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<p>Cognitive control deficits that persist following remission from depression are known to increase the risk of relapse. Cognitive Control Training (CCT) has shown promise in improving these impairments, but is typically delivered on a fixed schedule, irrespective of individual symptom trajectories. This study examined whether delivering just-in-time CCT booster sessions, tailored to personal depressive symptom patterns, could enhance outcomes.&#xa0;In a randomized controlled trial, 138 individuals with remitted depression first completed a 10-session fixed CCT protocol over two weeks. Participants were then randomly assigned to a control group (<i>n</i> = 70) or a booster group (<i>n</i> = 68), eligible for up to three series of three just-in-time booster sessions during a 13-week follow-up. Based on weekly assessments, eligibility was triggered when participants scored PHQ-9 ≥ 9 for two consecutive weeks. The primary outcome was depressive symptoms (PHQ-9); secondary outcomes included rumination, emotion regulation strategies, and cognitive control. Linear mixed-effects models assessed changes over time and between groups.&#xa0;No significant group-by-time interactions emerged after FDR correction. Small reductions in rumination and maladaptive emotion regulation were observed over time, though effects did not survive correction.&#xa0;Although no significant clinical or cognitive effects were observed, this study introduces an innovative framework for adapting cognitive training delivery based on personal depression trajectories. The findings may inform future personalized prevention strategies in depression care.</p><p>Trial Registration:&#xa0;This trial was registered at ClinicalTrials.gov (NCT05557760). The trial was prospectively registered prior to enrollment of the first participant.</p>

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Towards Targeted Prevention of Depression: A Phase II Trial on just-in-time Application of Cognitive Control Training with Booster Sessions

  • 期刊论文

  • 发表日期：

    2025年12月5日

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  • David Demeester,
  • Yannick Vander Zwalmen,
  • Chris Baeken,
  • Nick Verhaeghe,
  • Kristof Hoorelbeke,
  • Ernst H.W. Koster

摘要

Cognitive control deficits that persist following remission from depression are known to increase the risk of relapse. Cognitive Control Training (CCT) has shown promise in improving these impairments, but is typically delivered on a fixed schedule, irrespective of individual symptom trajectories. This study examined whether delivering just-in-time CCT booster sessions, tailored to personal depressive symptom patterns, could enhance outcomes. In a randomized controlled trial, 138 individuals with remitted depression first completed a 10-session fixed CCT protocol over two weeks. Participants were then randomly assigned to a control group (n = 70) or a booster group (n = 68), eligible for up to three series of three just-in-time booster sessions during a 13-week follow-up. Based on weekly assessments, eligibility was triggered when participants scored PHQ-9 ≥ 9 for two consecutive weeks. The primary outcome was depressive symptoms (PHQ-9); secondary outcomes included rumination, emotion regulation strategies, and cognitive control. Linear mixed-effects models assessed changes over time and between groups. No significant group-by-time interactions emerged after FDR correction. Small reductions in rumination and maladaptive emotion regulation were observed over time, though effects did not survive correction. Although no significant clinical or cognitive effects were observed, this study introduces an innovative framework for adapting cognitive training delivery based on personal depression trajectories. The findings may inform future personalized prevention strategies in depression care.

Trial Registration: This trial was registered at ClinicalTrials.gov (NCT05557760). The trial was prospectively registered prior to enrollment of the first participant.