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Cognitive bias modification to prevent depression (COPE): results of a randomised controlled trial

Published online by Cambridge University Press:  23 September 2019

Julian Basanovic Open the ORCID record for Julian Basanovic [Opens in a new window] ,
Ben Grafton Open the ORCID record for Ben Grafton [Opens in a new window] ,
Andrew Ford ,
Varsha Hirani ,
David Glance ,
Colin MacLeod Open the ORCID record for Colin MacLeod [Opens in a new window]  and
Osvaldo P. Almeida Open the ORCID record for Osvaldo P. Almeida [Opens in a new window]
Julian Basanovic*
Affiliation:
Centre for the Advancement of Research on Emotion, School of Psychological Science, The University of Western Australia, Western Australia, Australia
Ben Grafton
Affiliation:
Centre for the Advancement of Research on Emotion, School of Psychological Science, The University of Western Australia, Western Australia, Australia
Andrew Ford
Affiliation:
Medical School, The University of Western Australia, Western Australia, Australia Western Australian Centre for Health and Ageing, The University of Western Australia, Western Australia, Australia Department of Psychiatry, Royal Perth Hospital, Western Australia, Australia
Varsha Hirani
Affiliation:
Medical School, The University of Western Australia, Western Australia, Australia Western Australian Centre for Health and Ageing, The University of Western Australia, Western Australia, Australia
David Glance
Affiliation:
UWA Centre for Software Practice, The University of Western Australia, Western Australia, Australia
Colin MacLeod
Affiliation:
Centre for the Advancement of Research on Emotion, School of Psychological Science, The University of Western Australia, Western Australia, Australia
Osvaldo P. Almeida
Affiliation:
Medical School, The University of Western Australia, Western Australia, Australia Western Australian Centre for Health and Ageing, The University of Western Australia, Western Australia, Australia Department of Psychiatry, Royal Perth Hospital, Western Australia, Australia
*
Author for correspondence: Julian Basanovic, E-mail: julian.basanovic@uwa.edu.au
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Abstract

Background

Although efficacious treatments for major depression are available, efficacy is suboptimal and recurrence is common. Effective preventive strategies could reduce disability associated with the disorder, but current options are limited. Cognitive bias modification (CBM) is a novel and safe intervention that attenuates biases associated with depression. This study investigated whether the delivery of a CBM programme designed to attenuate negative cognitive biases over a period of 1 year would decrease the incidence of major depression among adults with subthreshold symptoms of depression.

Methods

Randomised double-blind controlled trial delivered an active CBM intervention or a control intervention over 52 weeks. Two hundred and two community-dwelling adults who reported subthreshold levels of depression were randomised (100 intervention, 102 control). The primary outcome of interest was the incidence of major depressive episode assessed at 11, 27 and 52 weeks. Secondary outcomes included onset of clinically significant symptoms of depression, change in severity of depression symptoms and change in cognitive biases.

Results

Adherence to the interventions was modest though did not differ between conditions. Incidence of major depressive episodes was low. Conditions did not differ in the incidence of major depressive episodes. Likewise, conditions did not differ in the incidence of clinically significant levels of depression, change in the severity of depression symptoms or change in cognitive biases.

Conclusions

Active CBM intervention did not decrease the incidence of major depressive episodes as compared to a control intervention. However, adherence to the intervention programme was modest and the programme failed to modify the expected mechanism of action.

Keywords

Cognitioncognitive bias modificationcognitive biasdepressionpsychological interventionrandomised controlled trial
Type
Original Articles
Information
Psychological Medicine , Volume 50 , Issue 15 , November 2020 , pp. 2514 - 2525
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Copyright
Copyright © Cambridge University Press 2019

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