Kucherer Shelly, Ferguson Robert J
aUniversity of Pittsburgh Medical Center and Department of Psychiatry, Pittsburgh, Pennsylvania bUniversity of Pittsburgh School of Medicine, Department of Medicine, Division of Hematology-Oncology, Pittsburgh, Pennsylvania, USA.
Curr Opin Support Palliat Care. 2017 Mar;11(1):46-51. doi: 10.1097/SPC.0000000000000247.
To provide the reader with an overview of the cognitive-behavioral conceptualization of cancer-related cognitive dysfunction (CRCD) and how cognitive behavioral therapy (CBT) can play an important role in treatment.
Recent findings show that Memory and Attention Adaptation Training (MAAT), a CBT developed to help cancer survivors develop adaptive skills to improve daily cognitive performance and emotional coping, may be an efficacious treatment of CRCD and can be delivered through videoconference technology to improve survivor access to care.
The etiology of CRCD remains largely undetermined and likely is produced by multiple mechanisms. This can include neuronal death, microvascular damage, inflammatory processes, and psychological factors of perceptions of inadequate cognitive capacity to meet performance demands and related emotional distress. As a result, there are a variety of treatments currently being researched. More research with larger sample sizes, multiple clinicians and multiple sites are needed to confirm efficacy, but CBT approaches such as Memory and Attention Adaptation Training that address multiple psychological factors involved may offer a flexible nonpharmacological approach to CRCD that optimizes quality of life outcomes.
为读者概述癌症相关认知功能障碍（CRCD）的认知行为概念化，以及认知行为疗法（CBT）如何在治疗中发挥重要作用。
最新研究结果表明，记忆与注意力适应训练（MAAT）是一种为帮助癌症幸存者培养适应性技能以改善日常认知表现和情绪应对而开发的CBT，可能是治疗CRCD的有效方法，并且可以通过视频会议技术进行，以提高幸存者获得护理的机会。
CRCD的病因在很大程度上仍未确定，可能由多种机制引起。这可能包括神经元死亡、微血管损伤、炎症过程以及对认知能力不足以满足表现要求的认知和相关情绪困扰等心理因素。因此，目前正在研究多种治疗方法。需要更多样本量更大、涉及多名临床医生和多个地点的研究来证实疗效，但像记忆与注意力适应训练这样涉及多种心理因素的CBT方法，可能为CRCD提供一种灵活的非药物治疗方法，从而优化生活质量结果。
