JMIR Publications

ABSTRACT

Background:

Subjective cognitive concerns (SCCs), in which patients perceive subtle cognitive changes despite normal neuropsychological testing, contribute to psychological distress and functional decline, and are increasingly considered to be a risk factor for future objective decline. Despite this “at-risk” period being an optimal time for intervention, there remains a need for targeted interventions for this population.

Objective:

The current pilot study explored the preliminary efficacy (N=15) of a brief, one-session emotion regulation intervention called, “Worry Less, Remember More”. The “Worry Less, Remember More” intervention was designed to reduce rumination and improve subjective cognitive functioning in Veterans with subjective cognitive changes.

Methods:

Veterans were randomized to either the active telehealth condition or wait-list control. Following the intervention, Veteran input was sought through semi-structured interviews with a subset of 12 participants, examining feasibility, acceptability, and perceived efficacy. Preliminary efficacy was also measured using pre- and post-intervention self-report measures.

Results:

Veterans reported this intervention was acceptable, with 92% of the sample reporting they benefited from the intervention and would recommend the intervention to others with similar difficulties. Semi-structured interviews revealed difficulties with feasibility, including problems with the remote consenting process, forgetting appointments, and needing additional strategies to remember to consistently use the interventions. The intervention improved self-reported cognitive symptoms on quantitative measures, but not self-reported rumination.

Conclusions:

This pilot study establishes preliminary feasibility, acceptability, and efficacy of the “Worry Less, Remember More” intervention for Veterans with subjective cognitive symptoms. Future iterations of the intervention may benefit from simplifying the electronic consent process, providing reminders for appointments, and incorporating compensatory cognitive strategies to assist with using the telehealth system, as well as applying the strategies learned in the intervention. While future research is needed with larger samples, including non-Veteran populations, the intervention may also be a useful clinical tool to bridge care between neuropsychology clinics and mental health treatment. Clinical Trial: Pilot study and was not registered.