Does cognitive flexibility predict treatment gains in Internet-delivered psychological treatment of social anxiety disorder, depression, or tinnitus?
Little is known about the individual factors that predict outcomes in Internet-administered psychological treatments. We hypothesized that greater cognitive flexibility (i.e. the ability to simultaneously consider several concepts and tasks and switch effortlessly between them in response to changes in environmental contingencies) would provide a better foundation for learning and employing the cognitive restructuring techniques taught and exercised in therapy, leading to greater treatment gains. Participants in three trials featuring Internet-administered psychological treatments for depression (n = 36), social anxiety disorder (n = 115) and tinnitus (n = 53) completed the 64-card Wisconsin Card Sorting Test (WCST) prior to treatment. We found no significant associations between perseverative errors on the WCST and treatment gains in any group. We also found low accuracy in the classification of treatment responders. We conclude that lower cognitive flexibility, as captured by perseverative errors on the WCST, should not impede successful outcomes in Internet-delivered psychological treatments.
Department of Psychology, Stockholm University, Stockholm, Sweden; Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden.
Philip
P
Lindner
Department of Psychology, Stockholm University , Stockholm , Sweden.
Per
0000-0002-2172-8813
P
Carlbring
Department of Behavioural Sciences and Learning, Linköping University , Linköping , Sweden.
Erik
E
Flodman
Department of Behavioural Sciences and Learning, Linköping University , Linköping , Sweden.
Amanda
A
Hebert
Department of Behavioural Sciences and Learning, Linköping University , Linköping , Sweden.
Stephanie
S
Poysti
NeuroVux Clinic, Norrbotten County Council , Luleå , Sweden.
Filip
F
Hagkvist
Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
Robert
R
Johansson
Department of Neuroscience, Uppsala University , Uppsala , Sweden.
Vendela
V
Zetterqvist Westin
Department of Clinical Psychology and Psychotherapy, University of Bern , Bern , Switzerland.
Thomas
T
Berger
Department of Clinical Neuroscience, Karolinska Institute, Stockholm, Sweden; Department of Behavioural Sciences and Learning, Linköping University, Linköping, Sweden.
Gerhard
G
Andersson
Internet; Perseveration; Prediction; Psychotherapy; Wisconsin Card Sorting Test