Longitudinal Changes of Cognitive Deficits and Treatment Outcome of Cognitive Behavioral Therapy for Major Depression

Abstract

The current study examined neuropsychological changes over the course of cognitive behavioral therapy (CBT) in outpatients with major depressive disorder and the influence of cognitive deficits as predictors of clinical outcome in depression. A neuropsychological test battery was carried out on depressed outpatients (N = 54) at the beginning and at the end of CBT. Small improvements were found in divided attention, figural memory, and processing speed from pre-to posttreatment. Cognitive deficits in executive functions before treatment predicted the clinical outcome at the end of CBT. The present study reveals that attention and memory deficits are most likely to improve over the course of treatment, whereas executive functions remain stable in the long term. Depressed patients with worse executive functions at the beginning of treatment seem to benefit more from long-term CBT therapy.

Adjunct treatment with ketamine enhances the therapeutic effects of extinction learning after chronic unpredictable stress

“…Antidepressants often fail to relieve cognitive deficits stemming from mPFC dysfunction ( Shilyansky et al, 2016 ). Cognitive behavioral therapies (CBT) can reverse cognitive deficits ( Bernhardt et al, 2021 ), yet only a small percentage of patients achieve full remission ( Wiles et al, 2013 ). Prolonged exposure therapy (PE), a type of CBT used to treat PTSD, involves re-exposure to a traumatic event in a safe context to reduce the maladaptive stress response elicited by reminders of the event ( Foa and Meadows, 1997 ).…”

Reward and Punishment Learning as Predictors of Cognitive Behavioral Therapy Response in Parkinson’s Disease Comorbid with Clinical Depression

“…15 Specifically, better performance on the set-shifting task of the Trail Making Test (i.e., lower completion time) is predictive of better outcomes for treatment of depression and impaired response inhibition on the Stroop test may be partly predictive of poorer response. 15 Similarly, better treatment response has also been associated in other research with poorer performance on the Wisconsin Card Sort Task, 16 in executive functioning, 17 and on a general neuropsychological battery. 18 Considering that CBT may also improve some aspects of neurocognitive functioning, 17 these findings are consistent with a compensation model of treatment prediction, 19,20 whereby individuals with deficits in several of these predictors are most likely to benefit.…”

“…15 Similarly, better treatment response has also been associated in other research with poorer performance on the Wisconsin Card Sort Task, 16 in executive functioning, 17 and on a general neuropsychological battery. 18 Considering that CBT may also improve some aspects of neurocognitive functioning, 17 these findings are consistent with a compensation model of treatment prediction, 19,20 whereby individuals with deficits in several of these predictors are most likely to benefit.…”

Executive functions beyond the “Holy Trinity”: A scoping review.

“…Regarding the first aspect, considering EF measured in the original studies, the instruments used to measure them varied reasonably between studies. For example, “planning” has been assessed using the Tower of London (e.g., Bernhardt et al, 2021), Rey-Osterrieth complex figure Test (e.g., Webster et al, 2019), and Zoo Map (e.g., Moreno-Manso et al, 2020), among other measures. In other words, even among investigations that include the assessment of the same construct, different instruments are often used (perhaps even different indices) to do so, which makes comparisons between their findings difficult.…”