Transdiagnostic Cognitive Control Training for Patients Waiting for Outpatient Psychotherapy: Randomized Clinical Trial
Bibliographic record
Abstract
Background: Various mental disorders are associated with impaired cognitive control, which is crucial for effective emotion regulation. Cognitive control training has demonstrated promise in enhancing emotion regulation and alleviating distress in disorders characterized by repetitive negative thinking, such as depression and anxiety. Objective: Given the importance of cognitive control and emotion regulation across mental disorders, this study investigates the efficacy of a mobile cognitive control training in a transdiagnostic outpatient sample awaiting psychotherapy. Methods: In this randomized clinical superiority trial with 2 parallel arms, 80 patients with various mental disorders from an outpatient waiting list received either 10 sessions of mobile cognitive control training using the Paced Auditory Serial Addition Test (PASAT) or an active control training using a speed of response task. The primary outcome was mental distress, measured by the Hopkins Symptom Checklist-11 (HSCL-11). Secondary outcomes included measures of cognitive control, rumination, repetitive negative thinking, difficulties in emotion regulation, cognitive emotion regulation, and disorder-specific symptoms. Outcomes were measured at baseline, post training, and at 3-month and 6-month follow-up. Results: Contrary to our primary hypothesis, cognitive control training was not superior in improving global mental distress directly after training (B=-.03, 95% CI -0.21, 0.16; t179.60=-0.26; P=.80; d=-0.04, 95% CI -0.35, 0.28); however, it led to greater improvements in cognitive control (B=-0.56, 95% CI -0.59,-0.54; z=-18.02; P<.001; d=-1.23, 95% CI -1.30,-1.20). This effect was similar at the 3-month and 6-month follow-up. Furthermore, at 3-month follow-up, cognitive control training resulted in fewer difficulties in emotion regulation (B=4.73, 95% CI 0.52, 9.12; t177.99=2.09; P=.04; d=0.34, 95% CI 0.04, 0.65), and anxiety symptoms (B=2.94, 95% CI 0.38, 5.82; t66.51=2.09; P=.04; d=0.70, 95% CI 0.09, 1.38), although the latter refers to a small subsample of patients with anxiety disorders. At 6-month follow-up, cognitive control training led to more adaptive cognitive emotion regulation (B=-5.18, 95% CI -9.74,-0.41; t180.90=-2.16; P=.03; d=-0.40, 95% CI -0.75,-0.03), and less social anxiety (B=2.00, 95% CI 0.14, 3.81; t43.43=2.08; P=.04; d=0.66, 95% CI 0.05, 1.24). The groups did not differ in any other outcome at any point in time. Conclusions: This study is the first to assess the efficacy of a mobile cognitive control training using the PASAT in a transdiagnostic outpatient sample. There was no evidence for the training's efficacy on global mental distress and only weak evidence for the superiority in measures of emotion regulation and anxiety at follow-ups. Potential mediating pathways and moderating factors, such as the number of training sessions, should be investigated in larger studies.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.004 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.002 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.002 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.004 | 0.003 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".