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Int J Geriatr Psychiatry. 2016 Apr;31(4):334-9. doi: 10.1002/gps.4325. Epub 2015 Jul 30.

The impact of executive function on response to cognitive behavioral therapy in late-life depression.

Author information

1
New Mexico VA Healthcare System, Albuquerque, NM, USA.
2
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University, Stanford, CA, USA.
3
Sierra-Pacific Mental Illness Research, Education, and Clinical Center (MIRECC), VA Palo Alto Health Care System, Palo Alto, CA, USA.
4
Department of Psychology, University of Oregon, Eugene, OR, USA.
5
Department of Psychology, University of Nevada, Las Vegas, NV, USA.

Abstract

OBJECTIVE:

Late-life depression (LLD) is a common and debilitating condition among older adults. Cognitive behavioral therapy (CBT) has strong empirical support for the treatment of depression in all ages, including in LLD. In teaching patients to identify, monitor, and challenge negative patterns in their thinking, CBT for LLD relies heavily on cognitive processes and, in particular, executive functioning, such as planning, sequencing, organizing, and selectively inhibiting information. It may be that the effectiveness of CBT lies in its ability to train these cognitive areas.

METHODS:

Participants with LLD completed a comprehensive neuropsychological battery before enrolling in CBT. The current study examined the relationship between neuropsychological function prior to treatment and response to CBT.

RESULTS:

When using three baseline measures of executive functioning that quantify set shifting, cognitive flexibility, and response inhibition to predict treatment response, only baseline Wisconsin Card Sort Task performance was associated with a significant drop in depression symptoms after CBT. Specifically, worse performance on the Wisconsin Card Sort Task was associated with better treatment response.

CONCLUSIONS:

These results suggest that CBT, which teaches cognitive techniques for improving psychiatric symptoms, may be especially beneficial in LLD if relative weaknesses in specific areas of executive functioning are present.

KEYWORDS:

cognitive behavioral therapy; executive function; late-life depression; neuropsychological performance; treatment response

PMID:
26230057
DOI:
10.1002/gps.4325
[Indexed for MEDLINE]

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