The Role of Cognitive Control in the Transdiagnostic Conceptualization of "Intrusive Thoughts"

NCT03414619 | Completed

• 1 other identifier: 2017P002114
• Study Type: interventional
• Target: 75
• Locations: 1 country
• Sites: 1

Brief Summary

The investigators are examining whether difficulties with cognitive control (i.e., the ability to stop one's thought process and shift attention) is a common problem across three types of repetitive, negative thinking: obsessions (as seen in obsessive compulsive disorder, OCD), worries (as seen in generalized anxiety disorder, GAD), and ruminations (as seen in major depressive disorder, MDD).

Conditions

Obsessive-Compulsive Disorder; Generalized Anxiety Disorder; Major Depressive Disorder

Keywords

OCD; GAD; MDD; Rumination; Obsession; Worry

Outcome Measures

Primary Outcomes (4)

• Commission Errors on the Go/No Go Task

  In the Go/No Go Task participants press a button immediately upon detecting a target stimulus (e.g., a square), but are told to refrain from responding to a "no go" stimulus (e.g., a cross of similar size). The main outcome is commission errors (i.e., responding to a "no go" stimulus).

  Day 1

• Response time on the Stroop Color Word Test

  In the Stroop Color Word Test participants are asked to name the color of the ink in which words are printed, rather than reading the words.

  Day 1

• Perseverative Errors on the Wisconsin Card Sort Test

  In the Wisconsin Card Sort Test participants are asked to match a stack of response cards to four stimulus cards without knowing the matching rule. They receive feedback for each trial about whether their matching was correct or not. After ten consecutive correct trials, the matching criterion changes without notice requiring the use of flexible goal-driven strategies.

  Day 1

• Gaze latency on the Attentional Engagement-Disengagement Task

  In the Attentional Engagement-Disengagement Task two emotional facial stimuli are presented on the computer screen (i.e., happy, disgusted, fearful, and sad faces paired with neutral faces) and eye tracking (when participants shift from the emotional to neutral face and vice versa) is measured.

  Day 1

Secondary Outcomes (2)

• Perseverative Thinking Questionnaire (PTQ)

  Day 1

• State measure of intrusive thinking

  Day 1

Study Arms (2)

Intrusive Thoughts Group

EXPERIMENTAL

Clinically significant intrusive thought in the domain of obsessions, worries, or depressive ruminations with a score above the clinical mean (≥ 37) on the trait repetitive negative thinking measure (Perseverative Thinking Questionnaire, PTQ). These participants will receive the Cognitive Control Tasks and Script Driven Imagery Intervention.

Behavioral: Cognitive Control Tasks and Script Driven Imagery

Non-psychiatric Control Group

EXPERIMENTAL

A score 1 SD below the community mean (≤ 15) on the trait repetitive negative thinking measure (Perseverative Thinking Questionnaire, PTQ). These participants will also receive the Cognitive Control Tasks and Script Driven Imagery Intervention.

Behavioral: Cognitive Control Tasks and Script Driven Imagery

Interventions

Cognitive Control Tasks and Script Driven Imagery BEHAVIORAL

All participants will receive a structured diagnostic assessment and complete self-report questionnaires about cognitive factors and anxiety/mood symptoms. They then will complete a battery of neuropsychological executive functioning tasks on the computer, each of which measures a different facet of cognitive control (i.e., response inhibition, cognitive flexibility, and attentional control). Finally, they will be guided through a standardized script-driven imagery paradigm that involves generating and listening to an individualized imaginal script associated with a moderately distressing intrusive thought. Self-report and psychophysiological data will be collected during this exercise.

Intrusive Thoughts Group; Non-psychiatric Control Group

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: Yes
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Adults (age 18+)
• Intrusive thoughts group: Clinically significant intrusive thought in the domain of obsessions, worries, or depressive ruminations with a score above the clinical mean (≥ 37) on the trait repetitive negative thinking measure (Perseverative Thinking Questionnaire, PTQ)
• Non-psychiatric control (NPC) group: A score 1 SD below the community mean (≤ 15) on the trait repetitive negative thinking measure (PTQ)
• Sufficient fluency of English to understand study procedures and questionnaires
• Ability to provide informed consent.
• Comfortable and capable of using a computer and completing reaction-time tasks.

You may not qualify if:

• Acute psychosis, mania, or suicidality
• Diagnosis of post-traumatic stress disorder (PTSD; in order to preserve diagnostic clarity of the domains of intrusive thoughts under investigation)
• Serious neurological disorder or impairment (e.g., brain damage, blindness), attention deficit hyperactivity disorder (ADHD), intellectual disability, or autism.

Sponsors & Collaborators

• Massachusetts General Hospital: lead
• Health Resources in Action, Inc.: collaborator

Study Sites (1)

Massachusetts General Hospital

Boston, Massachusetts, 02114, United States

Location

Related Publications (1)

• Daniel KE, Wilhelm S, Jacoby RJ. Predictors of polyregulation and its effectiveness following exposure to One's most personally distressing intrusive thought. J Behav Ther Exp Psychiatry. 2025 Mar;86:102001. doi: 10.1016/j.jbtep.2024.102001. Epub 2024 Dec 1.

  PMID: 39626971 DERIVED

MeSH Terms

Conditions

Obsessive-Compulsive Disorder; Generalized Anxiety Disorder; Depressive Disorder, Major; Rumination Syndrome; Obsessive Behavior

Condition Hierarchy (Ancestors)

Anxiety Disorders; Mental Disorders; Depressive Disorder; Mood Disorders; Gastrointestinal Diseases; Digestive System Diseases; Feeding and Eating Disorders; Behavioral Symptoms; Behavior

Study Officials

• Ryan J Jacoby, Ph.D.

  Massachusetts General Hospital

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NON RANDOMIZED
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Ryan Jane Jacoby, Ph.D., Clinical Psychologist, OCD and Related Disorders Program

Model Details: The current study has two diagnostic arms (the Intrusive Thoughts group and the Non-Psychiatric Control group) all receiving a single interventional protocol.

Study Record Dates

• First Submitted: January 23, 2018
• First Posted: January 30, 2018
• Study Start: May 18, 2018
• Primary Completion: March 6, 2020
• Study Completion: March 6, 2020
• Last Updated: March 18, 2020

Record last verified: 2020-03

Data Sharing

• IPD Sharing: Will not share

Locations

US (1)