Accepted for/Published in: JMIR mHealth and uHealth
Date Submitted: Aug 28, 2024
Open Peer Review Period: Aug 28, 2024 - Oct 23, 2024
Date Accepted: Oct 22, 2025
(closed for review but you can still tweet)
Transdiagnostic Cognitive Control Training for Patients waiting for Outpatient Psychotherapy: A Randomized Clinical Trial
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 major 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 waiting for psychotherapy.
Methods:
In this randomized clinical superiority trial with two parallel arms, 80 patients with various mental disorders from a waiting list of an outpatient clinic were allocated to receive either ten sessions of mobile cognitive control training using the Paced Auditory Serial Addition Test (PASAT) or an active control training focusing on response speed. Global mental symptom distress, measured by the Hopkins Symptom Checklist-11 (HSCL-11), served as the primary endpoint. Secondary outcomes included measures of cognitive control, rumination, repetitive negative thinking, difficulties in emotion regulation, cognitive emotion regulation, disorder-specific symptoms, work and social adjustment, and quality of life. Outcomes were measured at baseline, after training and at 3-month and 6-month follow-up.
Results:
Cognitive control training was not superior in primary and most secondary endpoints. As compared to the comparator intervention, it led to greater improvements in cognitive control and, at certain timepoints, in emotion regulation, and symptoms of anxiety.
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 symptom distress. Potential desirable effects regarding emotion regulation and anxiety symptoms should be investigated in larger studies. Clinical Trial: This study’s design was registered at the German Clinical Trials Register [https://trialsearch.who.int/Trial2.aspx?TrialID=DRKS00024408]
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