(PS9-A21) The Association of Treatment Credibility with Clinical Outcomes Following Computerized Cognitive Training

Mental health treatment is increasingly incorporating online, remote, and computerized options to facilitate social-distancing and appointment attendance, but more research is necessary to understand how computerized modalities are perceived and relate to outcomes. Patient-perceived treatment credibility (i.e., beliefs about how logical, suitable and efficacious a treatment will be) are associated with treatment outcomes. Credibility relies in part on therapeutic alliance, with greater therapeutic alliance linked to better clinical outcomes in standard psychotherapy. Computerized cognitive training techniques are an alternative treatment approach that can improve cognitive control and reduce mental health symptoms. Computerized cognitive training involves minimal therapeutic alliance and can be administered remotely online, therefore it may be a promising, low-cost, low-burden treatment approach. There is a paucity of research investigating the impact of treatment credibility on clinical outcomes following this type of computerized intervention. The present study sought to investigate the influence of participants’ treatment credibility on cognitive and symptom severity change in participants with post-traumatic stress disorder (PTSD). The present study included data from two randomized controlled trials of 37 veterans (10 female) and 37 civilian women with PTSD. In both trials participants were randomly assigned to complete a computerized cognitive training condition or a control condition. Cognitive performance and PTSD symptoms were assessed before and after treatment through the working memory span task and Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). A linear regression analysis was used to investigate if change in credibility score predicted change in PTSD symptoms and cognitive performance. In both veterans and civilians, PTSD symptom severity significantly decreased after treatment, p< .001. Change in credibility did not significantly predict change in veterans’ or civilians’ PTSD symptom severity, p=.076; p=0.75 or cognitive performance, p=.93; p=0.58, respectively. The present study investigated the association between treatment credibility and clinical outcomes. All participants rated the treatment as credible and reported a significant improvement in PTSD symptoms, but change in treatment credibility was not associated with changes in symptoms or cognition.  Although previous research indicates treatment credibility predicts treatment outcome in traditional psychotherapeutic treatment, the results suggest that credibility may play a less significant role in computerized cognitive training. Further understanding treatment credibility may aid in designing more effective computerized treatment.