Formulating Cognitive Functioning to Guide Personalised Treatment for People Diagnosed With Mental Disorders
Bibliographic record
Abstract
ABSTRACT Introduction Objective and subjective cognitive impairment are highly prevalent in mental disorders and transdiagnostic phenomena. Cognitive impairment is associated with poorer functional outcomes and therefore requires treatment, but little guidance is available for clinicians. The aim of this article is to provide guidance for formulating an individual's cognitive profile and how this can be used to personalise treatments for optimum cognitive and functional outcomes. Methods We first critique current models of psychopathology in relation to assessing and addressing cognitive functioning in the clinic. This is followed by a description of key methods for assessing objective and subjective cognitive functioning and how this information can be used to formulate a patient's cognitive profile and tailor treatment. Results Within current models of psychopathology, cognition is inadequately or simplistically represented, is only viewed from a deficit lens without considering strengths, does not consider subjective perceptions of cognitive functioning, and therefore, generally does not provide utility for guiding clinical practice. Both the profile of cognitive functioning (strengths and weaknesses) and estimated change from premorbid levels are key considerations for tailoring cognitive and functional treatments. Cognitive profile and change can be assessed using standardised cognitive tests through normative and idiographic methods, respectively. Subjective perception of cognitive functioning is a neglected but important additional aspect of cognitive functioning that warrants assessment. The complete cognitive profile can be used to guide the selection of cognition‐focused treatments, including psychoeducation, lifestyle adaptations, cognitive remediation, compensatory strategies, environmental supports, psychological therapy, and medication review. Conclusions We propose that cognition should be assessed in addition to presenting psychopathology because it is an independent transdiagnostic predictor of functional outcomes, which can enhance personalised clinical care. We recommend assessing both objective and subjective cognitive functioning to formulate the personalised treatment for optimal functional outcomes and promote a culture of recovery that includes cognitive health.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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 teacher head, 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".