Cognitive control training for urgency: A pilot randomized controlled trial in an acute clinical sample

Andrew D Peckham; Jenna P Sandler; Devin Dattolico; R Kathryn McHugh; Daniel S Johnson; Thröstur Björgvinsson; Diego A Pizzagalli; Courtney Beard

doi:10.1016/j.brat.2021.103968

Cognitive control training for urgency: A pilot randomized controlled trial in an acute clinical sample

Behav Res Ther. 2021 Nov:146:103968. doi: 10.1016/j.brat.2021.103968. Epub 2021 Sep 14.

Authors

Andrew D Peckham¹, Jenna P Sandler², Devin Dattolico³, R Kathryn McHugh⁴, Daniel S Johnson⁵, Thröstur Björgvinsson⁶, Diego A Pizzagalli⁷, Courtney Beard⁸

Affiliations

¹ McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. Electronic address: adpeckham@mclean.harvard.edu.
² McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA; Brandeis University, 415 South Street, Waltham, MA, 02453, USA. Electronic address: jpsandler@brandeis.edu.
³ McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA. Electronic address: ddattolico@partners.org.
⁴ McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. Electronic address: kmchugh@mclean.harvard.edu.
⁵ McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA. Electronic address: johnson.dan@husky.neu.edu.
⁶ McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. Electronic address: tbjorgvinsson@mclean.harvard.edu.
⁷ McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. Electronic address: dap@mclean.harvard.edu.
⁸ McLean Hospital, 115 Mill Street, Belmont, MA, 02478, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA, 02115, USA. Electronic address: cbeard@mclean.harvard.edu.

Abstract

Urgency - rash action in the context of strong emotion - is a facet of impulsivity closely related to many psychological disorders. Deficits in working memory and response inhibition are potential mechanisms underlying urgency, and a previous study showed that cognitive training targeting these domains is efficacious in reducing urgency. However, the feasibility and efficacy of this intervention has not yet been tested in a clinical sample or naturalistic treatment setting. To fill this gap, we conducted a pilot study of cognitive training for individuals reporting high levels of urgency in a partial hospitalization program. We evaluated this intervention in an open trial (n = 20), followed by a randomized controlled trial (n = 46) comparing cognitive training plus treatment as usual to treatment as usual. Results supported the feasibility and acceptability of cognitive training. Participants in the training group showed significant improvement on cognitive tasks, but groups did not differ in urgency. In pooled analyses combining the open trial and RCT, there was a significant reduction in distress intolerance in the training group only. Results indicate the potential benefit of cognitive training for distress intolerance, but do not support the use of cognitive training for urgency in acute clinical settings. The study conducted in the RCT phase of this manuscript is registered on ClinicalTrials.gov (NCT: NCT03527550). The full trial protocol is available on ClinicalTrials.gov.

Keywords: Cognitive training; Inhibition; Urgency; Working memory.

Publication types

Randomized Controlled Trial
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Cognition
Emotions*
Humans
Impulsive Behavior*
Pilot Projects

Associated data

ClinicalTrials.gov/NCT03527550

Abstract

Publication types

MeSH terms

Associated data

Grants and funding