Neuropsychological interventions using digital technologies have great potential. The advantages that are lost in the face-to-face are also accompanied by important gains. These entail ease of access, with the potential to link specialist clinicians with patients with specialist needs. The reach afforded by teleneuropsychological interventions can also aid clinicians to understand the distribution of clinical phenomena in specific dispersed populations, enabling real-time understanding of clinical data, facilitating effective theory building.
We propose a theoretical and treatment model derived from data of 102 patients (Female= 65%, N= 66; Male= 35% N=35) who are doctors, dentists and nurses currently working in the United Kingdom, referred to our teleneuropsychological services for a range of mental health difficulties. Our clinical data suggests a high prevalence of psychiatric disorders, particularly amongst general practitioners and consultants. This is surprisingly consistent with a systematic review by Imo (2017). Additionally, our data indicates that trainee doctors are the second highest group (23%, N=20) referred for psychological interventions. Often, the doctors as patients present with comorbid and complex difficulties masked by “burn out” (16%, N=14), where anxiety (82%, N=84), low mood (67%, N=69), poor sleep (26%, N=27) and stress (24%, N=24) are among the highest reported reasons for referral.
Our treatment model is developed from Zia’s stress model (2019) implicating stress-induced “stacking effect” modulated by the Prefrontal Cortex, incrementally expressed in the limbic and wider brain system. Moreover, it further confirms the initial Dipole Theory (2009) and recent substantial evidence supporting the importance of recognising the role of electromagnetic and quantum systems in the brain.
The intervention was guided by mitigating the impact of three core dimensions. (1) Vertical Loading, characterised by incremental increase in task difficulty and complexity, implicating higher cortical and executive functions. (2) Horizontal Loading, consisting of task shifting and entailing “Transitional Loading” akin to epileptiform synaptic surges. This creates limbic fatigue and paradoxically expresses itself through depressogenic and anxiety-laden symptoms. (3) “Quantum Loading“, predispositional associations create a global interpersonal and system fatigue, where the weight is more than the mass of the stimuli.
78% of patients reported a significant improvement in both symptoms of anxiety and low mood, and 12% reported an increase in symptoms due to ongoing stressors. In all cases, patients reported significant gains across the Psychological Assessment of Global Functioning (PAGF).
In conclusion, this approach has been an effective treatment model for these patients, explaining why general practitioners, consultants, trainees, and groups engaged in high “Transitional Loading” or “Quantum Loading” are at higher risk for comorbid psychiatric disorders. The proposed model lacks construct validity and requires further neuropsychological-specific application with a larger, randomised-controlled sample. However, the strength of this model is that it identifies and addresses the pathogenesis of the disorder rather than the symptom in isolation.
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