Mental health and Mild Cognitive Impairment: A systematic review of group psychological interventions for people with Mild Cognitive Impairment and an empirical study applying the common-sense model of self-regulation to Mild Cognitive Impairment

Lewis, Ffion 2025. Mental health and Mild Cognitive Impairment: A systematic review of group psychological interventions for people with Mild Cognitive Impairment and an empirical study applying the common-sense model of self-regulation to Mild Cognitive Impairment. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

Mild Cognitive Impairment (MCI) is a condition where an individual experiences a measurable decline in cognitive function, such as memory, attention, or executive function. However, their overall functional abilities remain relatively intact. It is estimated that the global prevalence of MCI in adults aged over 50 years old is 15% to 20%. Following their diagnosis of MCI, some people will remain stable, some will revert to normal, and some will progress to dementia. People with MCI (PwMCI) are 3.3 times more likely to develop dementia than matched controls. Research exploring the reason behind what might lead to PwMCI developing dementia or not has found associations with several factors, including physical health conditions (e.g. diabetes), mental health difficulties (e.g. depression), and lifestyle factors (e.g. smoking). PwMCI are also more likely to experience depression and anxiety compared with age-matched controls. The current papers aim to understand more about how to support the mental health of PwMCI. The systematic review aimed to evaluate group interventions' methodological quality and effectiveness for PwMCI. As MCI has become more prevalent in recent years, this has led to the development of a growing number of MCI-targeted interventions. Although the effectiveness of psychological therapies for PwMCI has been broadly studied, the impact of group-based psychological interventions remains underexplored. A search of relevant databases identified ten studies that met the inclusion criteria for this review. The quality of these studies was assessed, and their findings were synthesised narratively. The interventions reviewed included Cognitive Behavioural Therapy, mindfulness-based approaches, and a psychosocial group grounded in the Recovery Model. They also included self-empowerment interventions, which focus on increasing individuals' sense of control and autonomy over their lives, and self-efficacy interventions, designed to enhance individuals' confidence in managing challenges and achieving personal goals. Interventions were compared based on therapeutic model, duration, additional support provided, and involvement of significant others. Methodological quality varied considerably across the studies. Outcomes related to mood symptoms were reviewed, and only six of the ten studies reported statistically significant improvements in at least one outcome measure of mood. Studies that incorporated interventions focusing on the personal identity of PwMCI, particularly those emphasising self-empowerment, showed the most promising results. However, these findings should be interpreted cautiously due to differences between the studies and generally low methodological quality. The empirical paper aimed to see if the way PwMCI cope (coping styles) affects the link between how they view their illness (illness perception) and their mental health (levels of depression and anxiety). The hypotheses of this study were driven by the Common-Sense Model of Self-Regulation, which suggests that individuals facing health threats develop cognitive and emotional representations of their illness. These representations guide the selection of coping strategies, subsequently influencing their health and psychological outcomes. This model has been applied to many health conditions, but this is the first to explore these relationships in PwMCI. The results of the study indicate that avoidant coping styles significantly mediated the relationship between negative illness perceptions – including stronger negative emotions related to the diagnosis and a lower sense of personal control – and symptoms of depression and anxiety. This suggests that people who had more negative feelings towards their MCI or felt they had little control over their MCI were more likely to use avoidant coping strategies (such as denial), which led to higher levels of depression and anxiety. Coping styles that involve facing problems directly did not explain the link between positive views of illness and better mental health, as expected. While the study has some limitations, the results suggest that the Common-Sense Model of Self-Regulation can help explain why negative beliefs about illness and avoidant coping are linked in PwMCI. These findings indicate how interventions focusing on negative illness perceptions and coping styles are essential to improve the mental health of PwMCI. The findings of the empirical study and the systematic review complement and reinforce each other. The empirical study identified significant associations between how PwMCI perceive their condition, the coping strategies they adopt, and their mental health outcomes. Specifically, more negative illness perceptions and avoidant coping were linked to poorer mental health. This highlights the importance of addressing how individuals understand and manage their diagnosis. The systematic review supports this conclusion, as the only interventions found to be effective in improving mood symptoms focused on enhancing personal identity and promoting self-empowerment. As the empirical study suggests, these interventions likely helped participants develop more adaptive illness perceptions and coping strategies, which are key factors in improving mental health outcomes. Together, these findings underscore the importance of psychologically informed, identity-focused interventions for PwMCI.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Schools > Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	22 September 2025
Last Modified:	25 Sep 2025 15:30
URI:	https://orca.cardiff.ac.uk/id/eprint/181253

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