Trait and symptom change in group cognitive behaviour therapy for anxiety and depression.

Personality traits underlying both anxiety disorders and depression are more malleable than previously presumed. This study examined associations between changes in personality traits (i.e. negative affectivity and detachment) and alleviation of anxiety and depression symptoms following cognitive behaviour therapy (CBT). We hypothesized that decreases in negative affectivity would predict alleviation of depression and anxiety symptoms and decreases in detachment would predict decreases in depression and, to a lesser degree, anxiety symptoms. Data (N = 156) were collected in a randomized controlled trial comparing transdiagnostic and diagnosis-specific group CBT for patients with major depressive disorder, social anxiety disorder, panic disorder or agoraphobia. We assessed personality traits using the Personality Inventory for DSM-5 (PID-5) and symptoms with the Hopkins Symptom Checklist 25-item scale (SCL). Prediction was based on regression analyses. We found that decreases in negative affectivity predicted lower levels of depression and anxiety symptoms while decreases in detachment only predicted lower levels of depression symptoms. The findings substantiate current efforts to explicate the dynamic interplay between personality traits and symptoms and support the existing focus on targeting negative affectivity and detachment in therapy for anxiety disorders and depression. The trial is registered at clinicaltrials.gov (ID NCT02954731).

The Effects of Computer Based Cognitive Rehabilitation in Stroke Patients with Working Memory Impairment: A Systematic Review.

OBJECTIVES: To evaluate benefits and harms for computer based cognitive rehabilitation (CBCR) on working memory impairment after stroke. METHODS: PRISMA guidelines were followed. Four electronic databases were systematically searched: Embase, Pubmed/Medline, PsycInfo and Cochrane Library. Authors of relevant studies were contacted to detect unpublished data or articles not found by searching databases. SELECTION CRITERIA: Studies were eligible for inclusion in the systematic review if they 1) investigated the effects of CBCR on working memory after acquired brain injury in a patient sample which consisted of at least 50% stroke-patients, 2) it was possible to isolate the effects of CBCR-training by comparison to passive or active control groups, and 3) if the outcome assessment included a quantitative working memory outcome measure either isolated or as part of a general outcome measure. Included studies were further eligible for the meta-analysis if 1) they were conducted as a randomized controlled trial, 2) they included only stroke patients, and 3) the effects of CBCR on working memory could be isolated. RESULTS: Literature is limited and reported effects of CBCR on working memory after stroke are very heterogeneous. A meta-analysis was not performed as all studies used different measures of working memory. An additional analysis was performed in order to cautiously estimate the difference between the control interventions (whether passive or active) and CBCR interventions. The analysis revealed no meaningful differences in increase of working memory measures between control conditions and intervention conditions. However, this additional analysis should be interpreted with caution as it does not take the heterogeneity of outcome measures or the differences in sample sizes between studies into account. No harms were observed. CONCLUSION: There is insufficient evidence to conclude if CBCR is beneficial for patients with working memory deficits after stroke. SYSTEMATIC REVIEW NUMBER: This systematic review is registered in Prospero with registration ID: CRD42018087437.

The Effects of Computer-Based Cognitive Rehabilitation on Working Memory in Patients with Parkinson's Disease: A Systematic Review.

BACKGROUND: Deterioration of working memory(WM) is a common cognitive deficit in Parkinson's disease (PD), and severely influences the ability to lead an independent life. Interventions which can delay the impact of WM deficits could positively impact the independence and quality of life of patients. OBJECTIVE: To evaluate effects of computer-based cognitive rehabilitation (CBCR) on WM in patients with PD. METHODS: Pubmed, Embase, Psycinfo and Cochrane Library were systematically searched. Authors of included studies were contacted to detect unpublished data or articles not found by database-search. Broad selection criteria were applied because literature was expected to be limited. Studies were eligible for inclusion if they investigated the effects of CBCR on WM in a sample consisting of at least 50% PD patients, or in which the results of PD patients could be isolated. Studies were further eligible for inclusion in a planned meta-analysis if the effects of the CBCR intervention could be isolated, the CBCR intervention was compared to active or passive control groups consisting solely of PD patients, and the WM outcome measure could be isolated. RESULTS: Only six studies were included despite broad inclusion criteria. Study results were heterogeneous, and the risk of bias in study methodology was either unclear or high. Two studies were eligible for meta-analysis. A meta-analysis was not performed, because these studies used different measures of WM which were not rated as equally valid and reliable. CONCLUSION: Existing literature is sparse and provides insufficient evidence to conclude if CBCR benefits WM in PD patients.

The effects of computer-based cognitive rehabilitation in patients with visuospatial neglect following stroke: a systematic review.

OBJECTIVES: To identify studies concerning the effects of computer based cognitive rehabilitation (CBCR) on visuospatial neglect (VN) after stroke to summarize the current state of knowledge in this research field and make recommendations for future research. METHODS: Four electronic databases were systematically searched. Authors of relevant studies were contacted to detect unpublished data or articles not found by searching databases. Data was extracted from included studies using predefined coding schemes and characteristics and results of individual studies were summarized qualitatively. SELECTION CRITERIA: Studies were included if at least 50% of the included patients had a stroke, if the studies explored the effects of CBCR as a primary intervention for rehabilitation of VN and if they included neuropsychological outcome measures for the presence of VN. RESULTS: Seven studies were included. Six of the seven studies suggested positive effects of CBCR on VN after stroke. However, the study that did not find these effects was also the study with the strongest methodological quality. All included studies consisted of small samples, varied greatly in design and had various methodological limitations. CONCLUSION: Because the existing literature is very sparse and studies have various methodological limitations, it is currently not possible to either support or reject the effects of CBCR on VN after stroke. Future studies should aim to compare CBCR with active and passive control conditions and include larger samples in randomized and blinded designs.