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Depression is an increasingly common health problem among youth. There is growing empirical evidence that CBT is a promising treatment for childhood depression. It remains unclear what treatment-specific effects of CBT contribute to therapeutic gains. Cognitive theories propose that a primary mechanism of change in CBT are cognitive interventions that target depressogenic cognitions regarding the self, world, and future (cognitive triad), which are thought to mediate depression. The effects of cognitive interventions on depressive symptoms are thus hypothesized to be mediated by changes in the cognitive triad. No studies have investigated whether CBT for depressed youth works by treating the cognitive triad through the implementation of cognitive techniques. As part of a larger study analyzing the mechanisms of change in CBT for depressed youth, the purpose of this study was to investigate: (1) whether specific cognitive techniques are related to depressive symptom reduction in youth, and (2) if improvements in depressive symptoms are mediated through the cognitive triad of depressed youth. Participants were 42 girls, aged 8 to 14, who completed a manualized CBT protocol for depression in group format. Girls completed a diagnostic interview for depression and self-report measures assessing the cognitive triad. Group therapy sessions were coded for cognitive interventions. Results indicated a non-significant relation between levels of cognitive interventions and post-treatment depression scores, after controlling for pre-treatment depression. Therefore, tests of mediation were discontinued. Relevant control variables were added to the model to reduce error variance. After controlling for pre-treatment depression, age, presence of learning disorder, mastery of therapeutic skills, and behavioral interventions, cognitive interventions were significantly and positively associated with post-treatment depression. The relation between cognitive interventions and the cognitive triad was non-significant and meditational analyses were discontinued. Exploratory factor analysis revealed four cognitive interventions factors that were consistent with CBT theory. Further analyses revealed that all factors were not significantly related to post-treatment depression. Tests of interactions between cognitive interventions and behavioral interventions, age, and mastery level of therapeutic skills were also non-significant. Implications, limitations, and recommendations for further areas of research are presented. / text

Introduction It is widely reported that people with schizophrenia have social cognition deficits. In addition to their negative impact on functioning and quality of life, these deficits may also contribute to the use of violence. It has recently been established that social cognitive interventions (SCIs) can ameliorate deficits in facial affect recognition (FAR). This project aimed to systematically review whether SCIs can also improve theory of mind (ToM) abilities in people with schizophrenia. The empirical study aimed to explore whether the extent of the deficits in FAR and ToM in people with schizophrenia differed between those with and without a substantial history of violence. Method A systematic review was undertaken to identify studies where SCIs were provided to adults with schizophrenia or schizoaffective disorder. Key findings were highlighted with the quality of the studies’ methodology and reporting assessed. A quantitative research study was also undertaken involving 22 men aged 18-64 with a diagnosis of schizophrenia or schizoaffective disorder, comparing those with and without a substantial history of violence (SHV) on measures of FAR and ToM. Results The majority of the 13 studies included in the systematic review found that the provision of SCIs led to significant improvements in ToM. However, all studies demonstrated a potential for bias and were limited by inadequate sample size. In the empirical study, less than half of participants scored within the normal range for overall FAR ability, with no difference identified between the SHV and no-SHV group. However, the SHV group were poorer at recognising sadness and showed a tendency to perform better at the detection of faux pas, compared to the no-SHV group. Conclusions The systematic review identified that a wide range of SCIs can improve ToM abilities in people with schizophrenia. Its findings highlight that stringent, adequately powered studies should be undertaken, utilising standardised assessments of a range of levels of ToM ability, to enable identification of the most effective intervention. The findings of the empirical study are limited by a small and imbalanced sample size between groups and so must be interpreted with caution. However, patterns observed in the results highlight areas for further exploration. The strengths of this study’s design and recruitment challenges are discussed.

Background: With age, older adults experience declines in both short- and long-term memory. One way to counter these age-related declines is through memory interventions which include computerized cognitive training and non-computerized cognitive stimulation. This dissertation examined whether a cognitive training program, Dakim BrainFitness (Dakim Inc., 2002) and a program of cognitive stimulation, Mind Your Mind (Seagull & Seagull, 2007), enhance memory performance among cognitively-intact older adults residing in independent-living retirement communities. Specifically, the following research questions were proposed: (a) How effective is the computerized cognitive training program in improving memory performance relative to the cognitive stimulation program or a no-contact control condition? (b) How effective is the non-computerized cognitive stimulation program, Mind Your Mind, at improving memory performance relative to a control condition? and (c) Will memory training gains endure 3-months post-training for those who participate in cognitive training? Method: Fifty-three older adults were randomized to cognitive training (n = 19), cognitive stimulation (n = 17), or a no-contact control (n = 17) condition. Participants in the cognitive training and cognitive stimulation conditions were asked to complete five 25-minute sessions per week for a 10-week period. Memory outcome measures included the Auditory Verbal Learning Test (AVLT), the Hopkins Verbal Learning Test (HVLT), and the Wechsler Memory Scale-Third Edition (WMS-III) Family Pictures subtest. Outcome measures were administered at baseline, immediately post-training (or equivalent delay), and again at 3-months post-training. Results: Multivariate Analysis of Variance indicated no significant differences between the three training conditions on baseline characteristics and memory outcome scores (p = .660). To test hypotheses one and two, memory outcome measures were compared across training conditions and testing occasions. A repeated measures MANOVA indicated a significant group x time interaction, Wilks' Λ =.585, F(10,92) = 2.83, p = .004, partial η2 = .235. Follow-up analyses for each memory outcome measure from baseline to immediately post-training were conducted with training condition as the independent variable. Significant group x time interactions were found between conditions for AVLT delayed recall, F(2,50) = 3.683, p = .032, partial η2 = .128, and the HVLT immediate recall, F(2,50) = 5.059, p = .010, partial η2 = .168. No significant group x time interaction was indicated on the AVLT immediate recall, F(2,50) = 2.544, p = .089, partial η2 = .092. There was a marginally significant group x time interaction on the WMS-III Family Pictures delayed recall F(2,50) = 2.975, p = .060, partial η2 = .106. Post-hoc comparisons for significant outcome measures were conducted using Fisher's LSD test, while controlling for baseline performance. Results indicated that the cognitive training condition performed significantly better than the cognitive stimulation condition from baseline to immediately post-training on the AVLT delayed recall (p = .012), as well as on HVLT immediate recall (p < .001). The cognitive training condition also performed significantly better from baseline to immediately post-training as compared to the no-contact control condition (p = .011). A significant difference between the cognitive training condition and the no-contact control condition was also found on the WMS-III delayed recall measure (p = .030) immediately post-training. No significant differences between any of the conditions were found on either AVLT immediate or WMS-III Family Pictures immediate recall (ps > .05). There were no differences between the cognitive stimulation and control conditions across all memory outcomes (ps > .05). For hypothesis three, a repeated measures MANOVA indicated no main effect of time within the cognitive training condition for the memory outcome measures, Wilks' Λ = .047, F(6,11) = 2.11, p = .135, partial η2 = .535. Discussion: These findings provide evidence that the adaptive computerized cognitive training program, Dakim BrainFitness, significantly improved memory abilities as measured by the AVLT delayed recall, HVLT, and WMS-III Family Pictures delayed recall relative to cognitive stimulation. In contrast, there were no significant improvements for participants in the non-adaptive, non-computerized program of cognitive stimulation relative to controls. These findings coincide with the Model of Adult Cognitive Plasticity that in order to improve cognitive performance, there needs to be a mismatch between the individual's capacities and the demands of the task. Adaptive cognitive training may be more likely to provide a mismatch and produce positive plasticity changes in the brain. Future research pertains to exploring the cognitive benefits that these programs have on other types of cognitive domains.

Due to the world’s rapidly growing elderly population, dementia is becoming increasingly prevalent. This poses considerable health, social, and economic concerns as it impacts individuals, families and healthcare systems. Current research has shown that cognitive interventions may slow the decline of or improve brain functioning in older adults. This research investigates the use of intelligent socially assistive robots to engage individuals in person-centered cognitively stimulating activities. Specifically, in this thesis, a novel learning-based control architecture is developed to enable socially assistive robots to act as social motivators during an activity. A hierarchical reinforcement learning approach is used in the architecture so that the robot can learn appropriate assistive behaviours based on activity structure and personalize an interaction based on the individual’s behaviour and user state. Experiments show that the control architecture is effective in determining the robot’s optimal assistive behaviours for a memory game interaction and a meal assistance scenario.

Due to the world’s rapidly growing elderly population, dementia is becoming increasingly prevalent. This poses considerable health, social, and economic concerns as it impacts individuals, families and healthcare systems. Current research has shown that cognitive interventions may slow the decline of or improve brain functioning in older adults. This research investigates the use of intelligent socially assistive robots to engage individuals in person-centered cognitively stimulating activities. Specifically, in this thesis, a novel learning-based control architecture is developed to enable socially assistive robots to act as social motivators during an activity. A hierarchical reinforcement learning approach is used in the architecture so that the robot can learn appropriate assistive behaviours based on activity structure and personalize an interaction based on the individual’s behaviour and user state. Experiments show that the control architecture is effective in determining the robot’s optimal assistive behaviours for a memory game interaction and a meal assistance scenario.