Internet-Delivered Cognitive Control Training as a Preventive Intervention for Remitted Depressed Patients: Evidence From a Double-Blind Randomized Controlled Trial Study
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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DOI：
10.1037/ccp0000128
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发表时间：
2017-02-01
影响因子：
5.9
通讯作者：
Koster, Ernst H. W.
中科院分区：
文献类型：
--
作者：
Hoorelbeke, Kristof;Koster, Ernst H. W.
背景：认知控制障碍可能通过破坏情绪调节过程使缓解型抑郁症（RMD）患者在未来出现抑郁症状的风险增加。研究表明，直接针对认知控制对高特质反刍者和临床抑郁症患者有有益的影响。目前的研究测试了网络传递的认知控制训练（CCT）是否可以作为一种干预手段来提高RMD患者对抑郁的适应能力。方法：采用双盲随机对照设计评价CCT的效果。RMD患者在14天的时间内进行了10次基于工作记忆的CCT （N = 34）或低认知负荷训练（N = 34；主动控制条件）。评估分别在培训前、培训后2周和随访后3个月进行。忧郁和抑郁症状被选为主要结果测量，情绪调节和残余症状的替代指标被选为次要结果测量，以及功能指标。结果：与主动控制条件相比，CCT在认知转移任务、沉思、抑郁症状、残余抱怨、自我报告使用一般适应不良情绪调节策略和控制治疗意图后的恢复力方面显示出有益的效果。此外，完成CCT的人报告了经历性残疾和认知投诉的减少。然而，自我报告的适应性情绪调节策略的使用没有发现有益的影响。结论：这些发现证明了CCT作为一种干预措施的有效性，可以减少认知脆弱性、残留症状，并在抑郁症康复后培养恢复力。因此，CCT作为RMD患者的预防性干预具有潜力。ClinicalTrials.gov（标识符：NCT02407652）
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)