The impact of executive function on response to cognitive behavioral therapy in late-life depression

Goodkind, Madeleine S.; Gallagher‐Thompson, Dolores; Thompson, Larry W.; Kesler, Shelli R.; Anker, Lauren; Flournoy, John C.; Berman, Mika P.; Holland, Jason M.; O’Hara, Ruth

doi:10.1002/gps.4325

Cited by 46 publications

(36 citation statements)

References 41 publications

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“…However, upon comparison, it was observed that the efficacy of polytherapy was significantly greater than medical treatment. This finding is consistent with the studies by [22][23][24][25][26][27][28][29].…”

Section: Discussionsupporting

confidence: 83%

Application of Cognitive-behavioral Therapy in Obstructive Sleep Apnea: Comparison of CPAP Therapy and CBT on the Executive Functions of the Brain

Talebi¹,

Tabatabaye²,

Vahedi³

2017

J Sleep Disord Ther

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Purpose: Sleep apnea disorder brings about negative effects to the quality of life of the people involved. Debilitation of cognitive functioning is one of the consequences of this condition. Scant researches have been carried out to explore the efficacy of cognitive therapy on mitigating clinical symptoms and cognitive functions of the brain. The novelty of the present study is in combining cognitive method and medical treatment. This research aims to compare the effectiveness of continuous positive air pressure (CPAP) therapy and cognitive-behavioral treatment (CBT) on improving mental cognitive functions in patients with sleep apnea. Methods:The study population included all patients referred to the Bahar Sleep Disorders Clinic in Tehran, Iran. The sample consisted of 45 people who were randomly placed into three groups of 15 people (CPAP therapy, cognitive behavioral therapy, and control groups). All three groups were psychologically assessed prior to the intervention. Next, individuals in the cognitive-behavioral group underwent 12 sessions of cognitive training, progressive muscle relaxation, mental visualization, and sleep hygiene. The other group went through CPAP therapy. After the intervention, both groups were assessed psychologically. Data collection instruments included Wisconsin cognitive software, simple Stroop, complex Stroop, continuous performance, polysomnography device, and CPAP devices. Results:The results indicated that both types of intervention can enhance cognitive functioning; however, a greater efficacy is obtained by combining the two methods compared with the exclusive application of medical treatment. Conclusion:The authors propose cognitive-behavioral therapy OSA as a complement to medical treatment.

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Section: Discussionsupporting

confidence: 83%

Application of Cognitive-behavioral Therapy in Obstructive Sleep Apnea: Comparison of CPAP Therapy and CBT on the Executive Functions of the Brain

Talebi¹,

Tabatabaye²,

Vahedi³

2017

J Sleep Disord Ther

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“…Of interest, a recent study in older depressed patients is consistent with an opposing hypothesis (Goodkind et al, 2015) that lower pre-treatment ability to switch sets was associated with better response to treatment. These authors spectulated that this finding was related to the ability of cognitive behavior therapy to have a greater effect teaching patients to switch to more adaptive responses when the patient's switching ability was poorer at the beginning of treatment.…”

Section: Impact Of Pre-treatment Learning/memory and Inhibition/switcmentioning

confidence: 66%

Neurocognitive Correlates of Successful Treatment of PTSD in Female Veterans

Haaland

Sadek

Keller

et al. 2016

J Int Neuropsychol Soc

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Our finding that learning/memory predicted treatment success is consistent with previous studies. We extended these studies by showing that the effect was restricted to learning/memory, which is contrary to the executive function theory of PTSD. In contrast, the fact that only inhibition/switching significantly improved with better treatment success is consistent with its potential importance in maintaining PTSD symptoms. Future research should determine whether inhibition/switching abilities are a risk for development and maintenance of PTSD or whether such abilities have a broader reciprocal relationship with PTSD symptom change. (JINS, 2016, 22, 643-651).

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“…For example, Scogin et al(19) augmented CBT with memory training in an attempt to ameliorate deficits in encoding strategies; although CBT was effective at reducing depressive symptoms in this study, the additional training did not produce cognitive effects. However, depression is more often associated with executive dysfunction than memory deficits; as such, Goodkind and colleagues(20) used neuropsychological assessment to investigate cognitive outcomes of psychotherapy. Among depressed older adults, worse executive function at baseline predicted better treatment response to CBT.…”

Section: Psychosocial Treatmentsmentioning

confidence: 99%

“…As we discussed above under our review of PST, decades of research has demonstrated that deficits in the cognitive control network are associated with poor response to selective serotonin reuptake inhibitors (SSRI) medications, but PST seems uniquely suited to this variant of late life depression. In a study interrogating the role that cognitive deficits play in CBT, investigators including Gallagher-Thompson discovered that pretreatment deficits in cognitive flexibility appears to be associated with better outcomes(20). We have recently been funded to study the impact of a stepped behavioral intervention, called Engage, on LLD.…”

Section: Emerging Treatments and Future Directionsmentioning

confidence: 99%

Psychosocial Treatment Options for Major Depressive Disorder in Older Adults

Renn

Areán

2017

Curr Treat Options Psych

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Opinion Statement Late-life depression (LLD) is a public health concern with deleterious effects on overall health, cognition, quality of life, and mortality. Although LLD is relatively common, it is not a normal part of aging and is often under-recognized in older adults. However, psychotherapy is an effective treatment for LLD that aligns with many patients’ preferences and can improve health and functioning. This review synthesized the current literature on evidence-based psychotherapies for the treatment of depression in older adults. Findings suggest that active, skills-based psychotherapies (cognitive behavioral therapy [CBT] and problem-solving therapy [PST]) may be more effective for LLD than non-directive, supportive counseling. PST may be particularly relevant for offsetting skill deficit associated with LLD, such as in instances of cognitive impairment (especially executive dysfunction) and disability. Emerging treatments also consider contextual factors to improve treatment delivery, such as personalized care, access, and poverty. Tele-mental health represents one such exciting new way of improving access and uptake of treatment by older adults. Although these strategies hold promise, further investigation via randomized controlled trials and comparative effectiveness are necessary to advance our treatment of LLD. Priority should be given to recruiting and training the geriatric mental health workforce to deliver evidence-based psychosocial interventions for LLD.

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The impact of executive function on response to cognitive behavioral therapy in late-life depression

Abstract: These results suggest that CBT, which teaches cognitive techniques for improving psychiatric symptoms, may be especially beneficial in LLD if relative weaknesses in specific areas of executive functioning are present.

Cited by 46 publications

References 41 publications

Application of Cognitive-behavioral Therapy in Obstructive Sleep Apnea: Comparison of CPAP Therapy and CBT on the Executive Functions of the Brain

Application of Cognitive-behavioral Therapy in Obstructive Sleep Apnea: Comparison of CPAP Therapy and CBT on the Executive Functions of the Brain

Neurocognitive Correlates of Successful Treatment of PTSD in Female Veterans

Psychosocial Treatment Options for Major Depressive Disorder in Older Adults

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