6 Cognitive Tests for Research of Depression and Mood Disorders

Source: Cambridge Cognition website URL: https://cambridgecognition.com/6-cognitive-tests-for-research-of-depression-and-mood-disorders/ Accessed: 2026-06-11

Overview

Mood disorders affect 5-10% of the adult population in a given year (Waraich et al., 2004; Steel et al., 2014). The most common mood disorders are major depressive disorder, dysthymia, and bipolar disorder. In the WHO Global Burden of Disease study, depression was second only to ischaemic heart disease in terms of associated disability (Murray & Lopez, 1996).

Patients with depression frequently report subjective cognitive slowing and difficulty concentrating. Objectively measured cognitive dysfunction affects memory, attention, and executive function (Rock et al., 2013). Some deficits persist following remission, potentially impacting occupational function even after mood improvement.

CANTAB has a six-test battery specifically designed to assess cognition in studies of depression and mood disorders for both academic research and clinical trials.

1. One Touch Stockings of Cambridge (OTS)

Cognitive Domain: Executive function, spatial planning, working memory Based on: Tower of Hanoi test

Task: The participant is shown two displays of coloured balls held in stockings suspended from a beam. A row of numbered boxes appears along the bottom. The participant must work out how many moves are needed to match the bottom arrangement to the top arrangement, then touch the appropriate box.

Why for Depression: Patients with mood disorders often experience difficulties in executive functions such as planning, assessed by OTS (Rock et al., 2013).

2. Delayed Matching to Sample (DMS)

Cognitive Domain: Forced choice recognition memory for non-verbalisable patterns; simultaneous matching and short-term visual memory.

Task: The participant is shown a complex visual pattern, then after a brief delay, four patterns appear. The participant must touch the pattern matching the sample. Some trials are simultaneous; others have delays of 0, 4, or 12 seconds.

Why for Depression: Depressed patients show memory deficits. DMS is sensitive to these impairments and can assess changes over time in response to interventions.

3. Emotion Recognition Task (ERT)

Cognitive Domain: Ability to identify emotions in facial expressions; six basic emotions.

Task: Computer-morphed images derived from real individuals, each showing a specific emotion, are displayed one at a time for 200ms then immediately covered. The participant selects which emotion was displayed from six options. Brief presentation encourages implicit processing rather than conscious appraisal.

Why for Depression: Depressed individuals provide more negative ratings of emotional expressions (Kellough et al., 2008; Linde et al., 2015; Grady & Stahl, 2013), reflecting the well-known negative bias where positive or neutral stimuli are seen as more negative.

4. Spatial Working Memory (SWM)

Cognitive Domain: Retention and utilisation of visuospatial information; self-ordered; provides insight into executive function through strategy use.

Task: An array of coloured boxes contain tokens which participants search for by touching boxes. The number of boxes increases, making the task harder. Participants must not return to a box in which they previously found a token.

Why for Depression: Patients with depression have moderate impairments in working memory (Rock et al., 2013). Working memory is critical for everyday tasks.

5. Rapid Visual Information Processing (RVP)

Cognitive Domain: Sustained visual attention; continuous performance.

Task: Single digits appear in the centre of the screen at 100 per minute. Target sequences are displayed on the right. When the participant detects a sequence they press a blue button. There are 9 target sequences per minute.

Why for Depression: Sustained attention is impaired in depression (Rock et al., 2013).

6. Cambridge Gambling Task (CGT)

Cognitive Domain: Decision making and risk-taking behaviour outside a learning context.

Task: Participants decide whether a token is hidden behind a red or blue box, then bet a proportion of their points on the decision. The odds are made explicit by the ratio of red to blue boxes.

Why for Depression: As information from one trial does not inform the next, CGT places limited demands on learning and working memory, offering a clean measure of decision-making under risk. Decision-making under risk is typically impaired in depression (Clark et al., 2011).

Clinical Context

Psychotherapy (notably CBT) has a strong evidence base. Despite various treatment options, there is no universally successful intervention — patients experience high relapse rates and frequent persistence of cognitive symptoms after mood improves. Current research focuses on treatments that ameliorate cognitive impairment in mood disorders and on objective markers to identify the most effective treatment for each individual.

Why CANTAB for Depression Research

• Cognitive deficits reflect underlying dysfunction of monoamine neurochemical systems (Pringle et al., 2011) and emotional processing circuitry (Clark et al., 2009)
• Deficits represent core targets for existing and novel treatments (Ressler & Mayberg, 2007; Maalouf et al., 2010)
• Battery covers: sustained attention, delayed matching to sample, spatial working memory, executive function, planning, emotional recognition, decision-making under risk
• Discriminates neuropsychological profile of bipolar disorder from unipolar depression (Muralidharan et al., 2015)
• Differentiates effects of different medications (Clark et al., 2011)
• Avoids floor and ceiling effects through carefully chosen ranged task difficulties
• Cognitive performance correlates with quality of life, even early in bipolar disorder (Mackala et al., 2014)

References

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2. Steel Z, et al. (2014). Global prevalence of common mental disorders. Int J Epidemiol, 43(2):476-93.
3. Murray CJL, Lopez AD (1996). The global burden of disease. Geneva: WHO.
4. Rock PL, et al. (2013). Cognitive impairment in depression: a systematic review and meta-analysis. Psychol Med, 44(10):2029-2040.
5. Kellough JL, et al. (2008). Time course of selective attention in clinically depressed young adults. Behav Res Ther, 46:1238-1243.
6. Linde K, et al. (2015). Comparative effectiveness of psychological treatments for depressive disorders. BMC Fam Pract, 16:103.
7. Grady MM, Stahl SM (2013). Novel agents in development for the treatment of depression. CNS Spectr, 18 Suppl 1:37-40.
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12. Muralidharan K, et al. (2015). Are cognitive deficits similar in remitted early bipolar I disorder patients treated with lithium or valproate? Eur Neuropsychopharmacol, 25(2):223-30.
13. Mackala SA, et al. (2014). Cognitive performance and quality of life early in bipolar disorder. J Affect Disord, 168:119-24.
14. Clark L, et al. (2011). Impairment in risk-sensitive decision-making in older suicide attempters with depression. Psychol Aging, 26(2):321-330.