The influence of cognitive flexibility on treatment outcome and cognitive restructuring skill acquisition during cognitive behavioural treatment for anxiety and depression in older adults: Results of a pilot study.
There is some evidence that cognitive flexibility negatively impacts cognitive restructuring skill acquisition with brief training; however, there is little understanding of how this relates to learning cognitive restructuring over the course of a therapy program, and how it relates to overall treatment outcome. This study assessed the impact of cognitive flexibility on cognitive restructuring skill acquisition following group CBT, and on treatment outcome, along with changes in cognitive flexibility over treatment. 44 older participants with anxiety and depression completed self-report and neuropsychological tests of cognitive flexibility and a clinical interview at pre and post-treatment. Qualitative and quantitative measures of cognitive restructuring were completed at post-treatment. Pre-treatment cognitive flexibility was not related to the quality of cognitive restructuring at post-treatment or overall treatment outcome. However, it did predict reduction in subjective units of distress from using cognitive restructuring and therapist ratings of cognitive restructuring ability at post-treatment. Few participants showed changes in cognitive flexibility over treatment. Those with poorer cognitive flexibility may not find cognitive restructuring as useful to alleviate emotional distress as those with better cognitive flexibility. However, those with poorer cognitive flexibility can still benefit from standardised CBT, even if their use of cognitive restructuring is less effective.
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney 2109, Australia. Electronic address: carly.johnco@mq.edu.au.
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Johnco
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney 2109, Australia. Electronic address: Viviana.Wuthrich@mq.edu.au.
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Wuthrich
Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney 2109, Australia. Electronic address: ron.rapee@mq.edu.au.
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Rapee
D000368:Aged; D000375:Aging / Q000523:psychology*; D001007:Anxiety / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D003071:Cognition; D015928:Cognitive Behavioral Therapy; D003863:Depression / Q000150:complications / Q000523:psychology* / Q000628:therapy*; D005260:Female; D006801:Humans; D007858:Learning; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010865:Pilot Projects; D011615:Psychotherapy, Group; D016896:Treatment Outcome
Ageing; Cognitive behaviour therapy; Cognitive restructuring; Cognitive therapy; Executive function