Systematic review of executive function as a predictor of psychotherapy outcomes

Abstract

Background. Executive functioning is associated with important domains of human life, including individual goal attainment and mental health. Research has identified executive function as a potential transdiagnostic factor, which could explain existing variance in who benefits from psychotherapy. Objectives. This systematic review synthesises evidence regarding executive function as a predictor or moderator of psychotherapy outcome in adults. Methods. Reports were identified through searches in electronic bibliographic databases (MEDLINE, EMBASE, PsycINFO, The Cochrane Library, ClinicalTrials.gov Epistemonikos). Three reviewers independently screened abstracts and collectively confirmed study eligibility. Results were synthesised in a narrative form. Results. Findings display marked clinical and methodological heterogeneity, but indicate that executive function measures positively predict therapy outcome across the diagnostic groups investigated. Quality assessments indicate low or unclear methodological quality. Conclusions. The results are inconclusive due to limitations in the body of evidence. Implications of key findings. Recommendations for future research include higher methodological quality of studies, designing studies for investigating executive function as a moderator, combining several approaches for measurement of executive function, and using a common set of executive function predictors.