Umeå universitets logga

umu.sePublikationer
Ändra sökning
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf
Rehabilitation for improved cognition in patients with stress-related exhaustion disorder: RECO – a randomized clinical trial
Umeå universitet, Samhällsvetenskapliga fakulteten, Institutionen för psykologi.ORCID-id: 0000-0003-3256-9018
Umeå universitet, Medicinska fakulteten, Institutionen för samhällsmedicin och rehabilitering, Fysioterapi.ORCID-id: 0000-0002-2402-562X
Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR). Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Hvidovre, Denmark..ORCID-id: 0000-0002-4458-6475
Umeå universitet, Samhällsvetenskapliga fakulteten, Enheten för demografi och åldrandeforskning (CEDAR).ORCID-id: 0000-0002-1812-3581
Visa övriga samt affilieringar
2018 (Engelska)Ingår i: Stress, ISSN 1025-3890, E-ISSN 1607-8888, Vol. 21, nr 4, s. 279-291Artikel i tidskrift (Refereegranskat) Published
Abstract [en]

Stress-related exhaustion has been associated with selective and enduring cognitive impairments. However, little is known about how to address cognitive deficits in stress rehabilitation and how this influences stress recovery over time. The aim of this open-label, parallel randomized controlled trial (ClinicalTrials.gov: NCT03073772) was to investigate the long-term effects of 12 weeks cognitive or aerobic training on cognitive function, psychological health and work ability for patients diagnosed with exhaustion disorder (ED). One-hundred-and-thirty-two patients (111 women) participating in multimodal stress rehabilitation were randomized to receive additional cognitive training (n = 44), additional aerobic training (n = 47) or no additional training (n = 41). Treatment effects were assessed before, immediately after and one-year post intervention. The primary outcome was global cognitive function. Secondary outcomes included domain-specific cognition, self-reported burnout, depression, anxiety, fatigue and work ability, aerobic capacity and sick-leave levels. Intention-to-treat analysis revealed a small but lasting improvement in global cognitive functioning for the cognitive training group, paralleled by a large improvement on a trained updating task. The aerobic training group showed improvements in aerobic capacity and episodic memory immediately after training, but no long-term benefits. General improvements in psychological health and work ability were observed, with no difference between interventional groups. Our findings suggest that cognitive training may be a viable method to address cognitive impairments for patients with ED, whereas the effects of aerobic exercise on cognition may be more limited when performed during a restricted time period. The implications for clinical practice in supporting patients with ED to adhere to treatment are discussed.

Ort, förlag, år, upplaga, sidor
Taylor & Francis, 2018. Vol. 21, nr 4, s. 279-291
Nyckelord [en]
burnout, stress rehabilitation, cognitive training, aerobic training, exhaustion disorder, randomized controlled trial
Nationell ämneskategori
Tillämpad psykologi
Identifikatorer
URN: urn:nbn:se:umu:diva-147074DOI: 10.1080/10253890.2018.1461833ISI: 000442694000001PubMedID: 29693483Scopus ID: 2-s2.0-85046011368OAI: oai:DiVA.org:umu-147074DiVA, id: diva2:1201511
Forskningsfinansiär
Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2009-0772Forte, Forskningsrådet för hälsa, arbetsliv och välfärd, 2013-2056Försäkringskassan, 99368-2009/RS09Västerbottens läns landstingTillgänglig från: 2018-04-26 Skapad: 2018-04-26 Senast uppdaterad: 2023-03-24Bibliografiskt granskad
Ingår i avhandling
1. Rehabilitation for improved cognition in stress-related exhaustion: cognitive, neural and clinical perspectives
Öppna denna publikation i ny flik eller fönster >>Rehabilitation for improved cognition in stress-related exhaustion: cognitive, neural and clinical perspectives
2019 (Engelska)Doktorsavhandling, sammanläggning (Övrigt vetenskapligt)
Abstract [en]

Stress-related exhaustion disorder (ED) has been associated with concomitant cognitive impairment, perceived by patients to have large impact on everyday life. However, little is known about how to address cognition in stress rehabilitation and how this could influence stress recovery over time. The aim of this thesis was to evaluate the efficacy of additional cognitive and aerobic training for patients with ED who participated in a multimodal stress rehabilitation program. A further aim was to explore the neural correlates of ED. The main focus of this thesis was on cognitive training, the effects of which were studied from a cognitive, neural, and clinical perspective (Study I-III). The final part of this thesis (Study III) broadened the perspective and investigated the long-term effects of cognitive and aerobic training on cognitive and clinical outcomes.

Study I and II evaluated the effects of process-based cognitive training immediately following the intervention. The results from Study I showed that generalization of training effects following cognitive training was selective and restricted to tasks similar to those trained. The cognitive training group showed a greater reduction in burnout symptoms, and partial support was given for fewer subjective cognitive complaints compared to stress rehabilitation alone. Study II used functional neuroimaging to explore the neural effects of cognitive training, showing training-related activation increases at high working memory load; however, conclusions were restricted due to the small sample.

Study II additionally explored the neural correlates of ED by investigating within-group associations between burnout level and functional neural response during working memory updating. The results revealed that patients with higher levels of burnout showed greater recruitment of working memory-related regions during task execution, potentially reflecting a compensatory mechanism serving to uphold task performance.

Study III evaluated the clinical utility of addressing cognitive impairments in stress rehabilitation. Here, the effects of cognitive and aerobic training on several ED-related variables were investigated 1 year after the intervention. Cognitive training was associated with a small and lasting improvement in cognitive performance. Aerobic training yielded improvements in episodic memory immediately following the intervention, but no significant difference was found between the aerobic training group and the control group at 1-year follow-up. For psychological health and work ability, no additional benefits were seen for the added interventions relative to stress rehabilitation alone. However, a long-term improvement in burnout symptoms favouring cognitive training was observed when restricting the analysis to only include patients who had completed the intervention. This highlights the importance of supporting patients in adhering to added treatments.

In sum, the papers in this thesis provide initial evidence of neurocognitive plasticity in patients with ED and tentatively suggest that cognitive improvements following cognitive training may translate into alleviated clinical symptoms. These results support the argument that interventions targeting cognitive impairments holds a place in the effective rehabilitation of ED.

Ort, förlag, år, upplaga, sidor
Umeå: Umeå Universitet, 2019. s. 74
Nyckelord
stress rehabilitation, burnout, exhaustion disorder, cognitive training, aerobic training
Nationell ämneskategori
Tillämpad psykologi
Forskningsämne
klinisk psykologi
Identifikatorer
urn:nbn:se:umu:diva-154965 (URN)978-91-7601-998-6 (ISBN)
Disputation
2019-01-31, S213, Samhällsvetarhuset, Umeå, 09:15 (Svenska)
Opponent
Handledare
Tillgänglig från: 2019-01-10 Skapad: 2019-01-07 Senast uppdaterad: 2019-01-10Bibliografiskt granskad

Open Access i DiVA

fulltext(2147 kB)320 nedladdningar
Filinformation
Filnamn FULLTEXT02.pdfFilstorlek 2147 kBChecksumma SHA-512
64745ef28d853a0cddecbfdc63cb50a74eae1d2d5a1b6b7ea8d62a668d94f434b17113b2e1502716c35038cd362b0ccc5eeffe73542bc6c7edc400d2f23cfc7d
Typ fulltextMimetyp application/pdf

Övriga länkar

Förlagets fulltextPubMedScopus

Person

Malmberg Gavelin, HannaEskilsson, ThereseBoraxbekk, Carl-JohanJosefsson, MariaStigsdotter Neely, AnnaSlunga Järvholm, Lisbeth

Sök vidare i DiVA

Av författaren/redaktören
Malmberg Gavelin, HannaEskilsson, ThereseBoraxbekk, Carl-JohanJosefsson, MariaStigsdotter Neely, AnnaSlunga Järvholm, Lisbeth
Av organisationen
Institutionen för psykologiFysioterapiEnheten för demografi och åldrandeforskning (CEDAR)Yrkes- och miljömedicin
I samma tidskrift
Stress
Tillämpad psykologi

Sök vidare utanför DiVA

GoogleGoogle Scholar
Totalt: 329 nedladdningar
Antalet nedladdningar är summan av nedladdningar för alla fulltexter. Det kan inkludera t.ex tidigare versioner som nu inte längre är tillgängliga.

doi
pubmed
urn-nbn

Altmetricpoäng

doi
pubmed
urn-nbn
Totalt: 1248 träffar
RefereraExporteraLänk till posten
Permanent länk

Direktlänk
Referera
Referensformat
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Annat format
Fler format
Språk
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Annat språk
Fler språk
Utmatningsformat
  • html
  • text
  • asciidoc
  • rtf