Feasibility randomised controlled trial of online group Acceptance and Commitment Therapy for Functional Cognitive Disorder (ACT4FCD).

INTRODUCTION: Functional cognitive disorder (FCD) is seen increasingly in clinics commissioned to assess cognitive disorders. Patients report frequent cognitive, especially memory, failures. The diagnosis can be made clinically, and unnecessary investigations avoided. While there is some evidence that psychological treatments can be helpful, they are not routinely available. Therefore, we have developed a brief psychological intervention using the principles of acceptance and commitment therapy (ACT) that can be delivered in groups and online. We are conducting a feasibility study to assess whether the intervention can be delivered within a randomised controlled trial. We aim to study the feasibility of recruitment, willingness to be randomised to intervention or control condition, adherence to the intervention, completion of outcome measures and acceptability of treatment. METHODS AND ANALYSIS: We aim to recruit 48 participants randomised 50:50 to either the ACT intervention and treatment as usual (TAU), or TAU alone. ACT will be provided to participants in the treatment arm following completion of baseline outcome measures. Completion of these outcome measures will be repeated at 8, 16 and 26 weeks. The measures will assess several domains including psychological flexibility, subjective cognitive symptoms, mood and anxiety, health-related quality of life and functioning, healthcare utilisation, and satisfaction with care and participant-rated improvement. Fifteen participants will be selected for in-depth qualitative interviews about their experiences of living with FCD and of the ACT intervention. ETHICS AND DISSEMINATION: The study received a favourable opinion from the South East Scotland Research Ethics Committee 02 on 30 September 2022 (REC reference: 22/SS/0059). HRA approval was received on 1 November 2022 (IRAS 313730). The results will be published in full in an open-access journal. TRIAL REGISTRATION NUMBER: ISRCTN12939037.

Preoccupation with detail contributes to poor abstraction in women with anorexia nervosa.

The present study investigated preoccupation with detail as a potential mechanism underlying poor abstraction in anorexia nervosa (AN). Abstract thinking performance of 24 women with AN (16-31 years) was compared against that of 24 healthy controls matched for age, education and socio-economic status, using the Object Assembly subtest of the WAIS III. Participants also completed measures of two indices of preoccupation with detail: field dependence-independence (Group Embedded Figures Test) and obsessionality (Leyton Obsessional Inventory). Perfectionism (Perfectionism subscale of the EDI-II) and mental rigidity (Trail Making Test), sub-components of obsessionality, were also measured. Women with AN showed a significant deficit in abstract thinking performance, which could not be explained by a more general intellectual deficit or diminished information processing speed. The AN sample also showed a greater preoccupation with detail relative to the control group. Controlling for preoccupation with detail reduced the group difference in abstract thinking to non-significance. However, only field dependence-independence contributed significantly to the relationship between group membership and abstract thinking performance. Thus, poor abstract thinking in AN appears to be at least partly attributable to a field-independent cognitive style, characterised by a bias towards focusing on detail at the expense of considering the gestalt.