Long-term outcomes of an internet-delivered cognitive enhancement intervention targeting residual cognitive deficits after major depressive disorder: a 2-year follow-up of an open trial

Myklebost, Sunniva Brurok; Nordgreen, Tine; Klakegg, Oda Stakkestad; Hammar, Åsa

doi:10.3389/fpsyg.2023.1194689

Cited by 3 publications

(1 citation statement)

References 47 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The platform is also used for building the app and allows for the input of content, such as text, audio, videos, and images, to create modules. It has previously been used for other internet-delivered programs, including programs for ADHD [ 36 ], social anxiety [ 37 ], and cognitive residual symptoms after depression [ 38 ].…”

Section: Methodsmentioning

confidence: 99%

A Blended Intervention Targeting Emotion Dysregulation in Adults With Attention-Deficit/Hyperactivity Disorder: Development and Feasibility Study

Nordby,

Guribye,

Schønning

et al. 2024

JMIR Form Res

View full text Add to dashboard Cite

Background Many adults with attention-deficit/hyperactivity disorder (ADHD) experience difficulties related to emotion regulation. Such difficulties are known to substantially impact quality of life and overall functioning. Yet, there is a lack of treatment interventions specifically designed to address these challenges. Objective This study aimed to describe the development and assess the feasibility, along with the initial clinical outcomes, of a novel blended intervention for adults with ADHD. The blended intervention combines both face-to-face and digital components and is specifically designed to address emotion dysregulation in ADHD. Methods This intervention was an 8-week blended intervention combining weekly face-to-face group sessions with a supplementary digital companion app. The intervention is based on elements from dialectic behavioral therapy skills training and positive psychology. To evaluate its feasibility, we performed a 10-week feasibility study with an uncontrolled pre-post study design, including 16 adults with ADHD and co-occurring emotion dysregulation. The feasibility measures encompassed adherence, satisfaction, and perceived credibility of the intervention. Clinical outcomes were evaluated by self-reported symptoms of emotion dysregulation, inattention, hyperactivity-impulsivity, executive function, depression, anxiety, and a measure of quality of life. Paired sample 2-tailed t tests were used to analyze clinical outcomes with a Bonferroni-corrected significance level. Results Both treatment credibility and treatment satisfaction were rated favorably by the majority of the participants. In particular, the participants emphasized meeting others with ADHD as beneficial. In terms of adherence, 3 participants withdrew before initiating the intervention, while another 4 participants did not complete the intervention. On average, the participants who enrolled in the intervention attended 6.2 of the 8 group sessions and completed 6.7 of the 8 skills training modules in the companion app. In terms of clinical outcomes, there was a reduction in symptoms of emotion dysregulation from before to after the intervention (d=2.0). Significant improvements were also observed in measures of inattention (d=1.1) and hyperactivity-impulsivity (d=0.9). However, no significant improvements were found in the domains of depression, anxiety, quality of life, and executive functioning. Conclusions The results are encouraging, both in terms of feasibility and the preliminary clinical results on emotion dysregulation. The blended format, combining digital and face-to-face elements, may also seem to offer some advantages: the group-based format was valued as it facilitated peer interaction, while a rather high completion of modules in the companion app highlights its potential to enhance skills training between the group sessions. Future randomized controlled trials are called for to further evaluate the clinical effectiveness of the intervention. Trial Registration ClinicalTrials.gov NCT05644028; https://clinicaltrials.gov/study/NCT05644028

show abstract

Section: Methodsmentioning

confidence: 99%

A Blended Intervention Targeting Emotion Dysregulation in Adults With Attention-Deficit/Hyperactivity Disorder: Development and Feasibility Study

Nordby,

Guribye,

Schønning

et al. 2024

JMIR Form Res

View full text Add to dashboard Cite

show abstract

Efficacy of an internet-delivered cognitive enhancement intervention for subjective residual cognitive deficits in remitted major depressive disorder: A randomized crossover trial

Myklebost,

Heltne,

Hammar

et al. 2024

Journal of Affective Disorders

View full text Add to dashboard Cite

Neurobehavioral Affective Control Training (N-ACT): A randomized waitlist-controlled pilot trial to evaluate a novel transdiagnostic cognitive remediation program for emotion-related impulsivity and rumination (Preprint)

Allen,

Vensano-Elliott,

Ronold

et al. 2023

Preprint

View full text Add to dashboard Cite

BACKGROUND Inhibitory deficits are common in psychopathology. Emotion-related impulsivity (ERI) and rumination are general risk factors for psychiatric distress that are similarly associated with dysfunctional inhibition – particularly in affective contexts. A number of cognitive remediation procedures have been developed to improve inhibitory control; however, most programs focus on “cold” cognition independent of affective processing. This pilot trial will gather preliminary evidence for a new cognitive training intervention targeting “hot” affective control (i.e., inhibitory functions during elevated emotional arousal) in a transdiagnostic sample of adults who report emotion regulation problems. OBJECTIVE This manuscript describes a protocol for a randomized waitlist-controlled trial to assess changes in ERI and rumination after Neurobehavioral Affective Control Training (N-ACT), an eight-week cognitive training intervention designed to improve emotional response inhibition and emotional working memory. We hypothesize that N-ACT will enhance performance on behavioral tasks indexing these affective control processes. We further expect that the magnitude of affective control changes will predict complementary decreases in ERI and rumination. Finally, we hypothesize that affective control improvement will correspond to reduced psychopathology symptoms following N-ACT. Exploratory analyses will examine potential mechanisms underlying hypothesized changes across these dimensions, spanning multiple levels of analysis, e.g., behavior, psychophysiology, and self-report. METHODS The final sample will comprise 80 adults who report high levels of ERI and/or rumination. Participants will be randomized to (1) begin the N-ACT program without delay or (2) join a waitlist condition and then complete N-ACT. Exclusion criteria (confirmed via clinical interview) include active alcohol/substance use disorders, psychosis, and suicide risk. At baseline and post-intervention, participants will complete online measures of emotion regulation and psychiatric symptoms, as well as in-person assessment of executive functioning, pupillometry, and skin conductance. Individuals assigned to the control group will undergo an identical assessment before joining the waitlist, followed by parallel assessments before and after N-ACT. Participants will also complete ecological assessment over one week at baseline and one week after completing N-ACT, in addition to follow-up self-report measures six weeks later. RESULTS This trial is funded by support from the University of California Board of Regents and the Peder Sather foundation (10/22–9/24). Recruitment is scheduled to begin in fall 2023. We will begin data analysis once data collection is complete, which is planned to occur in fall 2024. CONCLUSIONS This research aims to determine the initial acceptability, efficacy, and feasibility of N-ACT, a novel cognitive remediation approach developed to address two key contributors to psychopathology: ERI and rumination. The N-ACT program specifically uses computerized adaptive behavioral tasks to strengthen affective inhibitory control processes theoretically and empirically linked to these characteristics. We ultimately seek to determine whether enhancing affective control through cognitive training produces downstream reductions in psychiatric symptoms via improved emotion regulation. CLINICALTRIAL ClinicalTrials.gov: NCTXXXX (Pending). Registered via Open Science Framework (OSF) on XX/XX/XXXX (Pending).

show abstract

Long-term outcomes of an internet-delivered cognitive enhancement intervention targeting residual cognitive deficits after major depressive disorder: a 2-year follow-up of an open trial

Cited by 3 publications

References 47 publications

A Blended Intervention Targeting Emotion Dysregulation in Adults With Attention-Deficit/Hyperactivity Disorder: Development and Feasibility Study

A Blended Intervention Targeting Emotion Dysregulation in Adults With Attention-Deficit/Hyperactivity Disorder: Development and Feasibility Study

Efficacy of an internet-delivered cognitive enhancement intervention for subjective residual cognitive deficits in remitted major depressive disorder: A randomized crossover trial

Neurobehavioral Affective Control Training (N-ACT): A randomized waitlist-controlled pilot trial to evaluate a novel transdiagnostic cognitive remediation program for emotion-related impulsivity and rumination (Preprint)

Contact Info

Product

Resources

About