Cognitive orientation and physical disease or health

This paper deals with a new approach to physical disease and health based on the theory of cognitive orientation (CO) (Kreitler and Kreitler, 1976, 1982). It presents an outline of the theory which is a comprehensive cognitive-motivational model of behaviour describing how cognitive contents and processes bring about the elicitation of behaviour. The theory generated a methodology for the prediction of behaviour that has been applied in different domains ofhealth psychology. Studies are described dealing with behaviours affecting health (quitting smoking, smoking, overeating, undergoing examinations for the early detection of breast cancer), behaviours of the individual in the role of sick person (hospitalization for safeguarding pregnancy, getting information on a cancer ward), aetiologies of physiopathologies (coronary heart disease, diabetes, vaginal infections) and disorders (menstrual and sexual disorders, and infertility in women), recovery and rehabilitation (from chronic pain, and following MI), and general health orientation. Finally, the outlines of an emergent CO model of physiopathology are presented, specifying how cognitions affect health, and in which sense the processes involved in physiopathology resemble and differ from those involved in the elicitation of overt behaviours.     

Cognitive enhancement, human evolution and bioethics

The goal of this article are three-fold. The first is to explore the relations between the properties designated by the terms "human", "post-human," "Transhuman", and to clarify the corresponding "isms". The second is to scrutinize the current techniques for cognitive enhancement in order to assess their relations with the three categories just mentioned, and, with the specific ethical issues that they are raising. The third is to examine whether general ethical principles could be invoked either in favor of or against, the normative proposals of post- and trans-humanism, and to consider how compatible the types of enhancement presently developed are with respect to these principles.     

Cognitive extension,enhancement, and the phenomenology of thinking

This paper brings together several strands of thought from both the analytic and phenomenological traditions in order to critically examine accounts of cognitive enhancement that rely on the idea of cognitive extension. First, I explain the idea of cognitive extension, the metaphysics of mind on which it depends, and how it has figured in recent discussions of cognitive enhancement. Then, I develop ideas from Husserl that emphasize the agential character of thought and the distinctive way that conscious thoughts are related to one another. I argue that these considerations are necessary for understanding why forms of cognitive extension may diminish our cognitive lives in different ways. This does not lead to a categorical rejection of cognitive enhancement as unethical or bad for human flourishing, but does warrant a conservative approach to the design and implementation of cognitive artifacts.     

Mental health enhancement of children and youth

The enhancement of positive mental health in children is discussed as a needed emphasis in the area of pastoral care to children and youth. Three modes of providing such enhancement are given. These are parenting education services, mental health exercises for the children or youth, and preaching and worship ministries in the local church. Illustrations and applications of each are discussed.     

Cognitive counseling for health care compliance

This paper proposes a therapy/counseling model based on RET and other cognitive approaches to enable the therapist in a health care setting to enhance patient compliance with medical and life-style treatment recommendations. Problems and reasons for low rates of compliance with treatment regimens in health settings are discussed. A four phase treatment/therapy approach including Assessment, Insight, Working Through and Homework is presented.     

Cognitive activity and risk of alzheimer's disease

Recent research suggests that frequent participation in cognitively stimulating activities may reduce risk of Alzheimer's disease in old age. We review epidemiological evidence of such an association. We then consider whether cognitive activity can account for the association between higher educational and occupational attainment and reduced risk of Alzheimer's disease. Finally, we discuss the behavioral and neurobiological mechanisms that may underlie the association between cognitive activity and risk of Alzheimer's disease.     

Cognitive organization of disease concepts in Singapore

Abstract

This research investigates illness cognition and its relationship to the use of different types of medicine in three ethnic groups in Singapore. Four hundred and twenty-nine Chinese, Malay, and Indian Singaporeans rated 24 diseases as to their similarity. Multidimensional scaling (MDS) indicated three dimensions. Regression of these dimensions against 17 disease attributes suggested that these dimensions represented spiritual/psychological causation, disease severity, and viral causation. When the dimensions were related to the use of, preference for and perceived effectiveness of different types of medicine it was found that Indian medicine tended to be used, preferred and perceived to be most effective for diseases low in severity whereas Chinese medicine was viewed most favourably for diseases perceived to be low in spiritual/psychological causation as well as those not seen as virally caused. Malay medicine tended to used, preferred and perceived as most effective for conditions believed to be non-serious and not caused by a virus. Western medicine was most likely to be used, preferred, and seen as most effective for diseases viewed as serious as well as those believed to be virally caused.     

Cognitive adaptation and mental health: A motivational analysis

The present study tested a motivational model where the beneficial impact that processes of cognitive adaptation have on mental health takes place through self‐determined motivation. The model proposes that the components of cognitive adaptation theory (positive self‐perceptions, perceptions of control, and optimism) foster a self‐determined motivation. In turn, self‐determined motivation predicts positive indices of mental health. In addition, the model posits that the beneficial role of cognitive adaptation on mental health is mediated by motivational processes. The model was tested using a 1‐year prospective design with a random sample from the general population. Results from structural equation modelling analysis provided empirical support for the proposed model. Results are discussed with regards to Taylor's ( 1983 ) cognitive adaptation theory, self‐determination theory (Deci & Ryan, 1991 ), and the Hierarchical Model of Intrinsic and Extrinsic Motivation (Vallerand, 1997 ). Copyright © 2004 John Wiley & Sons, Ltd.     

Motivational factors in health and disease

Evidence is reviewed that measures of motive strength, as measured through content analysis of associative thought, are related to physiological systems, the functioning of which affect health outcomes. Studies show that affiliative and power motive syndromes assessed in associative thought are associated with health and illness. A relaxed or easygoing affiliative motive syndrome characterizes insulin dependent Type I diabetics and can, if aroused, lead to poorer blood sugar control in such diabetics. A stressed power motive syndrome is associated with sympathetic activation, release of stress hormones, depressed immune functions, and greater susceptibility to infectious diseases. Affiliative trust and a greater sense of agency as measured in associative thought content are associated with better health. An intervention study and a longitudinal study have demonstrated that differences in the levels of these motivational variables are not simply the result of illness but lead to alterations in subsequent health status.     

Cognitive impairment in dementia: correlations with atrophy and cerebrovascular disease quantified by magnetic resonance imaging

This project assessed the contributions of atrophy and cerebrovascular disease (CVD) to cognitive impairment in dementia. Ten individuals with clinically diagnosed pure VaD were age-, sex-, and education-matched to individuals with AD. All participants underwent neuropsychological testing and MRI which were processed to generate quantitative indices of atrophy and CVD. A linear regression, including thalamic lesion and vCSF volumes, predicted cognitive status (R2 = .74; p < .0005). Three VaD subgroups were identified: thalamic lesion (n = 4), hippocampal infarcts (n = 3), and other (n = 3). In participants without thalamic lesion, vCSF predicted general cognition (R2 = .48), hippocampal atrophy predicted memory impairment (R2 = .33), and white matter lesions predicted executive dysfunction (R2 = .48). Both atrophy and CVD burden correlated highly with cognitive impairment and should be simultaneously assessed in studies of brain-behaviour relations in dementia.     

Cognitive resource limitations during sentence comprehension in Parkinson's disease

We report a single-case study of peripherally acquired dyslexia that meets the clinical criteria of "alexia without agraphia." The patient, AA, has a large infarct involving the left posterior cerebral artery. The most striking feature is a severe impairment in recognizing single visually presented letters that precludes explicit or implicit access to reading, even in a letter-by-letter fashion. AA can, however, differentiate letters from similar nonsense characters and digits, and he is also able to identify alphanumeric signs when the visual channel is bypassed (through somesthesic or kinesthesic presentation). Spelling tasks are also well performed. Since there is a breakdown in mapping a visually presented letter to its abstract graphemic representation, we propose the term "visuographemic alexia" for this kind of reading disorder. The pattern of deficits is interpreted following theoretical models previously developed in cognitive neuropsychology. An alexia for arabic numerals with preserved comprehension lends additional support for the crucial processing of different notational systems (e.g., phonographic vs logographic). More general perceptive disorders do not seem to account for these patterns; they are material-specific. Finally, we attempt to specify functional correlations with the implied neural networks.     

Cognitive slowing in decision tasks in early and advanced Parkinson's disease.

Ten untreated patients with recently diagnosed Parkinson's disease (PD), 9 treated patients with more advanced pathology, and 17 matched normal controls were investigated with three reaction tasks with increasing cognitive load but identical motor requirements: simple reaction, choice reaction with indicative stimuli, and choice reaction with ambiguous stimuli. Times required until a home key was released (= reaction time) and from then until a response key was pressed (= movement time) were recorded. Estimates of pure decision time (overall response time minus movement time in a simple reaction time task) revealed a difference between advanced and early PD patients. Advanced PD patients showed an overall slowing of decision time in the reaction time tasks, but the effect of the cognitive load of the tasks on the decision time was comparable to a control group. The untreated early PD patients performed quite normally in the more simple decision tasks but showed a disproportionate slowing of decision time in tasks with higher cognitive load.     

Cognitive and affective Theory of Mind in mild to moderate Alzheimer's disease

Theory of Mind (ToM) allows one's own and others' cognitive and emotional mental states to be inferred. Although many patients with Alzheimer's disease (AD) display impaired social functioning as their disease progresses, very few studies have investigated ToM in AD. Those that have done so suggest that patients' ToM deficits are the consequence of other cognitive impairments. The aim of this study was thus to investigate changes in both the cognitive and the affective dimensions of ToM in AD, using tasks designed to circumvent the patients' comprehension difficulties. Sixteen mild to moderate AD patients and 15 healthy controls matched on age, sex and education level underwent cognitive (preference judgment and first‐ and second‐order false belief) and affective (Reading the Mind in the Eyes) ToM assessments. Comprehension of false belief stories was verified and an additional neuropsychological examination was undergone. We observed impaired performances by AD patients on all the ToM tasks. While working memory and executive functioning impairments contributed to the deterioration in the more complex aspects of cognitive ToM abilities as highlighted by a correlation analysis, we failed to observe any comprehension difficulties in patients who performed poorly on simple cognitive ToM tasks, which suggests that AD truly affects cognitive ToM.     

Autonomy and coercion in disease prevention and health promotion

Most of the attention regarding the balance between autonomy and paternalism has been focused on the therapeutic relation. Much less attention has been devoted to the problem of autonomy in the application of medical knowledge for preventive purposes. Here, because the good to be achieved is social as well as individual, an unavoidable dilemma ensues. Effective preventive measures of benefit to all must necessarily limit autonomy and involve some coercion. I argue that there are principles which can be established to guide society in a moral use of coercion. The question of employing medical knowledge is not, as it is in therapeutic medicine, to preserve or enhance autonomy. Rather its aim is to enhance voluntary co-operation. Principles for moral use of coercion must thereby be derived from health as a moral value.     

Cognitive plasticity in Alzheimer's disease patients receiving cognitive stimulation programs

The main purpose of this article is to examine whether cognitive plasticity increases after cognitive training in Alzheimer's disease patients. Twenty six patients participated in this study, all of them diagnosed with mild Alzheimer's disease, 17 of them received a cognitive training program during 6 months, and the other 9 were assigned to the control group. Participants were assigned to experimental or control conditions for clinical reasons. In order to assess cognitive plasticity, all patients were assessed before and after treatment with three subtests from the "Bateria de Evaluación de Potencial de Aprendizaje en Demencias" [Assessment Battery of Learning Potential in Dementia] (BEPAD). After treatment, Alzheimer's disease patients improved their performance in all the tasks assessing cognitive plasticity: viso-spatial memory, audio-verbal memory and verbal fluency. However, the cognitive plasticity scores of the patients in the control group decreased. In conclusion, this study showed that cognitive stimulation programs can improve cognitive functioning in mildly demented patients, and patients who do not receive any cognitive interventions may reduce their cognitive functioning.     

Cognitive functions and corticostriatal circuits: insights from Huntington's disease

The basic mechanisms of information processing by corticostriatal circuits are currently a matter of intense debate amongst cognitive scientists. Huntington's disease, an autosomal-dominant neurogenetic disorder characterized clinically by a triad of motor, cognitive, and affective disturbance, is associated with neuronal loss within corticostriatal circuits, and as such provides a valuable model for understanding the role of these circuits in normal behaviour, and their disruption in disease. We review findings from our studies of the breakdown of cognition in Huntington's disease, with a particular emphasis on executive functions and visual recognition memory. We show that Huntington's disease patients exhibit a neuropsychological profile that shows a discernible pattern of progression with advancing disease, and appears to result from a breakdown in the mechanisms of response selection. These findings are consistent with recent computational models that suggest that corticostriatal circuits compute the patterns of sensory input and response output which are of behavioural significance within a particular environmental context.     

Cognitive influences on health symptoms from acute chemical exposure.

Symptom reports, perceived adverse health effects, and public health concerns are increasingly precipitated by the perception of chemical odors. This study examined the interaction between health cognitions, odor perception, and symptom reports. A group of 180 healthy men and women were exposed to 1 of 3 ambient odors, normatively rated as healthful (methyl salicylate, or wintergreen), harmful (butanol or alcohol), and ambiguous (isobomyl acetate, or balsam), after receiving 1 of 3 odorant characterizations (harmful, healthful, and neutral). Individuals given a harmful bias reported significantly more health symptoms following exposure and more intense odor and irritation during exposure than did those given a neutral or healthful bias. The overall pattern of results suggests that many of the health-related effects of exposure to odorants are mediated not by a direct agency of odors but by cognitive variables, such as mental models of the relationship between environmental odors and health.