Psychosocial adjustment to Mild Cognitive Impairment: The role of illness perceptions, cognitive fusion and cognitive impairment.

Probably not a substantial claim: may not pass S3 (load-bearing).

A similar study with well-educated males who had been diagnosed with MCI (n=30) found no significant association between illness perceptions and distress.

“A similar study (Lin, Gleason and Heidrich, 2012) with well-educated males who had been diagnosed with MCI (n= 30) found no significant association between illness perceptions and distress.”

• cites Lin, Gleason and Heidrich, 2012 sourceDisputed

  The Results (Relationships among domains; page unavailable) report significant associations between illness perceptions and emotional distress: perceived negative consequences (r = .40, p = .027) and a chronic timeline (r = .51, p = .004) were each associated with greater distress. The study included 30 people with MCI, but the Method (Procedure; page unavailable) identifies 24 men and 6 women, not 30 males. (LLM, conf=0.91)

  Checked by a reasoning model — may be wrong.

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Power calculations were carried out a-priori using G*power to calculate sample size estimates for correlation analysis to detect medium and large effect sizes, with a power of 0.80 and an alpha of <0.05.

“Power calculations were carried out a-priori, G*power (version 3.1) (Faul, Erdfelder, Buchner & Lang, 2009) was used to calculate sample size estimates for correlation analysis to detect medium and large effect sizes, with a power of 0.80 and an alpha of <0.05.”

• cites Faul, Erdfelder, Buchner & Lang, 2009 sourceSupported

Classified as probably not a substantial claim.

Cognitive fusion is a significant predictor of psychological distress and QoL in a range of health conditions including multiple sclerosis, chronic pain and cancer.

“Studies indicate that cognitive fusion is a significant predictor of psychological distress and QoL in a range of health conditions including multiple sclerosis (Ferenbach, 2011), chronic pain (McCracken & Vowles, 2014) and cancer (Gillanders et al., 2015).”

• cites Ferenbach, 2011Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites McCracken & Vowles, 2014 sourceCould not verify

  For the chronic-pain portion attributed to McCracken and Vowles, the 'ACT for Chronic Pain: Model, Process, and Evidence' section describes cognitive defusion as a treatment process, while 'Challenges in CBT for Chronic Pain' says pain-related cognitions correlate with functioning. Neither passage reports that cognitive fusion significantly predicts psychological distress or quality of life in people with chronic pain (searched: cognitive fusion, predictor, psychological distress, quality of life). (LLM, conf=0.72)

  Experimental — accuracy not yet measured
• cites Gillanders et al., 2015 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

MCI diagnosis can evoke a broad range of emotional responses in people diagnosed with MCI including worry, ambivalence or relief.

“Receiving a Mild Cognitive Impairment (MCI) diagnosis can evoke a broad range of emotional responses in people diagnosed with MCI including worry, ambivalence or relief (Dean & Wilcock, 2012;Gomersall et al. 2015).”

• cites Dean & Wilcock, 2012 sourceNot checked — no full text of the source
• cites Gomersall et al. 2015 sourceSupported

May combine two claims.

In Banningh et al. (2011), participants improved in adaptive appraisals after receiving CBT (p = 0.034) compared to the waiting list period, but distress (p = 0.34) and general well-being (p = 0.78) did not improve.

“Results showed that participants improved in adaptive appraisals after receiving CBT (p = 0.034) compared to the waiting list period.In contrast, distress (p = 0.34) and general well-being (p = 0.78) did not improve.”

• cites Banningh et al., 2011 sourceSupported

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The GAI-SF has been shown to have adequate sensitivity (.75) and internal consistency (Cronbach's α=0.71), and good specificity (.87) in a community-dwelling older adult sample.

“The GAI-SF has been shown to have adequate sensitivity (.75) and internal consistency (Cronbach's α=0.71), and good specificity (.87) in a community-dwelling older adult sample (Byrne & Pachana, 2011;Johnco, Knight, Tadic & Wuthrich, 2015).”

• cites Byrne & Pachana, 2011 sourceNot checked — no full text of the source
• cites Johnco, Knight, Tadic & Wuthrich, 2015 sourcePartly supported

  The Introduction (page unavailable) reports 75% sensitivity and 87% specificity from Byrne and Pachana (2011). The Results (page unavailable) report GAI-SF internal consistency of α = 0.718 in the non-clinical sample, not the stated α = 0.71; this paper’s own sensitivity and specificity estimates are also different (78.14% and 98.3%). (LLM, conf=0.85)

  Experimental — accuracy not yet measured

Probably not a substantial claim: may not pass S3 (load-bearing).

ACT-based interventions for other neurological conditions have shown initial promise.

“ACT-based interventions for other neurological conditions have shown initial promise (e.g.Sheppard, Forsyth, Hickling & Bianchi, 2010;Nordin & Rorsman, 2012;Gillanders & Gillanders, 2014b;Graham, Gillanders, Stuart & Gouick, 2015;Whiting, Deane, & McLeod, 2017) suggesting that ACT could be successfully adapted for people diagnosed with MCI.”

• cites Sheppard, Forsyth, Hickling & Bianchi, 2010 sourceNot checked — no full text of the source
• cites Nordin & Rorsman, 2012 sourceSupported
• cites Gillanders & Gillanders, 2014bNot matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

The two predictors accounted for only 4% of the variance in anxiety symptoms (Adj R2=.04) and the equation was non-significant (F(2,31)=1.6, p>0.05).

“The two predictors accounted for only 4% of the variance in anxiety symptoms (Adj R 2 =.04) and the equation was non-significant (F(2,31)=1.6,p>0.05).”

May combine two claims.

The two predictors accounted for 31% of the variance in QoL (Adj R2=.31, p<0.01) and the equation was significant (F(2,31)=8.3, p<0.001).

“The two predictors accounted for 31% of the variance in QoL (Adj R 2 =.31,p<0.01)and the equation was significant (F(2,31)=8.3,p<0.001).”

May combine two claims.

A higher number of self-reported MCI symptoms were associated with increased distress and lower QoL.

“A higher number of self-reported MCI symptoms were associated with increased distress and lower QoL.”

May combine two claims.

The two predictors (cognitive impairment and threat appraisals) accounted for 19% of the variance in depression symptoms (Adj R2=.19) and the equation was significant (F(2,31)=4.9, p<0.01).

“The two predictors accounted for 19% of the variance in depression symptoms (Adj R 2 =.19) and the equation was significant (F(2,31)=4.9,p<0.01).”

Probably not a substantial claim: may not pass S4 (based).

Limited research has focused on individual experiences of receiving an MCI diagnosis.

“Limited research has focused on individual experiences of receiving this diagnosis.”

Probably not a substantial claim: may not pass S4 (based).

To date, there have been no studies investigating the role of cognitive fusion in adjustment to MCI.

“To date, there have been no studies investigating the role of cognitive fusion in adjustment to MCI.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Anxiety and depression symptoms significantly increase risk of progression from MCI to dementia by around 18% and 25% respectively.

“A meta-analysis found that anxiety and depression symptoms significantly increase risk of progression from MCI to dementia by around 18% and 25% respectively (Mourao, Mansur, Malloy-Diniz, Castro-Costa & Diniz, 2016;Li & Li, 2018).”

• cites Mourao, Mansur, Malloy-Diniz, Castro-Costa & Diniz, 2016Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Li & Li, 2018Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Classified as probably not a substantial claim.

The Common Sense Model (CSM) of Self-Regulation proposes that illness perceptions can have a direct effect on coping behaviour and emotional wellbeing.

“The Common Sense Model (CSM) of Self-Regulation (Leventhal, Meyer & Nerenz, 1980;Leventhal, Nerenz & Steele, 1984) offers a theoretical framework to explain diversity in individual responses to ill health and proposes that 'illness perceptions' can have a direct effect on coping behaviour and emotional wellbeing.”

• cites Leventhal, Meyer & Nerenz, 1980Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Leventhal, Nerenz & Steele, 1984Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

May combine two claims.

Stevenson (2014) provided some evidence to support the CSM with an older adult MCI population (n=19): perceptions regarding the consequences and emotional impact of MCI were associated with increased anxiety symptoms, but no association was found between perceptions of MCI and quality of life.

“Stevenson (2014) provided some evidence to support the CSM with an older adult MCI population (n=19).Perceptions regarding the consequences and emotional impact of MCI were associated with increased anxiety symptoms.No association was found between perceptions of MCI and quality of life (QoL) in their sample.”

• cites Stevenson, 2014Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

MCI is a vague term and makes the person confused as to whether they will go on to develop dementia or not.

“MCI is a vague term and makes the person confused as to whether they will go on to develop dementia or not (Corner and Bond, 2006).”

• cites Corner and Bond, 2006 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

All variables met the assumption of normality, except for GAI-SF, GDS-5 and IPQ-MCI subscales: chronic timeline and treatment control; transformations resulted in a marked improvement in normality.

“All variables met the assumption of normality, except for GAI-SF, GDS-5 and IPQ-MCI subscales: chronic timeline and treatment control.Transformations (square root and logarithmic) were conducted and resulted in a marked improvement in normality.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Although the current study shows a pattern of relationships at the group level, the work is not yet sufficiently developed to provide cut-off scores for identifying individuals whose appraisals or cognitive fusion put them at greater risk of poor adjustment.

“Although the current study shows a pattern of relationships at the group level, the work is not yet sufficiently developed to provide cut-off scores for identifying individuals whose appraisals or cognitive fusion put them at greater risk of poor adjustment.”

Classified as probably not a substantial claim.

The decision to exclude participants within the first three months post diagnosis was made to get a more stable estimate of the associations between constructs, given the cross-sectional and self-report methodology used.

“The decision to exclude these participants from the current study was made in order to get a more stable estimate of the associations between constructs, given the cross sectional and self-report methodology used.”

• AssumptionRests on an assumption: Relationships between appraisals, fusion, distress and QoL are likely to be relatively less stable during the first three months post diagnosis.

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

ACT can be used to organize the work of teams, and different professionals within a team can be trained to deliver elements of ACT work at different levels.

“ACT can be used to organize the work of teams, and different professionals within a team can be trained to deliver elements of ACT work at different levels.”

• cites Gauntlett-Gilbert, 2011Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

There is good evidence that ACT can be used as an overarching framework to support and inform the work of multidisciplinary teams in complex healthcare settings.

“Fortunately, there is good evidence that ACT can be used as an overarching framework to support and inform the work of multidisciplinary teams in complex healthcare settings (e.g.Gauntlett-Gilbert, 2011).”

• cites Gauntlett-Gilbert, 2011Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

ACT may be preferable to direct cognitive-change techniques synonymous with Cognitive Therapy, as patient perceptions about their condition could be realistic.

“This approach may be preferable to direct cognitive-change techniques synonymous with Cognitive Therapy, as patient perceptions about their condition could be realistic (e.g.'MCI strongly affects the way others see or treat me').”

Probably not a substantial claim: may not pass S3 (load-bearing).

The opt-in recruitment method may have reduced overall participation in the study.

“The opt-in recruitment method may have reduced overall participation in the study.”

Classified as probably not a substantial claim.

A strength of the study is that it measured adjustment variables within a specific three to nine month time frame post diagnosis.

“A strength of the study is that it measured adjustment variables within a specific three to nine month time frame post diagnosis.”

May combine two claims.

The QoL-AD has demonstrated good concurrent validity and internal reliability (Cronbach's α=.90) when administered to individuals diagnosed with MCI.

“The QoL-AD has demonstrated good concurrent validity and internal reliability (Cronbach's α=.90) when administered to individuals diagnosed with MCI (Tatsumi, Yamamoto, Nakaaki, Hadano & Narumoto, 2011).”

• cites Tatsumi, Yamamoto, Nakaaki, Hadano & Narumoto, 2011 sourceNot checked — no full text of the source

Probably not a substantial claim: may not pass S3 (load-bearing).

The CFQ has not been validated with people diagnosed with MCI.

“The CFQ has not been validated with people diagnosed with MCI, however research has demonstrated”

May combine two claims.

The composite threat appraisal variable comprised 67 items and the Cronbach's alpha indicated adequate internal consistency (α=.86) in the current sample.

“The composite variable comprised 67 items and the Cronbach's alpha indicated adequate internal consistency (α=.86) in the current sample.”

Probably not a substantial claim: may not pass S2 (checkable).

Rather than attempting to directly modify perceptions, ACT would attempt to reduce the regulatory effect perceptions were having on patient behaviour.

“Rather than attempting to directly modify perceptions, ACT would attempt to reduce the regulatory effect perceptions were having on patient behaviour (e.g.social avoidance).”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

ACT, which directly targets cognitive fusion, may offer potential to reduce distress in people diagnosed with MCI.

“ACT, which directly targets cognitive fusion, may also offer potential to reduce distress in people diagnosed with MCI.”

Probably not a substantial claim: may not pass S2 (checkable). May combine two claims.

Findings provide an understanding concerning the factors involved in patients' adjustment to MCI and assist with development of assessment and early intervention procedures for patients with increased distress or reduced life satisfaction following diagnosis.

“Findings provide an understanding concerning the factors involved in patients' adjustment to MCI and assist with development of assessment and early intervention procedures for patients with increased distress or reduced life satisfaction following diagnosis.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

Validation studies suggest that the MoCA has high test-retest reliability, good internal consistency (Cronbach's α = 0.83) and adequate levels of sensitivity (90%) and specificity (87%) for detecting MCI.

“Validation studies suggest that the MoCA has high test-retest reliability, good internal consistency (Cronbach's α = 0.83) and adequate levels of sensitivity (90%) and specificity (87%) for detecting MCI.”

• cites Nasreddine et al., 2005 sourceNot checked — no full text of the source

May combine two claims.

The study had a low sample size and low power, which is a clear limitation.

“A clear limitation of the study is the low sample size and power.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Control appraisals could be a treatment target from within a cognitive behavioural perspective.

“Control appraisals could be a treatment target from within a cognitive behavioural perspective.”

Classified as probably not a substantial claim. May combine two claims.

There were no violations of linearity, homoscedasticity or multi-collinearity.

“There were no violations of linearity, homoscedasticity or multi-collinearity.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

The nine-month boundary and the inclusion of a cognitive screening measure (MoCA) most likely minimised the inclusion of participants who had experienced either remittance of cognitive problems or further cognitive decline.

“Furthermore, the ninemonth boundary and the inclusion of a cognitive screening measure (MoCA) most likely minimised the inclusion of participants who had experienced either remittance of cognitive problems or further cognitive decline.”

Probably not a substantial claim: may not pass S2 (checkable).

Our findings suggest that illness perceptions could be modified, from within a theoretically consistent ACT-model, to improve QoL amongst patients adjusting to MCI.

“Our findings suggest that illness perceptions could be modified, from within a theoretically consistent ACT-model, to improve QoL amongst patients adjusting to MCI.”

Probably not a substantial claim: may not pass S2 (checkable).

Cognitive modification treatments, such as CBT, may hold potential to improve mood and life satisfaction in people diagnosed with MCI by attempting to directly change maladaptive beliefs about the condition.

“Cognitive modification treatments, such as CBT, may hold potential to improve mood and life satisfaction in people diagnosed with MCI by attempting to directly change maladaptive beliefs about the condition.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

Helping people to step back from such appraisals, using 'defusion' strategies from Acceptance and Commitment Therapy, could be an alternative route to enhancing wellbeing and reducing distress for people with MCI.

“Alternatively, the findings of this study also suggest that helping people to step back from such appraisals, using 'defusion' strategies from Acceptance and Commitment Therapy, could be an alternative route to enhancing wellbeing and reducing distress for people with MCI.”

Probably not a substantial claim: may not pass S2 (checkable), S3 (load-bearing).

ACT could be successfully adapted for people diagnosed with MCI.

“suggesting that ACT could be successfully adapted for people diagnosed with MCI.”

Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

The IPQ-MCI has been validated with an MCI population and demonstrates adequate internal consistency (Cronbach's α ranging from .62 to .86).

“The IPQ-MCI has been validated with an MCI population and demonstrates adequate internal consistency (Cronbach's α ranging from .62 to .86)(Lin et al., 2012;Lin & Heidrich, 2012).”

• cites Lin et al., 2012Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

• cites Lin & Heidrich, 2012Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing).

All participants provided informed consent prior to commencement of the study.

“All participants provided informed consent prior to commencement of the study.”

Probably not a substantial claim: may not pass S3 (load-bearing).

The CFQ has demonstrated adequate internal consistency in an older adult population with chronic pain (Cronbach's α=.74).

“The CFQ has demonstrated adequate internal consistency in an older adult population with chronic pain (Cronbach's α=.74) (Scott, Daly, Yu, & McCracken et al. 2017).”

• cites Scott, Daly, Yu, & McCracken et al. 2017Not matched

  Couldn’t be matched to a paper in Crossref, so it can’t be checked.

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

The opt-in recruitment method may have placed greater demand on the cognitive capabilities of the sample.

“it may have placed greater demand on the cognitive capabilities of the sample”

Probably not a substantial claim: may not pass S2 (checkable).

ACT may be more fitting for MCI diagnosis than direct cognitive-change techniques because it aims to change the function rather than the form of threatening illness perceptions.

“ACT may be more fitting for MCI diagnosis, as it would aim to change the function rather than the form of threatening illness perceptions.”

Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

The opt-in recruitment method may have influenced the sample such that people who held more neutral appraisals of MCI may not have felt motivated to take part.

“may have potentially influenced the sample as people who may have held more neutral appraisals of MCI may not have felt motivated to take part.”