Cognitive Factors in Psych

Impact of beliefs on Depression

"triad" of negative bias relative to self, world and future thinks everyone is out to get them, think the world is going to end and it sucks

Compensatory thinking techniques: Cognitive Orientation to Daily Occupation (CO-OP)

4 step strategy used with children to help work through motor tasks Working yourself through motor tasks

Therapeutic techniques for cognitive interventions and depressive disorders

Activity scheduling Graded task assignments (having people engage in things that are progressively more challenging- graded task assignment expose people to their fears and challenges ) Self monitoring Cognitive restructuring Challenging dysfunctional assumptions Relapse prevention

Cognitive adaption interventions:

Adapting tasks and environment

Cognitive problems in schizophrenia

Allocation policy Modulation of arousal Automaticity

Cognitive remediation interventions

Attempt to improve specific cognitive skill Integrated psychological therapy Dynamic interactional approach

Cognitive skills most affected by psychiatric conditions:

Attention Memory Executive functioning

Cognitive aspects of psychotic disorders

Attention, memory capacity, conceptual processing, executive functioning

Cognitive interventions for schizophrenia: Focus on negative symptoms

Attention/memory deficits

Intervention strategies for areas of cognitive impairment

Automatic processing Selective attention Divided attention Vigilance Memory Working memory Concept formation/categorization Schemas and scripts Problem solving Decision-making

Cognitive Skills: Attention

Automaticity v controlled process Selected attention Divided attention Vigilance

Cognitive interventions for schizophrenia: psychiatric rehab

Case mgmt; skills training; adjustment

Behavioral experiments

Client and therapist work collaboratively to create opportunities for client to test thoughts/beliefs and related behavior to test for relative utility or validity

OT interventions in cognitive psych

Client-centered assessment Cognitive remediation Environment and task adaptation Compensatory thinking techniques

Other cognitive interventions

Cognitive disability practice model (Allen, 1996) Errorless learning Reality orientation and validation therapy Classroom/parental interventions ADHD

Executive Functions

Concept formation /categorization Schema and scripts Problem solving Decision making Metacognition

OT role in cognitive factors

Consultant Collaborator Evaluation Observer Educator/trainer

Common cognitive distortions in depression

Dichotomous thinking Overgeneralization Mind reading Catastrophizing- I'm going to get kicked out of the program "Should" statements- i should be better

Cognitive strategies and techniques

Directly target thoughts and beliefs with emphasis on cognitive restructuring, which is reframing existing negative/distorted beliefs in a positive or more neutral way Guided discovery Dysfunctional thought record TIC TOC technique Ellis' Identifying ABC's: Activating event; irrational Belief; emotional and behavioral Consequences Acquiring knowledge

Impact of beliefs on eating disorder

Distortions of thoughts need for control, distortion in beliefs in self concept and body image.

Cognitive beliefs and mental illness: nature of beliefs

Dynamic "layers" of beliefs (internal core- what moral and values are built off of) Information processing Self fulfilling prophecies (keep thinking that negative that is going to happen. and when it does will completely focus on those negatives.) Development of beliefs Social contexts and relationships and beliefs

Assigning homework

Experiment with, practice, apply or supplement

Cognitive remediation interventions: Attempt to improve specific cognitive skill

Found to be helpful, but lacks generalizability to real-life functioning

Compensatory thinking techniques: Talk self through a task/situation: i.e. leaving the house in the morning

Helps support automatic processing

Decision making

Heuristics: mental cheat sheets about making decisions based of off logic and values. aspects of decision making. Ties in with judgment and metacognition. consequences- Long term and short term

Cognitive aspects of anxiety disorders

Hypersensitivity to rejection, chronically self-focused, actual v. ideal self

Cognitive interventions for schizophrenia: Integrated model addressing both cognitive and social dysfunction

Information processing

Cognitive interventions for schizophrenia

Integrated model addressing both cognitive and social dysfunction Focus on negative symptoms Psychiatric rehab

Cognitive development Principles

Invariant sequence of development (does not vary) Progress must be enabled (if they are not in an environment that is challenging them, they will not change and evolve) Cannot skip a stage People use highest structure of which they are capable and will use what they have learned before. Don't believe "all or nothing"

Cognitive adaption interventions: Adaptation of environment often includes:

Labels, signs, symbols, alarms, beepers, checklists...other thoughts?

Cognitive behavioral theory/ therapy

Learning theory and behaviorism Social learning theory and social cognitive theory Behaviorally oriented CBT models Cognitively oriented CBT models OT and CBT models

Compensatory thinking techniques

Memory mnemonics - examples? Talk self through a task/situation: i.e. leaving the house in the morning Goal Management Training Cognitive Orientation to Daily Occupation (CO-OP)

Cognitive aspects of Depressive disorders

Negative views and negative content Tend to stick around for longer time period. Can effect entire life "imi a horrible person, suck at life" I'm not even going to try this because its not going to work" Impact all aspects of the world

Impact of beliefs on Anxiety

OCD inflated sense of responsibility/need for control PTSD belief that they "causes" abuse (think they caused the abuse to happen and they think that it is their fault.)

Cognitive remediation interventions: Dynamic interactional approach

PEO and functional info processing of the person, focusing on processing strategies and self monitoring

Cognitive assessment and evaluations

Performance based Neuropsychological testing Cognitive assessment in OT Test of Everyday Attention (1994) Multiple Errands Test (1991) LOTCA (2005) KTA (1993) Contextual Memory Test (2005) Allen Cognitive Level Screen (1990) Mini-Mental State Exam (1975) EFPT (Executive Function Performance Test) (2003)

Cognitive remediation interventions: Integrated psychological therapy

Social and problem solving skills

Cognitive disability practice model (Allen, 1996) Errorless learning

Structured to prevent mistakes via small steps, simple task and overlearning through repetition, practice and positive reinforcement

Classroom/parental interventions ADHD

Support use of behavioral strategies across contexts

Compensatory thinking techniques: Goal Management Training

Teach a series of questions or steps to help self-monitor while working toward a goal

Reality orientation and validation therapy

Used w dementia to alleviate disorientation, use reality board, name tag, reminiscence Validation focuses on addressing the feeling Reality: dates, news articles, pictures of loved ones, memories, reminiscing, validation: addressing the feelings.

Conceptual flexibility:

ability for brain to shift and adapt to certain environments. important processes (Wisconsin card sort test) sorting cards based on certain criteria and having to go back to sort them again.

Problem solving

ability to recognize that there is a problem and how to come up with solutions and to see if the solution will be beneficial or not. 5 set system: identify, idea, solution, review, conclusion

Vigilance:

being hyper aware of something. lifeguard- has to pay attention and not get distracted because there could always be something that requires action or attention. just focusing on one thing.

Selected attention:

choosing what you are focusing on. having a lot of different things going on but focusing on just one thing.

Compensatory:

compensation- certain devices: alarms, cell phones, check lists, pictures, reminders. allow person to function without getting better at the skill.

Cognitive Adaptation Training:

diff. strategies for apathetic vs disinhibited behaviors in Schizophrenia

Long Term Memory

different memories Semantic episodic procedural

Modulation of arousal

does process arousal properly. increase sensitivity to specific stimuli, once levels of arousal are off its hard to bring back to homeostasis

Automaticity vs controlled process

don't have to be cognitively aware of it (morning routine, driving) vs Having to actively focus on something and remember what you are focusing on. (first day of school, new job)

Episodic

events, (first day of school)

Semantic

facts, dates, info

Behavioral strategies and techniques -

focus on activating or monitoring overt or covert behaviors Behavioral experiments Assigning homework Scheduling activities Self monitoring Challenging dysfunctional assumptions (can be both cognitive and behavioral) Relapse preventio

Self- monitoring

having people catch their negatives thoughts. being aware of their mood. knowing how they are feeling.

Relapse prevention

help person keep thinking about their awareness of negative thoughts so they don't increase their anxiety or depression

Procedural

how to do something (drive, bike)

Short term memory

immediate recall 7 +- 2 pieces of info

Ideas for adapting a task.

increase or decrease the complexity of the task (grading) tools that you can use: large grips, check list, reminders, adjust schedule, buying pre chopped veggies instead of cooking yourself. online banking

Allocation policy

less Automaticity, cant engaged as easily and it requires more thought processes.

Schema and scripts

more general. knowing how to go to the airport. script: trip through BWI to texas. specific things for BWI. close it in a little bit

Divided attention

multitasking, doing more than one thing focusing on them all

Remediation:

picks a skill and work with person to get better at that skill.

What does cognition address?

processes associated with perceiving, making sense of and using information

Cognitive interventions and schizophrenia

remediation & compensatory Attentional deficits Memory deficits Conceptual flexibility (WCST)

Woking memory

takes piece of info from STM and puts it into action

Barriers to using compensatory thinking techniques??

the more scheduled and regular it will be easier to use. if its new it will be harder love cognitive levels

Cognitive remediation:

trying to get people onto the automaticity so they can just act without thinking

Concept formation /categorization

we do this everyday. put things into schemes and categories in oder to understand it. It is typically unconscious. helps us access information quickly