Volume 11, Issue 2 (March & April - Special Issue on COVID-19 2020)                   BCN 2020, 11(2): 129-132 | Back to browse issues page


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Zarrabian S, Hassani-Abharian P. COVID-19 Pandemic and the Importance of Cognitive Rehabilitation. BCN 2020; 11 (2) :129-132
URL: http://bcn.iums.ac.ir/article-1-1774-en.html
1- Cognitive and Neuroscience Research Center (CNRC), Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran.
2- Institute for Cognitive Science Studies, Brain and Cognition Clinic, Tehran, Iran.
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Since its outbreak in December 2019 in Wuhan, China, COVID-19 reached a pandemic state in less than 6 months and is still on the rise (world Health Organization, 2020). Considering the high transmissibility of COVID-19 (Wilder-Smith, Chiew, & Lee, 2020), global health and social actions should be taken to stop or reduce human-to-human transmission of the virus. As community transmission is one of the important transmission levels (world Health Organization, 2020), the methods of human beings’ judgment should be considered if we want to tackle the disease effectively. 
The topic of COVID-19 arises almost every time one surfs the Internet and different social media sites, watches TV, listens to the radio, or even has a friendly conversation. A closer look at the current situation reveals that two pandemics should be considered regarding COVID-19. One is the pandemic of the disease itself and the other one is the pandemic of COVID-19 fear, which is caused by a fearful response to unknown conditions (Ren, Gao, & Chen, 2020). The positive side of the situation that should be taken into account is that although COVID-19 is a new virus, its fear is not (Ren, Gao, & Chen, 2020). A review of the literature published on AIDS (acquired immunodeficiency syndrome), SARS (severe acute respiratory syndrome), MERS ( Middle East respiratory syndrome), and EVD (Ebola virus disease) can help us to deal with the current situation (Christensen, Dube, Haushofer, Siddiqi, & Voors, 2018; world Health Organization, 2012). 
Eustress can be useful and protects individuals by following the health officials’ advice and sticking to self-care guidelines. However, the thought of dying of COVID-19 is an internal stressor (Liu & Doan, 2020) and, like other stressors, causes cognitive impairments in different domains namely attention (Dutra, Marx, McGlinchey, DeGutis, & Esterman, 2018), learning and memory (Schwabe, Joels, Roozendaal, Wolf, & Oitzl, 2012), and executive domains such as decision-making (Starcke & Brand, 2012) and problem-solving (Cheng & Lam, 1997).  
    Because cardiovascular diseases and cancers are still the main causes of death (world Health Organization, 2020), why there is a global fear of coronavirus. We answer this question using cognitive biases. A cognitive bias is a systematic error in judgment and decision-making, which might happen as a result of cognitive limitations, motivational factors, and or adaptations to natural environments (Mata, 2012). It should be kept in mind that in addition to those who are at risk of experiencing a severe case of the disease-older people and those with pre-existing medical conditions such as chronic respiratory disease, cardiovascular disease, and diabetes-other people also experience fear of COVID-19 (Menotti, Puddu, Maiani, & Catasta, 2016). The most related biases to the fear of COVID-19 include fortune-telling, catastrophizing, fundamental attribution error, disqualifying positives, negative filter, overgeneralizing, dichotomous thinking, should statements, personalization, blaming, unfair comparisons, regret orientation, what if statements, emotional reasoning, ignoring counter-evidence, and judgment focus (Ahorsu, Lin, Imani, Saffari, Griffiths, & Pakpour, 2020; Beck, Emery, & Greenberg, 2005; Cook, Meyer, & Knowles, 2019; Kuru,  Safak, Özdemir, Tulacı, Özdel,  Özkula,  & Örsel, 2018; “List of cognitive biases,” 2020; Mann & Beech, 2003; Mizes, Landolf-Fritsche, & Grossman-McKee, 1987). On the other hand, several cognitive biases can relegate self-care practices. These biases include optimism bias, ostrich effect, normalcy bias, apocalyptic beliefs, just-world hypothesis, accepting the victim role, and escaping responsibilities (Ahorsu et al., 2020; Beck et al., 2005; Cook et al., 2019; Kuru et al., 2018; “List of cognitive biases,” 2020; Mann & Beech, 2003; Mizes et al., 1987).
    Behavioral restraints such as quarantine and loss of contact with family members and friends impose different levels of isolation on people and cause stress. The effects of different stressors on cognitive performances have been well-established in different cognitive domains such as risk perception (Renn, 1997), working memory, attention (Vander Haegen & Luminet, 2015), decision making, problem solving (Ostell, 1991), and emotion control (Lok & Bishop, 1999).
Hence, we propose simple steps to ameliorate the above-mentioned cognitive biases and contain the spread of irrational fear. The first step is to develop a critical mindset to spot fake news and hoaxes. Considering the source, content, time of publication and publisher of the news yields useful information. Besides, it should be kept in mind that fake news targets your emotions (Guo, Cao, Zhang, Shu, & Liu, 2019). Breaking the cycle of fake news is an effective step to lessen the spread of fear. To be informed of the essential information that helps with self-care, people should dedicate a fair amount of time to update themselves reading information published by the authoritative sources. Also, people should refrain from surfing the Internet and different social media, which increases their stress level. The second step is to make a positive intervention approach within their control and accept those out of it to reduce the stress (Folkman, 1984). 
    Besides other interventions such as cognitive behavioral therapy, Cognitive Rehabilitation Therapy (CRT) might be considered as a useful intervention because of the importance of cognitive deficits in cognitive distortions. CRT attempts to enhance functioning and independence (Sale & Gentile, 2018). Using different interventions, CRT aims to decline brain functional impairments or to lessen the disabling impact of those impairments (Shoulson, Wilhelm, & Koehler, 2012). CRT has been proven as an effective way to reduce cognitive biases and increase an individual’s capacity for processing and interpretation of information (Antoni et al., 2001; Carrico et al., 2005). We believe that among diverse stress management methods, cognitive-behavioral stress management interventions are valuable choices to be considered.
Fortunately, cognitive functions can also be improved in healthy individuals and this includes the large population that might be at risk of COVID-19. Cognitive enhancement is frequently associated with the use of methods, devices, or drugs to improve cognition, and our experience gained from laboratory animals or through a history of use in humans has had great affluence in its development (Dubljević, Venero, & Knafo, 2015; Eack, Mesholam-Gately, Greenwald, Hogarty, & Keshavan, 2013). Recent studies have also reported on the beneficial application of computer-based brain exercises and cognitive games (Bozoki, Radovanovic, Winn, Heeter, & Anthony, 2013). 
Successful survival requires proper interaction with the environment. As briefly mentioned here, cognitive rehabilitation and cognitive enhancement methods have enough flexibility to meet the needs of a diverse population.
Ethical Considerations
Compliance with ethical guidelines
This paper is a commentary letter and we didn’t have any human or animal participant. Furthermore, all statement, which are pointed within the above manuscript, are referred to their related references.
Funding
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
Authors' contributions
Both authors contributed equally in preparing all parts of the research.
Conflict of interest
The authors declared no conflict of interest.


References
Ahorsu, D. K., Lin, C. Y., Imani, V., Saffari, M., Griffiths, M. D., & Pakpour, A. H. (2020). The fear of COVID-19 scale: development and initial validation. International Journal of Mental Health and Addiction. [Published Online] [DOI:10.1007/s11469-020-00270-8] [PMID] [PMCID]
Antoni, M. H., Lehman, J. M., Kilbourn, K. M., Boyers, A. E., Culver, J. L., & Alferi, S. M., et al., (2001). Cognitive-behavioral stress management intervention decreases the prevalence of depression and enhances benefit finding among women under treatment for early-stage breast cancer. Health Psychology, 20(1), 20-32. [DOI:10.1037//0278-6133.20.1.20] [PMID]
Beck, A. T., Emery, G., & Greenberg, R. L. (2005). Anxiety disorders and phobias: A cognitive perspective. Gary Emery: Basic Books.
Christensen, D., Dube, O., Haushofer, J., Siddiqi, B., & Voors, M. (2018). Healthcare delivery during crises: Experimental Evidence from Sierra Leone’s Ebola Outbreak. Retrieved from: https://pdfs.semanticscholar.org/da17/b8d34f6e49adee4de689b0e1a4e03fdf08ae.pdf .
Bozoki, A., Radovanovic, M., Winn, B., Heeter, C., & Anthony, J. C. (2013). Effects of a computer-based cognitive exercise program on age-related cognitive decline. Archives of Gerontology and Geriatrics, 57(1), 1-7.[DOI:10.1016/j.archger.2013.02.009] [PMID]
Carrico, A. W., Antoni, M. H., Pereira, D. B., Fletcher, M. A., Klimas, N., & Lechner, S. C., et al., (2005). Cognitive behavioral stress management effects on mood, social support, and a marker of antiviral immunity are maintained up to 1 year in HIV-infected gay men. International Journal of Behavioral Medicine, 12(4), 218-26.  [DOI:10.1207/s15327558ijbm1204_2] [PMID]
Cheng, S. K., & Lam, D. J. (1997). Relationships among life stress, problem solving, self-esteem, and dysphoria in Hong Kong adolescents: Test of a model. Journal of Social and Clinical Psychology, 16(3), 343-55. [DOI:10.1521/jscp.1997.16.3.343]
Cook, S. I., Meyer, D., & Knowles, S. R. (2019). Relationships between psychoevolutionary fear of evaluation, cognitive distortions, and social anxiety symptoms: A preliminary structural equation model. Australian Journal of Psychology, 71(2), 92-9. [DOI:10.1111/ajpy.12215]
Dubljević, V., Venero, C., & Knafo, S. (2015). What is cognitive enhancement? Cognitive Enhancement. Amsterdam, Netherlands: Elsevier. pp. 1-9. [DOI:10.1016/B978-0-12-417042-1.00013-9]
Dutra, S. J., Marx, B. P., McGlinchey, R., DeGutis, J., & Esterman, M. (2018). Reward ameliorates posttraumatic stress disorder-related impairment in sustained attention. Chronic Stress (Thousand Oaks), 2(26), [published onlin][DOI:10.1177/2470547018812400] [PMID] [PMCID]
Eack, S. M., Mesholam-Gately, R. I., Greenwald, D. P., Hogarty, S. S., & Keshavan, M. S. (2013). Negative symptom improvement during cognitive rehabilitation: results from a 2-year trial of Cognitive Enhancement Therapy. Psychiatry Research, 209(1), 21-6. [DOI:10.1016/j.psychres.2013.03.020] [PMID] [PMCID]
Folkman, S. (1984). Personal control and stress and coping processes: a theoretical analysis. Journal Of Personality And Social Psychology, 46(4), 839. [DOI:10.1037/0022-3514.46.4.839] [PMID]
Guo, C., Cao, J., Zhang, X., Shu, K., & Liu, H. (2019). Well-posedness and invariant measures for a class of stochastic 3D Navier-Stokes equations with damping driven by jump noise. Journal of Differential Equations, 267(10), 5938-75. [DOI:10.1016/j.jde.2019.06.015]
Kuru, E., Safak, Y., Özdemir, İ., Tulacı, R., Özdel, K., Özkula, N., & Örsel, S. (2018). Cognitive distortions in patients with social anxiety disorder: Comparison of a clinical group and healthy controls. The European Journal of Psychiatry, 32(2), 97-104. [DOI:10.1016/j.ejpsy.2017.08.004]
List of cognitive biases. (2020, 27 April 2020). Retrieved 30 April 2020. Retrieved from: https://en.wikipedia.org/wiki/List_of_cognitive_biases
Liu, C. H., & Doan, S. N. (2020). Psychosocial Stress Contagion in Children and Families During the COVID-19 Pandemic. Clinical Pediatrics (Phila), 9922820927044.  [DOI:10.1177/0009922820927044] [PMID]
Lok, C.-F., & Bishop, G. D. (1999). Emotion control, stress, and health. Psychology and health, 14(5), 813-27. [DOI:10.1080/08870449908407349]
Mann, R. E., & Beech, A. R. (2003). Cognitive distortions, schemas, and implicit theories. Sexual Deviance: Issues And Controversies, 135-53. [Published Online] [DOI:10.4135/9781483328751.n8]
Mata, R. (2012). Cognitive bias. Encyclopedia Of Human Behaviour, 1, 531-5. [DOI:10.1016/B978-0-12-375000-6.00094-X]
Menotti, A., Puddu, P. E., Maiani, G., & Catasta, G. (2016). Cardiovascular and other causes of death as a function of lifestyle habits in a quasi extinct middle-aged male population. A 50-year follow-up study. International Journal of Cardiology, 210, 173-8. [DOI:10.1016/j.ijcard.2016.02.115] [PMID]
Mizes, J. S., Landolf-Fritsche, B., & Grossman-McKee, D. (1987). Patterns of distorted cognitions in phobic disorders: An investigation of clinically severe simple phobics, social phobics, and agoraphobics. Cognitive Therapy and Research, 11(5), 583-92. [DOI:10.1007/BF01183860]
World Health Organization. (2020). Coronavirus disease 2019 (COVID-19): situation report. Geneva, Switzerland: World Health Organization..
Ostell, A. (1991). Coping, problem solving and stress: a framework for intervention strategies. Psychology and Psychotherapy, 64(Pt 1), 11-24. [DOI:10.1111/j.2044-8341.1991.tb01638.x] [PMID]
Ren, S. Y., Gao, R. D., & Chen, Y. L. (2020). Fear can be more harmful than the severe acute respiratory syndrome coronavirus 2 in controlling the corona virus disease 2019 epidemic. World Journal of Clinical Cases, 8(4), 652. [DOI:10.12998/wjcc.v8.i4.652] [PMID] [PMCID]
Renn, O. (1997). Health impacts of large releases of radionuclides. Mental health, stress and risk perception: insights from psychological research. Ciba Foundation symposium, 203, 205-26.[DOI:10.1002/9780470515006.ch15] [PMID]
Sale, P., & Gentile, G. (2018). Cognitive Rehabilitation Therapy for Neurologic Diseases Rehabilitation Medicine for Elderly Patients. Germany: Springer. pp. 341-7. [DOI:10.1007/978-3-319-57406-6_34]
Schwabe, L., Joels, M., Roozendaal, B., Wolf, O. T., & Oitzl, M. S. (2012). Stress effects on memory: an update and integration. Neuroscience & Biobehavioral Reviews, 36(7), 1740-9. [DOI:10.1016/j.neubiorev.2011.07.002] [PMID]
Shoulson, I., Wilhelm, E. E., & Koehler, R. (2012). Cognitive rehabilitation therapy for traumatic brain injury: evaluating the evidence. Washington, D.C.,: National Academies Press.
Starcke, K., & Brand, M. (2012). Decision making under stress: a selective review. Neuroscience & Biobehavioral Reviews, 36(4), 1228-48. [DOI:10.1016/j.neubiorev.2012.02.003] [PMID]
Vander Haegen, M., & Luminet, O. (2015). Stress, psychosocial mediators, and cognitive mediators in parents of child cancer patients and cancer survivors: attention and working memory pathway perspectives. Journal of Psychosocial Oncology, 33(5), 504-50.  [DOI:10.1080/07347332.2015.1067279] [PMID]
Wilder-Smith, A., Chiew, C. J., & Lee, V. J. (2020). Can we contain the COVID-19 outbreak with the same measures as for SARS? Lancet Infectious Diseases, 20(5), e102-e7. [DOI:10.1016/S1473-3099(20)30129-8]
World Health Organization. (2012). Developing tools for strategic communication to the media on Emerging Infectious Diseases (EID): report of an informal consultation, WHO-SEARO, New Delhi, 26 May 2011. WHO Regional Office for South-East Asia. Geneva, Switzerland: World Health Organization.
Type of Study: Commentary | Subject: Behavioral Neuroscience
Received: 2020/05/4 | Accepted: 2020/07/1 | Published: 2020/06/15

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