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Perskaudas R, Myers CE, Interian A, Gluck MA, Herzallah MM, Baum A, Dobkin RD. Reward and Punishment Learning as Predictors of Cognitive Behavioral Therapy Response in Parkinson's Disease Comorbid with Clinical Depression. J Geriatr Psychiatry Neurol 2024; 37:282-293. [PMID: 38158704 DOI: 10.1177/08919887231218753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
Depression is highly comorbid among individuals with Parkinson's Disease (PD), who often experience unique challenges to accessing and benefitting from empirically supported interventions like Cognitive Behavioral Therapy (CBT). Given the role of reward processing in both depression and PD, this study analyzed a subset (N = 25) of participants who participated in a pilot telemedicine intervention of PD-informed CBT, and also completed a Reward- and Punishment-Learning Task (RPLT) at baseline. At the conclusion of CBT, participants were categorized into treatment responders (n = 14) and non-responders (n = 11). Responders learned more optimally from negative rather than positive feedback on the RPLT, while this pattern was reversed in non-responders. Computational modeling suggested group differences in learning rate to negative feedback may drive the observed differences. Overall, the results suggest that a within-subject bias for punishment-based learning might help to predict response to CBT intervention for depression in those with PD.Plain Language Summary Performance on a Computerized Task may predict which Parkinson's Disease Patients benefit from Cognitive Behavioral Treatment of Clinical DepressionWhy was the study done? Clinical depression regularly arises in individuals with Parkinson's Disease (PD) due to the neurobiological changes with the onset and progression of the disease as well as the unique psychosocial difficulties associated with living with a chronic condition. Nonetheless, psychiatric disorders among individuals with PD are often underdiagnosed and likewise undertreated for a variety of reasons. The results of our study have implications about how to improve the accuracy and specificity of mental health treatment recommendations in the future to maximize benefits for individuals with PD, who often face additional barriers to accessing quality mental health treatment.What did the researchers do? We explored whether performance on a computerized task called the Reward- and Punishment-Learning Task (RPLT) helped to predict response to Cognitive Behavioral Therapy (CBT) for depression better than other predictors identified in previous studies. Twenty-five individuals with PD and clinical depression that completed a 10-week telehealth CBT program were assessed for: Demographics (Age, gender, etc.); Clinical information (PD duration, mental health diagnoses, levels of anxiety/depression, etc.); Neurocognitive performance (Memory, processing speed, impulse control, etc.); and RPLT performance.What did the researchers find? A total of 14 participants significantly benefitted from CBT treatment while 11 did not significantly benefit from treatment.There were no differences before treatment in the demographics, clinical information, and neurocognitive performance of those participants who ended up benefitting from the treatment versus those who did not.There were, however, differences before treatment in RPLT performance so that those individuals that benefitted from CBT seemed to learn better from negative feedback.What do the findings mean? Our results suggest that the CBT program benefitted those PD patients with clinical depression that seemed to overall learn best from avoiding punishment rather than obtaining reward which was targeted in CBT by focusing on increasing engagement in rewarding activities. The Reward- and Punishment-Learning Task hence may be a useful tool to help predict treatment response and provide more individualized recommendations on how to best maximize the benefits of psychotherapy for individuals with PD that may struggle to connect to mental health care. Caution is recommended about interpretating these results beyond this study as the overall number of participants was small and the data for this study were collected as part of a previous study so there was no opportunity to include additional measurements of interest.
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Affiliation(s)
- Rokas Perskaudas
- Mental Health Research and Program Development, VA New Jersey Healthcare System, Lyons, NJ, USA
- War Related Illness and Injury Study Center, VA New Jersey Healthcare System, East Orange, NJ, USA
| | - Catherine E Myers
- Research Service, VA New Jersey Health Care System, East Orange, NJ, USA
- Department of Pharmacology, Physiology & Neuroscience, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Alejandro Interian
- Mental Health Research and Program Development, VA New Jersey Healthcare System, Lyons, NJ, USA
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
| | - Mark A Gluck
- Center for Molecular and Behavioral Neuroscience, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - Mohammad M Herzallah
- Center for Molecular and Behavioral Neuroscience, Rutgers, The State University of New Jersey, Newark, NJ, USA
- Palestinian Neuroscience Initiative, Al-Quds University, Abu Dis, Jerusalem, Palestine
| | - Allan Baum
- Ramapo College of New Jersey, Mahwah, NJ, USA
| | - Roseanne D Dobkin
- Department of Psychiatry, Robert Wood Johnson Medical School, Rutgers, The State University of New Jersey, Piscataway, NJ, USA
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Hudson CC, Traynor J, Björgvinsson T, Beard C, Forgeard M, Hsu KJ. Performance-based attentional control, but not self-reported attentional control, predicts changes in depressive symptoms in short-term psychotherapy. Behav Res Ther 2024; 173:104476. [PMID: 38199180 DOI: 10.1016/j.brat.2024.104476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Revised: 12/18/2023] [Accepted: 01/03/2024] [Indexed: 01/12/2024]
Abstract
OBJECTIVE Although impairments in attentional control are pervasive across psychopathology, there is substantial individual differences. In the current study, we examined whether individual differences in self-reported and performance-based measures of attentional control predict changes in depressive symptoms and well-being in a diagnostically diverse sample of patients attending a CBT-based partial hospital program. METHOD Participants were 89 patients (56.2% men, 75.3% non-Hispanic White). At baseline, patients completed the self-reported Attentional Control Scale and the Rapid Serial Visual Presentation task (RSVP), a behavioral measure of attentional control. Depressive symptoms were assessed daily using the Patient Health Questionnaire and well-being was assessed using the Mental Health Continuum Short Form. RESULTS On average, greater self-reported attentional control was significantly associated with lower depressive symptoms, β = -0.49, t(52) = 4.84, p < .001, 95% CIs [-0.69, -0.29], and greater well-being, β = 0.45, t(53) = 3.90, p < .001, 95% CIs [0.22, 0.67]. More accurate task-based performance was associated with a decline in depressive symptoms over time, β = -0.02, t(32) = 2.50, p = .02, 95% CIs [-0.04, -0.01]. Neither self-reported nor performance-based measures of attentional control predicted changes in well-being. Finally, exploratory analyses suggest that depressive symptoms also improved over time for individuals who underestimated self-reported attentional control abilities relative to task-based performance, β = -0.19, t(32) = 2.23, p = .03, 95% CIs [-0.36, -0.02]. CONCLUSIONS Results suggest that performance-based attentional control may be an important target for assessment and intervention, as well as a potential mechanism underlying risk and recovery.
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Affiliation(s)
- Chloe C Hudson
- McLean Hospital, USA; Harvard Medical School, USA; Virginia Polytechnic Institute and State University, USA.
| | | | | | | | | | - Kean J Hsu
- Georgetown University, USA; National University of Singapore, Singapore
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Kashyap H, Mehta UM, Reddy RP, Bharath RD. Role of Cognitive Control in Psychotherapy: An Integrated Review. Indian J Psychol Med 2023; 45:462-470. [PMID: 37772131 PMCID: PMC10523513 DOI: 10.1177/02537176221128611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2023] Open
Abstract
Background Cognitive control (CC), including shifting, updating, and inhibiting functions, may play an integral role in various aspects of psychotherapy; however, research on this is limited. This review aims to link the disparate lines of evidence on CC as they relate to psychotherapy processes, techniques, and outcomes. Methods A systematic search of the literature on neuropsychological domains relating to psychotherapy in adults with anxiety/depression yielded 18 eligible studies. The review also uses a narrative format to explore other potential links between CC and psychotherapy that are underinvestigated, and highlights the need for research and application to evidence-based practice of psychotherapy. Results and conclusions Findings suggest that CC may predict psychotherapy outcomes and also improve as a function of psychotherapy. Analog sample studies suggest a possible link between CC and techniques for regulation of cognition and emotion, such as reappraisal, mindfulness, and cognitive restructuring. CC may also play an integral role in the regulation of behavior. Study of CC in the context of psychotherapy may potentially explain individual differences in psychotherapy outcomes and mechanisms of action of various psychotherapy techniques and processes. Such an understanding may have possible implications for "best fit" matching clients to therapies and modifying psychological interventions to account for poorer CC abilities. CC may be enhanced through training and further research is warranted on the impact of such training in facilitating better long-term psychotherapy outcomes.
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Affiliation(s)
- Himani Kashyap
- Dept. of Clinical Psychology & Cognite
Clinic, National Institute of Mental Health And Neuro Sciences, Bengaluru, Karnataka,
India
| | - Urvakhsh Meherwan Mehta
- Dept. of Psychiatry, National Institute of
Mental Health And Neuro Sciences, Bengaluru, Karnataka, India
| | - Rajakumari P. Reddy
- Dept. of Clinical Psychology & Cognite
Clinic, National Institute of Mental Health And Neuro Sciences, Bengaluru, Karnataka,
India
| | - Rose Dawn Bharath
- Dept. of Neuroimaging and Interventional
Radiology, National Institute of Mental Health And Neuro Sciences, Bengaluru, Karnataka,
India
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Rosellini AJ, Andrea AM, Galiano CS, Hwang I, Brown TA, Luedtke A, Kessler RC. Developing Transdiagnostic Internalizing Disorder Prognostic Indices for Outpatient Cognitive Behavioral Therapy. Behav Ther 2023; 54:461-475. [PMID: 37088504 PMCID: PMC10126479 DOI: 10.1016/j.beth.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 11/03/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
A growing literature is devoted to understanding and predicting heterogeneity in response to cognitive behavioral therapy (CBT), including using supervised machine learning to develop prognostic models that could be used to inform treatment planning. The current study developed CBT prognostic models using data from a broad dimensionally oriented pretreatment assessment (324 predictors) of 1,210 outpatients with internalizing psychopathology. Super learning was implemented to develop prognostic indices for three outcomes assessed at 12-month follow-up: principal diagnosis improvement (attained by 65.8% of patients), principal diagnosis remission (56.8%), and transdiagnostic full remission (14.3%). The models for principal diagnosis remission and transdiagnostic remission performed best (AUROCs = 0.71-0.73). Calibration was modest for all three models. Three-quarters (77.3%) of patients in the top tertile of the predicted probability distribution achieved principal diagnosis remission, compared to 35.0% in the bottom tertile. One-third (35.3%) of patients in the top two deciles of predicted probabilities for transdiagnostic complete remission achieved this outcome, compared to 2.7% in the bottom tertile. Key predictors included principal diagnosis severity, social anxiety diagnosis/severity, hopelessness, temperament, and global impairment. While additional work is needed to improve performance, integration of CBT prognostic models ultimately could lead to more effective and efficient treatment of patients with internalizing psychopathology.
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Steinberger DC, Barch DM. Investigating the Link Between Depression, Cognition, and Motivation in Late Childhood. Child Psychiatry Hum Dev 2023; 54:570-581. [PMID: 34677743 PMCID: PMC9023587 DOI: 10.1007/s10578-021-01267-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/10/2021] [Indexed: 11/26/2022]
Abstract
Research has revealed broad cognitive deficits (e.g., memory, learning) in depression, and that motivation may account for this link. We tested the state (i.e., only present during depression), trait (i.e., underlying vulnerability) and scar (i.e., lasting corollary) hypotheses of cognitive dysfunction in depression. We additionally tested subjective motivation as a mediator of the concurrent depression-cognition link. In a longitudinal sample of 11,878 children ages 9-11, we found no evidence of a concurrent state or longitudinal trait or scar relationship between depression and cognition. The pattern of depression-cognition relationships-which precluded a mediator analysis-in our childhood sample is a departure from previous studies. Our findings indicate that cognitive deficits are not strongly associated with depression in childhood, in contrast with the impairment commonly seen in older individuals with depression.
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Affiliation(s)
- David C Steinberger
- Department of Psychological & Brain Sciences, Washington University in St. Louis, Saint Louis, MO, USA.
- , Somerville, USA.
| | - Deanna M Barch
- Department of Psychological & Brain Sciences, Washington University in St. Louis, Saint Louis, MO, USA
- Department of Psychiatry, Washington University in St. Louis, Saint Louis, MO, USA
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Scala JJ, Ganz AB, Snyder MP. Precision Medicine Approaches to Mental Health Care. Physiology (Bethesda) 2023; 38:0. [PMID: 36099270 PMCID: PMC9870582 DOI: 10.1152/physiol.00013.2022] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2022] [Revised: 08/08/2022] [Accepted: 09/12/2022] [Indexed: 02/04/2023] Open
Abstract
Developing a more comprehensive understanding of the physiological underpinnings of mental illness, precision medicine has the potential to revolutionize psychiatric care. With recent breakthroughs in next-generation multi-omics technologies and data analytics, it is becoming more feasible to leverage multimodal biomarkers, from genetic variants to neuroimaging biomarkers, to objectify diagnostics and treatment decisions in psychiatry and improve patient outcomes. Ongoing work in precision psychiatry will parallel progress in precision oncology and cardiology to develop an expanded suite of blood- and neuroimaging-based diagnostic tests, empower monitoring of treatment efficacy over time, and reduce patient exposure to ineffective treatments. The emerging model of precision psychiatry has the potential to mitigate some of psychiatry's most pressing issues, including improving disease classification, lengthy treatment duration, and suboptimal treatment outcomes. This narrative-style review summarizes some of the emerging breakthroughs and recurring challenges in the application of precision medicine approaches to mental health care.
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Affiliation(s)
- Jack J Scala
- Department of Genetics, Stanford University, Stanford, California
| | - Ariel B Ganz
- Department of Genetics, Stanford University, Stanford, California
| | - Michael P Snyder
- Department of Genetics, Stanford University, Stanford, California
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Sorkhou M, Rabin RA, Rabin JS, Kloiber S, McIntyre RS, George TP. Effects of 28 days of cannabis abstinence on cognition in major depressive disorder: A pilot study. Am J Addict 2022; 31:454-462. [PMID: 35690891 DOI: 10.1111/ajad.13305] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Revised: 05/24/2022] [Accepted: 05/27/2022] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Cannabis is a widely used substance that may impair select cognitive domains, including attention and memory. Problematic cannabis use is a common clinical problem among patients with major depressive disorder (MDD). Few studies have investigated the effects of cannabis abstinence on cognition in MDD. Thus, our study aimed to determine whether a 28-day period of cannabis abstinence is associated with improvements in cognition in patients with MDD and comorbid cannabis use disorder (CUD). METHODS We evaluated the effects of 28 days of cannabis abstinence on cognition in MDD patients with comorbid CUD facilitated by contingency management, motivational interviewing, psychoeducation, and coping-skills training (N = 11). Primary outcomes included Baseline to Day 28 changes in verbal memory and learning, while secondary outcomes included Baseline to Day 28 changes in working memory, visuospatial working memory (VSWM), visual search speed, mental flexibility, response inhibition, attention, manual dexterity, and fine motor movement. RESULTS Eight participants (72.7%) met the pre-specified criteria for cannabis abstinence and three participants significantly reduced their cannabis use (≥90%). Visual search speed, selective attention, and VSWM improved over the study period. These improvements were not associated with changes in cannabis metabolite levels from baseline to endpoint. DISCUSSION AND CONCLUSIONS Our findings suggest that 28 days of cannabis abstinence may improve select cognitive domains in patients with MDD and comorbid CUD. SCIENTIFIC SIGNIFICANCE This is the first study to longitudinally examine the effects of cannabis on cognition in MDD. CLINICAL TRIAL Effects of Cannabis Abstinence on Symptoms and Cognition in Depression (NCT03624933; https://www. CLINICALTRIALS gov).
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Affiliation(s)
- Maryam Sorkhou
- Institute of Medical Sciences (IMS), Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Centre for Complex Interventions, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
| | - Rachel A Rabin
- Department of Psychiatry, Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Jennifer S Rabin
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.,Harquail Centre for Neuromodulation, Sunnybrook Research Institute, Toronto, Ontario, Canada.,Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Stefan Kloiber
- Institute of Medical Sciences (IMS), Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Adult Psychiatry and Health Systems Division, CAMH, Toronto, Ontario, Canada
| | - Roger S McIntyre
- Institute of Medical Sciences (IMS), Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Mood Disorders Psychopharmacology Clinic, Toronto Western Hospital, Toronto, Ontario, Canada
| | - Tony P George
- Institute of Medical Sciences (IMS), Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.,Centre for Complex Interventions, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada.,Addictions Divisions, Centre for Complex Interventions, Centre for Addiction and Mental Health (CAMH), Toronto, Ontario, Canada
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8
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Can integrating the Memory Support Intervention into cognitive therapy improve depression outcome? A randomized controlled trial. Behav Res Ther 2022; 157:104167. [DOI: 10.1016/j.brat.2022.104167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Revised: 07/12/2022] [Accepted: 07/22/2022] [Indexed: 11/18/2022]
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9
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Pantazatos SP, Yttredahl A, Rubin-Falcone H, Kishon R, Oquendo MA, John Mann J, Miller JM. Depression-related anterior cingulate prefrontal resting state connectivity normalizes following cognitive behavioral therapy. Eur Psychiatry 2020; 63:e37. [PMID: 32284075 PMCID: PMC7355178 DOI: 10.1192/j.eurpsy.2020.34] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023] Open
Abstract
Background. Aberrant activity of the subcallosal cingulate (SCC) is a common theme across pharmacologic treatment efficacy prediction studies. The functioning of the SCC in psychotherapeutic interventions is relatively understudied, as are functional differences among SCC subdivisions. We conducted functional connectivity analyses (rsFC) on resting-state functional magnetic resonance imaging (fMRI) data, collected before and after a course of cognitive behavioral therapy (CBT) in patients with major depressive disorder (MDD), using seeds from three SCC subdivisions. Methods. Resting-state data were collected from unmedicated patients with current MDD (Hamilton Depression Rating Scale-17 > 16) before and after 14-sessions of CBT monotherapy. Treatment outcome was assessed using the Beck Depression Inventory (BDI). Rostral anterior cingulate (rACC), anterior subcallosal cingulate (aSCC), and Brodmann’s area 25 (BA25) masks were used as seeds in connectivity analyses that assessed baseline rsFC and symptom severity, changes in connectivity related to symptom improvement after CBT, and prediction of treatment outcomes using whole-brain baseline connectivity. Results. Pretreatment BDI negatively correlated with pretreatment rACC ~ dorsolateral prefrontal cortex and aSCC ~ lateral prefrontal cortex rsFC. In a region-of-interest longitudinal analysis, rsFC between these regions increased post-treatment (p < 0.05FDR). In whole-brain analyses, BA25 ~ paracentral lobule and rACC ~ paracentral lobule connectivities decreased post-treatment. Whole-brain baseline rsFC with SCC did not predict clinical improvement. Conclusions. rsFC features of rACC and aSCC, but not BA25, correlated inversely with baseline depression severity, and increased following CBT. Subdivisions of SCC involved in top-down emotion regulation may be more involved in cognitive interventions, while BA25 may be more informative for interventions targeting bottom-up processing. Results emphasize the importance of subdividing the SCC in connectivity analyses.
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Affiliation(s)
- Spiro P Pantazatos
- Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York, USA.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Ashley Yttredahl
- Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York, USA.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Harry Rubin-Falcone
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA.,Department of Electrical Engineering and Computer Science, University of Michigan, Ann Arbor, Michigan, USA
| | - Ronit Kishon
- Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Maria A Oquendo
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - J John Mann
- Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York, USA.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
| | - Jeffrey M Miller
- Molecular Imaging and Neuropathology, New York State Psychiatric Institute, New York, New York, USA.,Department of Psychiatry, Columbia University Irving Medical Center, New York, New York, USA
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Bruijniks SJE, Sijbrandij M, Huibers MJH. The effects of retrieval versus rehearsal of online problem-solving therapy sessions on recall, problem-solving skills and distress in distressed individuals: An experimental study. J Behav Ther Exp Psychiatry 2020; 66:101485. [PMID: 31491535 DOI: 10.1016/j.jbtep.2019.101485] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 03/29/2019] [Accepted: 05/14/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Improving memory for the content of therapy sessions might increase the effects of psychological interventions. Previous studies showed that healthy individuals who took a memory test (retrieval) of studied material showed better long-term memory retention than individuals who restudied (rehearsal) the material. The aim of the current study was to find out whether we can translate these findings to a subclinical setting. METHODS Individuals with moderate levels of distress were randomized into retrieving (n = 46) or rehearsing (n = 49) four weekly sessions of online Problem-Solving Therapy (PST). Session recall, problem-solving skills and distress were measured at baseline, three days after each session and at one-week follow-up. RESULTS Retrieval led to overall higher recall, but this difference disappeared when controlling for the time spent on retrieval versus rehearsal. Retrieval did not lead to better problem-solving skills or less distress, compared to rehearsal. Baseline working memory performance moderated the effect of condition on recall after controlling for the time spent on retrieval versus rehearsal: the effect of retrieval compared to rehearsal on recall was larger for individuals with lower working memory performance. LIMITATIONS The sample mostly consisted of university students with overall high working memory scores. CONCLUSIONS This study provided the first evidence that retrieval of the content of PST sessions may lead to better session recall compared to rehearsal of the PST sessions in individuals with a low working memory score. Implications for the use of cognitive support strategies within a therapeutic setting are discussed.
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Affiliation(s)
- Sanne J E Bruijniks
- Department of Clinical, Neuro-, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands.
| | - Marit Sijbrandij
- Department of Clinical, Neuro-, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands
| | - Marcus J H Huibers
- Department of Clinical, Neuro-, and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, the Netherlands; Department of Psychology, University of Pennsylvania, Philadelphia, United States
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11
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Psychological Mindedness and Alexithymia Predict Symptom Reduction in Cognitive Behavior Therapy for Major Depressive Disorder. Int J Cogn Ther 2019. [DOI: 10.1007/s41811-019-00062-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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