New research published in Psychological Medicine provides evidence that a common psychotherapeutic strategy can enhance performance during a reinforcement learning task. The study indicates that cognitive distancing improves decision-making by making people more deliberate in their choices and heightening their sensitivity to adverse results. These changes in how people learn from outcomes might explain why cognitive distancing is helpful in managing emotions.
Emotion regulation difficulties are prevalent across psychiatric disorders, and effective psychological treatments have been shown to improve these difficulties. Cognitive distancing, where individuals distance themselves from negative thoughts and emotions, is a fundamental technique in cognitive behavioral therapy (CBT) and other therapies. It aims to promote disengagement from intense emotions and reduce distress.
In essence, cognitive distancing involves mentally stepping back from immediate reactions and viewing situations from a more objective and calm perspective. By adopting the viewpoint of an external observer, individuals can gain psychological distance from their intense emotions and negative thoughts.
In contrast to the advancements in understanding the pharmacological mechanisms of psychiatric treatments, the mechanisms underlying psychological interventions remain unclear. Since reward learning is impaired in many psychiatric disorders and is targeted by both pharmacological and psychological treatments, the researchers aimed to investigate whether cognitive distancing could impact reward learning in a manner similar to pharmacological interventions.
“The mechanisms of current treatments for mental ill-health – both how they work, and why, for many, they don’t work – remain poorly understood. This is especially true for psychological therapies such as cognitive behavioural therapy,” explained study author Quentin Dercon, a PhD student at University College London.
“However, it has long been thought that pharmacological (drug-based) treatments such as antidepressants may act through their effects on neurotransmitter systems to resolve biases in learning and decision-making, which are known to emerge in conditions such as depression. We were interested in testing whether a specific technique taught in many modalities of psychological therapy – ‘cognitive distancing’ – may also acutely affect simple learning processes, as this could help to explain how emotion regulation strategies such as distancing may help to resolve symptoms of mental ill-health.”
To test this hypothesis, the researchers recruited a diverse group of participants through the Prolific platform. This online study comprised a reinforcement learning task and a series of psychiatric questionnaires. Out of the 995 participants, half received a cognitive distancing intervention, whereas the other half did not.
Participants were divided into two groups: one received a cognitive distancing intervention, while the other did not. The reinforcement learning task involved choosing between pairs of Japanese Hiragana characters associated with different reward probabilities.
The researchers found that participants who underwent the cognitive distancing intervention performed better on the reinforcement learning task. They exhibited improved accuracy in choosing symbols associated with different reward probabilities, particularly in pairs with closer reward probabilities. This suggested that cognitive distancing might have enhanced participants’ ability to learn from feedback and make more advantageous choices.
“We found that teaching people a technique borrowed from psychological therapy was sufficient to induce subtle changes in how they learned the value of choices while playing a simple game, and improved their overall performance compared to control participants,” Dercon told PsyPost. “This was despite the fact that this intervention – known as ‘cognitive distancing’ – was subtle and self-guided: participants were simply told to try to control their immediate emotional response to feedback (i.e., being told whether they were ‘correct’ or ‘incorrect’) after making choices.
“Our work provides some preliminary evidence that techniques taught in psychological therapy may help improve symptoms of mental ill-health by encouraging people to change how they view and learn from information in the world, processes which are known to be biased in mental health disorders such as depression and anxiety.”
Importantly, the study revealed that cognitive distancing led to alterations in reinforcement learning processes. Distanced participants exhibited higher inverse temperature values, indicating a decreased level of stochasticity in their choices. In other words, they were more likely to consistently choose the option that had a higher expected reward, rather than making more exploratory or random choices. Distanced participants also demonstrated increased sensitivity to negative feedback.
“We found evidence that, compared to control participants, participants practicing cognitive distancing had higher negative learning rates, which means that they more quickly replaced old information about the value of certain choices with new information when that information was negative (i.e., being told that choice was ‘incorrect’),” Dercon explained.
“This is counterintuitive, given we would expect biases towards negative information to be associated with poorer mental health. However, in the context of our experiment, this was not associated with worse performance – in fact, those in the distancing group on average performed slightly better in the task.”
“In exploratory analyses, we found some clues as to why this may be the case – this bias (relative to control participants) appeared to emerge later in the task, when some learning had taken place, and so negative information may be rarer but also potentially more informative. This is why we speculate that this may represent more effective engagement with negative information.”
Previous studies have found that the use of antidepressant medications can also lead to heightened sensitivity to negative outcomes. This indicates that psychological interventions like cognitive distancing and pharmaceutical treatments such as antidepressants might share a common mechanism.
While the new study provides important insights into the effects of cognitive distancing on decision-making, the research has a few limitations to consider. Dercon highlighted three significant caveats. Firstly, the participants recruited for the study represented the general population, encompassing a variety of psychiatric symptoms. Therefore, the conclusions drawn from this research might not directly extend to clinical populations that specifically receive psychological interventions.
Secondly, “this is an acute intervention (and a subtle one at that) – it cannot be seen as analogous to the effects of long-term psychological therapy.” Lastly, the researchers were unable to assess how effectively individuals were applying cognitive distancing during the study. Consequently, substantial variations likely existed among participants within the group practicing cognitive distancing.
These limitations underscore the need for further research to unravel the interactions between cognitive interventions, psychological processes, and mental health outcomes, Dercon explained: “Do psychological interventions such as distancing modulate learning processes similarly in those with high levels of (e.g., depression) symptoms? Do changes in learning processes mediate the positive effects of psychotherapeutic techniques such as distancing longitudinally? What factors predict how well an individual can engage with and benefit from psychotherapeutic techniques such as distancing, and psychological therapies more broadly?”
The study, “A core component of psychological therapy causes adaptive changes in computational learning mechanisms“, was authored by Quentin Dercon, Sara Z. Mehrhof, Timothy R. Sandhu, Caitlin Hitchcock, Rebecca P. Lawson, Diego A. Pizzagalli, Tim Dalgleish, and Camilla L. Nord.
