Riding the waves: A functional‐cognitive perspective on the relations among behaviour therapy,cognitive behaviour therapy and acceptance and commitment therapy

Different types of therapy explain psychopathology and the effects of psychotherapy differently. Different explanations are, however, not necessarily mutually exclusive. Based on the idea that functional and cognitive explanations are situated at different levels, we argue that functional therapies such as traditional Behaviour Therapy (BT) and Acceptance and Commitment Therapy (ACT) are not necessarily incompatible with Cognitive Behaviour Therapy (CBT). Whether a functional and a cognitive therapy actually align depends on whether they highlight the same type of environmental causes. This functional‐cognitive perspective reveals various differences and communalities among BT, CBT and ACT.     

Cognitive Alexithymia Mediates the Association Between Avoidant Attachment and Interpersonal Problems in Patients With Somatoform Disorder

Patients with somatoform disorder (SFD) are characterized by the presence of chronic physical complaints that are not fully explained by a general medical condition or another mental disorder. Insecure attachment patterns are common in this patient group, which are often associated with interpersonal difficulties. In the present study, the mediational role of two types of alexithymia and negative affectivity (NA) was examined in the association between attachment styles and interpersonal problems in a group of 120 patients with SFD. Patients were requested to fill out several self-report questionnaires for the assessment of attachment strategies, alexithymia, NA, and interpersonal problems. Cognitive alexithymia (i.e., the inability to identify and verbalize emotions) mediated the relationship between avoidant attachment patterns and interpersonal problems, even after controlling for NA. Preliminary findings also suggested that NA acted as a moderator of the mediator cognitive alexithymia. These results have important implications for clinical practice, as this study clearly shows that interpersonal problems do not automatically follow from insecure attachment strategies, but are contingent upon alexithymic features. It is recommended to target alexithymic features in patients with SFD, particularly in the context of negative emotions. Therefore, cognitive alexithymia may be an important therapeutic focus, specifically in the treatment of avoidant ptients with SFD.     

Self-deception as affective coping. An empirical perspective on philosophical issues

In the philosophical literature, self-deception is mainly approached through the analysis of paradoxes. Yet, it is agreed that self-deception is motivated by protection from distress. In this paper, we argue, with the help of findings from cognitive neuroscience and psychology, that self-deception is a type of affective coping.First, we criticize the main solutions to the paradoxes of self-deception. We then present a new approach to self-deception. Self-deception, we argue, involves three appraisals of the distressing evidence: (a) appraisal of the strength of evidence as uncertain, (b) low coping potential and (c) negative anticipation along the lines of Damasio’s somatic marker hypothesis. At the same time, desire impacts the treatment of flattering evidence via dopamine. Our main proposal is that self-deception involves emotional mechanisms provoking a preference for immediate reward despite possible long-term negative repercussions. In the last part, we use this emotional model to revisit the philosophical paradoxes.     

Self-regulatory driving behaviours amongst older drivers according to cognitive status

Self-regulation of older drivers was explored according to their cognitive status in this pilot study by examining situations commonly avoided by older drivers. In addition, the role of driver insight on self-regulation was examined via passenger reports. Telephone interviews were conducted comprising 49 drivers aged 65 years and above and 40 passengers who acted as informants. Self-regulation was found to be common, with the majority of drivers (71.4%) reporting sometimes or always avoiding one of seven driving situations. However, drivers with cognitive impairment reported self-regulating more often than drivers without cognitive impairment. The largest discrepancy between passenger and driver reports of self-regulation behaviours was found for the drivers with cognitive impairment. These results possibly reflect a decreased awareness of self-regulatory driving behaviours in this subgroup of older drivers and may suggest that other external factors are contributing to self-regulation in older drivers with cognitive impairment. A discussion of these factors is provided with the aim of maintaining mobility and enhancing quality of life in this growing segment of the driver population.     

Development and initial validity of the Exercise-Related Cognitive Errors Questionnaire

ObjectiveCognitive errors (CEs) reflect individuals' biased evaluations of context-relevant information. In the exercise domain, a valid form of exercise CE assessment is needed. The Exercise-related Cognitive Errors Questionnaire (E-CEQ) was developed to determine to what extent adults make cognitive errors regarding exercise decisions. The purpose of this study was to develop and provide initial validity evidence for the E-CEQ.DesignThe current study used an online self-report survey.MethodFirst, 24 initial vignettes representing 6 CEs were created and content validated. Second, data from 364 adults (M_age = 29.1, SD_age = 11.6; 81.3% female) was gathered to examine the E-CEQ's factor structure. Finally, data from the 364 participants was used to examine aspects of criterion-related validity.ResultsA 16-item, three-factor model was retained as the final E-CEQ factor structure and had good psychometric properties (χ² = 164.35, df = 75, p < .001; RMSEA = .057; CFI = .947; TLI = .915). Evidence of the questionnaire's predictive utility is provided. For example, exercise CEs were negatively related to exercise and accounted for 4.9% of additional variance beyond the contribution of past exercise in predicting exercise intention.ConclusionsThe steps taken to examine different forms of validity helped provide a platform from which to continue (a) to study biases linked to cognitive errors and (b) the E-CEQ validation process through ongoing investigation.     

Cognitive mediation of putting: Use of a think-aloud measure and implications for studies of golf-putting in the laboratory

ObjectivesWhereas accounts of skilled performance based on automaticity (Beilock & Carr, 2001; Fitts & Posner, 1967) emphasize reduced cognitive involvement in advanced skill, other accounts propose that skilled performance relies on increased cognitive control (Ericsson & Kintsch, 1995). The objective of this study was to test predictions differentiating the automaticity and cognitive control accounts by assessing thinking during golf putting.DesignThe cognitive processes of less-skilled and more-skilled golfers were examined during putting using concurrent, think-aloud verbal reports. The design included putting conditions that differed in complexity and thus the need to adapt the putt to the particular conditions.MethodPutting complexity was manipulated via changes to putt length and perceived stress during putting. Putts were executed from two starting locations (i.e., the same starting location as the previous putt or a new starting location).ResultsThe analysis showed that, during putting: more thoughts were verbalized overall by more-skilled golfers than less-skilled golfers; both groups verbalized more thoughts overall during higher-complexity putts (i.e., longer distance putts, and putts under higher stress when executed from a new starting location) than lower-complexity putts; and the two groups did not differ significantly in the number of thoughts related to motor mechanics.ConclusionsThe results of this study provide support for a cognitive control account of skilled performance and suggest that the path to skilled performance involves the acquisition of more refined higher-level cognitive representations mediating planning and analysis.     

Health‐adjusted neuropsychological test norms based on 463 older Swedish car drivers

There is a need for improved normative information in particular for older persons. The present study provides neuropsychological test norms on seven cognitive tests used in a sample representing the general older driving population, when uncontrolled and controlled for physical health. A group of 463 healthy Swedish car drivers, aged 65 to 84 years, participated in a medical and neuropsychological examination. The latter included tests of visual scanning, mental shifting, visual spatial function, memory, reaction time, selective attention, and simultaneous capacity. Hierarchical regression analyses demonstrated that, when uncontrolled for health, old age was associated with significant impairment on all seven tests. Education was associated with a significant advantage for all tests except most reaction time subtests. Women outperformed men on selective attention. Controlling for health did not consistently change the associations with education, but generally weakened those with age, indicating rises in normative scores of up to 0.36 SD (residual). In terms of variance explained, impaired health predicted on average 2.5%, age 2.9%, education 2.1% and gender 0.1%. It was concluded (1) that individual regression‐based predictions of expected values have the advantage of allowing control for the impact of health on normative scores in addition to the adjustment for various demographic and performance‐related variables and (2) that health‐adjusted norms have the potential to classify functional status more accurately, to the extent that these norms diverge from norms uncontrolled for physical health.     

Walking impairs cognitive performance among people with multiple sclerosis but not controls

People with multiple sclerosis (MS) complain of problems completing two tasks simultaneously; sometimes called ‘dual-tasking’ (DT). Previous research in DT among people with MS has focused on how adding a cognitive task interferes with gait and few have measured how adding a motor task could interfere with cognition. We aimed to determine the extent to which walking affects a concurrent working memory task in people with MS compared to healthy controls. We recruited MS participants (n = 13) and controls (n = 10) matched by age (±3 years), education (±3 years) and gender. Participants first completed the cognitive task (subtracting 7’s from the previous number) and then again while walking on an instrumented walkway. Although there were no baseline differences in cognition or walking between MS participants and controls, MS participants demonstrated a 52% decrease in number of correct answers during DT (p < 0.001). Mental Tracking Rate (% correct answers/min) correlated strongly with MS-related disability measured using the Expanded Disability Status Scale (EDSS; r(11) = −0.68, p < 0.01). We propose that compromised mental tracking during walking could be related to limited neural resource capacity and could be a potentially useful outcome measure to detect ecologically valid dual tasking impairments.     

Exploring inter-task transfer following a CO-OP approach with four children with DCD: A single subject multiple baseline design

IntroductionCognitive Orientation to daily Occupational Performance (CO-OP) approach has been shown to be effective for improving the performance of tasks worked on in therapy and the use of cognitive strategies. No study to date seems to have explored its effectiveness for improving performance of untrained tasks (inter-task transfer) in children with Developmental Coordination Disorder (DCD).ObjectiveThis study aimed to determine whether CO-OP leads to improved performance in an untrained task.MethodsA single-subject design with multiple baselines across skills was adopted, with three replications. Four children with DCD (7–12 years) received 10 sessions of CO-OP intervention where each child worked on three tasks during therapy sessions and a fourth task was identified, but not worked on, to verify inter-task transfer. Task performance was rated over four phases (baseline, intervention, post-intervention, follow-up) using the Performance Quality Rating Scale (PQRS-OD). Graphed data was statistically analyzed using a two or three standard deviation band method.ResultsSignificant improvement was obtained for 11 of 12 tasks worked on during therapy and for two of the four untrained tasks.ConclusionThese results indicate that the effectiveness of CO-OP to improve untrained tasks in children merit further exploration.     

Effort to reduce postural sway affects both cognitive and motor performances in individuals with Parkinson’s disease

ObjectivesTo assess the effects of voluntarily reducing postural sway on postural control and to determine the attention level needed to do so in healthy adults (n = 16, 65.9 ± 9.7) and persons with PD (n = 25, 65.8 ± 9.5 years). Tasks: quiet and still standing conditions with and without a category task. Cognitive performance, center of pressure (CoP) displacement variability (RMSCoP) and velocity (VCoP) were assessed in the anterior-posterior (AP) and medial-lateral (ML) directions.Controls showed larger RMSCoP (AP) and VCoP (AP and ML) during still versus quiet standing (p < 0.01), while the PD group demonstrated no changes. In the PD group, RMSCoP and VCoP (ML) increased in still standing when performed with the cognitive task (p < 0.05). In both groups, cognitive responses decreased in still standing (p < 0.05).In PD, attempting to reduce postural sway did not affect postural control under single task conditions, however ML CoP variability and velocity did increase as a dual task. In older adults, increased displacement and velocity in both AP and ML directions was observed during single, but not dual task conditions. Therefore standing still might not be an adequate postural strategy as it increases the attentional demand and affects motor performance, putting persons with PD at greater risk for falls.