Mind over chronic pain: A meta-analysis of cognitive restructuring in chronically ill adults.

OBJECTIVE: This meta-analysis synthesizes research on the impact of cognitive restructuring on chronic pain intensity, aiming to integrate diverse methodologies and findings while evaluating potential moderators. METHODS: Following PRISMA guidelines, we systematically searched multiple databases (PubMed, Web of Science, JSTOR, Sage, Social Science Research Network, PsycArticles, ScienceDirect, and Education Resources Information Center) until July 2023. Studies involving adults (≥18 years) diagnosed with chronic conditions who underwent cognitive restructuring to reduce chronic pain intensity, were included. Eligible studies compared this intervention with a control group. We excluded studies incorporating cognitive restructuring within broader interventions, lacking statistical data, or not written in English. Study quality was assessed using the Cochrane Risk of Bias tool (RoB 2). RESULTS: After reviewing 18,312 studies, we selected 11 studies published between 1991 and 2022, involving 693 participants with chronic conditions. A significant large overall effect size was found (d = 0.94, 95% CI 0.48 to 1.40). Moderation analyses revealed significant differences based on sex and study quality, with effects less pronounced among females and more substantial in higher-quality studies. CONCLUSION: Despite limitations such as statistical instability due to a small number of studies in certain moderator categories and methodological variability, this meta-analysis highlights the robust effects of cognitive restructuring on chronic pain intensity. The findings are valuable for guiding power calculations and future research expectations. Clinically, these results support the significant effect of cognitive restructuring in both individual and group settings, regardless of age, particularly when facilitated by teams that include psychologists.

Cognitive Restructuring during Depressive Symptoms: A Scoping Review.

Cognitive restructuring (CR) aims to get people to challenge and modify their cognitive distortions, generating alternative, more adaptive thoughts. Behavioral, emotional, and physiological responses are modified by analyzing and changing dysfunctional thoughts. The person must have the cognitive capacity to participate in the analysis of their thoughts. CR for people with depression has positive effects, although there is little research on how it should be structured and applied. CR is a thought modification technique presented in the Nursing Interventions Classification (NIC), but is not organized in a sequential approach, and there is no procedure for applying it in practice. This scoping review aims to identify the structure, contents and assessment instruments used in CR for people with depressive symptoms and to analyze the health outcomes of applying the CR technique in this population. Out of 515 articles, seven studies were included in the review, up to 2021 and without any time limitation. The studies were not guided by a consistent and sound framework of the CR technique and each study used its own framework, although they used similar techniques. We grouped CR into six steps. No specific studies were found regarding intervention by nurses. CR is effective in reducing depressive symptoms, so it is an important therapeutic tool that should be used on people with depression. With this scoping review, mental health nurses will have a more comprehensive idea of the techniques that can be used in the application of CR to patients with depressive symptoms.

Rod and frame test parameters for neuropsychology studies.

BACKGROUND: The rod and frame test (RFT), a measure of field dependence-independence, recently has reemerged as a measure of research interest and potential diagnostic value in neuropsychology. In the standard RFT, the subject experiences offsetting visual cues from a frame surrounding an embedded rod, while the subject's postural/vestibular cues provide the sense of verticality as the subject attempts to set the rod to vertical. The paper shows that RFTs not adhering to RFT parameters can reduce the test's visual framework impact experienced by the subject. Comparisons of neuropsychological studies will highlight that correct adherence to RFT testing conditions can strengthen RFT effects. METHOD: This review presents the parameters that have been studied which impact on subject performance on the RFT. It identifies how computer administered RFTs have been applied to enhance the study of the RFT parameters and make the RFT more accessible to the study of different diagnostic groups. The article also critiques studies by identifying how the RFT's parameters, study's design and statistical analysis may have diminished identifying the full effects of the RFT experience. RESULTS: Parameters impacting judgments of verticality of the rod can include: perceived size of rod and frame, the gap between the ends of the rod and surrounding frame, presentation of the rod within an encompassing 3D visual framework that visually blocks out the surrounding environment, a dark room, instructions stressing egocentric vs allocentric strategies, double frame surrounding the rod to assess global perception effects, etc. Details are presented how gap size likely affected results in neuropsychology studies. Potentially, these and other experiments may be studied using computer administered RFTs. CONCLUSIONS: Based on the descriptions of computer administered RFTs, this article suggested that incorporating these technologies can provide better understanding underlying the RFT, and in turn, understanding neuropsychology processes.

Changes in trauma appraisal during brief internet-based exposure and cognitive restructuring treatment for Arabic-speaking people with PTSD.

Background: Maladaptive trauma appraisal plays an important role in the development and maintenance of posttraumatic stress disorder (PTSD). While studies have demonstrated the effectiveness of exposure and cognitive treatments for PTSD symptomatology, the effect of such treatments on specific trauma appraisals is still not well understood.Objective: The study investigated the effect of an exposure and a cognitive restructuring internet-based treatment on specific trauma appraisals in Arabic-speaking participants with PTSD.Method: 334 participants received either an exposure (n = 167) or a cognitive restructuring (n = 167) internet-based treatment. PTSD symptom severity (PCL-5) and specific trauma appraisals (TAQ) were assessed at pre- and post-treatment. Changes in specific trauma appraisals within and between the two treatments were analyzed using multi-group change modelling. Associations between changes in PTSD symptom severity and changes in trauma appraisals were evaluated using Pearson product-moment correlation. For both treatments, participants with versus without reliable improvement were compared regarding changes in specific trauma appraisals using Welch tests. Analyses were performed on 100 multiple imputed datasets.Results: Both treatments yielded significant changes in shame, self-blame, fear, anger, and alienation (all ps < .001). Changes in betrayal were only significant in the cognitive restructuring treatment (p < .001). There was no evidence of differences between treatments for any specific trauma appraisal. Changes in PTSD symptom severity were significantly associated with changes in trauma appraisals (all ps < .001). In both treatments, participants who experienced reliable improvement in PTSD symptom severity showed significantly larger pre- to post-treatment changes in specific trauma appraisals compared to those without reliable improvement. Again, differences in betrayal were only significant in the cognitive restructuring treatment.Conclusions: The findings indicate that both treatments are effective in reducing trauma appraisals in Arabic-speaking people with PTSD. Changes in trauma appraisal seem to be associated with changes in PTSD symptomatology.Trial registration: German Clinical Trials Register identifier: DRKS00010245.

Exposure and cognitive restructuring treatment in Arabic-speaking individuals with PTSD yield significant changes in shame, self-blame, fear, anger, and alienation.Changes in PTSD symptoms are positively associated with changes in specific trauma appraisals.There is no evidence of differences between both treatments for any specific trauma appraisal.

Imagery rescripting and cognitive restructuring for inpatients with moderate and severe depression - a controlled pilot study.

BACKGROUND: This controlled pilot study investigates the effect of the combined use of cognitive restructuring (CR) and imagery rescripting (IR) compared to treatment as usual among inpatients with moderate and severe depression. Alongside expert ratings and self-report tools, fitness wristbands were used as an assessment tool. METHODS: In addition to the standard inpatient care (SIC) program, 33 inpatients with moderate and severe depression were randomly assigned to an intervention group (two sessions of IR and CR) or an active treatment-as-usual (TAU) control group (two sessions of problem-solving and build-up of positive activity). Depression severity was assessed by the Hamilton Depression Rating Scale-21 (HDRS-21), the Beck Depression Inventory-II (BDI-II), and as a diagnostic adjunct daily step count via the Fitbit Charge 3™. We applied for analyses of HDRS-21 and BDI-II, 2 × 2 repeated-measures analysis of variance (ANOVA), and an asymptotic Wilcoxon test for step count. RESULTS: The main effect of time on both treatments was η2 = .402. Based on the data from the HDRS-21, patients in the intervention group achieved significantly greater improvements over time than the TAU group (η2 = .34). The BDI-II data did not demonstrate a significant interaction effect by group (η2 = .067). The daily hourly step count for participants of the intervention group was significantly higher (r = .67) than the step count for the control group. CONCLUSIONS: The findings support the utilization of imagery-based interventions for treating depression. They also provide insights into using fitness trackers as psychopathological assessment tools for depressed patients. TRIAL REGISTRATION: The trial is registered at the German Clinical Trials Register (Deutsches Register Klinischer Studien) under the registration number: DRKS00030809.

Preliminary Efficacy of a Brief Cognitive Restructuring Intervention to Reduce Sexual Coercion Intentions: Roles of Alcohol and Emotion Regulation.

Sexual coercion (SC), the use of nonphysical tactics to obtain sexual contact with a nonconsenting partner, is a prevalent form of sexual misconduct that is associated with several physical and psychological health concerns. Therefore, effective preventative interventions to reduce SC prevalence are needed. Alcohol consumption and difficulties in emotion regulation (ER) are two risk factors that contribute to SC. Cognitive restructuring (CR) has the potential to reduce SC intentions by improving ER through actively challenging one's thoughts to modify emotions. This study represents a secondary data analysis to examine the effectiveness of a brief, web-based CR intervention in reducing SC intentions. To test whether the intervention would remain beneficial in the presence of alcohol, we tested effects among intoxicated versus sober participants. Young, male, heavy episodic drinkers with a history of sexual aggression (N = 137) were randomized into a CR intervention versus control condition as well as alcohol consumption versus no alcohol condition. Then, participants completed a sexual aggression analog scenario. General linear regression analyses showed that intoxicated men reported stronger SC intentions than sober men. Additionally, relative to controls, men in the CR condition who had better preexisting ER cognitive reappraisal skills had significantly lower SC intentions. Our findings provide preliminary support for CR as an effective strategy to reduce SC intentions among sexually aggressive, heavy episodic drinking men with better cognitive reappraisal skills. If findings are replicated, this brief, web-based CR intervention could overcome potential challenges in dissemination and be easily applied in clinical settings.

Exposure Versus Cognitive Restructuring Techniques in Brief Internet-Based Cognitive Behavioral Treatment for Arabic-Speaking People With Posttraumatic Stress Disorder: Randomized Clinical Trial.

BACKGROUND: Cognitive behavioral interventions delivered via the internet are demonstrably efficacious treatment options for posttraumatic stress disorder (PTSD) in underserved, Arabic-speaking populations. However, the role of specific treatment components remains unclear, particularly in conflict-affected areas of the Middle East and North Africa. OBJECTIVE: This study aims to evaluate 2 brief internet-based treatments in terms of efficacy, including change in PTSD symptom severity during treatment. Both treatments were developed in line with Interapy, an internet-based, therapist-assisted cognitive behavioral therapy protocol for PTSD and adapted to the specific research question. The first treatment comprised self-confrontation and social sharing (exposure treatment; 6 sessions); the second comprised cognitive restructuring and social sharing (cognitive restructuring treatment; 6 sessions). The 2 treatments were compared with each other and with a waitlist control group. METHODS: In total, 365 Arabic-speaking participants from the Middle East and North Africa (mean age 25.49, SD 6.68 y) with PTSD were allocated to cognitive restructuring treatment (n=118, 32.3%), exposure treatment (n=122, 33.4%), or a waitlist control group (n=125, 34.2%) between February 2021 and December 2022. PTSD symptom severity, posttraumatic maladaptive cognitions, anxiety, depressive and somatoform symptom severity, and quality of life were assessed via self-report at baseline and after treatment or waiting time. PTSD symptom severity was also measured throughout treatment or waiting time. Treatment satisfaction was assessed after treatment completion. Treatment use and satisfaction were compared between the 2 treatment conditions using appropriate statistical tests (eg, chi-square and Welch tests). Multiple imputation was performed to address missing data and evaluate treatment-associated changes. These changes were analyzed using multigroup change modeling in the completer and intention-to-treat samples. RESULTS: Overall, 200 (N=240, 83.3%) participants started any of the treatments, of whom 123 (61.5%) completed the treatment. Treatment condition was not significantly associated with the proportion of participants who started versus did not start treatment (P=.20) or with treatment completion versus treatment dropout (P=.71). High treatment satisfaction was reported, with no significant differences between the treatment conditions (P=.48). In both treatment conditions, PTSD, anxiety, depressive and somatoform symptom severity, and posttraumatic maladaptive cognitions decreased, and quality of life improved significantly from baseline to the posttreatment time point (P≤.001 in all cases). Compared with the baseline assessment, overall PTSD symptom severity decreased significantly after 4 sessions in both treatment conditions (P<.001). Moreover, both treatment conditions were significantly superior to the waitlist control group regarding overall PTSD symptom severity (P<.001) and most other comorbid mental health symptoms (P<.001 to P=.03). Differences between the 2 conditions in the magnitude of change for all outcome measures were nonsignificant. CONCLUSIONS: Internet-based cognitive behavioral treatments for PTSD focusing primarily on either self-confrontation or cognitive restructuring are applicable and efficacious for Arabic-speaking participants. TRIAL REGISTRATION: German Clinical Trials Register DRKS00010245; https://drks.de/search/de/trial/DRKS00010245.

Cognitive reappraisal in mHealth interventions to foster mental health in adults: a systematic review and meta-analysis.

Background: An increasing number of mHealth interventions aim to contribute to mental healthcare of which interventions that foster cognitive reappraisal may be particularly effective. Objectives: To evaluate the efficacy of mHealth interventions enhancing cognitive reappraisal to improve mental health in adult populations. Methods: The literature search (four databases) yielded 30 eligible randomized controlled trials (comprising 3,904 participants). We performed a multi-level meta-analysis to examine differences between intervention and comparator conditions at post-intervention assessment. Moderator analyses were conducted for potential moderator variables (e.g., type of comparators). Results: Most interventions were CBT-based with other training components in addition to cognitive reappraisal. We found preliminary evidence for a small to medium effect favouring mHealth interventions to enhance cognitive reappraisal over comparators, M(SMD) = 0.34, p = .002. When analysing single symptoms, there was evidence for a small to medium effect of mHealth interventions on anxiety and depressive symptoms, but not for psychological distress and well-being. All analyses showed substantial heterogeneity. Moderator analyses revealed evidence for more favourable effects in studies with passive comparators. There was an overall high risk of bias in most of the studies. Conclusions: We found preliminary evidence for a small to medium effect of mHealth interventions including a cognitive reappraisal component to improve mental health. However, most of the interventions were complex (i.e., reappraisal was provided alongside other components), which prevents us from examining reappraisal-specific effects beyond general mental health promotion in mHealth. Dismantling studies examining the effects of single intervention components are warranted to corroborate these promising results. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=142149, identifier [CRD42019142149].

Cross-Cultural Efficacy of the Acceptance and Cognitive Restructuring Intervention Program (ACRIP) on the Internet Gaming Disorder Symptoms of Selected Asian Adolescents.

Empirical evidence shows that Internet Gaming Disorder (IGD) with poor psychological well-being increases. IGD has become an emerging issue of significant public health concern and the World Health Organization has recently recognized it as a mental health condition. This study examined the efficacy of the Acceptance and Cognitive Restructuring Intervention Program (ACRIP) in reducing the symptoms of IGD and improving the psychological well-being of adolescent gamers from select Asian cultures after proving it effective in a prior study in the Indian setting. The development of the ACRIP employed a sequential exploratory research design and randomized controlled trial on thirty participants. Internet Gaming Disorder (IGDS9-SF) and Ryff's Psychological well-being (PWB) scales were used to measure the severity of the gaming disorder and the state of psychological health of the experimental and control groups. Power analysis ascertained the study with a power of 0.90, indicating a strong probability of obtaining a statistically significant effect. Statistical analyses using paired t-test and MANOVA on post-test mean scores on IGD and PWB of the experimental group showed a significant difference which suggested that the ACRIP is efficacious and culture-free.

Differential engagement of the posterior cingulate cortex during cognitive restructuring of negative self- and social beliefs.

Negative self-beliefs are a core feature of psychopathology, encompassing both negative appraisals about oneself directly (i.e. self-judgment) and negative inferences of how the self is appraised by others (i.e. social judgment). Challenging maladaptive self-beliefs via cognitive restructuring is a core treatment mechanism of gold-standard psychotherapies. However, the neural mechanisms underlying the restructuring of these two kinds of negative self-beliefs are poorly understood. Eighty-six healthy participants cognitively restructured self-judgment and social-judgment negative self-belief statements during 7 Tesla functional magnetic resonance imaging scanning. Cognitive restructuring broadly elicited activation in the core default mode network (DMN), salience and frontoparietal control regions. Restructuring self-judgment relative to social-judgment beliefs was associated with comparatively higher activation in the ventral posterior cingulate cortex (PCC)/retrosplenial cortex, while challenging social-judgment statements was associated with higher activation in the dorsal PCC/precuneus. While both regions showed increased functional connectivity with the supplementary and pre-supplementary motor areas during restructuring, the dorsal PCC displayed greater task-dependent connectivity with distributed regions involved in salience, attention and social cognition. Our findings indicate distinct patterns of PCC engagement contingent upon self- and social domains, highlighting a specialized role of the dorsal PCC in supporting neural interactions between the DMN and frontoparietal/salience networks during cognitive restructuring.

Three ways to change your mind: an epistemic framework for cognitive interventions.

Belief change is an important element of much CBT, yet very little consideration has been given to the theories of knowledge, the epistemology, which underlie this process. This article argues that understanding the epistemic basis of the techniques therapists use can help guide their choice of interventions. The empirical evidence for cognitive restructuring is considered, the importance of distancing and decentring noted, and three epistemic styles are identified: the rational-empiricist, pragmatist and 'constructivist' approaches. Different schools of CBT emphasise one or more of these. The article describes how these epistemes can be used to make decisions about which cognitive interventions to use, particularly when clients may be sceptical about reality testing because of entrenched beliefs or real-life adversity.

Listening to a popular upbeat song can lead to more adaptive cognitive inferences for stressful events in non-clinical adult populations.

OBJECTIVE: We tested the effect of music on idiographic cognitive inferences about stressful events. METHOD: In Study 1 (n = 336), adult participants from the United States were randomly assigned to non-familiar songs that differed by lyrical content and tempo. In Studies 2 (n = 302) and 3 (n = 323), adult participants from the United States were randomly assigned to either a positive, neutral or no-song condition. RESULTS: The results of Study 1 failed to support any of the study hypotheses. Given the null results, we decided to conduct a second study focused on increasing external validity and power (i.e., including fewer experimental conditions). The results of Study 2 showed that adults randomly assigned to a familiar upbeat song condition experienced an increase in positive affect and a decrease in event-specific negative cognitions. A third study was then conducted to replicate the results and rule out a potential confound. Results of Study 3 corroborated the results of Study 2. CONCLUSION: Taken together (Studies 2 and 3), results indicate it may be useful for future research to test the extent to which familiar upbeat music can be helpful during cognitive restructuring activities in psychotherapy to nudge people to generate more adaptive cognitions.

Should cognitive restructuring precede imagery rescripting? An experimental pilot study.

BACKGROUND AND OBJECTIVES: Imagery rescripting (ImRs) is a promising therapeutic technique used in treatment for a variety of psychiatric disorders. During an ImRs session, an aversive disorder-related memory, is activated in imagination and rescripted to a more positive outcome. It has been shown to successfully weaken the negative cognitive meaning, so-called encapsulated beliefs of the targeted aversive memory. In many studies, ImRs is preceded by a cognitive restructuring (CR) technique focused on the encapsulated belief of the target memory. It is not clear whether adding such a CR technique is necessary or that ImRs as standalone technique can achieve comparable effects. METHODS: Students with mild psychological distress (N = 53) were randomized over one session of cognitive restructuring plus imagery rescripting (CR + ImRs), a therapist attention placebo plus imagery rescripting (PLA + ImRs) and a double therapist attention placebo (PLA + PLA). Believability of the idiosyncratic encapsulated belief (primary outcome) and quality (vividness, distress and emotional connotation: secondary outcome) of the target memory were assessed at pre, post and at 1-week follow-up. RESULTS: Results indicate that both, CR + ImRs and PLA + ImRs, reduced the believability of the encapsulated beliefs in greater extent than PLA + PLA. No differences appeared between the two ImRs conditions. For the secondary outcomes no differences between the three conditions were found. LIMITATIONS: This study should be seen as a pilot study, moreover a non-clinical sample was used. CONCLUSION: Findings suggest that a CR technique preceding ImRs is redundant. However, this study needs replication in a larger sample.

Vindicating pollyanna? An experimental test of cognitive restructuring and positive thinking interventions.

OBJECTIVE: Despite its considerable potential, psychotherapy research has made limited use of small-scale experimental study designs to test intervention components. This study employs such a design to test the immediate effects on emotional experience of two approaches to changing negative thoughts, cognitive restructuring and fostering positive thinking. Cognitive restructuring draws on the strategies core to cognitive behavioral therapies. Fostering positive thinking has also received attention, though less so as a psychological intervention. METHOD: We tested the benefits of these strategies over a brief interval by randomizing 230 participants to complete a worksheet introducing one of the two strategies. Participants reported their skills prior to exposure to these worksheets and affect was assessed immediately prior to and following use of worksheets. RESULTS: Participants' negative affect reduced following both strategies. Conditions did not differ significantly in affect change. Analysis of potential moderators showed that, among those with higher levels of cognitive behavioral therapy skills, the positive thinking condition produced greater gains in positive affect than the cognitive restructuring condition. CONCLUSIONS: These results indicate that both forms of brief interventions promote reductions in negative affect. Positive thinking interventions, which are not focused on the accuracy of one's thinking, appear to be particularly effective in promoting positive affect.

A cognitive-behavioral approach to teacher burnout: A randomized controlled trial of a group therapy program.

BACKGROUND AND OBJECTIVES: As a well-known phenomenon with significant social, biological, and psychological impacts, burnout syndrome has been viewed and treated from different therapeutic perspectives. However, few studies have evaluated interventions to prevent and alleviate teacher burnout. DESIGN: This study comprised a randomized controlled trial (RCT) of a group-based cognitive-behavioral therapy (CBT) program for teacher burnout, with assessments at pre-treatment, post-treatment, and 6-month follow-up. METHODS: The Maslach Burnout Inventory-Educators Survey (MBI-ES) was administered to 242 English language teachers with diverse professional profiles in Iran. Of these, 62 teachers with burnout symptoms were randomly assigned to either a group-based eight-week CBT treatment program or a waiting list control condition. RESULTS: The results of a series of mixed factorial ANOVAs demonstrated significantly greater improvements for the treatment compared to the control condition on the total score and three subscales of the MBI-ES (teachers' emotional exhaustion, depersonalization, and reduced personal accomplishment) at post-treatment, with treatment effects maintained at 6-month follow-up. CONCLUSIONS: This CBT intervention has promise for supporting teachers in stressful occupational conditions and reducing their burnout.

Trauma-focused therapies for post-traumatic stress in psychosis: study protocol for the RE.PROCESS randomized controlled trial.

INTRODUCTION: Many people with psychotic disorders experience symptoms of post-traumatic stress disorder (PTSD). In recent years, several trauma-focused therapies (TFTs), including cognitive restructuring (CR), prolonged exposure (PE), and eye movement desensitization and reprocessing (EMDR) have been studied and found to be safe and effective in reducing PTSD symptoms in individuals with psychosis. However, studies were conducted in different countries, with varying inclusion criteria, therapy duration, control groups, and trial outcomes. RE.PROCESS will be the first study to compare the impact of CR, PE, and EMDR with a waiting list control condition within the same context. METHODS AND ANALYSIS: This is the protocol of a pragmatic, single-blind, multicentre, superiority randomized controlled trial, in which CR, PE, and EMDR are compared to a waiting list control condition for TFT (WL) in a naturalistic treatment setting. Inclusion criteria are as follows: age ≥ 16 years; meeting full DSM-5 diagnostic criteria for PTSD on the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5), with a total CAPS score ≥ 23; and a psychotic disorder in the schizophrenia spectrum confirmed by the Structured Clinical Interview for DSM-5 (SCID-5). Participants (N=200) will be randomly allocated to 16 sessions of one of the TFTs or WL, in addition to receiving treatment as usual (TAU) for psychosis. The primary objective is to compare the effects of CR, PE, and EMDR to WL on researcher-rated severity of PTSD symptoms over time from baseline to 6-month follow-up. Secondary objectives are to examine these effects at the separate time-points (i.e., mid-treatment, post-treatment, and at 6-month follow-up) and to test the effects for clinician-rated presence of PTSD diagnosis, and self-rated severity of (complex) PTSD symptoms. DISCUSSION: This is the first RCT to directly compare the effects of CR, PE, and EMDR within the same context to TAU on PTSD symptoms in individuals with psychosis and PTSD. Secondary effects on clinical and functional outcomes will be investigated both directly after therapy and long term. TRIAL REGISTRATION: ISRCTN ISRCTN56150327 . Registered 18 June 2019.

Effectiveness of Cognitive Restructuring on Intensity of Pain in Cancer Patients: A Pilot Study in Oncology Department of Tertiary Care Hospital.

BACKGROUND: Pain is a most feared symptom among cancer patients. It not only affects physical health but it is a psychological burden and affects overall quality of life in cancer patients. it interferes the activity of daily living and treatment outcome. cognitive restructuring is very useful psychological treatment to reduce pain. OBJECTIVES: The purpose of the study was to assess level of pain, evaluate effectiveness of cognitive restructuring on intensity of pain and to find association of pain with demographic variables. METHODS: Quasi experimental  study was conducted in oncology department of SKIMS tertiary care hospital. Purposive sampling technique was used to select 22 patients for study group and 22 patients for control group. CBPS and Numerical rating pain scale was used to measure intensity of pain. Data collected by interview method. RESULTS: The results showed significant difference p<0.05 at only  in anxiety,face and activity on CBPS scores. Mean score of NPRS was 27.27% of moderate pain  and severe pain reduced from 63.64 to  to 0.%  in study group after CR. Results revealed Significant association of pain with age, gender and period of illness. CONCLUSION: Based on findings of the study it is concluded that CR has significant impact in cancer patients  on reducing pain and can ease problems related to pain. CR is an appropriate intervention to reduce the symptoms of cancer patients which has indirect impact on cancer treatment.

Verbal Behavior Analysis of Expert and Inexperienced Therapists Applying the Socratic Method.

The Socratic method, as an eminently verbal procedure, will be analyzed from a behavioral perspective in order to clarify how verbal conditioning works within. This work compares the verbalizations that expert and inexperienced therapists emit during Socratic method to find out which and why certain therapist verbalizations are most successful in changing client responses. The sample consisted of 113 Socratic method fragments from 18 cases, analyzed by observational methodology. The expert therapists had more than 6 years of experience, the inexperienced less than 2. Experts had fewer failure Socratic method fragments, but there were no differences in successful ones. The way of questioning had a different pattern: Inexperienced therapists suggested more the response, experts used more didactic verbalizations; also, experts used the aversive component more and contingently. The creation of guidelines based on functional description of verbal interaction and the need for novice psychologists training are some implications of these results.

Neuropsychological approach to subjective cognitive complaints in cognitively unimpaired older people: A systematic review.

OBJECTIVE: A systemized approach to subjective cognitive complaints (SCCs) in elderly people is needed owing to the high prevalence of such complaints and their impact on the psychosocial well-being of those affected. The aim of this study was to carry out a systematic review of the characteristics and effectiveness of intervention programmes that use a neuropsychological approach to target SCCs in cognitively unimpaired older people and that are tested in randomized controlled trials. METHODS: The search included a time-unlimited query of Scopus, PsycInfo and Medline, yielding 215 articles, of which only 7 met the inclusion/exclusion criteria. RESULTS: The number of intervention programmes was very limited (11 interventions), but diverse, with cognitive stimulation, physical exercise, psychoeducation and cognitive restructuring all used to address SCCs. CONCLUSIONS: Interventions including only cognitive stimulation were not effective in reducing SCCs, but interventions including cognitive stimulation and psychoeducation, physical exercise, and group sessions and discussions reinforced by the therapist were effective.