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Title: Pre-therapy skills required to be ready for cognitive behavioural therapy in people living with dementia
Author: Stott, Joshua Charles Hugh
ISNI:       0000 0004 7661 2345
Awarding Body: UCL (University College London)
Current Institution: University College London (University of London)
Date of Award: 2018
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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.
Supervisor: Charlesworth, G. ; Scior, K. Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available