in all groups. Proxies did not report any functional changes over time, yet their evaluations were significantly more favorable than those of the participants, both pretraining (p < .0005) and posttraining (p = .004). Although we found no evidence of improvement on subjective mental functioning, we adduce several factors that encourage further research into the effects of computerized cognitive training on subjective performance.     

计算机心理干预在物质成瘾中的应用

针对物质成瘾者的计算机心理干预以传统心理干预理论为基础,通过计算机和网络对成瘾者进行干预。该方法通过提高成瘾者的自我效能感、应对技能、戒断动机等,达到帮助其戒断并预防复吸的目的。计算机心理干预对成瘾者虽有一定效果,但也存在一些问题,如其能否够弥补传统干预的不足,测量方法是否有效等。未来研究应进一步提高计算机干预的有效性,比较不同计算机干预方法对不同成瘾物质的适用性及有限性,并结合计算机干预与认知训练,推动计算机心理干预在物质成瘾中的应用。     

Working memory training and transfer in older adults

There has been a great deal of interest, both privately and commercially, in using working memory training exercises to improve general cognitive function. However, many of the laboratory findings for older adults, a group in which this training is of utmost interest, are discouraging due to the lack of transfer to other tasks and skills. Importantly, improvements in everyday functioning remain largely unexamined in relation to WM training. We trained working memory in older adults using a task that encourages transfer in young adults (Chein & Morrison, 2010). We tested transfer to measures of working memory (e.g., Reading Span), everyday cognitive functioning [the Test of Everyday Attention (TEA) and the California Verbal Learning Test (CVLT)], and other tasks of interest. Relative to controls, trained participants showed transfer improvements in Reading Span and the number of repetitions on the CVLT. Training group participants were also significantly more likely to self-report improvements in everyday attention. Our findings support the use of ecological tasks as a measure of transfer in an older adult population.     

Preparing for novelty with diverse training

This study investigated the ability to generalize acquired skills from training conditions to novel conditions, in a complex perceptual and cognitive task of luggage screening. We examined category and exemplar diversity during training for preparing learners to detect novel items during transfer. Category diversity was manipulated in terms of heterogeneity of training categories: Participants either trained with targets from one category or with targets from several categories. Exemplar diversity was manipulated between participants by presenting either a few or many exemplars for both category diversity conditions. Seventy‐two participants were trained to identify threats in pieces of luggage. Thereafter they were transferred to novel stimuli. Results can be summarized in support for the diversity of training hypothesis for preparing for novelty: To the best training for novel luggage screening situations is achieved using fewer items in a variety of categories. Copyright © 2010 John Wiley & Sons, Ltd.     

Computerized cognitive training during physical inactivity improves executive functioning in older adults

The hippocampus is closely tied to spatial navigation, a central component in cognitive functioning, and critically involved in age-associated cognitive decline and dementia. This study evaluated a novel, cognitive computerized spatial navigation training (CSNT) program targeting the hippocampus, with expectation of mitigating possible cognitive decline with bed rest (BR). During a 14-day BR study with 16 healthy, older men (mean age = 60 ± 3, range = 55–65 years), half received CSNT for 12 days in 50-min sessions and half were controls (watching documentaries). This design uniquely controlled diet, sleep, and other personal and environmental activities. Although there were no cognitive declines in controls post-BR, CSNT participants demonstrated significant increases in executive/attention ability and processing speed, and continued spatial navigation testing showed improvement to 400 days post-BR. This intervention may prove useful to mitigate cognitive declines known to occur in long periods of immobilization and could have broader implications in protecting against age-related cognitive decline.     

An empowerment model of memory training

The authors outline an empowerment model of memory rehabilitation. Unlike conventional cognitive rehabilitation methods, clients' plan and control the treatment process from the earliest stages of therapy. The client identifies functional goals and the therapy is geared to achieve those goals. The empowerment model also emphasizes domain-specific compensatory training. Memory strategies and prosthetic devices are chosen so as to maximize transfer of training in the workplace, training programme, or in the client's activities of daily living. Group therapy involves clients teaching their newly learned skills to other clients. The authors present research findings to document the efficacy of the empowerment model, describe its limitations, and discuss how the model can be implemented effectively.     

The impact of dialectical behaviour therapy training on therapists in Singapore: A mixed-methods study

Background

While dialectical behaviour therapy (DBT) has much empirical support for treating borderline personality disorder (BPD) and other conditions, little research has examined the dissemination of DBT in Southeast Asia.

Aims

This study evaluated training outcomes following a 5-day intensive DBT training programme in a group of psychologists in Singapore, who were in the process of implementing DBT as part of the training's objectives.

Methodology

A mixed-methods design was employed. Fourteen psychologists from a public psychiatric hospital in Singapore were recruited. Seven self-selected into DBT training, and the remaining were matched controls who were not attending the training programme. The latter served as a nonrandomised control group. Prior to and 3 months after training, all participants completed measures of stigma towards BPD patients, burnout and therapeutic alliance. DBT training participants additionally attended a focus group discussion assessing their experiences and challenges implementing DBT in Singapore's context.

Findings

Quantitative analyses using mixed ANOVA showed that, compared with controls, DBT-trained participants demonstrated significantly greater increases in acceptance towards BPD patients. No between-group differences were found on changes in burnout or therapy alliance with patients. Analyses of qualitative data using thematic analysis revealed that DBT training impacted the way participants conceptualised and delivered therapy for BPD patients, and highlighted several challenges in implementing DBT in the local hospital context.

Conclusion

The findings demonstrate the potential of DBT training in improving clinicians' attitudes towards BPD patients and support a need for policymakers to prepare organisations for DBT implementation to ensure programme sustainability.     

Non-pharmacologic Interventions for CFS: A Randomized Trial

Non-pharmacological behavioral treatments for CFS have been suggested as promising. These trials have tested protocols composed of behavioral, cognitive and cognitive–behavioral interventions but there have been few efforts to differentially evaluate their outcomes. The primary purpose of the current study was to evaluate the effectiveness of nurse delivered non-pharmacologic interventions. In the present study, 114 participants diagnosed with CFS were randomly assigned to four 6-month interventions. The interventions were: cognitive–behavior therapy, cognitive therapy, anaerobic activity, and a relaxation control group. The study found that these interventions led to increases in several areas of functioning, with more consistent changes occurring among those participants in the cognitive condition. For the 25 variables in this study, significant change occurred for 28%, 20%, 16%, and 12% of the variables for the cognitive, cognitive behavior therapy, anaerobic activity, and relaxation conditions, respectively. However, the majority of participants continued to be diagnosed with CFS following the treatment trial. Implications of these findings are discussed.     

Managing daily life with age-related sensory loss: cognitive resources gain in importance

This paper investigates the role of cognitive resources in everyday functioning, comparing visually impaired, hearing impaired, and sensory unimpaired older adults. According to arguments that cognitive resources are of increased importance and a greater awareness of cognitive restrictions exists among sensory impaired individuals, in particular among visually impaired individuals, we hypothesized differential relationships between resources and outcomes when comparing sensory impaired and sensory unimpaired older adults. Findings are based on samples of 121 visually impaired, 116 hearing impaired, and 150 sensory unimpaired older adults (M = 82 years). Results from a sample of 43 dual sensory impaired older adults are reported for comparison. Assessment relied on established instruments (e.g., WAIS-R, ADL/IADL). Structural equation modeling showed that cognitive resources and behavior-related everyday functioning were more strongly related in the sensory impaired groups as compared to the sensory unimpaired group. Cognitive resources and evaluation of everyday functioning were significantly linked only among the sensory impaired groups. When medical condition was controlled for, these effects persisted. It is concluded that both cognitive training as well as psychosocial support may serve as important additions to classic vision and hearing loss rehabilitation.     

Working memory training improvements and gains in non-trained cognitive tasks in young and older adults

Previous studies on working memory training have indicated that transfer to non-trained tasks of other cognitive domains may be possible. The aim of this study is to compare working memory training and transfer effects between younger and older adults (n = 60). A novel approach to adaptive n-back training (12 sessions) was implemented by varying the working memory load and the presentation speed. All participants completed a neuropsychological battery of tests before and after the training. On average, younger training participants achieved difficulty level 12 after training, while older training participants only reached difficulty level 5. In younger participants, transfer to Verbal Fluency and Digit Symbol Substitution test was found. In older participants, we observed a transfer to Digit Span Forward, CERAD Delayed Recall, and Digit Symbol Substitution test. Results suggest that working memory training may be a beneficial intervention for maintaining and improving cognitive functioning in old age.     

Mindfulness meditation improves cognition: Evidence of brief mental training

Although research has found that long-term mindfulness meditation practice promotes executive functioning and the ability to sustain attention, the effects of brief mindfulness meditation training have not been fully explored. We examined whether brief meditation training affects cognition and mood when compared to an active control group. After four sessions of either meditation training or listening to a recorded book, participants with no prior meditation experience were assessed with measures of mood, verbal fluency, visual coding, and working memory. Both interventions were effective at improving mood but only brief meditation training reduced fatigue, anxiety, and increased mindfulness. Moreover, brief mindfulness training significantly improved visuo-spatial processing, working memory, and executive functioning. Our findings suggest that 4 days of meditation training can enhance the ability to sustain attention; benefits that have previously been reported with long-term meditators.     

Participant modelling training programme: Tutoring the paraprofessional

A participant modelling training programme designed to improve self-efficacy and the ability to cope effectively with stressful situations was implemented with paraprofessional young counsellors who work in conjunction with youth advancement counsellors. Self-efficacy was measured by assessing their beliefs about their ability to cope effectively and successfully with various situations. Their motivation to engage in such a task was also assessed before and after the training programme. Contrary to prediction, following the training the self-efficacy of subjects decreased significantly. However, their motivation to get started and become involved with the disadvantaged youth significantly increased. The results are discussed in terms of reality perception and participant modelling training.     

The unique impact of parent training for separation anxiety disorder in children

This investigation examined the preliminary efficacy of an integrated cognitive-behavioral parent-training protocol for six families of separation-anxious children (7 to 10 years of age) using a multiple baseline design across participants. Although families were assessed on child, parent, and clinician ratings at pre- and posttreatment as well as 6-month follow-up, only parents received education and training. Although the parent-training protocol was largely effective and treatment gains were maintained at 6-month follow-up, only those child participants whose parents experienced clinically significant improvement on parental process measures (i.e., enhanced efficacy or satisfaction, reduced stress) achieved high end-state functioning. Implications regarding the importance of individualized family-based interventions for treating anxious youth are discussed.     

Memory training and strategy use in older adults: results from the ACTIVE study

Little is known about the long-term effects of memory training in later life on strategy use. Data from the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) study (n = 1,401) were used to describe strategy use in a community-dwelling sample of older adults. Strategy clustering scores on verbal list learning tasks of episodic memory were used to test the impact of memory training on strategy use and study longitudinal associations between strategy clustering, memory performance, and everyday functioning. Results suggested that younger, female, white, healthier, and more educated participants show higher strategy clustering scores initially but no characteristics were consistently associated with different trajectories in strategy clustering across all strategy clustering measures together. Memory training had significant immediate effects on all measures of strategy use that were maintained through five years of follow-up. With respect to longitudinal mediation, pre-post training changes in most strategy clustering scores mediate changes in objective memory performance and everyday functioning, implying that strategies can be modified and are closely related to both memory ability and the ability to function independently. This study provides evidence that older adults can be trained to use cognitive strategies, the effects are durable, and strategies are associated with memory and everyday functioning.