1. Mobile Cognitive Training for Young Adults with Depressive Symptoms
Jeffrey N. Motter, MA1,2, Alice Grinberg, MA, EdM1,2, Joel R. Sneed, Ph.D1,2,3
1The Graduate Center, City University of New York
2Queens College, City University of New York
3Columbia University and the New York State Psychiatric Institute

2. Background Depression is characterized by: Low mood Loss of interest
High lifetime prevalence:16.6% in the US
(Kessler et al., 2005)
High rates of recurrence: 85%
(Mueller et al., 1999)
Only 37.5% receive adequate treatment
(Wang et al., 2005)

3. Background
Depression manifests with cognitive deficits in multiple domains
Attention
Working Memory
Processing Speed
Autobiographical Memory
Delayed Verbal Memory
Executive Functioning
(Ahern & Semkovska, 2017)
Cognitive deficits affect quality of life and persist following treatment
(Paelecke-Habermann et al., 2005)(Baune et al., 2010)

4. Background
Meta-Analysis of Computerized Cognitive Training (CCT) for Depression
Motter et al. (2016)

5. Background Mechanism remains unclear
Processing speed has received little attention
Impaired in depressed
Underlies higher order functions
Not targeted or assessed in CCT for depression
Potentially mediates improvement from CCT

6. Aims and Hypotheses
Aim 1: To determine if mobile CCT can lead to changes in mood, cognition, and daily functioning
H1: It is hypothesized that there will be improved mood (BDI-II) following CCT
H2: It is hypothesized that there will be improved processing speed (WAIS-IV Coding) following CCT
H3: It is hypothesized that there will be improved daily functioning (Sheehan Disability Scale) following CCT
Aim 2: To determine whether processing speed training leads to greater improvement than verbal ability training
H1: It is hypothesized that there will be a greater improvement in mood, cognition, and daily functioning for patients randomized to the processing speed group compared to the verbal group.

7. Method
Participants recruited via online advertisements, listserv announcements, and flyers in the community
Inclusion criteria:
Age 18-29
Mild depressive symptoms
(Hamilton Depression Rating Scale≥10)
Own a smartphone
Exclusion criteria:
Psychiatric comorbidity
Neurological history
Suicidal intent

8. Method Clinical and mood assessment
Anxiety Disorders Interview Schedule for DSM-IV
Hamilton Depression Rating Scale
Beck Depression Inventory II
Sheehan Disability Scale
Neuropsychological testing battery
DKEFS Color Word Interference
DKEFS Trails
DKEFS Verbal Fluency
WAIS-IV Coding
WAIS-IV Digit Span
California Verbal Learning Test-II
User Engagement Scale

9. Method
Participants randomized to processing speed games group or verbal games group from the Peak mobile cognitive training app
Both groups completed 40 fifteen-minute sessions of CCT over 8 weeks

10. Method
Processing Speed Games
Verbal Games

11. Preliminary Results N=46 recruited N=35 completed 8 weeks of training
Mean age: 21.0 (SD 3.7)
81.4% female
Race:
White: 45.7%
Asian: 28.3 %
Hispanic: 13.0%
Black: 4.2%
Other: 8.7%
Mean HDRS: 16.3 (SD 5.5)

12. Preliminary Results: Mood
Effect of Time: F=68.7, p<0.001
Time x Group Interaction: F=0.0, p=0.899
Effect of Time: F=40.6, p<0.001
Time x Group Interaction: F=1.0, p=0.336

13. Preliminary Results: Processing Speed
Effect of Time: F=34.6, p<0.001
Time x Group Interaction: F=1.0, p=0.335
Effect of Time: F=14.4, p=0.001
Time x Group Interaction: F=1.1, p=0.304

14. Preliminary Results: Executive Functioning
Effect of Time: F=8.5, p=0.006
Time x Group Interaction: F=2.2, p=0.151
Effect of Time: F=20.1, p<0.001
Time x Group Interaction: F=1.0, p=0.319

15. Preliminary Results: Daily Functioning
Effect of Time: F=7.8, p=0.009
Time x Group Interaction: F=2.0, p=0.163
Effect of Time: F=28.6, p<0.001
Time x Group Interaction: F=0.0, p=0.892

16. Preliminary Results
Significant regression equation predicting BDI-II change based on training time (F(1,32)=6.8, p=0.014), with an R2 of 0.176)
Engagement did not predict BDI-II or Coding change
Engagement did not differ across groups

17. Preliminary Results CCT improved: Mood Daily Functioning
Processing Speed
Executive Functioning
Letter Fluency
Verbal Memory (Immediate and Delayed)
CCT did not improve:
Attention
Working Memory

18. Discussion CCT leads to gains in mood, cognition, daily functioning
Gains do not depend on module content
Magnitude of mood improvement increases with training load
Comparable engagement across groups

19. Discussion Looking forward: Real-time mood measurements during CCT
Experimentally modified expectancy and engagement
How does CCT compare to other mentally stimulating programs?
What functional and structural changes are responsible for CCT’s impact on mood and cognition?

20. Acknowledgments Special thanks to our trusted RAs: Kevin Nobari
Ayelet Abelow
Allan Porter
Waseem Iqnaibi
Dahlia Lieberman

21. References
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