The effectiveness of cognitive control training in reducing rumination in adults with major depressive disorder: a systematic review
Keywords:
Cognitive control training, rumination, executive function, depressionAbstract
Objectives Cognitive control deficiencies have been identified as an underlying mechanism for rumination. Cognitive control training (CCT) that targets working memory performance hence has potential as a preventative intervention for depression. This systematic review investigates whether CCT reduces rumination in adults with major depressive disorder. The review questions are 1) Is CCT effective in reducing rumination in adults with depression? and 2) Are any changes in rumination linked to training-related changes in executive function?
Materials and Methods The databases Web of Science, MEDLINE, and APA PsycINFO were searched from 2009 to 29 July 2022 using keywords relevant to CCT and depression. Selection criteria were: a) any study measuring rumination before and after CCT in depression; b) adult with formally diagnosed depression; c) CCT strategies used included either the Wells task and adaptive Paced Auditory Serial Addition Task (aPASAT) either alone or in combination. Two raters assessed the quality of each study using the Standard Quality Assessment Criteria tool (QualSyst). The evidence gathered from the included studies are synthesised as summary tables and a narrative summary.
Results From 464 studies, 8 studies were included in the review. There was considerable heterogeneity between studies. Following training, rumination decreased significantly over time; however there were few significant differences between training and active control groups. However, CCT did not appear to have difference effects on self-reported cognitive complaints relative to active control conditions.
Conclusion CCT's benefits develop from before to after training both for rumination and executive function. The limitations of this review are the use of a sole rater in the selection process, and this review focused only on one of several approaches to CCT.
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