Cognitive Control Training for Urgency in a Naturalistic Clinical Setting

Mass General Brigham

Status: Terminated

Conditions: Mental Disorders; Impulsive Behavior

Treatments: Other: Cognitive Control Training

Study type: Interventional

Funder types: Other; NIH

Identifiers

NCT03527550

1F32MH115530 (U.S. NIH Grant/Contract)

2017P001550

Details and patient eligibility

About

This study is designed to test whether computer-based cognitive exercises are helpful for reducing a specific type of impulsivity. Also, the study is testing whether these are exercises are associated with specific changes in behavior and in the brain. Participants will be psychiatric patients enrolled in a partial hospitalization program. Half of these participants will receive usual treatment, and half will complete computer-based cognitive exercises in addition to usual treatment.

Full description

Impulsivity has different components. One personality trait related to impulsivity, known as "urgency," is strongly related to many different mental health symptoms and risky behaviors. Urgency refers to impulsivity specifically in the context of strong emotions.

Research shows that higher levels of urgency are related to specific deficits in cognition. Problems with response inhibition--the ability to cancel or withhold a planned action--are associated with urgency. Also, research shows that difficulties in another aspect of cognition--working memory--may moderate the relationship between inhibition deficits and urgency. One previous study found that people who practiced computerized response inhibition and working memory tasks for two weeks reported significant decreases in urgency.

It is unknown if these computerized tasks would be helpful for reducing urgency in adults with psychiatric disorders. Furthermore, it is unknown if changes in urgency are related to changes in the brain mechanisms that help to support response inhibition. This study will collect data on brain activity while people are completing response inhibition tasks.

Enrollment: 46 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Currently receiving treatment at the McLean Hospital Behavioral Health Partial Hospital Program (PHP)
• Report an average score of 3.0 or greater on the Negative Urgency scale, the Positive Urgency scale, or 3.0 or greater on both scales, upon admission to the PHP
• Right-handed (if enrolled in EEG arm)

Exclusion criteria

• Currently undergoing electroconvulsive therapy (ECT)
• Current symptoms of acute mania
• Current symptoms of acute psychosis
• History of traumatic brain injury

Trial design

Primary purpose: Basic Science

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

---

46 participants in 2 patient groups

Cognitive Training plus Treatment as Usual

Experimental group

Description:

Participants in this arm will receive daily computerized cognitive training sessions during partial hospitalization, in addition to treatment as usual. Cognitive training sessions will alternate between response inhibition training and working memory training.

Treatment:

Other: Cognitive Control Training

Treatment as Usual (TAU)

No Intervention group

Description:

Participants in the Treatment As Usual group will receive usual treatment in the partial hospitalization program.