JMIR Publications

ABSTRACT

Background:

Cognitive Control Training (CCT) has gained attention in recent years as a preventative intervention in the context of major depressive disorder. To date, uncertainty exists around the working mechanisms of CCT, and how its effects unfold over time.

Objective:

The objective of the study was to examine cognitive and affective transfer effects following an unusual high number of training sessions.

Methods:

This case study presents data of a participant completing a large amount of training sessions (n=55) over the course of one year in two training phases: 10 initial sessions, followed by an additional 45 sessions. Reliable change indices (RCI) were calculated for several self-report questionnaires, measuring cognitive and affective functioning.

Results:

Cognitive task performance suggests improved cognitive functioning after training (accuracy scores increased from 24% at baseline to 61% shortly after training), which was maintained at follow-up (accuracy scores around 50%). RCI suggest a decrease in depressive symptoms (BDI score decreased from 23 at baseline to 3 following initial training). Similarly, burn-out symptoms following CCT showed a similar decrease. Maladaptive emotion regulation strategies displayed high variability, decreasing after periods of training, but increasing when no training was performed. However, no changes in repetitive negative thinking were observed. Thematic analysis from an in-depth interview focusing on CCT adherence and user experience pointed to the importance of independency and accessibility of online CCT in perceived agency, as well as the need for clear feedback mechanisms following training.

Conclusions:

Training task performance indicates further increases in performance beyond typical amounts of training sessions (10-20 sessions), hinting that more sessions could be beneficial for continued improvement in cognitive functioning. In line with prior research, CCT decreased depressive symptomatology. However, its effects on emotion regulation remain unclear. Further mechanistic studies into temporal unfolding of CCT effects are necessary to investigate potential working mechanisms.