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The impact of executive function on response to cognitive behavioral therapy in late‐life depression
Author(s) -
Goodkind Madeleine S.,
GallagherThompson Dolores,
Thompson Larry W.,
Kesler Shelli R.,
Anker Lauren,
Flournoy John,
Berman Mika P.,
Holland Jason M.,
O'Hara Ruth M.
Publication year - 2016
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4325
Subject(s) - cognitive flexibility , neuropsychology , psychology , depression (economics) , executive dysfunction , cognition , late life depression , clinical psychology , executive functions , iowa gambling task , cognitive therapy , cognitive remediation therapy , flexibility (engineering) , cognitive behavioral therapy , wisconsin card sorting test , neuropsychological assessment , psychiatry , statistics , mathematics , economics , macroeconomics
Objective Late‐life depression (LLD) is a common and debilitating condition among older adults. Cognitive behavioral therapy (CBT) has strong empirical support for the treatment of depression in all ages, including in LLD. In teaching patients to identify, monitor, and challenge negative patterns in their thinking, CBT for LLD relies heavily on cognitive processes and, in particular, executive functioning, such as planning, sequencing, organizing, and selectively inhibiting information. It may be that the effectiveness of CBT lies in its ability to train these cognitive areas. Methods Participants with LLD completed a comprehensive neuropsychological battery before enrolling in CBT. The current study examined the relationship between neuropsychological function prior to treatment and response to CBT. Results When using three baseline measures of executive functioning that quantify set shifting, cognitive flexibility, and response inhibition to predict treatment response, only baseline Wisconsin Card Sort Task performance was associated with a significant drop in depression symptoms after CBT. Specifically, worse performance on the Wisconsin Card Sort Task was associated with better treatment response. Conclusions These results suggest that CBT, which teaches cognitive techniques for improving psychiatric symptoms, may be especially beneficial in LLD if relative weaknesses in specific areas of executive functioning are present. Copyright © 2015 John Wiley & Sons, Ltd.