Symposia
Cognitive Science/ Cognitive Processes
Andrew Peckham, Ph.D. (he/him/his)
Clinical Psychologist/Assistant Professor
VA Bedford Healthcare System/UMass Chan Medical School
Bedford, Massachusetts
Jenna Sandler, B.A.
Junior Specialist
UC Davis MIND Institute
Sacramento, California
Devin Dattolico, B.S.
Graduate Student
Harvard T.H. Chan School of Public Health
Boston, Massachusetts
Thröstur Björgvinsson, ABPP, Ph.D. (he/him/his)
Director, Behavioral Health Partial Hospital Program
McLean Hospital
Belmont, Massachusetts
Courtney Beard, Ph.D.
Psychologist
McLean Hospital
Belmont, Massachusetts
Impulsivity in the context of strong emotion (“urgency”) is tied to many symptoms including substance use, suicidal behavior, and anxiety. Poor working memory and inhibitory control are linked to urgency, raising the possibility that training targeting these domains could enhance treatment outcomes for people with elevated urgency. This study tested the feasibility, acceptability, and efficacy of a cognitive training intervention for urgency in a partial hospitalization program (PHP) for adults with psychological disorders.
A brief screening measure assessing urgency was integrated into clinical progress monitoring at a PHP, and those with high urgency were recruited. Twenty participants completed an open trial involving daily computerized working memory and inhibitory control exercises added to treatment as usual (TAU); 46 participants were randomized to either TAU or to receive TAU combined with cognitive training. Participants completed pre- and post-treatment measures of cognition, impulsivity, and intervention acceptability.
Across the open trial and RCT, results supported the feasibility of integrating cognitive training into the PHP setting: 76.2% of participants completed the intervention, and participants improved their performance on both cognitive training tasks (ps < .001), indicating sufficient engagement in training. Results of an acceptability measure indicated moderate or greater levels of acceptability for both training tasks. However, there was no change in impulsivity: those receiving training plus TAU did not differ from those receiving TAU, both in terms of impulsivity during negative emotions (Time X Group p = .86) and positive emotions (p = .77).
Results of this study support the feasibility and acceptability of integrating relatively demanding cognitive training procedures into an acute clinical setting. Yet, despite previous evidence of a link between specific cognitive deficits and specific forms of impulsivity, there was no added clinical benefit to receiving cognitive training. Together, this highlights the need for future studies to evaluate the most optimal methods for targeting cognitive vulnerabilities in clinical settings.