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Pre-therapy skills required to be ready for cognitive behavioural therapy in people living with dementia

Stott, Joshua Charles Hugh; (2018) Pre-therapy skills required to be ready for cognitive behavioural therapy in people living with dementia. Doctoral thesis (Ph.D), UCL (University College London). Green open access

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Abstract

Background: People living with dementia (PLWD) commonly experience depression and anxiety. For the general adult population, cognitive behavioural therapy (CBT) is a recommended treatment. Adapted forms of CBT have been used with PLWD. However, method of adaptation and outcomes are inconsistent across studies. Examining pre-therapy skills required to take part in a core aspect of CBT (cognitive restructuring) in PLWD could inform future adaptation. Given the limited previous work in PLWD, the intellectual disability literature was systematically reviewed and integrated with the dementia literature to inform aims. Main aims: 1) to develop measures of pre-therapy skills (behaviour-thought-feeling discrimination and cognitive mediation) validated for use with PLWD; 2) to compare performance of PLWD and older (OA) and younger (YA) adults without a recognised neurocognitive impairment on these validated pre-therapy skill measures; 3) to examine whether neurocognition mediates observed differences between PLWD and OA in pre-therapy skill performance; 4) to examine neurocognitive correlates of pre-therapy skill measures in PLWD with a focus on memory, language and executive function. Main methods: 102 PLWD, 77 OA and 56 YA were recruited. Measures of pre-therapy skills used in an intellectual disability context were adapted for PLWD using a published framework and subjected to factor analysis and validity checks. Performance on pre-therapy skills measures was compared across groups, mediation of between group differences was assessed (using structural equation modelling) and correlations between pre-therapy skills and neurocognitive functions were examined. Main findings: Tools were developed. PLWD scored lower than OA who scored lower than YA on pre-therapy skills measures. Differences between OA and PLWD but not between OA and YA were mediated by neurocognition. Pre-therapy skill performance was associated with scores on measures of language and, to a lesser extent, executive function. Use of tools within, and implications of findings for, CBT practice and research are discussed.

Type: Thesis (Doctoral)
Qualification: Ph.D
Title: Pre-therapy skills required to be ready for cognitive behavioural therapy in people living with dementia
Event: UCL (University College London)
Open access status: An open access version is available from UCL Discovery
Language: English
Additional information: Copyright © The Author [year]. Original content in this thesis is licensed under the terms of the Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request.
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: https://discovery.ucl.ac.uk/id/eprint/10061784
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