An Open-Label Feasibility Trial Examining the Effectiveness of a Cognitive Training Program, Goal Management Training, in Individuals With Posttraumatic Stress Disorder

Boyd, Jenna E.; O’Connor, Charlene; Protopopescu, Alina; Jetly, Rakesh; Rhind, Shawn G.; Lanius, Ruth A.; McKinnon, Margaret C.

doi:10.1177/2470547019841599

Cited by 11 publications

(13 citation statements)

References 52 publications

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“…Compared to earlier studies (Van Hooren et al, 2007;Alfonso et al, 2011;Levine et al, 2011;Boyd et al, 2019), the number of sessions in the current study was fewer (five sessions) and sessions were stretched out over a longer time period (3 months). This session structure (i.e., five group sessions) was employed to reduce traveling in this geographically dispersed population.…”

Section: Discussionmentioning

confidence: 66%

“…GMT and GMT principles have been found to improve both neurocognitive performance and self-reported EFs for diverse conditions, such as ABI [e.g., Levine et al (2000) and Tornås et al (2016)], age-related cognitive decline (Levine et al, 2007), schizophrenia (Levaux et al, 2012), spina bifida (Stubberud et al, 2013(Stubberud et al, , 2014, and attention deficit hyperactivity disorder (ADHD) (Jensen et al, 2021). Current results also suggest that GMT has the capacity to improve aspects of mental health (Levaux et al, 2012;Stubberud et al, 2015;Boyd et al, 2019;Hagen et al, 2020) and HRQoL (Cuberos-Urbano et al, 2018).…”

Section: Introductionmentioning

confidence: 76%

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Cognitive Rehabilitation for Neurocognitive Late Effects in Adult Survivors of Childhood Acute Lymphoblastic Leukemia: A Feasibility and Case-Series Study

et al. 2021

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Neurocognitive late effects following the diagnosis and treatment of childhood acute lymphoblastic leukemia (ALL) commonly include impaired executive functions (EFs), with negative consequences for one’s health-related quality of life and mental health. However, interventions for EF impairments are scarce. Thus, the aims of this study were to (1) explore the feasibility and acceptability of the cognitive rehabilitation program Goal Management Training (GMT) and (2) examine whether GMT is associated with positive outcomes across cases of ALL survivors with EF complaints. Four participants (median age 31.5 years) underwent nine GMT modules in a total of five group sessions. Rehabilitation was focused on compensatory strategies to improve real-life EFs. Participants were evaluated at 2-week and 6-month follow-ups. Evaluation of feasibility and acceptability included adherence, a semi structured interview, self-reports, and safety. Additionally, therapists’ experience with implementation was evaluated. Outcome measures included self-reports and neurocognitive tests of attention, EF, and processing speed. All participants completed GMT and rated the intervention as useful, suitable, and satisfactory. The reliable change index showed improved daily life EFs (two participants) and neurocognitive performance (three participants) at 6-month follow-up. Additionally, all participants improved on a “real-life” task involving EF. A future randomized controlled trial is recommended.

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Section: Discussionmentioning

confidence: 66%

Section: Introductionmentioning

confidence: 76%

Cognitive Rehabilitation for Neurocognitive Late Effects in Adult Survivors of Childhood Acute Lymphoblastic Leukemia: A Feasibility and Case-Series Study

et al. 2021

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“…Target sample size ( n = 40) was selected based on other similar cognitive remediation feasibility studies [e.g., ( 62 – 64 )]. Participants ( n = 27) were women who were either registered patients of St. Joseph's Healthcare Hamilton, referred to the group by a regulated health professional, or individuals recruited through the community via newspaper and community presentations.…”

Section: Methodsmentioning

confidence: 99%

Preliminary Support for a Cognitive Remediation Intervention for Women During the Menopausal Transition: A Pilot Study

Ballantyne¹,

King²,

Green³

2021

Front. Glob. Womens Health

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Background: Menopause is associated with physical and emotional symptoms, and subjective cognitive concerns that are generally not borne out on objective cognitive measures. This discrepancy suggests that a psychological rather than biological mechanism likely mediates the cognitive concerns of women in menopause. The current study assessed the feasibility and effectiveness of a cognitive remediation intervention with the goal of reducing subjective perceptions of cognitive difficulty during the menopause.Methods: Twenty-seven menopausal women (M age = 53.74, SD = 4.14) completed a 5-week group-based intervention (with a post-group booster) consisting of 2-h weekly sessions. Participants completed pre- and post-intervention measures capturing subjective cognitive ability, mood, anxiety, stress, personality, and objective cognitive tests. The primary variable of interest was self-reported cognitive confidence measured by the Memory and Cognitive Confidence Scale (MACCS).Results: All but one MACCS subscale significantly decreased over the course of treatment (with lower scores associated with higher confidence) and effect sizes ranged from small to large (d = −0.39 to −0.91) with gains maintained at 1-month follow-up. Interestingly, no change in objective cognitive test performance was observed, indicating increases in subjective cognitive confidence in the absence of objective cognitive improvement. There was no change in mood, anxiety, or stress scores. Two-level HLM analyses revealed that those with higher baseline neuroticism, as measured by the NEO Personality Inventory, had smaller decreases in post-group MACCS High Standards subscale relative to those with lower baseline neuroticism (p = 0.027, d = −0.45). Those with higher baseline depression scores on the Depression Anxiety Stress Scale (DASS-21) had a smaller decrease in post-intervention MACCS Total Score relative to those with lower depression ratings.Conclusion: To our knowledge, this is the first feasibility study of its kind targeting perceptions of cognitive impairment during menopause. Although generally well-tolerated, recruitment and scheduling difficulties were flagged as challenges to engagement while a small sample size and lack of control group limit conclusions about efficacy. Providing current results could be replicated with enhanced methods, these results provide support that cognitive remediation is a feasible and credible treatment, and may improve quality of life for women in menopause.Clinical Trial Registration:www.ClinicalTrials.gov, identifier: NCT03311880.

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“…At six-month follow-up, GMT was associated with significant improvement on self-report measures of executive functioning and depressive symptoms. GMT has also been associated with improvements in executive functioning, processing speed, verbal memory, and symptom severity in individuals with PTSD [ 28 , 29 ], and in executive functioning and subjective cognition in individuals with obsessive-compulsive disorder [ 30 ]. GMT may also impact patterns of emotional response, improving performance on self-report and objective measures of emotion regulation and impulsivity [ 28 , 29 , 30 ].…”

Section: Introductionmentioning

confidence: 99%

“…GMT has also been associated with improvements in executive functioning, processing speed, verbal memory, and symptom severity in individuals with PTSD [ 28 , 29 ], and in executive functioning and subjective cognition in individuals with obsessive-compulsive disorder [ 30 ]. GMT may also impact patterns of emotional response, improving performance on self-report and objective measures of emotion regulation and impulsivity [ 28 , 29 , 30 ]. Notably, in these studies, GMT appears to slow responding on challenging cognitive tasks, including when under emotional distress (i.e., stopping to think before acting impulsively, a skill vital to emotion regulation, including the management of anger and inappropriate comments and actions).…”

Section: Introductionmentioning

confidence: 99%

A Pilot Study Assessing the Effects of Goal Management Training on Cognitive Functions among Individuals with Major Depressive Disorder and the Effect of Post-Traumatic Symptoms on Response to Intervention

et al. 2022

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Recent meta-analyses highlight alterations in cognitive functioning among individuals with major depressive disorder (MDD), with performance deficits observed across multiple cognitive domains including executive functioning, memory, and attention. Moreover, impaired concentration is a formal diagnostic criterion for a major depressive episode. Notably, cognitive impairment is reported frequently in MDD and is associated with poor treatment response. Despite this knowledge, research examining the effectiveness of top-down, adjunctive treatments for cognitive dysfunction in MDD remains in its infancy. The primary aim of the present study was to perform a pilot investigation of the implementation of a standardized cognitive remediation program, Goal Management Training (GMT), among individuals with a primary diagnosis of MDD. A secondary aim was to explore how comorbid symptoms of post-traumatic stress disorder (PTSD) among those MDD patients exposed to trauma may affect treatment response. A final sample of thirty individuals were randomized to either participate in the nine-week GMT program (active group; n = 16) or to complete a nine-week waiting period (waitlist control; n = 14). One participant was excluded from the GMT group analysis following study completion due to meeting an exclusion criteria. In total, 60% of the individuals allocated to the GMT program were trauma exposed (n = 9). Groups were assessed at baseline, post-treatment, and at three-month follow-up. The assessment comprised neuropsychological tasks assessing a variety of cognitive domains, subjective measures of functioning and symptom severity, as well as a clinical interview to establish a primary diagnosis of MDD. Significant gains in processing speed, attention/concentration, and response inhibition were observed for the participants in the GMT condition relative to participants in the waitlist control condition. Individuals in the GMT condition also reported improvements in subjective cognitive functioning from baseline to post-treatment. Heightened PTSD symptom severity was associated with reduced response to treatment with respect to the domain of processing speed. The results of this pilot investigation highlight not only the potential utility of GMT as an augmentative treatment in MDD, but also highlight the contribution of comorbid symptoms of PTSD to diminished treatment response among trauma-exposed individuals with MDD. The study is limited primarily by its small pilot sample and the absence of a program evaluation component to gauge participant opinions and feedback of the treatment protocol.

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An Open-Label Feasibility Trial Examining the Effectiveness of a Cognitive Training Program, Goal Management Training, in Individuals With Posttraumatic Stress Disorder

Cited by 11 publications

References 52 publications

Cognitive Rehabilitation for Neurocognitive Late Effects in Adult Survivors of Childhood Acute Lymphoblastic Leukemia: A Feasibility and Case-Series Study

Cognitive Rehabilitation for Neurocognitive Late Effects in Adult Survivors of Childhood Acute Lymphoblastic Leukemia: A Feasibility and Case-Series Study

Preliminary Support for a Cognitive Remediation Intervention for Women During the Menopausal Transition: A Pilot Study

A Pilot Study Assessing the Effects of Goal Management Training on Cognitive Functions among Individuals with Major Depressive Disorder and the Effect of Post-Traumatic Symptoms on Response to Intervention

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