Internet-Delivered Cognitive Control Training as a Preventive Intervention for Remitted Depressed Patients: Evidence From a Double-Blind Randomized Controlled Trial Study

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Abstract

Background: Cognitive control impairments may place remitted depressed (RMD) patients at increased risk for developing future depressive symptomatology by disrupting emotion regulation processes. Research has shown that directly targeting cognitive control has beneficial effects on high trait ruminators and clinically depressed patients. The current study tested whether internet-delivered cognitive control training (CCT) can be used as an intervention to increase resilience to depression in RMD patients. Method: Effects of CCT were assessed using a double-blind randomized controlled design. RMD patients performed 10 sessions of a working memory-based CCT (N = 34) or a low cognitive load training (N = 34; active control condition) over a period of 14 days. Assessments took place prior to training, immediately following 2 weeks of training, and at 3 months follow-up. Brooding and depressive symptomatology were selected as primary outcome measures, alternative indicators for emotion regulation and residual symptomatology were selected as secondary outcome measures, along with indicators of functioning. Results: Compared to an active control condition, CCT demonstrated beneficial effects on a cognitive transfer task, brooding, depressive symptomatology, residual complaints, self-reported use of general maladaptive emotion regulation strategies, and resilience after controlling for intention to treat. Furthermore, completers of the CCT reported a reduction in experienced disability and cognitive complaints. However, no beneficial effects were found for self-reported use of adaptive emotion regulation strategies. Conclusions: These findings demonstrate the effectiveness of CCT as an intervention to reduce cognitive vulnerability, residual symptomatology, and foster resilience following recovery from depression. CCT thus holds potential as a preventive intervention for RMD patients. ClinicalTrials.gov (Identifier: NCT02407652)

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