Can electronic diary compliance yield information on cognitive control in remitted depressed- and never-depressed individuals? Insights from a multi-study analysis

Major Depressive Disorder (MDD) is associated with cognitive control deficits that often persist after remission, affecting daily life functioning and increasing relapse risk. Residual symptoms such as negative affect and low motivation may impede cognitive control and thereby hamper goal directed behavior, and as such functioning in daily life. This study examined whether goal-directed behavior, for which we took compliance in responding to daily questionnaires in an experience sampling method (ESM) study as a proxy, 1) could reflect cognitive control allocation, 2) differs over time in individuals with remitted MDD compared to never-depressed (ND) individuals, and 3) relates to factors associated with cognitive control allocation and depressive vulnerability, including positive and negative affect, rumination, sleep quality, motivation, and lack of interest. Remitted MDD (rMDD) and ND individuals participated in three studies with daily (5 to 10) ESM measurements over a period of two weeks to four months. ESM compliance (calculated as the mean response rate and variability (SD) in response rate), inhibitory control (assessed with the Sustained Attention to Response Task), and factors related to depressive relapse vulnerability (positive and negative affect, rumination, sleep quality, motivation, and lack of interest) were assessed. Kendall’s correlations and Linear Mixed Effect models examined the relationships between ESM compliance, inhibitory control, and depressive vulnerability factors. Linear mixed effect models showed no evidence for a relationship (∆AIC below -2) between lab-based cognitive control and compliance. However, correlational analyses showed a positive relationship between mean compliance and inhibitory control [τb = .32, p=0.002; BF10=23.1] and a negative relationship between compliance variability and inhibitory control [τb = -.28, p=0.005; BF10=8.7]. The strength of the correlation was comparable to negative affect, which was also found to relate to mean compliance [τb = -0.20; p below 0.001; BF10=2091.4] and compliance variability [τb = 0.20; p below 0.001; BF10=1896.3]. Changes in compliance over days did not differ between rMDD and ND individuals (∆AIC below -2). No significant associations between compliance and other vulnerability factors were observed (p below 0.05).These findings indicate mixed evidence for ESM compliance as a reflection of cognitive control, with correlations suggesting that cognitive control and negative affect are associated with compliance. No significant associations with other vulnerability factors were found. Future research could explore the utility of ESM compliance in assessing cognitive control and goal pursuit using an optimized design for that question.