[The shared educational assessment in the smoking cessation process]. / Le bilan éducatif partagé dans le processus de sevrage tabagique.

In the context of smoking cessation, the shared educational assessment (BEP) enables us to assess the smoker's needs, define specific objectives and set up appropriate educational workshops. This multidisciplinary approach helps smokers to maintain their smoking cessation. The BEP is the first step in the educational process, exploring the various classic dimensions of therapeutic patient education (TPE) and then defining an action plan based on the priorities identified.

Common transdiagnostic cognitive deficits among people with psychiatric disorders exposed to childhood maltreatment: a meta-analysis.

INTRODUCTION: Previous meta-analyses have shown a moderate negative impact of maltreatment on the neuropsychological functioning of people with or without psychiatric disorders compared to healthy groups. The objectives of the present meta-analysis were to (1) investigate the impact of maltreatment on neuropsychological functioning of people with psychiatric disorders and to (2) evaluate the moderating effect of age, at the time of the cognitive assessment, on neuropsychological functioning. METHODS: Seventeen studies published between 1970 and July 2017 were included. RESULTS: The results showed a negative impact of maltreatment with a small effect size (g = -0.25) on the neuropsychological performances in the group with psychiatric disorders with a history of exposure to childhood maltreatment compared to the group with psychiatric disorders without a history of exposure to childhood maltreatment. Cognitive domains that are significantly affected by maltreatment are: working memory (g = -0.56), verbal episodic memory (g = -0.39), intelligence (g = -0.27) and processing speed (g = -0.21). The impact of childhood maltreatment on the cognitive profile is greater in adults than young people. CONCLUSIONS: Clinicians should consider these common cognitive deficits using a transdiagnostic approach in cognitive interventions.

A meta-analysis on the impact of psychiatric disorders and maltreatment on cognition.

OBJECTIVE: Few studies have attempted to describe the range of cognitive impairments in individuals with psychiatric disorders who experienced maltreatment as children. The aims of this meta-analysis were to establish the impact of maltreatment and psychiatric disorders on cognition, and to examine the change in impact from childhood to adulthood. METHOD: Twelve publications from 1970 to 2013 were included, with the following inclusion criteria: (a) individuals with a psychiatric disorder who experienced maltreatment, (b) use of at least 1 standardized neuropsychological measure, and (c) use of a control group without any psychiatric disorder or mistreatment. The majority of studies (10/12) were about posttraumatic stress disorder. Several effect sizes were calculated (Hedge's g) according to the cognitive domains. RESULTS: The results of the meta-analysis demonstrate that the combination of psychiatric disorders and childhood maltreatment has a negative impact on global cognitive performance, with a moderate effect size (g = -0.59). The most affected cognitive domains for individuals aged 7- to 18-years-old were visual episodic memory (g = -0.97), executive functioning (g = -0.90), and intelligence (g = -0.68). For individuals over the age of 18-years-old, the most affected cognitive domains were verbal episodic memory (g = -0.77), visuospatial/problem solving (g = -0.73), and attention (g = -0.72). The impact of maltreatment and psychiatric disorders was greater in children than in adults (slope = 0.008, p < .002). CONCLUSION: The results suggest that exposure to maltreatment and the presence of psychiatric disorders have a broad impact on cognition, with specific neuropsychological profile.

Neuropsychological Profile of Children, Adolescents and Adults Experiencing Maltreatment: A Meta-analysis.

OBJECTIVE: Few studies have attempted to describe the range of cognitive impairments affecting people who have experienced child maltreatment. The aim of this meta-analysis was to examine the neuropsychological profile of these people and to determine the cognitive impacts of maltreatment from childhood to adulthood. METHOD: Fifty-two publications from 1970 to 2013 were included. RESULTS: The affected cognitive domains were working memory (g = -.65), attention (g = -.63), intelligence (g = -.56) and speed of processing (g = -.49). The impact of maltreatment was greater in young children (g = -.71) and less pronounced in adults (g = -.26). CONCLUSIONS: These results suggest that exposure to maltreatment has an impact on specific cognitive processes, regardless of age.

Top-down computerized cognitive remediation in schizophrenia: a case study of an individual with impairment in verbal fluency.

The objective of this case study was to assess the specific effect of cognitive remediation for schizophrenia on the pattern of cognitive impairments. Case A is a 33-year-old man with a schizophrenia diagnosis and impairments in visual memory, inhibition, problem solving, and verbal fluency. He was provided with a therapist delivered cognitive remediation program involving practice and strategy which was designed to train attention, memory, executive functioning, visual-perceptual processing, and metacognitive skills. Neuropsychological and clinical assessments were administered at baseline and after three months of treatment. At posttest assessment, Case A had improved significantly on targeted (visual memory and problem solving) and nontargeted (verbal fluency) cognitive processes. The results of the current case study suggest that (1) it is possible to improve specific cognitive processes with targeted exercises, as seen by the improvement in visual memory due to training exercises targeting this cognitive domain; (2) cognitive remediation can produce improvements in cognitive processes not targeted during remediation since verbal fluency was improved while there was no training exercise on this specific cognitive process; and (3) including learning strategies in cognitive remediation increases the value of the approach and enhances participant improvement, possibly because strategies using verbalization can lead to improvement in verbal fluency even if it was not practiced.

Specific attention disorders in drivers with traumatic brain injury.

OBJECTIVE: To highlight the impact of the increasing attentional load on performance of both normal drivers and drivers with traumatic brain injury. BACKGROUND: Patients with brain injury have a higher accident risk than people with no brain injury [1], probably as a result of persistent attention disorders. METHOD: Ten patients and 10 paired controls took part in a computerized selective attention task involving specific attentional processes. They were asked to monitor a speedometer and to ignore sudden changes in the surrounding environment in three separate experimental situations involving different attentional load. RESULTS: Although, in the control situation, patients' results were equivalent to controls', they displayed specific disorders in more complex situations where the attentional load increased. CONCLUSION: These difficulties may have a negative impact on real driving situations.