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Title:Kratko- in dolgoročni učinki računalniško vodene kognitivne remediacije na pozornost, spomin in izvršilne funkcije pri depresiji ter možnost transferja na prilagoditvene sposobnosti : doktorska disertacija
Authors:ID Klojčnik, Monika (Author)
ID Bakračevič, Karin (Mentor) More about this mentor... New window
Files:.pdf DOK_Klojcnik_Monika_2025.pdf (2,61 MB)
MD5: 63466F78CDAFF36A1A7A19D0D4482DFA
 
Language:Slovenian
Work type:Doctoral dissertation
Typology:2.08 - Doctoral Dissertation
Organization:FF - Faculty of Arts
Abstract:Bolniki z depresijo lahko izkazujejo resne kognitivne motnje, ki lahko trajajo dlje časa kljub zdravljenju z zdravili in psihoterapevtski obravnavi. Oslabljeno kognitivno funkcioniranje ni omejeno zgolj na akutno fazo depresije, ampak vztraja tudi v obdobjih remisije ter se poslabšuje s ponavljajočimi se epizodami. Kognitivni primanjkljaji, povezani z depresijo, prav tako napovedujejo raven vsakodnevnega in psihosocialnega funkcioniranja in so pomemben dejavnik pri vzdrževanju začaranega kroga depresivne simptomatike. Kognitivna remediacija predstavlja obetavno metodo za obravnavo kognitivnih primanjkljajev pri depresiji in navadno vključuje trening kognitivnih funkcij in razvoj kognitivnih strategij ter je namenjena izboljšanju kognitivnega funkcioniranja ali kompenzaciji oslabljenih kognitivnih funkcij v vsakdanjem življenju. Cilj doktorske študije je bil oceniti učinkovitost kognitivne remediacije na vzorcu depresivnih udeležencev. Bolniki (N = 50) z depresijo so bili naključno razporejeni v aktivno ali kontrolno skupino. Aktivna intervencija (računalniško podprta kognitivna remediacija) je obsegala 15 sej s programsko opremo CogniPlus; prav tako so bili udeleženci eksperimentalne skupine vsak teden deležni verbalne seje, namenjene prenosu kognitivnih veščin v resnične situacije. Vsi udeleženci so pred in po kognitivni remediaciji opravili nevropsihološko testiranje. Glavna področja intervencije so bila pozornost, verbalni in vizualni spomin ter izvršilne funkcije; ocenjevali smo tudi učinek daljnega transferja in generalizacije na prilagoditvene sposobnosti. Poleg kratkoročnega učinka kognitivne remediacije nas je zanimal še dolgoročni učinek, ki smo ga preverjali v obdobju treh mesecev po zaključenem programu v obliki samoocene. Naši rezultati kažejo, da je kognitivna remediacija lahko učinkovita metoda za obravnavo kognitivnih motenj pri depresiji, in sicer je eksperimentalna skupina po intervenciji dosegala višje rezultate kot kontrolna skupina na področju verbalnega in vizualnega spomina, pozornosti, delovnega spomina, fluentnosti in izvršilnih funkcij. Opisanega napredka ne moremo pripisati izboljšanju razpoloženja, saj eksperimentalna skupina po intervenciji ni poročala o morebitnem zmanjšanju depresivne simptomatike. Eksperimentalna skupina je po intervenciji poročala o napredku na področju prilagoditvenih funkcij, ki je vztrajal tudi v obdobju trimesečnega spremljanja. Podobno je vztrajal učinek s področja vedenjske regulacije, a je med spremljanjem izginil pozitivni učinek metakognitivnih sposobnosti. Kognitivna remediacija predstavlja eno izmed možnosti izboljšanja kognitivnega in globalnega delovanja pri bolnikih z depresijo. Psihosocialna rehabilitacija depresivnih bolnikov bi morala vključevati tudi intervencije, ciljane na kognicijo, saj le-ta neposredno ali posredno krepi bolnika in ga motivira za boljše delovanje; izboljšanje kognitivnih funkcij pa vodi v splošno višjo zmogljivost bolnika.
Keywords:depresija, kognitivne funkcije, kognitivna remediacija, prilagoditvene sposobnosti.
Place of publishing:Maribor
Place of performance:Maribor
Publisher:M. Klojčnik
Year of publishing:2024
Number of pages:1 spletni vir (1 datoteka PDF (VIII, 157 str.))
PID:20.500.12556/DKUM-90224 New window
UDC:159.95:615.851-056.34(043.3)
COBISS.SI-ID:233438979 New window
Publication date in DKUM:22.04.2025
Views:179
Downloads:69
Metadata:XML DC-XML DC-RDF
Categories:FF
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Licences

License:CC BY-NC-ND 4.0, Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International
Link:http://creativecommons.org/licenses/by-nc-nd/4.0/
Description:The most restrictive Creative Commons license. This only allows people to download and share the work for no commercial gain and for no other purposes.
Licensing start date:26.08.2024

Secondary language

Language:English
Title:Short- and long-term effects of computerized cognitive remediation on attention, memory and executive functions in depression and possibility of transfer on functional skills
Abstract:Patients with depression can exhibit serious cognitive impairments that can persist for a long time despite treatment with medication and psychotherapeutic interventions. Impaired cognitive functioning is not limited to the acute phase of depression but also persists during periods of remission and worsens with recurrent episodes. Cognitive deficits associated with depression also predict the level of everyday and psychosocial functioning and are an important factor in maintaining the vicious cycle of depressive symptoms. Cognitive remediation represents a promising method for addressing cognitive deficits in depression and typically involves cognitive function training and the development of cognitive strategies aimed at improving cognitive functioning or compensating for impaired cognitive functions in everyday life. The doctoral study aimed to evaluate the effectiveness of cognitive remediation in a sample of depressed participants. Patients (N = 50) with depression were randomly assigned to an active or control group. The active intervention (computer-assisted cognitive remediation) consisted of 15 sessions using the CogniPlus software, and participants in the experimental group also received weekly verbal sessions aimed at transferring cognitive skills to real-life situations. All participants underwent neuropsychological testing before and after cognitive remediation. The main areas of intervention were attention, verbal and visual memory, and executive functions, and we also assessed the effect of near transfer on related cognitive functions and far transfer on adaptive abilities. In addition to the short-term effect of cognitive remediation, we were interested in its long-term effect, which we evaluated through self-assessment three months after the program ended. Our results indicate that cognitive remediation can be an effective method for addressing cognitive impairments in depression. Specifically, the experimental group achieved higher scores than the control group in verbal and visual memory, attention, working memory, fluency, and executive functions after the intervention. These improvements cannot be attributed to mood enhancement, as the experimental group did not report any reduction in depressive symptoms after the intervention. The experimental group reported progress in adaptive functions after the intervention which persisted during the three-month follow-up period. Similarly, the effect on behavioral regulation persisted but the positive effect on metacognitive abilities disappeared during the follow-up. Cognitive remediation is one of the options for improving cognitive and global functioning in patients with depression. Psychosocial rehabilitation of depressed patients should also include interventions targeting cognition, as it directly or indirectly empowers the patient and motivates them for better functioning.
Keywords:depression, cognitive functions, cognitive remediations, adaptive skills


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