The role of individual differences in cognitive training and transfer

Working Memory Training Does Not Improve Performance on Measures of Intelligence or Other Measures of "Far Transfer": Evidence From a Meta-Analytic Review

It has been claimed that working memory training programs produce diverse beneficial effects. This article presents a meta-analysis of working memory training studies (with a pretest-posttest design and a control group) that have examined transfer to other measures (nonverbal ability, verbal ability, word decoding, reading comprehension, or arithmetic; 87 publications with 145 experimental comparisons). Immediately following training there were reliable improvements on measures of intermediate transfer (verbal and visuospatial working memory). For measures of far transfer (nonverbal ability, verbal ability, word decoding, reading comprehension, arithmetic) there was no convincing evidence of any reliable improvements when working memory training was compared with a treated control condition. Furthermore, mediation analyses indicated that across studies, the degree of improvement on working memory measures was not related to the magnitude of far-transfer effects found. Finally, analysis of publication bias shows that there is no evidential value from the studies of working memory training using treated controls. The authors conclude that working memory training programs appear to produce short-term, specific training effects that do not generalize to measures of "real-world" cognitive skills. These results seriously question the practical and theoretical importance of current computerized working memory programs as methods of training working memory skills.

Emotional working memory training as an online intervention for adolescent anxiety and depression: A randomised controlled trial

Objective

Anxiety and depression are highly prevalent disorders in adolescence. They are associated with deficits in working memory (WM), which also appears to increase rumination, worry, and negative mood. WM training, especially in an emotional context, might help in reducing or preventing these disorders. The current study investigated the direct effects of online emotional WM training on WM capacity, and short‐ and long‐term effects on symptoms of anxiety and depression, and secondary measures of emotional functioning.

Methods

Unselected adolescents (n = 168, aged 11–18) were randomised over an active or placebo emotional WM training. WM was assessed before and after 4 weeks of bi‐weekly training. Emotional functioning was assessed pre‐ and post‐training and at 3, 6, and 12 months follow‐up.

Results

Improvements in WM capacity and both short‐ and long‐term emotional functioning were found in both training groups, with the only group difference being a trend for a larger increase in self‐esteem in the active group compared to the placebo group.

Conclusions

The general improvements irrespective of training condition suggest non‐specific training or time effects, or some shared active ingredient in both conditions. Future research is necessary to detect potentially effective components of (emotional) WM training and to increase adolescent engagement with online training.

Postoperative Rehabilitation Strategies Used by Adults With Cochlear Implants: A Pilot Study

Objectives/Hypothesis

Aural rehabilitation is not standardized for adults after cochlear implantation. Most cochlear implant (CI) centers in the United States do not routinely enroll adult CI users in focused postoperative rehabilitation programs due to poor reimbursement and lack of data supporting (or refuting) the efficacy of any one specific approach. Consequently, patients generally assume a self‐driven approach toward rehabilitation. This exploratory pilot study examined rehabilitation strategies pursued by adults with CIs and associated these strategies with speech recognition and CI‐specific quality of life (QOL).

Study Design

Cross‐sectional study of 23 postlingually deafened adults with CIs.

Methods

Participants responded to an open‐ended questionnaire regarding rehabilitation strategies. A subset underwent in‐depth interviews. Thematic content analysis was applied to the questionnaires and interview transcripts. Participants also underwent word recognition testing and completed a CI‐related QOL measure. Participants were classified as having good or poor performance (upper or lower quartile for speech recognition) and high or low QOL (upper or lower quartile for QOL). Rehabilitation themes were compared and contrasted among groups.

Results

Five rehabilitation themes were identified: 1) Preimplant expectations of postoperative performance, 2) personal motivation, 3) social support, 4) specific rehabilitation strategies, and 5) patient‐perceived role of the audiologist. Patients with good speech recognition and high QOL tended to pursue more active rehabilitation and had greater social support. Patient expectations and motivation played significant roles in postoperative QOL.

Conclusion

Postoperative patient‐driven rehabilitation strategies are highly variable but appear to relate to outcomes. Larger‐scale extensions of this pilot study are needed.

There is no convincing evidence that working memory training is effective: A reply to Au et al. (2014) and Karbach and Verhaeghen (2014)

The possible cognitive benefits of working memory training programs have been the subject of intense interest and controversy. Recently two meta-analyses have claimed that working memory training can be effective in enhancing cognitive skills in adulthood (Au et al. Behavioural Brain Research 228:(1) 107-115, 2014) and stemming cognitive decline in old age (Karbach & Verhaeghen Psychological Science 25:2027-2037, 2014). The current article critically evaluates these claims. We argue that these meta-analyses produce misleading results because of (1) biases in the studies included, (2) a failure to take account of baseline differences when calculating effect sizes, and (3) a failure to emphasize the difference between studies with treated versus untreated control groups. We present new meta-analyses and conclude that there is no convincing evidence that working memory training produces general cognitive benefits.

Improving fluid intelligence with training on working memory: a meta-analysis

Working memory (WM), the ability to store and manipulate information for short periods of time, is an important predictor of scholastic aptitude and a critical bottleneck underlying higher-order cognitive processes, including controlled attention and reasoning. Recent interventions targeting WM have suggested plasticity of the WM system by demonstrating improvements in both trained and untrained WM tasks. However, evidence on transfer of improved WM into more general cognitive domains such as fluid intelligence (Gf) has been more equivocal. Therefore, we conducted a meta-analysis focusing on one specific training program, n-back. We searched PubMed and Google Scholar for all n-back training studies with Gf outcome measures, a control group, and healthy participants between 18 and 50 years of age. In total, we included 20 studies in our analyses that met our criteria and found a small but significant positive effect of n-back training on improving Gf. Several factors that moderate this transfer are identified and discussed. We conclude that short-term cognitive training on the order of weeks can result in beneficial effects in important cognitive functions as measured by laboratory tests.

Dual N-Back Working Memory Training in Healthy Adults: A Randomized Comparison to Processing Speed Training

Enhancing cognitive ability is an attractive concept, particularly for middle-aged adults interested in maintaining cognitive functioning and preventing age-related declines. Computerized working memory training has been investigated as a safe method of cognitive enhancement in younger and older adults, although few studies have considered the potential impact of working memory training on middle-aged adults. This study investigated dual n-back working memory training in healthy adults aged 30–60. Fifty-seven adults completed measures of working memory, processing speed, and fluid intelligence before and after a 5-week web-based dual n-back or active control (processing speed) training program. Results: Repeated measures multivariate analysis of variance failed to identify improvements across the three cognitive composites, working memory, processing speed, and fluid intelligence, after training. Follow-up Bayesian analyses supported null findings for training effects for each individual composite. Findings suggest that dual n-back working memory training may not benefit working memory or fluid intelligence in healthy adults. Further investigation is necessary to clarify if other forms of working memory training may be beneficial, and what factors impact training-related benefits, should they occur, in this population.

Training of resistance to proactive interference and working memory in older adults: a randomized double-blind study

BACKGROUND

Working memory (WM) performance is often decreased in older adults. Despite the growing popularity of WM trainings, underlying mechanisms are still poorly understood. Resistance to proactive interference (PI) constitutes a candidate process that contributes to WM performance and might influence training or transfer effects. Here, we investigated whether PI resistance can be enhanced in older adults using a WM training with specifically increased PI-demands. Further, we investigated whether potential effects of such a training were stable and entailed any transfer on non-trained tasks.

METHOD

Healthy old adults (N = 25, 68.8 ± 5.5 years) trained with a recent-probes and an n-back task daily for two weeks. Two different training regimens (high vs. low PI-amount in the tasks) were applied as between-participants manipulation, to which participants were randomly assigned. Near transfer tasks included interference tasks; far transfer tasks assessed fluid intelligence (gF) or speed. Immediate transfer was assessed directly after training; a follow-up measurement was conducted after two months.

RESULTS

Both groups similarly improved in PI resistance in both training tasks. Thus, PI susceptibility was generally reduced in the two training groups and there was no difference between WM training with high versus low PI demands. Further, there was no differential near or far transfer on non-trained tasks, neither immediately after the training nor in the follow-up.

CONCLUSION

PI-demands in WM training tasks do not seem critical for enhancing WM performance or PI resistance in older adults. Instead, improved resistance to PI appears to be an unspecific side-effect of a WM training.

High-gamma power changes after cognitive intervention: preliminary results from twenty-one senior adult subjects

INTRODUCTION

Brain-imaging techniques have begun to be popular in evaluating the effectiveness of cognitive intervention training. Although gamma activities are rarely used as an index of training effects, they have several characteristics that suggest their potential suitability for this purpose. This pilot study examined whether cognitive training in elderly people affected the high-gamma activity associated with attentional processing and whether high-gamma power changes were related to changes in behavioral performance.

METHODS

We analyzed (MEG) magnetoencephalography data obtained from 35 healthy elderly subjects (60-75 years old) who had participated in our previous intervention study in which the subjects were randomly assigned to one of the three types of intervention groups: Group V trained in a vehicle with a newly developed onboard cognitive training program, Group P trained with a similar program but on a personal computer, and Group C was trained to solve a crossword puzzle as an active control group. High-gamma (52-100 Hz) activity during a three-stimulus visual oddball task was measured before and after training. As a result of exclusion in the MEG data analysis stage, the final sample consisted of five subjects in Group V, nine subjects in Group P, and seven subjects in Group C.

RESULTS

Results showed that high-gamma activities were differently altered between groups after cognitive intervention. In particular, members of Group V, who showed significant improvements in cognitive function after training, exhibited increased high-gamma power in the left middle frontal gyrus during top-down anticipatory target processing. High-gamma power changes in this region were also associated with changes in behavioral performance.

CONCLUSIONS

Our preliminary results suggest the usefulness of high-gamma activities as an index of the effectiveness of cognitive training in elderly subjects.

Combining brain stimulation and video game to promote long-term transfer of learning and cognitive enhancement

Cognitive training offers the potential for individualised learning, prevention of cognitive decline, and rehabilitation. However, key research challenges include ecological validity (training design), transfer of learning and long-term effects. Given that cognitive training and neuromodulation affect neuroplasticity, their combination could promote greater, synergistic effects. We investigated whether combining transcranial direct current stimulation (tDCS) with cognitive training could further enhance cognitive performance compared to training alone, and promote transfer within a short period of time. Healthy adults received real or sham tDCS over their dorsolateral prefrontal cortices during two 30-minute mathematics training sessions involving body movements. To examine the role of training, an active control group received tDCS during a non-mathematical task. Those who received real tDCS performed significantly better in the game than the sham group, and showed transfer effects to working memory, a related but non-numerical cognitive domain. This transfer effect was absent in active and sham control groups. Furthermore, training gains were more pronounced amongst those with lower baseline cognitive abilities, suggesting the potential for reducing cognitive inequalities. All effects associated with real tDCS remained 2 months post-training. Our study demonstrates the potential benefit of this approach for long-term enhancement of human learning and cognition.

Behavioral Outcome Effects of Serious Gaming as an Adjunct to Treatment for Children With Attention-Deficit/Hyperactivity Disorder: A Randomized Controlled Trial

Background

The need for accessible and motivating treatment approaches within mental health has led to the development of an Internet-based serious game intervention (called “Plan-It Commander”) as an adjunct to treatment as usual for children with attention-deficit/hyperactivity disorder (ADHD).

Objective

The aim was to determine the effects of Plan-It Commander on daily life skills of children with ADHD in a multisite randomized controlled crossover open-label trial.

Methods

Participants (N=170) in this 20-week trial had a diagnosis of ADHD and ranged in age from 8 to 12 years (male: 80.6%, 137/170; female: 19.4%, 33/170). They were randomized to a serious game intervention group (group 1; n=88) or a treatment-as-usual crossover group (group 2; n=82). Participants randomized to group 1 received a serious game intervention in addition to treatment as usual for the first 10 weeks and then received treatment as usual for the next 10 weeks. Participants randomized to group 2 received treatment as usual for the first 10 weeks and crossed over to the serious game intervention in addition to treatment as usual for the subsequent 10 weeks. Primary (parent report) and secondary (parent, teacher, and child self-report) outcome measures were administered at baseline, 10 weeks, and 10-week follow-up.

Results

After 10 weeks, participants in group 1 compared to group 2 achieved significantly greater improvements on the primary outcome of time management skills (parent-reported; P=.004) and on secondary outcomes of the social skill of responsibility (parent-reported; P=.04), and working memory (parent-reported; P=.02). Parents and teachers reported that total social skills improved over time within groups, whereas effects on total social skills and teacher-reported planning/organizing skills were nonsignificant between groups. Within group 1, positive effects were maintained or further improved in the last 10 weeks of the study. Participants in group 2, who played the serious game during the second period of the study (weeks 10 to 20), improved on comparable domains of daily life functioning over time.

Conclusions

Plan-It Commander offers an effective therapeutic approach as an adjunct intervention to traditional therapeutic ADHD approaches that improve functional outcomes in daily life.

Trial Registration

International Standard Randomized Controlled Trial Number (ISRCTN): 62056259; http://www.controlled-trials.com/ISRCTN62056259 (Archived by WebCite at http://www.webcitation.org/6eNsiTDJV).

Investigating the Improvement of Decoding Abilities and Working Memory in Children with Incremental or Entity Personal Conceptions of Intelligence: Two Case Reports

One of the most significant current discussions has led to the hypothesis that domain-specific training programs alone are not enough to improve reading achievement or working memory abilities. Incremental or Entity personal conceptions of intelligence may be assumed to be an important prognostic factor to overcome domain-specific deficits. Specifically, incremental students tend to be more oriented toward change and autonomy and are able to adopt more efficacious strategies. This study aims at examining the effect of personal conceptions of intelligence to strengthen the efficacy of a multidimensional intervention program in order to improve decoding abilities and working memory. Participants included two children (M age = 10 years) with developmental dyslexia and different conceptions of intelligence. The children were tested on a whole battery of reading and spelling tests commonly used in the assessment of reading disabilities in Italy. Afterwards, they were given a multimedia test to measure motivational factors such as conceptions of intelligence and achievement goals. The children took part in the T.I.R.D. Multimedia Training for the Rehabilitation of Dyslexia (Rappo and Pepi, 2010) reinforced by specific units to improve verbal working memory for 3 months. This training consisted of specific tasks to rehabilitate both visual and phonological strategies (sound blending, word segmentation, alliteration test and rhyme test, letter recognition, digraph recognition, trigraph recognition, and word recognition as samples of visual tasks) and verbal working memory (rapid words and non-words recognition). Posttest evaluations showed that the child holding the incremental theory of intelligence improved more than the child holding a static representation. On the whole this study highlights the importance of treatment programs in which both specificity of deficits and motivational factors are both taken into account. There is a need to plan multifaceted intervention programs based on a transverse approach, considering both cognitive and motivational factors.

Task complexity and location specific changes of cortical thickness in executive and salience networks after working memory training

Novel activities and experiences shape the brain's structure and organisation and, hence, our behaviour. However, evidence from structural plasticity studies remains mixed and the neural correlates of learning and practice are still poorly understood. We conducted a robustly designed study into grey matter plasticity following 2 months of working memory training. We generated a priori hypotheses regarding the location of plastic effects across three cognitive control networks (executive, anterior salience and basal ganglia networks), and compared the effects of adaptive training (n=20) with a well-matched active control group (n=20) which differed in training complexity and included extensive cognitive assessment before and after the training. Adaptive training relative to control activities resulted in a complex pattern of subtle and localised structural changes: Training was associated with increases in cortical thickness in right-lateralised executive regions, notably the right caudal middle frontal cortex, as well as increases in the volume of the left pallidum. In addition the training group showed reductions of thickness in the right insula, which were correlated with training-induced improvements in backward digit span performance. Unexpectedly, control activities were associated with reductions in thickness in the right pars triangularis. These results suggest that the direction of activity-induced plastic changes depend on the level of training complexity as well as brain location. These observations are consistent with the view that the brain responds dynamically to environmental demands by focusing resources on task relevant networks and eliminating irrelevant processing for the purpose of energy reduction.

Social Working Memory Training Improves Perspective-Taking Accuracy

Despite the importance of perspective taking for navigating the social world, even healthy adults frequently misinterpret what other people think and feel. Yet, to date, no research examines whether perspective-taking accuracy can be improved among healthy adult samples. Building off of work suggesting that social working memory (SWM) capacity (i.e., the ability to maintain and manipulate social cognitive information in mind) predicts perspective-taking skills, we developed a novel SWM training intervention to test the hypothesis that SWM training improves perspective-taking accuracy. Participants were randomly assigned to complete 12 days of either SWM training or nonsocial, “cognitive working memory” (CWM) training (active control condition). Perspective-taking accuracy was assessed pre- and posttraining. SWM training significantly increased perspective-taking accuracy and these improvements significantly surpassed improvements made by participants who underwent CWM training. SWM training therefore may be an efficient route toward improved perspective-taking accuracy.

Gray matter responsiveness to adaptive working memory training: a surface-based morphometry study

Here we analyze gray matter indices before and after completing a challenging adaptive cognitive training program based on the n-back task. The considered gray matter indices were cortical thickness (CT) and cortical surface area (CSA). Twenty-eight young women (age range 17-22 years) completed 24 training sessions over the course of 3 months (12 weeks, 24 sessions), showing expected performance improvements. CT and CSA values for the training group were compared with those of a matched control group. Statistical analyses were computed using a ROI framework defined by brain areas distinguished by their genetic underpinning. The interaction between group and time was analyzed. Middle temporal, ventral frontal, inferior parietal cortices, and pars opercularis were the regions where the training group showed conservation of gray matter with respect to the control group. These regions support working memory, resistance to interference, and inhibition. Furthermore, an interaction with baseline intelligence differences showed that the expected decreasing trend at the biological level for individuals showing relatively low intelligence levels at baseline was attenuated by the completed training.

Cognitive Bias Modification for adolescents with substance use problems--Can serious games help?

BACKGROUND AND OBJECTIVES

Excessive use of psychoactive substances and resulting disorders are a major societal problem, and the most prevalent mental disorder in young men. Recent reviews have concluded that Cognitive Bias Modification (CBM) shows promise as an intervention method in this field. As adolescence is a critical formative period, successful early intervention may be key in preventing later substance use disorders that are difficult to treat. One issue with adolescents, however, is that they often lack the motivation to change their behavior, and to engage in multisession cognitive training programs. The upcoming use of serious games for health may provide a solution to this motivational challenge.

METHODS

As the use of game-elements in CBM is fairly new, there are very few published studies in this field. This review therefore focuses on currently available evidence from similar fields, such as cognitive training, as well as several ongoing CBM gamification projects, to illustrate the general principles.

RESULTS

A number of steps in the gamification process are identified, starting with the original, evidence-based CBM task, towards full integration in a game. While more data is needed, some steps seem better suited for CBM gamification than others. Based on the current evidence, several recommendations are made.

LIMITATIONS

As the field is still in its infancy, further research is needed before firm conclusions can be drawn.

CONCLUSIONS

Gamified CBM may be a promising way to reach at risk youth, but the term "game" should be used with caution. Suggestions are made for future research.

Individual differences and specificity of prefrontal gamma frequency-tACS on fluid intelligence capabilities

Emerging evidence suggests that transcranial alternating current stimulation (tACS) is an effective, frequency-specific modulator of endogenous brain oscillations, with the potential to alter cognitive performance. Here, we show that reduction in response latencies to solve complex logic problem indexing fluid intelligence is obtained through 40 Hz-tACS (gamma band) applied to the prefrontal cortex. This improvement in human performance depends on individual ability, with slower performers at baseline receiving greater benefits. The effect could have not being explained by regression to the mean, and showed task and frequency specificity: it was not observed for trials not involving logical reasoning, as well as with the application of low frequency 5 Hz-tACS (theta band) or non-periodic high frequency random noise stimulation (101-640 Hz). Moreover, performance in a spatial working memory task was not affected by brain stimulation, excluding possible effects on fluid intelligence enhancement through an increase in memory performance. We suggest that such high-level cognitive functions are dissociable by frequency-specific neuromodulatory effects, possibly related to entrainment of specific brain rhythms. We conclude that individual differences in cognitive abilities, due to acquired or developmental origins, could be reduced during frequency-specific tACS, a finding that should be taken into account for future individual cognitive rehabilitation studies.

Working Memory, Reasoning, and Task Switching Training: Transfer Effects, Limitations, and Great Expectations?

Although some studies have shown that cognitive training can produce improvements to untrained cognitive domains (far transfer), many others fail to show these effects, especially when it comes to improving fluid intelligence. The current study was designed to overcome several limitations of previous training studies by incorporating training expectancy assessments, an active control group, and "Mind Frontiers," a video game-based mobile program comprised of six adaptive, cognitively demanding training tasks that have been found to lead to increased scores in fluid intelligence (Gf) tests. We hypothesize that such integrated training may lead to broad improvements in cognitive abilities by targeting aspects of working memory, executive function, reasoning, and problem solving. Ninety participants completed 20 hour-and-a-half long training sessions over four to five weeks, 45 of whom played Mind Frontiers and 45 of whom completed visual search and change detection tasks (active control). After training, the Mind Frontiers group improved in working memory n-back tests, a composite measure of perceptual speed, and a composite measure of reaction time in reasoning tests. No training-related improvements were found in reasoning accuracy or other working memory tests, nor in composite measures of episodic memory, selective attention, divided attention, and multi-tasking. Perceived self-improvement in the tested abilities did not differ between groups. A general expectancy difference in problem-solving was observed between groups, but this perceived benefit did not correlate with training-related improvement. In summary, although these findings provide modest evidence regarding the efficacy of an integrated cognitive training program, more research is needed to determine the utility of Mind Frontiers as a cognitive training tool.

A randomized controlled trial of the effects of working memory training in methadone maintenance patients

OBJECTIVE

Working memory impairment in individuals with chronic opioid dependence can play a major role in cognitive and treatment outcomes. Cognitive training targeting working memory shows promise for improved function in substance use disorders. To date, cognitive training has not been incorporated as an adjunctive treatment for opioid dependence.

METHODS

Methadone maintenance patients were randomly assigned to experimental (n=28) or active control (n=28) 25-session computerized training and run in parallel. Cognitive and drug use outcomes were assessed before and after training.

RESULTS

Participants in the experimental condition showed performance improvements on two of four working memory measures, and both groups improved on a third measure of working memory performance. Less frequent drug use was found in the experimental group than in the control group post-training. In contrast to previous findings with stimulant users, no significant effect of working memory training on delay discounting was found using either hypothetical or real rewards. There were no group differences on working memory outcome measures that were dissimilar from the training tasks, suggesting that another mechanism (e.g., increased distress tolerance) may have driven drug use results.

CONCLUSIONS

Working memory training improves performance on some measures of working memory in methadone maintenance patients, and may impact drug use outcomes. Working memory training shows promise in patients with substance use disorders; however, further research is needed to understand the mechanisms through which performance is improved and drug use outcomes are impacted.

Normative data on the n-back task for children and young adolescents

The n-back task is a frequently used measure of working memory (WM) in cognitive neuroscience research contexts, and it has become widely adopted in other areas over the last decade. This study aimed to obtain normative data for the n-back task from a large sample of children and adolescents. To this end, a computerized verbal n-back task with three levels of WM load (1-back, 2-back, and 3-back) was administered to 3722 Spanish school children aged 7–13 years. Results showed an overall age-related increase in performance for the different levels of difficulty. This trend was less pronounced at 1-back than at 2-back when hits were considered. Gender differences were also observed, with girls outperforming boys although taking more time to respond. The theoretical implications of these results are discussed. Normative data stratified by age and gender for the three WM load levels are provided.

Visuospatial working memory training facilitates visually-aided explicit sequence learning

Finger sequence learning requires visuospatial working memory (WM). However, the dynamics between age, WM training, and motor skill acquisition are unclear. Therefore, we examined how visuospatial WM training improves finger movement sequential accuracy in younger (n=26, 21.1±1.37years) and older adults (n=22, 70.6±4.01years). After performing a finger sequence learning exercise and numerical and spatial WM tasks, participants in each age group were randomly assigned to either the experimental (EX) or control (CO) groups. For one hour daily over a 10-day period, the EX group practiced an adaptive n-back spatial task while those in the CO group practiced a non-adaptive version. As a result of WM practice, the EX participants increased their accuracy in the spatial n-back tasks, while accuracy remained unimproved in the numerical n-back tasks. In all groups, reaction times (RT) became shorter in most numerical and spatial n-back tasks. The learners in the EX group - but not in the CO group - showed improvements in their retention of finger sequences. The findings support our hypothesis that computerized visuospatial WM training improves finger sequence learning both in younger and in older adults. We discuss the theoretical implications and clinical relevance of this research for motor learning and functional rehabilitation.

Training working memory to improve attentional control in anxiety: A proof-of-principle study using behavioral and electrophysiological measures

Trait anxiety is associated with impairments in attentional control and processing efficiency (see Berggren & Derakshan, 2013, for a review). Working memory training using the adaptive dual n-back task has shown to improve attentional control in subclinical depression with transfer effects at the behavioral and neural level on a working memory task (Owens, Koster, & Derakshan, 2013). Here, we examined the beneficial effects of working memory training on attentional control in pre-selected high trait anxious individuals who underwent a three week daily training intervention using the adaptive dual n-back task. Pre and post outcome measures of attentional control were assessed using a Flanker task that included a stress induction and an emotional a Antisaccade task (with angry and neutral faces as target). Resting state EEG (theta/beta ratio) was recorded to as a neural marker of trait attentional control. Our results showed that adaptive working memory training improved attentional control with transfer effects on the Flanker task and resting state EEG, but effects of training on the Antisaccade task were less conclusive. Finally, training related gains were associated with lower levels of trait anxiety at post (vs pre) intervention. Our results demonstrate that adaptive working memory training in anxiety can have beneficial effects on attentional control and cognitive performance that may protect against emotional vulnerability in individuals at risk of developing clinical anxiety.

Childhood antecedents and risk for adult mental disorders

Progress in treating and preventing mental disorders may follow from research that integrates development, genetics, and neuroscience. This review first delineates how longitudinal research has identified three particular groups of disorders shown to differ on the basis of symptom trajectories and risk-factor profiles. In the next section, the review describes how research on genetic contributions to psychopathology has elucidated the nature of risk for two groups of disorders, the neurodevelopmental and psychotic disorders. In the third section, the review describes how research on environmental contributions to psychopathology has targeted early temperament, its associated perturbations in information-processing functions, and its relations to a third group of disorders, the emotional disorders. For all three groups of disorders, such integrative research has generated ideas about novel interventions. The hope is that over the coming decade such ideas will lead to novel treatments that alter the trajectory of risk in developmental psychopathology.

Evaluating an Online Cognitive Training Platform for Older Adults: User Experience and Implementation Requirements

Decline of cognitive function is a part of aging. However, intensive cognitive training can improve important cognitive functions, such as attention and working memory. Because existing systems are not older adult-friendly and are usually not based on scientific evidence, an online platform was developed for cognitive training with information and communication features and evaluated in an 8-week field test. In a randomized clinical trial with 80 older adults, findings from log data analysis and questionnaires revealed a good use of the online platform. Communication or assistive features were not used often. Good usability ratings were given to the cognitive exercises. Subjective improvements of cognitive functions due to the training were reported. The current article presents concrete requirements and recommendations for deploying cognitive training software in older adult residential homes.

Benefits of extending and adjusting the level of difficulty on computerized cognitive training for children with intellectual disabilities

Training on working memory (WM) improves attention and WM in children with attention-deficit hyperactivity disorder and memory impairments. However, for children with intellectual disabilities (ID), the results have been less encouraging. In this preliminary study it was hypothesized that children with ID would benefit from an extended amount of training and that the level of difficulty during training would affect the outcome. We included 21 children with mild or moderate ID aged 8–13 years. They went through between 37 and 50 training sessions with an adaptive computerized program on WM and non-verbal reasoning (NVR). The children were divided into two subgroups with different difficulty levels during training. The transfer to untrained cognitive tests was compared to the results of 22 children with ID training only 25 sessions, and to a control group. We found that the training group with the extended training program improved significantly on a block design task measuring NVR and on a WM task compared to the control group. There was also a significantly larger improvement on block design relative to the training group with the shorter training time. The children that received easier training tasks also improved significantly more on a verbal WM task compared to children with more demanding tasks. In conclusion, these preliminary data suggest that children with ID might benefit from cognitive training with longer training periods and less demanding tasks, compared to children without disabilities.

Investigating the effectiveness of working memory training in the context of Personality Systems Interaction theory

Previous research has shown mixed results for the ability of working memory training to improve fluid intelligence. The aims of this study were first to replicate these improvements, and then to explore the moderating role of Personality Systems Interaction (PSI) personality factors. By using three different training methods and an active-contact control group, we examined the effects of 25 days of cognitive training on 142 participants. After examining our results in context of PSI theory, we found that different training methods yielded different IQ gains in participants, depending on their personality styles. In addition, these correlations suggested a meaningful pattern, indicating that PSI theory may be able to account for the different outcomes of cognitive training studies. Our findings may facilitate tailor-made cognitive training interventions in the future, and can contribute to explaining the mechanisms underlying the far transfer of working memory training to fluid intelligence.

Could training executive function improve treatment outcomes for eating disorders?

Current gold standard treatments for eating disorders (EDs) lack satisfactory efficacy, and traditional psychological treatments do not directly address executive functioning deficits underpinning ED pathology. The goal of this paper is to explore the potential for enhancing ED treatment outcomes by improving executive functioning deficits that have been demonstrated to underlie eating pathology. To achieve our objective, we (1) review existing evidence for executive functioning deficits that underpin EDs and consider the extent to which these deficits could be targeted in neurocognitive training programs, (2) present the evidence for the one ED neurocognitive training program well-studied to date (Cognitive Remediation Therapy), (3) discuss the utility of neurocognitive training programs that have been developed for other psychiatric disorders with similar deficits, and (4) provide suggestions for the future development and research of neurocognitive training programs for EDs. Despite the fact that the body of empirical work on neurocognitive training programs for eating disorders is very small, we conclude that their potential is high given the combined evidence for the role of deficits in executive functioning in EDs, the initial promise of Cognitive Remediation Training, and the success in treating related conditions with neurocognitive training. Based on the evidence to date, it appears that the development and empirical evaluation of neurocognitive training programs for EDs is warranted.

What's working in working memory training? An educational perspective

Working memory training programs have generated great interest, with claims that the training interventions can have profound beneficial effects on children's academic and intellectual attainment. We describe the criteria by which to evaluate evidence for or against the benefit of working memory training. Despite the promising results of initial research studies, the current review of all of the available evidence of working memory training efficacy is less optimistic. Our conclusion is that working memory training produces limited benefits in terms of specific gains on short-term and working memory tasks that are very similar to the training programs, but no advantage for academic and achievement-based reading and arithmetic outcomes.

The relationship between intelligence and training gains is moderated by training strategy

We examined the relationship between training regimen and fluid intelligence in the learning of a complex video game. Fifty non-game-playing young adults were trained on a game called Space Fortress for 30 hours with one of two training regimens: (1) Hybrid Variable-Priority Training (HVT), with part-task training and a focus on improving specific skills and managing task priorities, and (2) Full Emphasis Training (FET) in which participants practiced the whole game to obtain the highest overall score. Fluid intelligence was measured with the Raven's Progressive Matrix task before training. With FET, fluid intelligence was positively associated with learning, suggesting that intellectual ability played a substantial role in determining individual differences in training success. In contrast, with HVT, fluid intelligence was not associated with learning, suggesting that individual differences in fluid intelligence do not factor into training success in a regimen that emphasizes component tasks and flexible task coordination. By analyzing training effects in terms of individual differences and training regimens, the current study offers a training approach that minimizes the potentially limiting effect of individual differences.

Clinical characteristics, pathophysiology, and management of noncentral nervous system cancer-related cognitive impairment in adults

Answer questions and earn CME/CNE Over the past few decades, a body of research has emerged confirming what many adult patients with noncentral nervous system cancer have long reported-that cancer and its treatment are frequently associated with cancer-related cognitive impairment (CRCI). The severity of CRCI varies, and symptoms can emerge early or late in the disease course. Nonetheless, CRCI is typically mild to moderate in nature and primarily involves the domains of memory, attention, executive functioning, and processing speed. Animal models and novel neuroimaging techniques have begun to unravel the pathophysiologic mechanisms underlying CRCI, including the role of inflammatory cascades, direct neurotoxic effects, damage to progenitor cells, white matter abnormalities, and reduced functional connectivity, among others. Given the paucity of research on CRCI with other cancer populations, this review synthesizes the current literature with a deliberate focus on CRCI within the context of breast cancer. A hypothetical case-study approach is used to illustrate how CRCI often presents clinically and how current science can inform practice. While the literature regarding intervention for CRCI is nascent, behavioral and pharmacologic approaches are discussed.

Cognitive training as a resolution for early executive function difficulties in children with intellectual disabilities

Core executive functions (EF) such as attention, and working memory have been strongly associated with academic achievement, language development and behavioral stability. In the case of children who are vulnerable to cognitive and learning problems because of an underlying intellectual disability, EF difficulties will likely exacerbate an already compromised cognitive system. The current review examines cognitive training programs that aim to improve EF, specifically focusing on the potential of this type of intervention for children who have intellectual disabilities. We conclude that despite considerable discrepancies regarding reported intervention effects, these inconsistencies can be attributed to flaws in both program and study design. We discuss the steps needed to address these limitations and to facilitate the advancement of non-pharmaceutical interventions for children with intellectual disabilities.

Does working memory training have to be adaptive?

This study tested the common assumption that, to be most effective, working memory (WM) training should be adaptive (i.e., task difficulty is adjusted to individual performance). Indirect evidence for this assumption stems from studies comparing adaptive training to a condition in which tasks are practiced on the easiest level of difficulty only [cf. Klingberg (Trends Cogn Sci 14:317-324, 2010)], thereby, however, confounding adaptivity and exposure to varying task difficulty. For a more direct test of this hypothesis, we randomly assigned 130 young adults to one of the three WM training procedures (adaptive, randomized, or self-selected change in training task difficulty) or to an active control group. Despite large performance increases in the trained WM tasks, we observed neither transfer to untrained structurally dissimilar WM tasks nor far transfer to reasoning. Surprisingly, neither training nor transfer effects were modulated by training procedure, indicating that exposure to varying levels of task difficulty is sufficient for inducing training gains.

Reliable gains? Evidence for substantially underpowered designs in studies of working memory training transfer to fluid intelligence

In recent years, cognitive scientists and commercial interests (e.g., Fit Brains, Lumosity) have focused research attention and financial resources on cognitive tasks, especially working memory tasks, to explore and exploit possible transfer effects to general cognitive abilities, such as fluid intelligence. The increased research attention has produced mixed findings, as well as contention about the disposition of the evidence base. To address this contention, Au et al. (2014) recently conducted a meta-analysis of extant controlled experimental studies of n-back task training transfer effects on measures of fluid intelligence in healthy adults; the results of which showed a small training transfer effect. Using several approaches, the current review evaluated and re-analyzed the meta-analytic data for the presence of two different forms of small-study effects: (1) publication bias in the presence of low power and; (2) low power in the absence of publication bias. The results of these approaches showed no evidence of selection bias in the working memory training literature, but did show evidence of small-study effects related to low power in the absence of publication bias. While the effect size estimate identified by Au et al. (2014) provided the most precise estimate to date, it should be interpreted in the context of a uniformly low-powered base of evidence. The present work concludes with a brief set of considerations for assessing the adequacy of a body of research findings for the application of meta-analytic techniques.

How to build better memory training games

Can we create engaging training programs that improve working memory (WM) skills? While there are numerous procedures that attempt to do so, there is a great deal of controversy regarding their efficacy. Nonetheless, recent meta-analytic evidence shows consistent improvements across studies on lab-based tasks generalizing beyond the specific training effects (Au et al., 2014; Karbach and Verhaeghen, 2014), however, there is little research into how WM training aids participants in their daily life. Here we propose that incorporating design principles from the fields of Perceptual Learning (PL) and Computer Science might augment the efficacy of WM training, and ultimately lead to greater learning and transfer. In particular, the field of PL has identified numerous mechanisms (including attention, reinforcement, multisensory facilitation and multi-stimulus training) that promote brain plasticity. Also, computer science has made great progress in the scientific approach to game design that can be used to create engaging environments for learning. We suggest that approaches integrating knowledge across these fields may lead to a more effective WM interventions and better reflect real world conditions.

Do We Really Become Smarter When Our Fluid-Intelligence Test Scores Improve?

Recent reports of training-induced gains on fluid intelligence tests have fueled an explosion of interest in cognitive training-now a billion-dollar industry. The interpretation of these results is questionable because score gains can be dominated by factors that play marginal roles in the scores themselves, and because intelligence gain is not the only possible explanation for the observed control-adjusted far transfer across tasks. Here we present novel evidence that the test score gains used to measure the efficacy of cognitive training may reflect strategy refinement instead of intelligence gains. A novel scanpath analysis of eye movement data from 35 participants solving Raven's Advanced Progressive Matrices on two separate sessions indicated that one-third of the variance of score gains could be attributed to test-taking strategy alone, as revealed by characteristic changes in eye-fixation patterns. When the strategic contaminant was partialled out, the residual score gains were no longer significant. These results are compatible with established theories of skill acquisition suggesting that procedural knowledge tacitly acquired during training can later be utilized at posttest. Our novel method and result both underline a reason to be wary of purported intelligence gains, but also provide a way forward for testing for them in the future.