Balogh, Annamaria; (2023) Using cognitive tasks to measure clinically relevant cognition in depression and anxiety: Implications for cognitive behavioural therapy. Doctoral thesis (Ph.D), UCL (University College London).

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Abstract

Changes in cognition are thought to contribute to the development and/or maintenance of depression and anxiety disorders. In theory, cognitive behavioural therapy, the most common psychological therapy for depression and anxiety, exerts its effect through modifying cognitive biases observed in patients. Most of the evidence about cognition underpinning depression/anxiety comes from self-reported questionnaires and clinicianrated scales. As an addition to current measurement tools, cognitive tasks could possibly be integrated with clinical practice as more objective and more precise measures of cognition. This, however, requires the development of tasks that measure clinically relevant cognitive processes. As an initial step towards this, in the first two experimental chapters I present results about the association between depression/anxiety symptoms and performance on a battery of cognitive tasks. I found in the first study as well as in the follow-up replication study and mega-analysis that participants with higher depression/anxiety symptom scores were faster at identifying changes in images in a change blindness task. This suggests that change blindness could possibly be used as a behavioural signature for attentional mechanisms underlying depression/anxiety. In the third experimental chapter I examine whether this effect is present in a case-control study. In addition, I investigate metacognitive processes in patients vs. healthy controls, which could have implications for mechanisms underlying psychological therapy. There was no evidence for change blindness and metacognition effects although this final pilot study included in the thesis did not have adequate power to detect effect sizes in the range typically observed in clinical literature. Overall, this thesis presents the research process through which cognitive tasks relevant to the treatment of depression and anxiety could be identified, and makes a case for the potential benefits of integrating cognitive tasks with psychological therapy as assessment and potentially even therapeutic tools as means to improve personalised treatment.

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