24 Mindfulness-based cognitive therapy enhances executive control in recurrent depression in a randomized wait-list controlled trial

Sorensen, Lin; Jensen, Daniel Andre; Vollestad, Jon; Adolfsdottir, Steinunn; Svendsen, Julie Lillebostad; Visted, Endre; Osnes, Berge; Schanche, Elisabeth · 2023 · Crossref

DOI: 10.1017/s1355617723011062

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Summary

This study investigates whether Mindfulness-Based Cognitive Therapy (MBCT) improves executive control in adults with recurrent depression, addressing a gap in understanding how standard psychotherapy affects cognitive functioning. While MBCT is known to prevent depressive relapses and mindfulness training generally improves executive control in healthy populations, previous studies on MBCT’s impact on executive and attentional control in recurrent depression have yielded mixed results. The authors hypothesized that MBCT would enhance executive control and reduce attentional fluctuations compared to a wait-list control group, and that these cognitive improvements might be linked to reductions in depression symptoms. The research employed a randomized wait-list controlled trial design involving 64 adults with recurrent depression in partial or full remission. Participants were randomized into either an MBCT group or a wait-list control (WLC) group. Cognitive performance was assessed using the revised Attention Network Test (ANT-R) at baseline (T0) and post-treatment (T1), measuring executive control, alerting, orienting, and attention fluctuations via intra-individual reaction time variability (IIVRT) and exgaussian-mean of longer reaction times (TAU). Depression symptoms were measured using the Beck Depression Inventory-II (BDI-II). Baseline equivalence was confirmed across groups for age, gender, education, full-scale IQ, and executive control measures using the D-KEFS Stroop and Trail Making Test. Results indicated that the MBCT group demonstrated significantly higher efficiency in conflict detection, as measured by executive control scores from T0 to T1, compared to the WLC group. This improvement in executive control was independent of the greater reduction in depression symptoms observed in the MBCT group. However, reductions in depression symptoms at T1 were associated with enhanced efficiency in responding to alerting cues during conflict detection. No significant differences were found between the MBCT and WLC groups regarding attention fluctuation measures (IIVRT and TAU) at T1. The findings suggest that MBCT enhances executive control in adults with recurrent depression, potentially targeting a key cognitive vulnerability factor associated with the chronic course of the disorder. This cognitive improvement may contribute to MBCT’s efficacy in preventing depressive relapses. Additionally, the study highlights that symptom reduction is linked to improved alertness in conflict detection, further supporting the role of MBCT in addressing both emotional and cognitive aspects of recurrent depression.

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• executive function