Performance-based attentional control, but not self-reported attentional control, predicts changes in depressive symptoms in short-term psychotherapy.

Objective: Although impairments in attentional control are pervasive across psychopathology, there is substantial individual differences. In the current study, we examined whether individual differences in self-reported and performance-based measures of attentional control predict changes in depressive symptoms and well-being in a diagnostically diverse sample of patients attending a CBT-based partial hospital program.

Method: Participants were 89 patients (56.2% men, 75.3% non-Hispanic White). At baseline, patients completed the self-reported Attentional Control Scale and the Rapid Serial Visual Presentation task (RSVP), a behavioral measure of attentional control. Depressive symptoms were assessed daily using the Patient Health Questionnaire and well-being was assessed using the Mental Health Continuum Short Form.

Results: On average, greater self-reported attentional control was significantly associated with lower depressive symptoms, β = -0.49, t(52) = 4.84, p < .001, 95% CIs [-0.69, -0.29], and greater well-being, β = 0.45, t(53) = 3.90, p < .001, 95% CIs [0.22, 0.67]. More accurate task-based performance was associated with a decline in depressive symptoms over time, β = -0.02, t(32) = 2.50, p = .02, 95% CIs [-0.04, -0.01]. Neither self-reported nor performance-based measures of attentional control predicted changes in well-being. Finally, exploratory analyses suggest that depressive symptoms also improved over time for individuals who underestimated self-reported attentional control abilities relative to task-based performance, β = -0.19, t(32) = 2.23, p = .03, 95% CIs [-0.36, -0.02].

Conclusions: Results suggest that performance-based attentional control may be an important target for assessment and intervention, as well as a potential mechanism underlying risk and recovery.