Taking Control of Your Functional Cognitive Symptoms: Workbook—A Novel Intervention 2025 Cotton et al

Andy

Andy

Senior Member (Voting rights)

Abstract​

Objective:​

Functional cognitive disorder (FCD) is a subtype of functional neurological disorder (FND). FCD may include various cognitive symptoms, precipitants, and comorbid conditions (such as other FNDs, concussion, fatigue, or fibromyalgia). However, no widely available behavioral health interventions exist for FCD. The authors developed a therapist-guided and patient-led treatment for veterans and civilians with FCD.

Methods:​

A well-known evidence-based treatment for functional seizures (an FCD-adjacent condition often with cognitive symptoms) was adapted to fit hypothesized mechanisms of FCD. The process used a health research format following the guidance for reporting intervention development studies. Key processes included determining the broad intervention framework, obtaining detailed FCD-specific content based on expert consensus, collecting evidence, developing theory, conducting target population–centered approaches, considering specialty subgroups, and gathering feedback from veteran and civilian stakeholders.

Results:​

The authors created a comprehensive 14-chapter manualized therapist-guided neurobehavioral therapy protocol for FCD symptoms independent of etiology, the Taking Control of Your Functional Cognitive Symptoms: Workbook. Initial feasibility, tolerability, and utility were assessed with two target-population stakeholders with FCD (one civilian patient and one veteran patient), with both reporting a Patient Global Impression of Change scale rating of 1 (indicating that their condition had very much improved).

Conclusions:​

This promising new multimodality behavioral health intervention can be considered to be in stage 1 (i.e., intervention generation, refinement, modification, adaptation, and pilot testing). Further pilot testing is being conducted and will need to be followed by traditional efficacy testing (in stage 2).

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The paper said:
A well-known evidence-based treatment for functional seizures (an FCD-adjacent condition often with cognitive symptoms) was adapted to fit hypothesized mechanisms of FCD. The process used a health research format following the guidance for reporting intervention development studies. Key processes included determining the broad intervention framework, obtaining detailed FCD-specific content based on expert consensus, collecting evidence, developing theory, conducting target population–centered approaches, considering specialty subgroups, and gathering feedback from veteran and civilian stakeholders.
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This is an impressive word salad.
This promising new multimodality behavioral health intervention can be considered to be in stage 1 (i.e., intervention generation, refinement, modification, adaptation, and pilot testing). Further pilot testing is being conducted and will need to be followed by traditional efficacy testing (in stage 2).
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Already cashed the check for fully-grown chickens without producing a single egg is what you do when you are selling a bunch of bullshit. Who decides that it's promising? The people who are selling the fraudulent nonsense?

This paper appears to be in the tradition of "we did something, here's how we did it", even though it does not matter one bit. "We took the solution. We diluted it. We diluted it again. We shook it. It was shook. We diluted it again. Send money."

Honestly, if this was all a cruel joke and these people were just fucking with us, how would it look any different? I can't think of anything.
 
Sean said:
:banghead:
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:banhappy::emoji_santa::emoji_money_mouth: in absence of tooth fairy/narnia/made-up land emoticon and the poop one. In a dream world if we had one for Catherine Tate's bigoted grandma character I might have used that too.

it feels like a trend for introducing a functional pre-fix for anything to cover all eventualities of what some HCP mightn't fancy doing that day seems to be like selling the equivalent of the Monopoly advance to go (and collect £200) card for HCPs to have in their back pocket and an excuse for having sent anyone to 'the re-education department' to be dealt with by someone else, whatever they present with, and think they have their back covered as long as someone 'wrote a few words, whatever they say'

"feasibility, tolerability, and utility were assessed with two target-population stakeholders with FCD (one civilian patient and one veteran patient), with both reporting a Patient Global Impression of Change scale rating of 1 (indicating that their condition had very much improved)."

what is utility? because the other two (feasibility and tolerability) don't matter as primary reasons to do it or 'effectiveness' as in 'does it cure'. On these measures they might as well start giving people a hamburger/veggieburger and claiming the condition much improved because people ate it fine.

DO any of these even check it actually changed people's function or diagnosed their condition or are we not bothering with that now for these people as long as 'they'll put up with it'. But then making claims based on these 'measures' that their condition 'had very much improved'.

And testing it on two people - taking the pee?
 
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rvallee said:
Publication count stonks go up.
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and maybe Garner will reference it on TwitterX between LP posts although I'm not sure that counts as a 'citation' for the Ref (Research excellence framework or whatever academics get assessed by in the US, Canada )?

I notice 2 of the authors are from Edinburgh Uni Centre for CLinical Brain Sciences which is home of Sharpe, Carson, Stone so...

Is it multimodality and 'new' because the workbook has stickers with it this time or something?
 
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