Does cognitive flexibility predict treatment gains in Internet-delivered psychological treatment of social anxiety disorder, depression, or tinnitus?

Abstract

Little is known about the individual factors that predict outcomes in Internet-administered psychological treatments. We hypothesized that greater cognitive flexibility (i.e. the ability to simultaneously consider several concepts and tasks and switch effortlessly between them in response to changes in environmental contingencies) would provide a better foundation for learning and employing the cognitive restructuring techniques taught and exercised in therapy, leading to greater treatment gains. Participants in three trials featuring Internet-administered psychological treatments for depression (n = 36), social anxiety disorder (n = 115) and tinnitus (n = 53) completed the 64-card Wisconsin Card Sorting Test (WCST) prior to treatment. We found no significant associations between perseverative errors on the WCST and treatment gains in any group. We also found low accuracy in the classification of treatment responders. We conclude that lower cognitive flexibility, as captured by perseverative errors on the WCST, should not impede successful outcomes in Internet-delivered psychological treatments.

Group Rumination: Social Interactions Around Music in People with Depression

“…Similar gender imbalances are often found in studies relating to mental health issues such as depression (see for e.g., Lindner et al, 2016), and likely reflect the higher incidence of depression in females than males (Freeman and Freeman, 2013). Participants ranged in age from 16 to 74 years of age ( m = 24.9, SD = 11) and were mostly from the U.S. (72.3%), Australia (10.3%), and the U.K. (5.2%), with 12.2% being from a number of other countries in South America, Africa, Asia, and Europe.…”

Music Use for Mood Regulation: Self-Awareness and Conscious Listening Choices in Young People With Tendencies to Depression

“…The current study is limited by the fact that the sample was primarily female. This gender imbalance is not unusual in studies relating to mental health (see for e.g., Lindner et al, 2016), and is likely a reflection of the higher rates of depression among females (Freeman and Freeman, 2013). Nevertheless, future studies could benefit from recruitment of a more balanced sample so as to explore gender differences in strategy selection and outcomes of music use.…”

Internet interventions: Past, present and future

“…Third, cognitive function could potentially influence the outcome of internet interventions, for example in older adults, but also in persons with depression which is known to influence cognition ( Gotlib and Hammen, 2009 ). We have studied executive function in association with clinical trials and whereas most studies have shown no effects ( Andersson et al, 2008b ; Lindner et al, 2016 ), we did recently find an association between perseverative errors and negative outcome in a study on ICBT for older adults ( Silfvernagel et al, 2018 ).…”

“…The third historical background, which has been around for a long time as well, is computerized testing and interventions ( Marks et al, 1998 ), with early programs like Eliza ( Epstein and Klinkenberg, 2001 ). While the focus of internet interventions research and clinical practice is often on treatment, an equally important area is computerized testing using the internet, and not only online questionnaires ( van Ballegooijen et al, 2016 ), but also cognitive testing ( Lindner et al, 2016 ), and more recently collecting data using smartphones ( Luxton et al, 2011 ).…”