Cognitive rehabilitation treatment for mental slowness in conversion disorder: A case report

Figures & data

Table 1. JH’s performance on the NPA

Neurocognitive domain	Test	Score at T0	Score at T4^a
Language	BNT	166/175
	Animal naming	37
	Letter fluency (N + A)	16
Working memory	Digit span	17**	22
Memory	RAVLT
	Immediate recall	37*	38
	Delayed recall	6/15**	7/15
	Recognition	28/30	29/30
	RBMT
	Immediate recall	12.5*
	Delayed recall	9.5**
	ROCFT/MTCF^b
	Immediate recall	10*	29
	Delayed recall	9**	29
Information processing speed	TMT-A	34	46
	Symbol substitution	37**	47
	Stroop
	Part I	86**	64**
	Part II	120*	79**
Attention	TMT-B	129**	65
	Stroop
	Part III	176	154*
	d2	26**
Executive functioning	Rule learning	4
	Key search test	3
	Zoo map test	2
Malingering	TOMM	50/50	50/50

* ≤16th percentile.

** ≤6th percentile compared with normative data.

^a Parallel versions for the RAVLT and ROCFT are used.

^b ROCFT was used at T0, MTCF was used at T4.

Table 2. ROM questionnaires at intake and after TPM

Questionnaire	Scores at intake	Scores after TPM
OQ	93	75
PHQ-15	8
PHQ-9	11	7
GAD-7	5
LKV	85	47
BPI	5	3

Abbreviations: OQ: Outcome Questionnaire; PHQ: Patient Health Questionnaire; GAD: General Anxiety Disorder; LKV (Dutch abbreviation): Physical Symptoms Questionnaire; BPI: Brief Pain Inventory.

Figure 1. Scores on the LKV and MSQ over time during TPM.

Abbreviations: LKV (Dutch abbreviation): Physical Symptom Questionnaire; MSQ: Mental Slowness Questionnaire; freq.; frequency; sev.: severity; weight.: weighted. Note: MSQ is not assessed during T2 and T3.

Table 3. The cognitive strategy in TPM

Questions to be asked	Main objective to be taught
1. Are there two or more things to be done at the same time for which there is not enough time? If yes: go to step 2, else just do the task	To recognize time pressure in the task at hand
2. Make a short plan of which things can be done before the actual task begins	To prevent as much time pressure as possible
3. Make an emergency plan describing what to do in case of overwhelming time pressure	Dealing with time pressure as quickly and effectively as possible
4. Plan and emergency plan ready? Then use it regularly	Urging the patient to monitor him/herself while using the TPM strategy

Source: Extracted with permission from Fasotti et al. (2000).

Fasotti, L., Kovacs, F., Eling, P. A. T. M., & Brouwer, W. H. (2000). Time pressure management as a compensatory strategy training after closed head injury. Neuropsychological Rehabilitation: An International Journal, 10, 47–65. doi:10.1080/0960201003889291

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