Towards targeted prevention of depression: A pilot study on just-in-time application of cognitive control training with booster sessions

Background:Cognitive control deficits that persist following remission from depression are known to increase the risk of relapse. Cognitive Control Training (CCT) has shown promise in improving these impairments, but is typically delivered according to a fixed schedule, irrespective of individual symptom trajectories. This study examined whether delivering just-in-time CCT booster sessions, tailored to personal depressive symptom patterns, could enhance outcomes.Methods:In a randomized controlled trial, 138 remitted depressed individuals first completed a 10-session fixed CCT schedule. Following this, participants were randomly assigned to either a booster group receiving just-in-time CCT booster sessions or a control group receiving no additional training. Outcome measures included depressive symptoms (PHQ-9) as the primary outcome, and secondary outcomes such as repetitive negative thinking, maladaptive and adaptive emotion regulation strategies, and cognitive control. Linear mixed-effects models were used to assess changes over time and group differences.Results:There were no significant clinical effects of adding just-in-time booster sessions compared to the control condition. Conclusions: Although no significant clinical or cognitive effects were observed, this study offers an innovative framework for adapting cognitive training delivery based on personal depression trajectories. The findings may inform the development of future personalized prevention strategies in depression care.Trial registration:This trial was registered at ClinicalTrials.gov (NCT05557760). The trial was prospectively registered prior to enrollment of the first participant.