RESULTS: Post-cognitive behavioral therapy, a significant decrease was observed in Beck Depression Inventory-II, Mental Defeat Scale, Cognitive Flexibility Scale, and Patient Health Questionnaire-9 scores. Together, these findings suggest that the CCFQ taps into processes related to effective coping. Since the data in the present study were cross-sectional, mediation analyses were not intended to address causality. Prior to these analyses, an Exploratory Structural Equation Model (ESEM) was used to confirm the two-factor structure of the CCFQ and to test alternative models. However, as the present study included only females, it is remains uncertain whether a similar pattern of results would be observed amongst males. The questionnaire measures 2 aspects of cognitive flexibility: – the ability to perceive and generate many alternative solutions – the Alternatives subscale, – a tendency to perceive difficult situations as controlla-ble – the Control subscale [22]. These additional validation measures were also used to investigate distinct and overlapping features of the Cognitive Flexibility Inventory and the CCFQ. doi: 10.1007/s10608-015-9702-8. To this end, a brief (18-item) self-report measure – the Cognitive Control and Flexibility Questionnaire (CCFQ) – was developed. In the Emotion Regulation Questionnaire, reappraisal largely refers to “changing what I’m thinking about” to either reduce negative emotions or enhance positive emotions (Gross and John, 2003). In Study 2 (N = 368), lower scores on the CCFQ were related to more negative stressor appraisals (i.e., greater perceived threat and uncontrollability) of a personally meaningful stressful event. The CCFQ in Relation to Stressor Appraisals and Coping Style, Study 3. Ther. It was hypothesized that the CCFQ would more directly tap into cognitive control and emotional regulation, whereas the Cognitive Flexibility Inventory would be more aligned with flexibility in coping. Cognitive control: easy to identify but hard to define. Statistical analyses were performed using SPSS version 20 for Windows (SPSS Science, Chicago, IL, United States). Once the TSST (or control task) were completed, participants filled out several questionnaires concerning stressor appraisals, mood state, and cognitive flexibility. doi: 10.1037/h0059831, Gross, J. J., and John, O. P. (2003). Thus, further exploration into how cognitive control and flexibility might be apparent in these contexts might be important, especially in understanding how reductions in these abilities might favor mental health disturbances. Cognition 115, 458–465. Some features of the site may not work correctly. Finally, the CCFQ was intended to measure trait-like abilities which can, however, be diminished following chronic or prolonged stressor exposure. Neuropsychologia 46, 224–232. In sum, the two-factor model with the four residual correlations provided the best absolute fit and relative fit to the data. Upon completion of the study, participants received written debriefing and were compensated with course credit. Accordingly, we propose that cognitive control and flexibility can, in fact, be expressed multiple ways. Comparison of five rules for determining the number of components to retain. Furthermore, whereas problem-focused coping was more aligned with the appraisal and coping flexibility subscale, emotion-focused and avoidant coping were more strongly linked to the cognitive control over emotion subscale of the CCFQ. These data are consistent with the view that these specific appraisal dimensions are particularly linked to depressive characteristics, and speak to the tendency to interpret (negative) life events as particularly threatening and beyond the individual’s control in promoting elevated and sustained depressive affect (Beck et al., 1979; Folkman and Lazarus, 1986; Abramson et al., 1989). Neurosci. The ‘Trier Social Stress Test’ — a tool for investigating psychobiological stress responses in a laboratory setting. These findings were unique to cognitive control over emotion, as the appraisal and coping flexibility component of the CCFQ did not moderate the effects of stressor condition on negative affect, ΔR2 = 0.02, F(1,42) = 1.72, p = 0.20. 29, 14–24. Responses ranged on a six-point scale from 0 (not at all) to 6 (extremely), with higher scores indicating greater intensity of negative affect (α = 0.89). Biobehav. Greater scores on both subscales of the CCFQ were related to less perceived threat; instead the situation was appraised as a challenge and more controllable. TABLE 2. doi: 10.1073/pnas.1206608109, Goldfarb, E. V., Froböse, M. I., Cools, R., and Phelps, E. A. In the formula below, Cort represents the absolute cortisol value in μg/dl and T refers to the length of time between cortisol sample collections. Cognitive control, and the processes underlying this ability (executive functions) have also been implicated in self- and emotional-regulation, as well as mental health outcomes (Gotlib and Joormann, 2010; Hofmann et al., 2012). The residual correlations were between: (1) “My thoughts and emotions interfere with my ability to concentrate” and “I get easily distracted by upsetting thoughts or feelings,” (2) between “I consider the situation from multiple viewpoints before responding” and “I take the time to see things from different perspectives before reacting,” (3) between “I can remain in control over my thoughts and emotions” and “I control my thoughts and feelings by putting the situation in context,” and (4) between “I take the time to think of several ways to best cope with the situation before acting” and “I control my thoughts and feelings by putting the situation in context.” Because the wording for each pair of items was similar, we elected to include the residual correlations in the model to account for additional method variance. Post-cognitive behavioral therapy, a significant decrease was observed in Beck Depression Inventory-II, Mental Defeat Scale, Cognitive Flexibility Scale, and Patient Health Questionnaire-9 scores. 12, 128–139. Aging Neurosci. The only notable decrease in the correlation between the CCFQ and depressive symptoms appeared to occur when controlling for perseverative thinking and rumination. doi: 10.1023/A:1005591412406. Cognitive dysfunction in unipolar depression: implications for treatment. Participants responded to each statement on a scale ranging from 1 (strongly disagree) to 7 (strongly agree). Neurosci. Finally, Study 3 examined whether differences in CCFQ scores moderated the effects of an acute stressor on cognitive, affective, and neuroendocrine responses following the challenge. 108:624. doi: 10.1037//0033-295X.108.3.624, Cañas, J., Quesada, J., Antolí, A., and Fajardo, I. Neurosci. Perspect. doi: 10.1007/s00296-011-1975-y. A behavioral analysis of degree of reinforcement and ease of shifting to new responses in a Weigl-type card-sorting problem. For example, it is possible that an individual can be flexible in certain situations (e.g., multitasking) but not in others (e.g., emotional regulation). 139, 81–132. The relation between lower CCFQ scores and heightened depressive symptoms was also partially accounted for by less frequent engagement in problem-focused coping and more use of emotion-focused methods. (2003). From a cognitive (neuro)science perspective, cognitive flexibility has been viewed as an aspect of cognitive control (i.e., set-shifting) or the manifestation of multiple cognitive control processes which operate sequentially or in parallel (Dajani and Uddin, 2015; Marko and Riečanský, 2018; Zaehringer et al., 2018). Endocr. Brain Topogr. These findings are in line with reports that more frequent use of emotion-focused and avoidant coping, and limited engagement of problem-focused methods, were notable among depressed individuals (e.g., Whatley et al., 1998; Matheson and Anisman, 2003; Abdollahi et al., 2018). doi: 10.1080/10463281003765323, Nolen-Hoeksema, S., Wisco, B. E., and Lyubomirsky, S. (2008). For example, T1 represents the length of time between the collection of cortisol sample 1 (Cort1) and sample 2 (Cort2). Thought Control Questionnaire (TCQ). Concern has also been expressed that cognitive flexibility lacks a unified definition, and that an unrestricted perspective can result in very different constructs under the same name (Ionescu, 2012). Psychometric Properties of a Russian Version of the Cognitive Flexibility Inventory (CFI-R), Investigating the Reliability and Validity of the Cognitive Flexibility Inventory (CFI-I) among Iranian University Students, Development and validation of the Japanese version of cognitive flexibility scale. Natl. 21, 34–77. However, it might be the propensity for individuals who display difficulties of cognitive control and flexibility to specifically appraise stressor as threatening and uncontrollable that promotes sustained negative affect. Rethinking rumination. For instance, beyond repetitive negative thinking, disturbances of cognitive control can also be expressed by difficulties preventing negative emotional information from entering working memory and an inability to disengage such emotional material once it has been attended to (Gotlib and Joormann, 2010). The present research points to the CCFQ as a useful self-report tool to identify ways through which cognitive control and flexibility might be manifested in stressful situations, and how reductions in flexibility might be accompanied by elevated symptoms of depression. Dif. Furthermore, diminished cognitive control over emotion was linked to elevated and prolonged cortisol reactivity following an acute challenge, a neuroendocrine profile that has been associated with depressive illness (Juruena et al., 2017). (2007). Cognitive control and attentional functions. Science 324, 646–648. Psychol. The frontal assessment battery (FAB) reveals neurocognitive dysfunction in substance-dependent individuals in distinct executive domains: Abstract reasoning, motor programming, and cognitive flexibility. 61, 154–162. Neurosci. doi: 10.1162/jocn_a_01029, Gotlib, I. H., and Joormann, J. These findings suggest that the CCFQ captures aspects of cognitive control and of cognitive flexibility that might be relevant to stressful situations. doi: 10.1073/pnas.0807041106, Logue, S. F., and Gould, T. J. As displayed in Table 2, the cognitive control over emotion component of the CCFQ was more strongly linked to the control subscale of the Cognitive Flexibility Inventory. Kline, R. B. The Stress Appraisal Measure (SAM; Peacock and Wong, 1990) assessed several appraisal dimensions in response to the academic stressor including, perceptions of threat, challenge, centrality, control-by-self, control-by-others, and uncontrollable-by-anyone. (2013). doi: 10.1016/j.jad.2013.09.012, Vriezekolk, J. E., van Lankveld, W. G., Eijsbouts, A. M., van Helmond, T., Geenen, R., and van den Ende, C. H. (2012). 53, 79–92. Trends Cogn. Thus, greater cognitive control over emotion, or the ability to disengage from negative cognitive and emotional states, might not only serve to regulate emotions effectively, but might also play a role in regulating the cortisol response associated with a stressful situation. Nat. Following the 30-min habituation period involved in completing these measures, participants provided a baseline saliva sample (for cortisol determination) and were randomly assigned to either the stressor or control condition. The 18-item CCFQ was used to measure individual differences in cognitive control over emotion (α = 0.88) and appraisal and coping flexibility (α = 0.91). Moreover, the reappraisal process involves shifting “cognitive sets” that are elicited by a stressor, and thus this might be another way through which cognitive flexibility becomes apparent in stressful situations. As predicted, the TSST elicited greater negative affect than the control condition (b = 37.17, SE = 9.43, p < 0.001), but this effect depended on differences of cognitive control over emotion, ΔR2 = 0.08, F(1,42) = 0.7.35, p < 0.01. As assessed by the CCFQ, reduced cognitive control over emotion was associated with increased repetitive thinking and rumination, elevated negative affect following a stressful situation, and ultimately heightened symptoms of depression. Thus, cognitive flexibility as assessed by the CCFQ might not contribute to differences in overall perceived stressfulness concerning an acute challenge. 7, 134–140. ESEM was used to confirm the structure of the CCFQ. Although mental defeat and cognitive flexibility did not reach the level of the healthy control group, they demonstrated improvement. doi: 10.1016/j.concog.2008.12.008, Mordecai, K. L., Rubin, L. H., Eatough, E., Sundermann, E., Drogos, L., Savarese, A., et al. Together, these preliminary factor analyses and reliability assessments suggest that the CCFQ exhibits a stable two-factor structure in a student and community sample. The Wisconsin Card Sorting Test and the cognitive assessment of prefrontal executive functions: a critical update. doi: 10.1001/archpsyc.1961.01710120031004, Benedek, M., Franz, F., Heene, M., and Neubauer, A. C. (2012). No use, distribution or reproduction is permitted which does not comply with these terms. As expected, the CCFQ was correlated with the Cognitive Flexibility Inventory, suggesting some degree of content overlap between the two questionnaires. Selecting and Training Interviewers The cognitive test questionnaire was developed to be easily administered. 30, 190–200. The appraisal and coping flexibility dimension of the CCFQ assessed an individual’s perceived ability to engage in a set of deliberate effortful behaviors that can facilitate a comprehensive and favorable appraisal of a stressful situation as well as the selection of a broad range of coping strategies. Cortisol Area Under the Curve increase (AUCi; Pruessner et al., 2003) was computed to examine changes, represented by a single value, in cortisol levels elicited by the stressor and control tasks. As a final objective, the present study determined whether the CCFQ was able to capture aspects of cognitive control/flexibility that might be relevant to depressive disorders that are not measured by other questionnaires related to this construct. To be sure, the CCFQ was not developed as a diagnostic instrument, but instead was intended to compliment behavioral paradigms in determining common as well as different aspects of cognitive control and flexibility that are disturbed among individuals with depressive pathology. doi: 10.1017/S0140525X00002429, Sapolsky, R. M., Romero, L. M., and Munck, A. U. doi: 10.1016/j.tics.2005.03.010, Ochsner, K. N., Silvers, J. doi: 10.1016/j.tins.2015.07.003, Davis, R. N., and Nolen-Hoeksema, S. (2000). However, when negative appraisals are applied across situations without considering different characteristics of the various contexts, sustained negative mood is apt to occur (Lackner et al., 2015). However, encountering chronic stressors can progressively diminish these abilities (Liston et al., 2009), which could comprise effective emotional regulation. Atypical depression and non-atypical depression: Is HPA axis function a biomarker? 16, 174–180. 1, 293–319. 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