Taking Control of Your Functional Cognitive Symptoms Workbook: A Novel Intervention
Bibliographic record
Abstract
Abstract Background Functional cognitive disorder (FCD) is a subtype of functional neurological disorder (FND). FCD can present with various cognitive symptoms, precipitants, and comorbidities (other FNDs, concussion, fatigue, fibromyalgia, etc.). However, there are no widely available existing behavioral health interventions for FCD. The authors’ aim was to develop a therapist-guided treatment for FCD for widespread use among civilians and Veterans. Methods We adapted a well-known, evidence-based treatment for functional seizures (an adjacent condition often with cognitive symptoms), to fit the hypothesized mechanisms of FCD. The process is presented in GUIDED format (GUIDance for the rEporting of intervention Development). Key processes included determining broad intervention framework, detailed FCD specific content based on expert consensus, evidence, theory, target population centered approaches, specialty subgroup consideration and target population stakeholder feedback for Veteran and civilian populations. Findings We have created a comprehensive 14-chapter, manualized, therapist-guided neurobehavioral therapy protocol to target FCD symptoms independent of etiology – the Taking Control of Your Functional Cognitive Symptoms Workbook . Initial feasibility, tolerability, and utility were completed with 2 target population stakeholders with FCD (one civilian, one Veteran; both PGI-C rating = 1 “Very Much Improved”). The Template for Intervention Description and Replication (TIDieR) checklist is provided as a supplemental table. Interpretation This new promising multi-modality behavioral health intervention can be considered 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 (Stage 2). Key Messages FCD is an increasingly recognized subtype of FND. Despite existing models of FCD mechanisms, there are no widely available dedicated FCD-symptom focused behavioral health interventions. We have created the Taking Control of Your Functional Cognitive Symptoms: Workbook , a 14-chapter manualized therapist-guided neurobehavioral therapy protocol to target FCD symptoms regardless of cause / associated conditions, which shows early feasibility and promising clinical utility.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.002 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".