Predictors of Improvement in Subjective Executive Functioning Following an Internet-Delivered Cognitive Enhancement Intervention for Adults in Remission From Depression.

Introduction: Residual cognitive deficits are commonly reported by individuals in remission from depression, often affecting daily life functioning and mental health. To provide tailored and personalized cognitive enhancement interventions for this population, there is a need for a better understanding of the characteristics of those who benefit from such interventions. Therefore, this study aimed to identify predictors of changes in subjective executive functioning following an internet-delivered cognitive enhancement intervention for adults in remission from depression.

Methods: Data were collected from a randomized controlled trial investigating the efficacy of an internet-delivered cognitive enhancement intervention. Changes in subjective executive functioning from pre-treatment to the six-month follow-up were assessed in 44 participants in remission from depression, using the Behavior Rating Inventory of Executive Function Adult Global Executive Composite. Linear mixed model analyses were conducted to investigate the impact of demographic, clinical, and treatment credibility variables on change in subjective cognitive functioning over time.

Results: The results showed that shorter lifetime depression duration predicted greater improvements in subjective executive functioning (p = 0.031). Higher levels of treatment expectancy and credibility were related to greater improvements in subjective cognitive functioning (p = 0.024). Participants with a partner showed better treatment response than those without a partner (p < 0.001).

Conclusion: This study builds on previous research on cognitive enhancement interventions in remitted depression, highlighting the impact of depression duration, treatment expectancy, and credibility on treatment response. Interventions targeting cognitive deficits appear most effective for those with a shorter lifetime duration of depression. Therefore, efforts should be made to enhance outcomes in those with a chronic course. To maximize engagement and outcomes, these interventions should be delivered in a way that individuals in remission from depression view them as credible and capable of reducing their deficits. Previous research has not found partner status to predict change in subjective executive functioning. The effect of partner status on treatment response should be investigated further.