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Cui X, Zhang S, Yu S, Ding Q, Li X. Does working memory training improve emotion regulation and reduce internalizing symptoms? A pair of three-level meta-analyses. Behav Res Ther 2024; 179:104549. [PMID: 38761555 DOI: 10.1016/j.brat.2024.104549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 04/09/2024] [Accepted: 04/24/2024] [Indexed: 05/20/2024]
Abstract
BACKGROUND Emotional dysfunction is a core feature of many mental disorders. Working memory training (WM-T) is promising to improve emotion regulation and reduce internalizing symptoms (anxiety and depressive symptoms), but the results are mixed. Therefore, we conducted meta-analyses to clarify these mixed results. METHODS We searched Web of Science, PubMed, ScienceDirect, and EBSCO to identify relevant studies and screened the references. The effect size was calculated using Hedges' g. Three-level, random-effects models were run using metafor in R. RESULTS The current study included 44 articles, of which 29 were involved with emotion regulation, and 30 were involved with internalizing symptoms. The results showed that WM-T could yield emotional benefits, but the benefits were confined to enhancing explicit emotional regulation capacity and reducing anxiety symptoms. For the meta-analysis regarding the effect of WM-T on emotion regulation, there was no significant moderator. For the meta-analysis regarding the effect of WM-T on internalizing symptoms, the emotional valence of the material and control group were statistically significant moderators. CONCLUSION WM-T could yield certain emotional effects, but only to improve explicit emotion regulation capacity and reduce anxiety symptoms. In addition, some measures could enhance the effect, such as targeting specific populations, increasing the number of training sessions (≥15) or duration (>450 minutes), using negative material, and using n-back training tasks.
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Affiliation(s)
- Xiaobing Cui
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 10049, China
| | - Siyuan Zhang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 10049, China
| | - Shuting Yu
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 10049, China
| | - Qingwen Ding
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 10049, China
| | - Xuebing Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, 100101, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, 10049, China.
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Dali G, Poulton A, Chen LPE, Hester R. Extended ambulatory assessment of executive function: within-person reliability of working memory and inhibitory control tasks. J Clin Exp Neuropsychol 2024:1-13. [PMID: 38869317 DOI: 10.1080/13803395.2024.2364396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 05/30/2024] [Indexed: 06/14/2024]
Abstract
INTRODUCTION Ambulatory assessment of executive function - particularly in the form working memory (WM) - is increasingly common. Few studies to date, however, have also incorporated ambulatory measures of inhibitory control. Critically, the extended within-person reliability of ambulatory tasks tapping each of these constructs has been largely overlooked. METHOD Participants (N = 283, Mage = 23.74 years, SD = 9.04) received notifications every 3 days (for 4 weeks) to undertake ambulatory assessment versions of the n-Back and Stop-Signal Tasks (SST) via the smartphone application CheckCog. Within-person reliability of these measures was explored. RESULTS Compliance ranged from 66% (for eight sessions) to 89% (for four sessions). Our results reveal significant changes in performance within the first two sessions for both the n-Back and SST, with performance remaining largely consistent across the remaining (two to eight) sessions. In terms of test-retest reliability, the ICC (C, 1) values ranged from .29 to .68 on the n-Back (with overall accuracy being .51) and .31-.73 on the SST (with stop-signal reaction time being .53). CONCLUSION The results of the current study contribute to the literature by demonstrating the reliability of brief measures of executive function - in the form of inhibitory control and WM - delivered using smartphones in participants' natural environments. Based on our findings, the CheckCog app reliability tracks baseline systematic changes in WM and response inhibition across multiple time points and for an extended period in healthy individuals.
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Affiliation(s)
- Gezelle Dali
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
- Specialty of Addiction Medicine, Sydney Medical School, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Antoinette Poulton
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Li Peng Evelyn Chen
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
| | - Robert Hester
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, Australia
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Kade SA, du Toit SA, Danielson CT, Schweizer S, Morrison AS, Ong DC, Prasad A, Holder LJ, Han J, Torok M, Wong QJJ. Aberrant cognitive empathy in individuals with elevated social anxiety and regulation with emotional working memory training. Cogn Emot 2024; 38:605-623. [PMID: 38349272 DOI: 10.1080/02699931.2024.2314981] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 01/04/2024] [Indexed: 06/15/2024]
Abstract
Social anxiety may disrupt the empathic process, and well-regulated empathy is critical for navigating the social world. Two studies aimed to further understand empathy in the context of social anxiety. Study 1 compared individuals with elevated or normative social anxiety on a measure assessing cognitive and affective empathy for positive and negative emotions conveyed by other people ("targets"), completed under social threat. Relative to individuals with normative social anxiety, individuals with elevated social anxiety had greater cognitive empathy and no differences in affective empathy, regardless of emotion type. As greater cognitive empathy can be maladaptive, Study 2 tested whether this could be down-regulated. Individuals with elevated social anxiety underwent emotional working memory training (eWMT) for negative emotional information, or control training (CT). Effects on an empathy measure completed under social threat were assessed. Cognitive empathy for negative emotions decreased following eWMT but not CT, and this was only evident for those with higher pre-training working memory capacity. Cognitive empathy for positive emotions and affective empathy were not affected. Overall, social anxiety is associated with aberrant elevated cognitive empathy for negative and positive emotions, and the deviation in cognitive empathy for negative emotions can be regulated with eWMT for certain individuals.Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12618001196235..
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Affiliation(s)
- Saif A Kade
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Simone A du Toit
- School of Psychology, Western Sydney University, Sydney, Australia
| | | | - Susanne Schweizer
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Amanda S Morrison
- Department of Psychology, California State University, Hayward, CA, USA
| | - Desmond C Ong
- Department of Psychology, University of Texas at Austin, Austin, TX, USA
| | - Ashni Prasad
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Lauren J Holder
- School of Psychology, Western Sydney University, Sydney, Australia
| | - Jin Han
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, Australia
| | - Quincy J J Wong
- School of Psychology, Western Sydney University, Sydney, Australia
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Bomyea J, Feng S, Moore RC, Simmons AN, Thomas ML. Change in Resting-State Functional Connectivity Following Working Memory Training in Individuals With Repetitive Negative Thinking. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2024:S2451-9022(24)00119-8. [PMID: 38705463 DOI: 10.1016/j.bpsc.2024.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/17/2024] [Accepted: 04/25/2024] [Indexed: 05/07/2024]
Abstract
BACKGROUND Repetitive negative thinking (RNT) symptoms, which are characterized by pervasive, uncontrollable negative thoughts, are common in individuals with mood, anxiety, and traumatic stress disorders. Inability to regulate the contents of working memory is a hypothesized etiological factor in RNT, which suggests that training to improve working memory may be beneficial. This study examined the effects of working memory training on resting-state functional connectivity (rsFC) in individuals with elevated RNT and whether such changes would be associated with clinical improvement. METHODS We conducted a secondary analysis of pre-post resting-state data collected as part of a randomized controlled trial (NCT04912089) of working memory training interventions (n = 42) compared with a waitlist control group (n = 23). We hypothesized that individuals who completed training would show increased rsFC between the 2 key intrinsic connectivity networks-the default mode network (posterior cingulate cortex) and the frontoparietal network (dorsolateral prefrontal cortex). We explored whether the magnitude of rsFC change was associated with change in RNT symptom severity. RESULTS rsFC increased between the posterior cingulate cortex and regions including the frontal and parietal cortex in the training group compared with the waitlist group. Increased connectivity between the posterior cingulate cortex and superior frontal cortex was associated with RNT symptom reduction. CONCLUSIONS These data provide evidence that working memory training can modulate neural circuitry at rest in individuals with RNT. Results are consistent with accounts of working memory training effects on large-scale neurocircuitry changes and suggest that these changes may contribute to clinical promise of this type of intervention on transdiagnostic RNT symptoms.
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Affiliation(s)
- Jessica Bomyea
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California; Department of Psychiatry, University of California San Diego, San Diego, California.
| | - Shirley Feng
- Department of Psychiatry, University of California San Diego, San Diego, California; Massachusetts General Hospital, Athinoula A. Martinos Center for Biomedical Imaging, Boston, Massachusetts
| | - Raeanne C Moore
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Alan N Simmons
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California; Department of Psychiatry, University of California San Diego, San Diego, California
| | - Michael L Thomas
- Department of Psychology, Colorado State University, Fort Collins, Colorado
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Holzer KJ, Todorovic MS, Wilson EA, Steinberg A, Avidan MS, Haroutounian S. Cognitive flexibility training for chronic pain: a randomized clinical study. Pain Rep 2024; 9:e1120. [PMID: 38352025 PMCID: PMC10863938 DOI: 10.1097/pr9.0000000000001120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 09/12/2023] [Accepted: 10/09/2023] [Indexed: 02/16/2024] Open
Abstract
Introduction Previous studies suggest an association between cognitive flexibility and development of chronic pain after surgery. It is not known whether cognitive flexibility can be improved in patients with chronic pain. Objectives This study tested whether a neurocognitive training program results in improved cognitive flexibility and pain in patients with chronic pain. Methods We conducted a single-center, prospective, randomized study investigating 5-week daily neurocognitive training in patients with chronic pain. Participants (n = 145) were randomized into neurocognitive training or care as usual, and they completed assessments at baseline, posttreatment, and 3 months. The treatment group was asked to spend 35 minutes daily completing a program with tasks on cognitive flexibility, memory, attention, and speed. The primary outcome was performance on the neurocognitive performance test (NCPT). Secondary outcomes included levels of pain interference and severity. Results At 5 weeks, the treatment group showed greater improvements on NCPT compared with the control group (d = 0.37); effect size was smaller at 3 months (d = 0.18). The treatment group reported lower pain severity at 5 weeks (d = 0.16) and 3 months (d = 0.39) than the control group, but pain interference was only lower at 3 months (d = 0.20). Conclusions Outcomes suggest that using neurocognitive training to modify cognitive flexibility in patients with chronic pain may improve pain severity. This study provided effect size estimates to inform sample size calculations for randomized controlled trials to test the effectiveness of neurocognitive interventions for the prevention and treatment of chronic pain.
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Affiliation(s)
- Katherine J. Holzer
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Marko S. Todorovic
- Department of Anesthesiology, Virginia Mason Medical Center, Seattle, WA, USA
| | - Elizabeth A. Wilson
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Aaron Steinberg
- Emergency Department, SSM Health St. Mary's Hospital, St. Louis, MO, USA
| | - Michael S. Avidan
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA
| | - Simon Haroutounian
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA
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Edwards E, Chu KL, Carroll A. Inhibitory Control Training for Anxiety and Math Achievement in Primary School Children: Protocol for a Proof-of-Concept Study. JMIR Res Protoc 2024; 13:e52929. [PMID: 38477976 DOI: 10.2196/52929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 01/25/2024] [Indexed: 03/14/2024] Open
Abstract
BACKGROUND Cognitive control training (CCT) has shown potential to reduce emotional vulnerability in adults and adolescents. However, there is scant literature testing the efficacy of CCT for the reduction of anxiety and transferring the effects to educational outcomes in children. Building on the evidence that a greater ability to suppress a prepotent response (inhibitory control) is associated with higher math achievement in children, it is plausible that training inhibitory processes using a CCT paradigm may be beneficial for reducing anxiety, improving inhibitory control, and in turn increasing math achievement. OBJECTIVE This proof-of-concept study aims to investigate the efficacy of 15 sessions of inhibitory control training for reduction in anxiety and improvement in math achievement in primary school children. METHODS We will use a 2 (group: CCT, adaptive Go/No-Go vs active control, low-load task) multiplied by 4 (time: pre- vs posttraining vs 1-month vs 3-month follow-up) randomized design in a nonselected sample of 100 children aged 8-10 years. Both groups will complete 10 minutes of daily training for 3 weeks at school. The dependent variables will be anxiety and correlates (Spence Children's Anxiety Scale, Penn State Worry Questionnaire for Children, Revised Children's Anxiety and Depression Scale, Child Response Style Questionnaire, and Modified Abbreviated Math Anxiety Scale), inhibitory control (Go/No-Go task), shifting (color-shape shifting task), updating (n-back task), and math achievement (Applied Problems, Calculation, and Math Facts Fluency subtests from the Woodcock-Johnson IV Tests of Achievement). RESULTS We opened enrollment in September 2023. The initial results are expected to be published in late 2024. We predict that children in the CCT group will show a reduction in emotional symptoms; improvements in inhibition, shifting, and updating performance; and advances in math achievement from pre- to posttraining, and that these effects will be maintained at 1- and 3-month follow-ups, compared to children in the active control group. CONCLUSIONS The CCT paradigm used in our study will provide a greater understanding of the emotional and cognitive transfer effects on children and inform future work. Specifically, the findings will advance the knowledge of deploying inhibitory control training with children and provide valuable insights into its use for reducing anxiety and advancing math achievement. TRIAL REGISTRATION Open Science Framework ofs.io/de2qa; https://doi.org/10.17605/OSF.IO/DE2QA. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/52929.
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Baenas I, Mora-Maltas B, Etxandi M, Lucas I, Granero R, Fernández-Aranda F, Tovar S, Solé-Morata N, Gómez-Peña M, Moragas L, Del Pino-Gutiérrez A, Tapia J, Diéguez C, Goudriaan AE, Jiménez-Murcia S. Cluster analysis in gambling disorder based on sociodemographic, neuropsychological, and neuroendocrine features regulating energy homeostasis. Compr Psychiatry 2024; 128:152435. [PMID: 37976998 DOI: 10.1016/j.comppsych.2023.152435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 10/12/2023] [Accepted: 10/26/2023] [Indexed: 11/19/2023] Open
Abstract
BACKGROUND The heterogeneity of gambling disorder (GD) has led to the identification of different subtypes, mostly including phenotypic features, with distinctive implications on the GD severity and treatment outcome. However, clustering analyses based on potential endophenotypic features, such as neuropsychological and neuroendocrine factors, are scarce so far. AIMS This study firstly aimed to identify empirical clusters in individuals with GD based on sociodemographic (i.e., age and sex), neuropsychological (i.e., cognitive flexibility, inhibitory control, decision making, working memory, attention, and set-shifting), and neuroendocrine factors regulating energy homeostasis (i.e., leptin, ghrelin, adiponectin, and liver-expressed antimicrobial peptide 2, LEAP-2). The second objective was to compare the profiles between clusters, considering the variables used for the clustering procedure and other different sociodemographic, clinical, and psychological features. METHODS 297 seeking-treatment adult outpatients with GD (93.6% males, mean age of 39.58 years old) were evaluated through a semi-structured clinical interview, self-reported psychometric assessments, and a protocolized neuropsychological battery. Plasma concentrations of neuroendocrine factors were assessed in peripheral blood after an overnight fast. Agglomerative hierarchical clustering was applied using sociodemographic, neuropsychological, and neuroendocrine variables as indicators for the grouping procedure. Comparisons between the empirical groups were performed using Chi-square tests (χ2) for categorical variables, and analysis of variance (ANOVA) for quantitative measures. RESULTS Three-mutually-exclusive groups were obtained, being neuropsychological features those with the greatest weight in differentiating groups. The largest cluster (Cluster 1, 65.3%) was composed by younger males with strategic and online gambling preferences, scoring higher on self-reported impulsivity traits, but with a lower cognitive impairment. Cluster 2 (18.2%) and 3 (16.5%) were characterized by a significantly higher proportion of females and older patients with non-strategic gambling preferences and a worse neuropsychological performance. Particularly, Cluster 3 had the poorest neuropsychological performance, especially in cognitive flexibility, while Cluster 2 reported the poorest inhibitory control. This latter cluster was also distinguished by a poorer self-reported emotion regulation, the highest prevalence of food addiction, as well as a metabolic profile characterized by the highest mean concentrations of leptin, adiponectin, and LEAP-2. CONCLUSIONS To the best of our knowledge, this is the first study to identify well-differentiated GD clusters using neuropsychological and neuroendocrine features. Our findings reinforce the heterogeneous nature of the disorder and emphasize a role of potential endophenotypic features in GD subtyping. This more comprehensive characterization of GD profiles could contribute to optimize therapeutic interventions based on a medicine of precision.
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Affiliation(s)
- Isabel Baenas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain
| | - Bernat Mora-Maltas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain
| | - Mikel Etxandi
- Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain; Department of Psychiatry, Hospital Universitari Germans Trias i Pujol, IGTP Campus Can Ruti, Badalona, Spain
| | - Ignacio Lucas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain
| | - Roser Granero
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Psychobiology and Methodology, Autonomous University of Barcelona, Barcelona, Spain
| | - Fernando Fernández-Aranda
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain
| | - Sulay Tovar
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Physiology, CIMUS, University of Santiago de Compostela, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain
| | - Neus Solé-Morata
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain
| | - Mónica Gómez-Peña
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Laura Moragas
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain
| | - Amparo Del Pino-Gutiérrez
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Public Health, Mental Health and Perinatal Nursing, School of Nursing, University of Barcelona, Barcelona, Spain
| | - Javier Tapia
- Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Doctoral Program in Medicine and Translational Research, University of Barcelona (UB), Barcelona, Spain; Medical Direction of Ambulatory Processes, South Metropolitan Territorial Management, Bellvitge University Hospital, Barcelona, Spain
| | - Carlos Diéguez
- Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Physiology, CIMUS, University of Santiago de Compostela, Instituto de Investigación Sanitaria (IDIS), Santiago de Compostela, Spain
| | - Anna E Goudriaan
- Arkin Mental Health Care, Jellinek, Amsterdam Institute for Addiction Research, Amsterdam, The Netherlands; Amsterdam UMC, Department of Psychiatry, University of Amsterdam, Amsterdam, The Netherlands; Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Susana Jiménez-Murcia
- Clinical Psychology Department, Bellvitge University Hospital, Barcelona, Spain; Psychoneurobiology of Eating and Addictive Behaviors Group, Neurosciences Program, Bellvitge Biomedical Research Institute (IDIBELL), Barcelona, Spain; Ciber Physiopathology of Obesity and Nutrition (CIBERObn), Instituto de Salud Carlos III, Barcelona, Spain; Department of Clinical Sciences, School of Medicine and Health Sciences, University of Barcelona, Barcelona, Spain.
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Meiering MS, Weigner D, Enge S, Grimm S. Transdiagnostic phenomena of psychopathology in the context of the RDoC: protocol of a multimodal cross-sectional study. BMC Psychol 2023; 11:297. [PMID: 37770998 PMCID: PMC10540421 DOI: 10.1186/s40359-023-01335-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 09/18/2023] [Indexed: 09/30/2023] Open
Abstract
In the past, affective and cognitive processes related to psychopathology have been examined within the boundaries of phenotype-based diagnostic labels, which has led to inconsistent findings regarding their underlying operating principles. Investigating these processes dimensionally in healthy individuals and by means of multiple modalities may provide additional insights into the psychological and neuronal mechanisms at their core. The transdiagnostic phenomena Neuroticism and Rumination are known to be closely linked. However, the exact nature of their relationship remains to be elucidated. The same applies to the associations between Hedonic Capacity, Negativity Bias and different Emotion Regulation strategies.This multimodal cross-sectional study examines the relationship of the transdiagnostic phenomena Neuroticism and Rumination as well as Hedonic Capacity, the Negativity Bias and Emotion Regulation from a RDoC (Research Domain Criteria) perspective. A total of 120 currently healthy subjects (past 12 months) will complete several questionnaires regarding personality, emotion regulation, hedonic capacity, and psychopathologies as well as functional magnetic resonance imaging (fMRI) during cognitive and emotional processing, to obtain data on the circuit, behavioral and self-report level.This study aims to contribute to the understanding of the relationship between cognitive and affective processes associated with psychopathologies as well as their neuronal correlates. Ultimately, a grounded understanding of these processes could guide improvement of diagnostic labels and treatments. Limitations include the cross-sectional design and the limited variability in psychopathology scores due to the restriction of the sample to currently healthy subjects.
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Affiliation(s)
- Marvin S Meiering
- Department of Natural Sciences, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany.
- Department of Education and Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany.
| | - David Weigner
- Department of Natural Sciences, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany
- Department of Education and Psychology, Freie Universität Berlin, Habelschwerdter Allee 45, 14195, Berlin, Germany
| | - Sören Enge
- Department of Natural Sciences, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany
| | - Simone Grimm
- Department of Natural Sciences, MSB Medical School Berlin, Rüdesheimer Straße 50, 14197, Berlin, Germany
- Department of Psychiatry and Psychotherapy, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität Zu Berlin, Hindenburgdamm 30, 12203, Berlin, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Lenggstrasse 31, CH-8032, Zurich, Switzerland
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Sætren SS, Augusti EM, Myhre MC, Hafstad GS. The regulatory role of affective inhibitory control in somatic symptoms among adolescents exposed to child maltreatment: a population-based study. Eur Child Adolesc Psychiatry 2023; 32:1701-1710. [PMID: 35441902 PMCID: PMC10460330 DOI: 10.1007/s00787-022-01988-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 04/06/2022] [Indexed: 11/24/2022]
Abstract
Adolescents exposed to child maltreatment are at increased risk for various somatic symptoms, but which psychological factors that contribute to this relationship need to be further investigated. Emotion dysregulation is suggested to serve as a proximal link between child maltreatment and somatic complaints. The purpose of the present study was to investigate whether individual differences in affective inhibitory control, a central component in implicit emotion regulation, contribute to the risk of somatic symptoms in adolescents exposed to child maltreatment. Data were drawn from the UEVO study, a national population-based survey of adolescents between 12 and 16 years of age (N = 9240). For this study, we included participants who completed the emotional go/no-go task measuring affective inhibitory control (N = 7241; Mage/SD = 14 years/.87; 52% girls, 47% boys), of which N = 3349 reported at least one incident of maltreatment exposure (57% girls, 41% boys). Exposure to psychological abuse and sexual abuse were associated with somatic symptoms. Affective inhibitory control was related to somatic symptoms, both in the total sample and in adolescents exposed to child maltreatment. The strength of relationships between exposure to psychological abuse and somatic symptoms, as well as sexual abuse and somatic symptoms, were moderated by individual differences in affective inhibitory control problems. Our study suggests that psychological abuse and sexual abuse increase the risk for somatic symptoms in adolescence. Affective inhibitory control, a central component in implicit emotion regulation, was related to somatic symptoms and moderated the relationships between psychological abuse and somatic symptoms, and sexual abuse and somatic symptoms. Revealing these associations in a population-based sample indicates that treatment targeting affective inhibitory control may be beneficial and should be explored further in clinical settings.
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Affiliation(s)
- Sjur Skjørshammer Sætren
- Department for Child and Adolescent Research, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway.
- TIPS Centre for Clinical Research in Psychosis, Stavanger University Hospital, Jan Johnsens gate 12, 4011, Stavanger, Norway.
| | - Else-Marie Augusti
- Department for Child and Adolescent Research, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Mia Cathrine Myhre
- Department for Child and Adolescent Research, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Gertrud Sofie Hafstad
- Department for Child and Adolescent Research, Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
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Shahrajabian F, Hasani J, Griffiths MD, Aruguete M, Javad Emadi Chashmi S. Effects of emotional working memory training on problematic internet use, inhibition, attention, and working memory among young problematic internet users: A randomized control study. Addict Behav 2023; 141:107659. [PMID: 36805812 DOI: 10.1016/j.addbeh.2023.107659] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 02/06/2023] [Accepted: 02/09/2023] [Indexed: 02/13/2023]
Abstract
Problematic internet use (PIU) has been defined as an inability to control impulses to use the internet, and is associated with psychological, social, educational, and/or occupational problems. Considering the harmful effects of PIU, the present study evaluated a treatment intervention aimed at controlling PIU. A randomized control study investigated the effectiveness of emotional working memory training (eWMT) in improving inhibition, attention, and working memory among individuals with PIU in comparison with a placebo group. Young adults (N = 36) with PIU were either trained for 20 sessions in an n-back dual emotional task (eWMT; n = 18) or a feature matching task (placebo; n = 18). Results showed that 20 continuous sessions of eWMT significantly reduced the symptoms of PIU and improved participants' working memory, attention, and inhibition (compared to the placebo group). These preliminary findings suggest that eWMT can be considered a promising treatment to reduce PIU by improving individuals' cognitive and emotional functioning.
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Affiliation(s)
| | - Jafar Hasani
- Department of Clinical Psychology, Kharazmi University, Tehran, Iran.
| | - Mark D Griffiths
- International Gaming Research Unit, Cyberpsychology Research Group, NTU Psychology, Nottingham Trent University, UK
| | - Mara Aruguete
- Department of Social and Behavioral Sciences, Lincoln University, Jefferson City, MO, USA
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11
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Venturo-Conerly KE, Eisenman D, Wasil AR, Singla DR, Weisz JR. Meta-analysis: The Effectiveness of Youth Psychotherapy Interventions in Low- and Middle-Income Countries. J Am Acad Child Adolesc Psychiatry 2022:S0890-8567(22)01980-3. [PMID: 36563875 DOI: 10.1016/j.jaac.2022.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 07/20/2022] [Accepted: 12/13/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Because most youth psychotherapies are developed and tested in high-income countries, relatively little is known about their effectiveness or moderators in low- and middle-income countries (LMICs). To address this gap, we conducted a meta-analysis of randomized controlled trials (RCTs) testing psychotherapies for youth with multiple psychiatric conditions in LMICs, and we tested candidate moderators. METHOD We searched 9 international databases for RCTs of youth psychotherapies in LMICs published through January 2021. The RCTs targeted elevated symptoms of youth anxiety (including post-traumatic stress disorder [PTSD] and obsessive-compulsive disorder), depression, conduct problems, and attention problems. Using robust variance estimation, we estimated the pooled effect sizes (Hedges g) at post treatment and follow-up for intervention vs control conditions. RESULTS Of 5,145 articles identified, 34 articles (with 43 treatment-control comparisons and 4,176 participants) met methodological standards and were included. The overall pooled g with winsorized outliers was 1.01 (95% CI = 0.72-1.29, p < .001) at post treatment and 0.68 (95% CI = 0.29-1.07, p = .003) at follow-up. Interventions delivered by professional clinicians significantly outperformed those delivered by lay providers (g = 1.59 vs 0.53), but all interventions for conduct problems were delivered by professionals, and the difference for interventions targeting internalizing problems (g = 1.33 vs .53) was not significant. Interventions developed non-locally were more effective if they were not adapted to local contexts than if they were adapted locally (g = 2.31 vs 0.66), highlighting a need for further research on effective adaptations. Significant risk of bias was identified. CONCLUSION Overall, pooled effects of youth psychotherapies in LMICs were markedly larger than those in recent comparable non-LMIC meta-analyses, which have shown small-to-medium effects for youth psychotherapies. Findings highlight the potential benefits of youth psychotherapies in LMICs, as well as a need for more RCTs and improved study quality.
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Affiliation(s)
| | | | | | - Daisy R Singla
- Center of Addiction and Mental Health, Toronto, Ontario, Canada; University of Toronto, Ontario, Canada; Sinai Health, Toronto, Ontario, Canada
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12
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Basharpoor S, Zakibakhsh Mohammadi N, Heidari F, Azarkolah A, Vicario CM, Salehinejad MA. Emotional working memory training improves cognitive inhibitory abilities in individuals with borderline personality trait: A randomized parallel-group trial. J Affect Disord 2022; 319:181-188. [PMID: 36155238 DOI: 10.1016/j.jad.2022.09.089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Revised: 09/02/2022] [Accepted: 09/20/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Cognitive inhibition impairment is one of the causes of impulsive behaviors in individuals with borderline personality disorder (BPD). This study aimed to investigate the effect of emotional working memory training (EWMT) on cognitive inhibition in individuals with a clinically significant borderline personality trait. METHODS In a randomized, parallel-group trial, 40 individuals with borderline personality trait, were selected out of 1000 screened individuals and were randomly assigned to the experimental (N = 20) and waiting-list control (N = 20) groups based on the score on the Borderline Personality Scale and the follow-up Structured Clinical Interview for DSM-IV Personality Disorders. The experimental group underwent 10 sessions of EWMT and the control group did not receive any intervention (waiting list). Participants completed the Stroop Color and Word Test (SCWT) and Go/No-Go task Before and after the intervention. RESULTS EWMT significantly reduced reaction time of incongruent trials in the SCWT and commission errors in the Go/No-Go task after the intervention only in the experimental group. Furthermore, the interference score in SCWT and commission error rate at the post-intervention time were significantly lower for the experimental vs the waitlist group. LIMITATIONS The single-blind design and absence of follow-up measures. CONCLUSIONS EWMT can improve cognitive inhibition in individuals with borderline personality trait and could be used for therapeutic purposes of impulsivity behavior in BPD.
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Affiliation(s)
- Sajjad Basharpoor
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran.
| | - Nasim Zakibakhsh Mohammadi
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Fazeleh Heidari
- Department of Psychology, Faculty of Educational Sciences and Psychology, University of Mohaghegh Ardabili, Ardabil, Iran
| | - Anita Azarkolah
- Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran; Atieh Clinical Neuroscience Center, Tehran, Iran
| | - Carmelo M Vicario
- Department of Cognitive Science, University of Messina, Messina, Italy
| | - Mohammad Ali Salehinejad
- Department of Psychology and Neurosciences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany.
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13
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Comparing resting-state connectivity of working memory networks in U.S. Service members with mild traumatic brain injury and posttraumatic stress disorder. Brain Res 2022; 1796:148099. [PMID: 36162495 DOI: 10.1016/j.brainres.2022.148099] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 08/31/2022] [Accepted: 09/20/2022] [Indexed: 11/23/2022]
Abstract
Mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) are prevalent among military populations, and both have been associated with working memory (WM) impairments. Previous resting-state functional connectivity (rsFC) research conducted separately in PTSD and mTBI populations suggests that there may be similar and distinct abnormalities in WM-related networks. However, no studies have compared rsFC of WM brain regions in participants with mTBI versus PTSD. We used resting-state fMRI to investigate rsFC of WM networks in U.S. Service Members (n = 127; ages 18-59) with mTBI only (n = 46), PTSD only (n = 24), and an orthopedically injured (OI) control group (n = 57). We conducted voxelwise rsFC analyses with WM brain regions to test for differences in WM network connectivity in mTBI versus PTSD. Results revealed reduced rsFC between ventrolateral prefrontal cortex (vlPFC), lateral premotor cortex, and dorsolateral prefrontal cortex (dlPFC) WM regions and brain regions in the dorsal attention and somatomotor networks in both mTBI and PTSD groups versus controls. When compared to those with mTBI, individuals with PTSD had lower rsFC between both the lateral premotor WM seed region and middle occipital gyrus as well as between the dlPFC WM seed region and paracentral lobule. Interestingly, only vlPFC connectivity was significantly associated with WM performance across the samples. In conclusion, we found primarily overlapping patterns of reduced rsFC in WM brain regions in both mTBI and PTSD groups. Our finding of decreased vlPFC connectivity associated with WM is consistent with previous clinical and neuroimaging studies. Overall, these results provide support for shared neural substrates of WM in individuals with either mTBI or PTSD.
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14
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Schweizer S, Auer T, Hitchcock C, Lee-Carbon L, Rodrigues E, Dalgleish T. Affective Control Training (AffeCT) reduces negative affect in depressed individuals. J Affect Disord 2022; 313:167-176. [PMID: 35792299 DOI: 10.1016/j.jad.2022.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 06/09/2022] [Accepted: 06/16/2022] [Indexed: 11/18/2022]
Abstract
Depression is the leading cause of disability worldwide, with prevalence rates rising. Despite the scale of the problem, available pharmacological and psychological interventions only have limited efficacy. The National Institute of Health's Science of Behaviour Change framework proposes to address this issue by capitalising on insights from basic science to identify mechanisms that can be targeted by novel interventions. The current study evaluated the potential of a computerized programme aimed at improving affective control, a mechanistic target involved in both risk and maintenance of depression. In a first phase the cognitive profiles of 48 depressed individuals (mean age: 39 years, 75 % female) were compared to cognitive functioning in 16 never-depressed individuals (mean age: 31 years, 56 % female). The sole index of functioning that differed between diagnostic groups was reaction time across negative and positively valanced trials on an affective Stroop task (d = 0.58). This index was then used to evaluate an affective control training (AffeCT) against a placebo training. Results showed no significant changes on tasks that showed no differences with never-depressed individuals in Phase I. However, compared to placebo training, AffeCT led to significantly greater improvement in the target index, affective Stroop performance (d = 1.17). Importantly, AffeCT led to greater reductions in negative affect as measured by the Positive Affect and Negative Affect Schedule compared to the placebo training (d = 0.98). This proof-of-concept study shows promising benefits of AffeCT on depressed individuals' affect, but not depressive symptoms. It further supports the utility of the Science of Behaviour Change framework, highlighting the need for determining meaningful assays of target mechanisms when evaluating novel interventions.
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Affiliation(s)
- Susanne Schweizer
- University of Cambridge, Department of Psychology, Cambridge, UK; University of New South Wales, School of Psychology, Sydney, Australia.
| | - Tibor Auer
- University of Surrey, School of Psychology, Guildford, UK
| | - Caitlin Hitchcock
- University of Cambridge, Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK; University of Melbourne, Melbourne School of Psychological Sciences, Melbourne, Australia
| | - Leonie Lee-Carbon
- University of Cambridge, Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
| | - Evangeline Rodrigues
- University of Cambridge, Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK
| | - Tim Dalgleish
- University of Cambridge, Medical Research Council Cognition and Brain Sciences Unit, Cambridge, UK; Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
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15
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Żygierewicz J, Janik RA, Podolak IT, Drozd A, Malinowska U, Poziomska M, Wojciechowski J, Ogniewski P, Niedbalski P, Terczynska I, Rogala J. Decoding working memory-related information from repeated psychophysiological EEG experiments using convolutional and contrastive neural networks. J Neural Eng 2022; 19. [PMID: 35985292 DOI: 10.1088/1741-2552/ac8b38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 08/19/2022] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Extracting reliable information from EEG signals is difficult because the low signal-to-noise ratio and significant intersubject variability seriously hinder statistical analyses. However, recent advances in explainable machine learning open a new strategy to address this problem. APPROACH The current study evaluates this approach using results from the classification and decoding of electrical brain activity associated with information retention. We designed four neural network models differing in architecture, training strategies, and input representation to classify single experimental trials of a working memory task. MAIN RESULTS Our best models achieved an accuracy of 65.29$±0.76 and Matthews correlation coefficient of 0.288±0.018, outperforming the reference model trained on the same data. The highest correlation between classification score and behavioral performance was 0.36 (p=0.0007). Using analysis of input perturbation, we estimated the importance of EEG channels and frequency bands in the task at hand. The set of essential features identified for each network varies. We identified a subset of features common to all models that identified brain regions and frequency bands consistent with current neurophysiological knowledge of the processes critical to attention and working memory. Finally, we proposed sanity checks to examine further the robustness of each model's set of features. SIGNIFICANCE Our results indicate that explainable deep learning is a powerful tool for decoding information from EEG signals. It is crucial to train and analyze a range of models to identify stable and reliable features. Our results highlight the need for explainable modeling as the model with the highest accuracy appeared to use residual artifactual activity.
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Affiliation(s)
- Jarosław Żygierewicz
- Biomedical Physics, University of Warsaw Faculty of Physics, Pasteura 5, Warszawa, 02-093, POLAND
| | - Romuald A Janik
- Institute of Theoretical Physics, Jagiellonian University in Krakow Faculty of Physics Astronomy and Applied Computer Science, Łojasiewicza 6, Krakow, Małopolskie, 30-348, POLAND
| | - Igor T Podolak
- Faculty of Mathematics and Computer Science, Jagiellonian University in Krakow, Łojasiewicza 6, Krakow, Małopolska, 30-348, POLAND
| | - Alan Drozd
- Nencki Institute of Experimental Biology PAS, Pasteura 3, Warszawa, Mazowieckie, 02-093, POLAND
| | - Urszula Malinowska
- Nencki Institute of Experimental Biology PAS, Pasteura 3, Warszawa, Mazowieckie, 02-093, POLAND
| | - Martyna Poziomska
- University of Warsaw Faculty of Physics, Pasteura 5, Warszawa, 02-093, POLAND
| | - Jakub Wojciechowski
- Nencki Institute of Experimental Biology PAS, Pasteura 3, Warszawa, Mazowieckie, 02-093, POLAND
| | - Paweł Ogniewski
- ELMIKO BIOSIGNALS LTD, Sportowa 3, Milanowek, 05-822, POLAND
| | | | - Iwona Terczynska
- Institute of Mother and Child, Kasprzaka 17A, Warszawa, 01-211, POLAND
| | - Jacek Rogala
- Nencki Institute of Experimental Biology PAS, Pasteura 3, Warszawa, Mazowieckie, 02-093, POLAND
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16
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Draheim C, Pak R, Draheim AA, Engle RW. The role of attention control in complex real-world tasks. Psychon Bull Rev 2022; 29:1143-1197. [PMID: 35167106 PMCID: PMC8853083 DOI: 10.3758/s13423-021-02052-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 11/15/2022]
Abstract
Working memory capacity is an important psychological construct, and many real-world phenomena are strongly associated with individual differences in working memory functioning. Although working memory and attention are intertwined, several studies have recently shown that individual differences in the general ability to control attention is more strongly predictive of human behavior than working memory capacity. In this review, we argue that researchers would therefore generally be better suited to studying the role of attention control rather than memory-based abilities in explaining real-world behavior and performance in humans. The review begins with a discussion of relevant literature on the nature and measurement of both working memory capacity and attention control, including recent developments in the study of individual differences of attention control. We then selectively review existing literature on the role of both working memory and attention in various applied settings and explain, in each case, why a switch in emphasis to attention control is warranted. Topics covered include psychological testing, cognitive training, education, sports, police decision-making, human factors, and disorders within clinical psychology. The review concludes with general recommendations and best practices for researchers interested in conducting studies of individual differences in attention control.
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Affiliation(s)
- Christopher Draheim
- Department of Psychology, Lawrence University, Appleton, WI, USA.
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA.
| | - Richard Pak
- Department of Psychology, Clemson University, Clemson, SC, USA
| | - Amanda A Draheim
- Department of Psychology, Lawrence University, Appleton, WI, USA
| | - Randall W Engle
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA
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17
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Mathew AS, Lotfi S, Bennett KP, Larsen SE, Dean C, Larson CL, Lee HJ. Association between spatial working memory and Re-experiencing symptoms in PTSD. J Behav Ther Exp Psychiatry 2022; 75:101714. [PMID: 34906826 PMCID: PMC9173718 DOI: 10.1016/j.jbtep.2021.101714] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2020] [Revised: 04/13/2021] [Accepted: 12/04/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND OBJECTIVES Few studies have evaluated the link between working memory (WM) and post-traumatic stress disorder (PTSD). Further, it is unknown whether this relationship is accounted for by other relevant variables including negative affect, emotional dysregulation, or general non-WM-related cognitive control deficits, which are associated with PTSD. The purpose of this study was to determine the extent to which a computerized WM task could predict PTSD symptomology incrementally beyond the contribution of other relevant variables associated with PTSD. METHODS Thirty veterans were eligible to complete emotional symptom questionnaires, a heart-rate variability measure, and computerized tasks (i.e., emotional Stroop and automated complex span tasks). A three-stage hierarchical regression was conducted with the PCL-5 total score and symptom clusters (i.e., re-experiencing, avoidance, hyperarousal, and negative cognition/mood) as the dependent variable. RESULTS Results revealed that only the re-experiencing symptom cluster was significantly predicted by executive, verbal, and visuospatial WM tasks, which explained an additional 29.7% of the variance over and above other relevant variables. Most notably, the visuospatial task was the only WM task that significantly explained PCL-5 re-experiencing symptoms. LIMITATIONS This study was based on a small sample of veterans with PTSD and causality cannot be determined with this cross-sectional study. CONCLUSIONS Overall, the results suggest that deficits in visuospatial WM are significantly associated with PTSD re-experiencing symptoms after controlling for other relevant variables. Further research should evaluate whether an intervention to improve visuospatial WM capacity can be implemented to reduce re-experiencing symptoms.
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Affiliation(s)
- Abel S Mathew
- Department of Psychology, University of Wisconsin-Milwaukee, USA
| | - Salahadin Lotfi
- Department of Psychology, University of Wisconsin-Milwaukee, USA; Rogers Behavioral Health, Research Center and Clinical Effectiveness Department, USA
| | | | - Sadie E Larsen
- Milwaukee VA Medical Center, USA; Medical College of Wisconsin, USA
| | - Caron Dean
- Milwaukee VA Medical Center, USA; Medical College of Wisconsin, USA
| | | | - Han-Joo Lee
- Department of Psychology, University of Wisconsin-Milwaukee, USA.
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18
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Pan DN, Hoid D, Wang XB, Jia Z, Li X. When expanding training from working memory to emotional working memory: not only improving explicit emotion regulation but also implicit negative control for anxious individuals. Psychol Med 2022; 52:675-684. [PMID: 32600499 DOI: 10.1017/s0033291720002275] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND The effect of working memory training (WM-T) has been found to transfer to emotional wellbeing, despite some debate on whether an affective component in training is necessary to achieve specific emotion-related benefits. These novel cognitive trainings have not yet been tested in highly anxious individuals, who have deficits in implicit and explicit emotional regulation and should be the potential beneficiaries of these trainings. METHODS We designed two types of mobile phone-based training applications: (1) WMT and (2) an emotional working memory training (EWM-T) that comprised negative face distraction. Ninety-eight participants (33, WM-T; 35, EWM-T; 30, Control group) with high trait anxiety completed the 21-day intervention or placebo program and conducted pre- and post-test procedures, including questionnaires, emotional regulation and emotional Stroop tasks alongside electroencephalogram recording. Late positive potential (LPP) in emotion regulation task and P3 in the emotional Stroop task were adopted as neutral indicators for the explicit and implicit affective regulation/control processing. RESULTS Those who had received training (WM-T and EWM-T) showed enhanced explicit regulation (indexed by reduced LPP during reappraisal) compared with the control. Besides, individuals in EWM-T showed reduced behavioral attention bias and a decline of P3 in response to negative faces in an emotional Stroop task. The altered neural indicators were correlated with corresponding behavior indexes that contributed to the anxiety alleviation. CONCLUSIONS The general WM-T was effective in enhancing explicit emotional regulation, while training with emotional add-in further improved implicit emotional control. (E)WM-T shows potential as a beneficial intervention for the anxiety population.
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Affiliation(s)
- Dong-Ni Pan
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing10049, China
| | - Delhii Hoid
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing10049, China
| | - Xiao-Bo Wang
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing10049, China
| | - Zhuo Jia
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing10049, China
| | - Xuebing Li
- Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing100101, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing10049, China
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19
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Edwards EJ, Zec D, Campbell M, Hoorelbeke K, Koster EHW, Derakshan N, Wynne J. Cognitive control training for children with anxiety and depression: A systematic review. J Affect Disord 2022; 300:158-171. [PMID: 34983006 DOI: 10.1016/j.jad.2021.12.108] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 12/20/2021] [Accepted: 12/24/2021] [Indexed: 10/19/2022]
Abstract
Cognitive control training has gained traction as an intervention for reducing anxiety and depression vulnerability in adults. There are, however, a limited number of studies investigating such training interventions for reducing symptomology of anxiety and depression in children and adolescents. Thus, we aimed to provide a robust review and qualitative synthesis of the available research in young people. Twelve articles met the inclusion criteria, and all were randomised control trials. Evidence of the efficacy of cognitive control training for relief of symptoms are reported separately for anxiety, depression, and other related psychological factors, and on the basis of type of cognitive control training paradigm. A lack of standardisation in relation to type of intervention, duration and context, outcome measures and population was observed. Results are discussed in terms of these variations and recommendations for future research are provided.
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Affiliation(s)
| | - Dajana Zec
- School of Education, The University of Queensland, QLD 4072, Australia
| | - Marilyn Campbell
- School of Early Childhood and Inclusive Education, Queensland University of Technology, Brisbane, Australia
| | - Kristof Hoorelbeke
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | - Ernst H W Koster
- Department of Experimental Clinical and Health Psychology, Ghent University, Belgium
| | - Nazanin Derakshan
- Department of Psychological Science, Birkbeck University College of London, United Kingdom
| | - Jeffrey Wynne
- School of Education, The University of Queensland, QLD 4072, Australia
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20
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Minihan S, Songco A, Andrews JL, Grunewald K, Werner-Seidler A, Blakemore SJ, Christensen H, Fox E, Goodyer IM, Raffe W, Schweizer S. Development of a gamified cognitive training app “Social Brain Train” to enhance adolescent mental health: a participatory design study protocol. Wellcome Open Res 2022. [DOI: 10.12688/wellcomeopenres.17441.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Adolescence is a sensitive period for the onset of mental health disorders. Effective, easy-to-disseminate, scalable prevention and early interventions are urgently needed. Affective control has been proposed as a potential target mechanism. Training affective control has been shown to reduce mental health symptoms and improve emotion regulation. However, uptake and adherence to such training by adolescents has been low. Thus, the current study aims to receive end user (i.e., adolescents) feedback on a prototype of a novel app-based gamified affective control training program, the Social Brain Train. Methods: The proposed study aims to recruit participants aged 13-16 years old (N = 20) to provide user feedback on the Social Brain Train app. The first group of participants (n = 5) will complete an online questionnaire assessing demographics, symptoms of depression and anxiety, social rejection sensitivity and attitudes toward the malleability of cognition and mental health. They will complete two tasks assessing cognitive capacity and interpretation bias. Participants will be then be invited to an online group workshop, where they will be introduced to the app. They will train on the app for three days, and following app usage, participants will complete the aforementioned measures again, as well as provide ratings on app content, and complete a semi-structured interview to obtain in-depth user feedback, which will be used to inform modifications to the app. Following these modifications, a second group of participants (n = 15) will follow the same procedure, except they will train on the app for 14 days. Feedback from both groups of participants will be used to inform the final design. Conclusions: By including young people in the design of the Social Brain Train app, the proposed study will help us to develop a novel mental health intervention that young people find engaging, acceptable, and easy-to-use
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21
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Groves NB, Chan ESM, Marsh CL, Gaye F, Jaisle EM, Kofler MJ. Does central executive training and/or inhibitory control training improve emotion regulation for children with attention-deficit/hyperactivity disorder? A randomized controlled trial. Front Psychiatry 2022; 13:1034722. [PMID: 36561637 PMCID: PMC9763728 DOI: 10.3389/fpsyt.2022.1034722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
INTRODUCTION Approximately 48-54% of children with attention-deficit/hyperactivity disorder (ADHD) have impairing difficulties with emotion regulation, and these difficulties are not ameliorated by first-line ADHD treatments. Working memory and inhibitory control represent promising intervention targets given their functional, if not causal, links with ADHD-related emotion dysregulation. METHODS This preregistered randomized controlled trial tested whether two digital therapeutic training protocols that have been previously shown to improve working memory (Central Executive Training [CET]) and inhibitory control (Inhibitory Control Training [ICT]) can improve emotion regulation in a sample of 94 children with ADHD aged 8-13 years (M = 10.22, SD = 1.43; 76% White/non-Hispanic; 29 girls). RESULTS Results of Bayesian mixed model ANOVAs indicated both treatment groups demonstrated significant decreases in emotion dysregulation relative to pre-treatment at immediate post-treatment (parent report; d = 1.25, BF10 = 8.04 × 1013, p < 0.001), at 1-2 months after completing treatment (teacher report; d = 0.99, BF10 = 1.22 × 106, p < 0.001), and at 2-4-months follow-up (parent report; d = 1.22, BF10 = 1.15 × 1014, p < 0.001). Contrary to our hypotheses, the CET and ICT groups demonstrated equivalent reductions in emotion dysregulation and maintenance of effects. Exploratory analyses revealed that results were robust to control for informant expectancies, ADHD medication status/changes, in-person vs. at-home treatment, child age, and time from treatment completion to post-treatment ratings. DISCUSSION To determine whether working memory and inhibitory control are causally linked with ADHD-related emotion dysregulation, future studies should include active control conditions that do not train executive functions prior to making decisions about the clinical utility of CET/ICT for the treatment of emotion dysregulation in ADHD. CLINICAL TRIAL REGISTRATION [https://clinicaltrials.gov/], identifier [NCT03324464].
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Affiliation(s)
- Nicole B Groves
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Elizabeth S M Chan
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Carolyn L Marsh
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Fatou Gaye
- Department of Psychology, Florida State University, Tallahassee, FL, United States
| | - Emma M Jaisle
- Department of Psychology, Florida International University, Miami, FL, United States
| | - Michael J Kofler
- Department of Psychology, Florida State University, Tallahassee, FL, United States
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22
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Komasi S, Ahmadi M. Role of illness perception in explanation of severity of post-traumatic stress disorder symptoms after cardiovascular problems. ARYA ATHEROSCLEROSIS 2022; 18:1-6. [PMID: 36818151 PMCID: PMC9931603 DOI: 10.48305/arya.v18i1.2059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Accepted: 12/01/2021] [Indexed: 02/24/2023]
Abstract
BACKGROUND Given the role of post-traumatic stress disorder (PTSD) in morbidity and mortality of cardiac patients, the present study was conducted to determine the relationship between the perception of heart disease and severity of PTSD symptoms. METHODS Sampled using simple random sampling, 202 cardiovascular patients (50.5% women) were selected and included in this cross-sectional study. The patients admitted to a hospital from January to May 2017 in western Iran were selected and asked to complete the self-report demographic and cardiac risk factors inventory, Brief Illness Perception Questionnaire (Brief-IPQ), and National Stressful Events Survey PTSD Short Scale (NSESSS) checklist. The results were analyzed using the Pearson correlation coefficient and multiple regression analysis. RESULTS The mean age of patients was 53.5 ± 11.9 years. The results of the correlation coefficient showed a significant relationship between all the components of illness perception, except personal and treatment control, with PTSD (P < 0.05). The regression model could predict 22.5% of PTSD variance and the greatest role was for the emotional representation (P = 0.002) and female sex (P = 0.008). CONCLUSION The perception of cardiovascular patients of the cognitive and emotional components of the disease, especially in women, plays a significant role in experiencing the symptoms of PTSD. Thus, health professionals have to monitor all these components, especially the patient's perceptions and emotional reactions, and to come up with proper and timely interventions for patients at risk to control the adverse effects of PTSD after cardiovascular events.
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Affiliation(s)
- Saeid Komasi
- PhD Student, Department of Neuroscience and Psychopathology Research, Mind GPS Institute, Kermanshah, Iran
| | - Maryam Ahmadi
- PhD Student, Department of Nursing, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran,Address for correspondence: Maryam Ahmadi; PhD Student, Department of Nursing, University of Social Welfare and Rehabilitation
Sciences, Tehran, Iran;
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23
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Working memory and emotional interpretation bias in a sample of Syrian refugee adolescents. Eur Child Adolesc Psychiatry 2021; 30:1885-1894. [PMID: 33025075 DOI: 10.1007/s00787-020-01656-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 09/25/2020] [Indexed: 12/16/2022]
Abstract
The number of adolescent refugees around the world has been continuously increasing over the past few years trying to escape war and terror, among other things. Such experience not only increases the risk for mental health problems including anxiety, depression, and post-traumatic stress disorder (PTSD), but also may have implications for socio-cognitive development. This study tested cognitive-affective processing in refugee adolescents who had escaped armed conflict in Syria and now resided in Istanbul, Turkey. Adolescents were split into a high trauma (n = 31, 12 girls, mean age = 11.70 years, SD = 1.15 years) and low trauma (n = 27, 14 girls, mean age = 11.07 years, SD = 1.39 years) symptom group using median split, and performed a working memory task with emotional distraction to assess cognitive control and a surprise faces task to assess emotional interpretation bias. The results indicated that high (vs. low) trauma symptom youth were ~ 20% worse correctly remembering the spatial location of a cue, although both groups performed at very low levels. However, this finding was not modulated by emotion. In addition, although all youths also had a ~ 20% bias toward interpreting ambiguous (surprise) faces as more negative, the high (vs. low) symptom youth were faster when allocating such a face to the positive (vs. negative) emotion category. The findings suggest the impact of war-related trauma on cognitive-affective processes essential to healthy development.
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24
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Minihan S, Samimi Z, Schweizer S. The effectiveness of affective compared to neutral working memory training in university students with test anxiety. Behav Res Ther 2021; 147:103974. [PMID: 34624665 PMCID: PMC7611905 DOI: 10.1016/j.brat.2021.103974] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 09/14/2021] [Accepted: 09/23/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Test anxiety (TA), defined as the emotional, physiological, and behavioural responses surrounding situations involving formal evaluation of performance, is a relatively common occurrence, and, when present, can be a disruptive factor in students' academic careers. Research indicates that working memory, in particular, affective working memory, is impaired in individuals with TA. The current study therefore explored whether training the application of working memory in affective contexts could reduce TA and associated cognitive and affective impairments. METHOD 60 Iranian university students (50% female; 19-22 years) with TA symptoms were randomized to receive 20 sessions of affective working memory training (aWMT), neutral working memory training (nWMT) or to a no-training control group. Prior and immediately after training, all participants completed measures of TA, working memory, cognitive control, and emotion regulation. RESULTS Compared to the control group, both the aWMT and the nWMT groups demonstrated improved cognitive and affective functioning from pre-to post-training. However, the reduction in TA symptoms and improvement in emotion regulation was greater in the aWMT group compared to the nWMT group. CONCLUSION aWMT may be an effective means of not only reducing TA, but also enhancing cognitive and affective functioning. These preliminary findings are promising given the potential for free and easy dissemination of aWMT in schools and online settings, including low- and middle-income countries.
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Affiliation(s)
- Savannah Minihan
- University of New South Wales, School of Psychology, Developmental Affective Science Lab, Australia
| | - Zobair Samimi
- International University of Chabahar, Department of Educational Science, Chabahar, Iran
| | - Susanne Schweizer
- University of New South Wales, School of Psychology, Developmental Affective Science Lab, Australia; University of Cambridge, Department of Psychology, Developmental Cognitive Neuroscience Group, UK.
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25
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Executive Functioning and Emotion Regulation in Children with and without ADHD. Res Child Adolesc Psychopathol 2021; 50:721-735. [PMID: 34762251 DOI: 10.1007/s10802-021-00883-0] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/20/2021] [Indexed: 10/19/2022]
Abstract
Difficulties with emotion regulation affect the majority of youth with attention-deficit/hyperactivity disorder (ADHD) and predict greater functional impairment than ADHD symptoms alone. Deficits in executive functioning are also present for most children with ADHD, and have been linked with emotion regulation difficulties in both clinical and neurotypical populations throughout development. The current study was the first to assess all three core executive functions (working memory, inhibitory control, set shifting) simultaneously in a clinically-diverse sample of children with and without ADHD and common comorbidities and investigate the extent to which they uniquely predict emotion dysregulation. A sample of 151 children ages 8-13 years (M = 10.36, SD = 1.52; 52 girls; 70.2% White/Non-Hispanic) were assessed using a criterion battery of executive functioning tasks, teacher-reported ADHD symptoms, and parent-reported emotion regulation. Results of the bias-corrected, bootstrapped conditional effects path model revealed that better-developed working memory predicted better emotion regulation (β = 0.23) and fewer ADHD symptoms (β = -0.21 to -0.37), that ADHD symptoms (β = -0.18 to -0.20) independently predicted emotion dysregulation, and that working memory exerted indirect effects on emotion regulation through both inattention and hyperactivity/impulsivity (β = 0.04-0.07). Sensitivity analyses indicated that these effects were generally robust to control for age, sex, executive function interrelations, and inclusion/exclusion of children with co-occurring ASD. These findings underscore the importance of working memory (relative to inhibitory control and set shifting) and its relations with ADHD symptoms for understanding children's emotion regulation skills, and may help explain the limited efficacy of first-line ADHD treatments, which do not target working memory, for improving emotion regulation skills.
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26
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Ben-Avraham R, Afek A, Berezin Cohen N, Davidov A, Van Vleet T, Jordan J, Ben Yehudah A, Gilboa Y, Nahum M. Feasibility and preliminary effectiveness of mobile cognitive control training during basic combat training in the military. MILITARY PSYCHOLOGY 2021. [DOI: 10.1080/08995605.2021.1969162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Rina Ben-Avraham
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Anat Afek
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Noa Berezin Cohen
- Department of Health and Well-Being, Medical Corps, Israel Defense Forces (IDF), Israel
| | - Alex Davidov
- Medical Branch, Ground Forces, Israel Defense Forces (IDF), Israel
| | - Tom Van Vleet
- Department of Research and Development, Posit Science Corporation, San Francisco, California
| | - Josh Jordan
- Department of Psychology, Dominican University of California, San Rafael, California
| | - Ariel Ben Yehudah
- Department of Health and Well-Being, Medical Corps, Israel Defense Forces (IDF), Israel
| | - Yafit Gilboa
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
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27
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Nyvold O, Nygaard E, Augusti EM, Tamnes CK. Unity or diversity of executive functioning in children and adolescents with post-traumatic stress symptoms? A systematic review and meta-analysis. Child Neuropsychol 2021; 28:374-393. [PMID: 34553675 DOI: 10.1080/09297049.2021.1979950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
For some children, psychological reactions to a traumatic event develop into severe or persistent post-traumatic stress symptoms (PTSS) or the clinical condition of post-traumatic stress disorder (PTSD). Cognitive problems in children with PTSS have been reported, but it is not clear which specific functions are affected. Executive functions is a domain of particular interest, given its importance for academic performance and social and emotional functioning. A systematic literature search was performed, and 12 studies with 55 comparisons of executive functions in children with PTSS and healthy controls were eligible for meta-analysis. A subset of the studies also included a comparison group of children with traumatic experienced but without PTSS. Overall, across all tasks and measures, children with PTSS showed lower executive functioning than healthy controls (SMD = -0.57). The effect sizes between the subdomains complex tasks, verbal fluency, inhibition, shifting and working memory were not significantly different from each other, but was largest for verbal fluency (SMD = -1.45). Analyses comparing children with traumatic experiences with and without PTSS similarly showed overall lower executive functioning in the PTSS group (SMD = -0.34) and no significant differences in effect sizes between subdomains. The results have implications for assessment and clinical work with youth exposed to traumatic events. We should be aware of the poor executive functioning that may be an issue for some children with a history of trauma and subsequent development of PTSS, and the impact this could have on everyday functioning.
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Affiliation(s)
- Otelie Nyvold
- Nic Waals Institute, Lovisenberg Hospital, Oslo, Norway
| | - Egil Nygaard
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Else-Marie Augusti
- Norwegian Centre for Violence and Traumatic Stress Studies, Oslo, Norway
| | - Christian K Tamnes
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway.,NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
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28
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Echiverri-Cohen A, Spierer L, Perez M, Kulon M, Ellis MD, Craske M. Randomized-controlled trial of response inhibition training for individuals with PTSD and impaired response inhibition. Behav Res Ther 2021; 143:103885. [PMID: 34089923 DOI: 10.1016/j.brat.2021.103885] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 04/04/2021] [Accepted: 05/01/2021] [Indexed: 10/21/2022]
Abstract
Deficits in response inhibition, defined as an inability to stop a behavior that is no longer relevant, are characteristic of posttraumatic stress disorder (PTSD). Given that impaired response inhibition is associated with worse symptom recovery and accumulating evidence pointing to the effectiveness of cognitive control trainings in reducing PTSD symptoms, individuals with moderate to severe PTSD total severity (Posttraumatic Diagnostic Scale total score ≥ 21) and pre-training response inhibition deficits (M ≤ 75% successful inhibition on the Go/No-go) completed a 3-h, adaptive Go/No-go training designed to improve ability to withhold prepotent motor responses. Then forty-nine participants were randomized to an adaptive response inhibition training (n = 24, M = 19.27 years, SD = 0.70) or a waitlist condition (n = 25, M = 18.31 years, SD = 4.80). Behavioral response inhibition and self-reported trauma-related symptoms were assessed at pre- and post-training. Response inhibition training was associated with improved response inhibition on an untrained transfer Stop-Signal task and symptom reduction in PTSD compared to a waitlist group, at post-training. There was, however, reduced inhibition on a modified Go/No-go task from pre-to post-training. Overall, response inhibition deficits and PTSD symptoms are amenable to top-down remediation using response inhibition training. Our study provides preliminary evidence for the feasibility of response inhibition training in a PTSD sample characterized by response inhibition deficits.
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Affiliation(s)
| | - Lucas Spierer
- Neurology Unit, Medicine Section, Faculty of Science and Medicine, University of Fribourg, Switzerland
| | - Marcelina Perez
- Department of Psychology, University of California, Los Angeles, CA, USA
| | - Melissa Kulon
- Department of Psychology, University of California, Los Angeles, CA, USA
| | | | - Michelle Craske
- Department of Psychology, University of California, Los Angeles, CA, USA
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29
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Emerging Domain-Based Treatments for Pediatric Anxiety Disorders. Biol Psychiatry 2021; 89:716-725. [PMID: 33451677 DOI: 10.1016/j.biopsych.2020.08.030] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2020] [Revised: 08/19/2020] [Accepted: 08/19/2020] [Indexed: 12/25/2022]
Abstract
Domain-specific cognitive training treatments for pediatric anxiety disorders rely on accurate and reliable identification of specific underlying deficits and biases in neurocognitive functions. Once identified, such biases can serve as specific targets for therapeutic intervention. Clinical translations typically reflect mechanized training protocols designed to rectify the identified biases. Here, we review and synthesize research on key neurocognitive processes that emerge as potential targets for specialized cognitive training interventions in pediatric anxiety disorders in the domains of attention, interpretation, error monitoring, working memory, and fear learning. For each domain, we describe the current status of target establishment (i.e., an association between pediatric anxiety and a specific neurocognitive process), and then review extant translational efforts regarding these targets and the evidence supporting their clinical utility in youths. We then localize each of the domains within the path leading to efficacious, evidence-supported treatments for pediatric anxiety, providing a roadmap for future research. The review indicates that specific cognitive targets in pediatric anxiety have been established in all the reviewed domains except for fear learning, where a clear target is yet to be elucidated. In contrast, evidence for clinical efficacy emerged only in the threat-related attention domain, with some preliminary findings in the domains of interpretation and working memory. The path to clinical translation in the domain of error monitoring is yet unclear. Implications and potential avenues for future research and translation are discussed.
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30
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Smits FM, Geuze E, Schutter DJLG, van Honk J, Gladwin TE. Effects of tDCS during inhibitory control training on performance and PTSD, aggression and anxiety symptoms: a randomized-controlled trial in a military sample. Psychol Med 2021; 52:1-11. [PMID: 33757606 PMCID: PMC9811348 DOI: 10.1017/s0033291721000817] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 01/19/2021] [Accepted: 02/22/2021] [Indexed: 02/06/2023]
Abstract
BACKGROUND Post-traumatic stress disorder (PTSD), anxiety, and impulsive aggression are linked to transdiagnostic neurocognitive deficits. This includes impaired inhibitory control over inappropriate responses. Prior studies showed that inhibitory control can be improved by modulating the right inferior frontal gyrus (IFG) with transcranial direct current stimulation (tDCS) in combination with inhibitory control training. However, its clinical potential remains unclear. We therefore aimed to replicate a tDCS-enhanced inhibitory control training in a clinical sample and test whether this reduces stress-related mental health symptoms. METHODS In a preregistered double-blind randomized-controlled trial, 100 active-duty military personnel and post-active veterans with PTSD, anxiety, or impulsive aggression symptoms underwent a 5-session intervention where a stop-signal response inhibition training was combined with anodal tDCS over the right IFG for 20 min at 1.25 mA. Inhibitory control was evaluated with the emotional go/no-go task and implicit association test. Stress-related symptoms were assessed by self-report at baseline, post-intervention, and after 3-months and 1-year follow-ups. RESULTS Active relative to sham tDCS neither influenced performance during inhibitory control training nor on assessment tasks, and did also not significantly influence self-reported symptoms of PTSD, anxiety, impulsive aggression, or depression at post-assessment or follow-up. CONCLUSIONS Our results do not support the idea that anodal tDCS over the right IFG at 1.25 mA enhances response inhibition training in a clinical sample, or that this tDCS-training combination can reduce stress-related symptoms. Applying different tDCS parameters or combining tDCS with more challenging tasks might provide better conditions to modulate cognitive functioning and stress-related symptoms.
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Affiliation(s)
- Fenne M. Smits
- Brain Research & Innovation Centre, Ministry of Defence, Utrecht, the Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Elbert Geuze
- Brain Research & Innovation Centre, Ministry of Defence, Utrecht, the Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | - Jack van Honk
- Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, the Netherlands
- Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
- Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa
| | - Thomas E. Gladwin
- Behavioural Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands
- Institute for Lifecourse Development, University of Greenwich, London, UK
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31
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Alexander R, Aragón OR, Bookwala J, Cherbuin N, Gatt JM, Kahrilas IJ, Kästner N, Lawrence A, Lowe L, Morrison RG, Mueller SC, Nusslock R, Papadelis C, Polnaszek KL, Helene Richter S, Silton RL, Styliadis C. The neuroscience of positive emotions and affect: Implications for cultivating happiness and wellbeing. Neurosci Biobehav Rev 2021; 121:220-249. [PMID: 33307046 DOI: 10.1016/j.neubiorev.2020.12.002] [Citation(s) in RCA: 63] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Revised: 11/10/2020] [Accepted: 12/06/2020] [Indexed: 02/07/2023]
Abstract
This review paper provides an integrative account regarding neurophysiological correlates of positive emotions and affect that cumulatively contribute to the scaffolding for happiness and wellbeing in humans and other animals. This paper reviews the associations among neurotransmitters, hormones, brain networks, and cognitive functions in the context of positive emotions and affect. Consideration of lifespan developmental perspectives are incorporated, and we also examine the impact of healthy social relationships and environmental contexts on the modulation of positive emotions and affect. The neurophysiological processes that implement positive emotions are dynamic and modifiable, and meditative practices as well as flow states that change patterns of brain function and ultimately support wellbeing are also discussed. This review is part of "The Human Affectome Project" (http://neuroqualia.org/background.php), and in order to advance a primary aim of the Human Affectome Project, we also reviewed relevant linguistic dimensions and terminology that characterizes positive emotions and wellbeing. These linguistic dimensions are discussed within the context of the neuroscience literature with the overarching goal of generating novel recommendations for advancing neuroscience research on positive emotions and wellbeing.
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Affiliation(s)
- Rebecca Alexander
- Neuroscience Research Australia, Randwick, Sydney, NSW, 2031, Australia; Australian National University, Canberra, ACT, 2601, Australia
| | - Oriana R Aragón
- Yale University, 2 Hillhouse Ave, New Haven, CT, 06520, USA; Clemson University, 252 Sirrine Hall, Clemson, SC, 29634, USA
| | - Jamila Bookwala
- Department of Psychology and Program in Aging Studies, Lafayette College, 730 High Road, Easton, PA, USA
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health, and Wellbeing, Australian National University, Canberra, ACT, 2601, Australia
| | - Justine M Gatt
- Neuroscience Research Australia, Randwick, Sydney, NSW, 2031, Australia; School of Psychology, University of New South Wales, Randwick, Sydney, NSW, 2031, Australia
| | - Ian J Kahrilas
- Department of Psychology, Loyola University Chicago, 1032 W. Sheridan Road, Chicago, IL, 60660, USA
| | - Niklas Kästner
- Department of Behavioural Biology, University of Münster, Badestraße 13, 48149, Münster, Germany
| | - Alistair Lawrence
- Scotland's Rural College, King's Buildings, Edinburgh, EH9 3JG, United Kingdom; The Roslin Institute, University of Edinburgh, Easter Bush, EH25 9RG, United Kingdom
| | - Leroy Lowe
- Neuroqualia (NGO), Truro, NS, B2N 1X5, Canada
| | - Robert G Morrison
- Department of Psychology, Loyola University Chicago, 1032 W. Sheridan Road, Chicago, IL, 60660, USA
| | - Sven C Mueller
- Department of Experimental Clinical and Health Psychology, Ghent University, Ghent, Belgium; Department of Personality, Psychological Assessment and Treatment, University of Deusto, Bilbao, Spain
| | - Robin Nusslock
- Department of Psychology and Institute for Policy Research, Northwestern University, 2029 Sheridan Road, Evanston, IL, 60208, USA
| | - Christos Papadelis
- Jane and John Justin Neurosciences Center, Cook Children's Health Care System, 1500 Cooper St, Fort Worth, TX, 76104, USA; Laboratory of Children's Brain Dynamics, Division of Newborn Medicine, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kelly L Polnaszek
- Department of Psychology, Loyola University Chicago, 1032 W. Sheridan Road, Chicago, IL, 60660, USA
| | - S Helene Richter
- Department of Behavioural Biology, University of Münster, Badestraße 13, 48149, Münster, Germany
| | - Rebecca L Silton
- Department of Psychology, Loyola University Chicago, 1032 W. Sheridan Road, Chicago, IL, 60660, USA; Institute for Innovations in Developmental Sciences, Northwestern University, 633 N. Saint Clair, Chicago, IL, 60611, USA.
| | - Charis Styliadis
- Neuroscience of Cognition and Affection group, Lab of Medical Physics, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece
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The Effects of Emotional Working Memory Training on Worry Symptoms and Error-Related Negativity of Individuals with High Trait Anxiety: A Randomized Controlled Study. COGNITIVE THERAPY AND RESEARCH 2020. [DOI: 10.1007/s10608-020-10164-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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Mewton L, Hodge A, Gates N, Visontay R, Lees B, Teesson M. A randomised double-blind trial of cognitive training for the prevention of psychopathology in at-risk youth. Behav Res Ther 2020; 132:103672. [PMID: 32629291 DOI: 10.1016/j.brat.2020.103672] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 05/21/2020] [Accepted: 06/04/2020] [Indexed: 12/27/2022]
Abstract
BACKGROUND The aim of this study was to evaluate the effectiveness of online cognitive training as a means of reducing psychopathology in at-risk youth. METHODS In a double-blind randomised controlled trial, 228 youths (mean age = 18.6, 74.6% female) were randomly allocated to either an intervention group (n = 114; online cognitive training focused on executive functioning) and a control group (n = 114; online cognitive training focused on other cognitive abilities). Participants were assessed online at baseline, post-training, 3-, 6- and 12-month follow-up. The primary outcome of the study was overall psychopathology as measured by the Strengths and Difficulties Questionnaire. Secondary outcomes were executive functioning ability (assessed using the n-back, trail-making and Stroop tasks), day-to-day functioning and risky drinking. RESULTS Mixed model intention-to-treat analyses indicated that psychopathology increased and day-to-day functioning decreased, regardless of intervention group. Those in the intervention group improved more than those in the control group in terms of the n-back task, but this was not statistically significant after adjusting for multiple comparisons. There were no statistically significant effects on risky drinking, or the trail-making and Stroop tasks. CONCLUSION This study failed to provide evidence for the efficacy of cognitive training as a stand-alone intervention for psychopathology.
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Affiliation(s)
- Louise Mewton
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia.
| | - Antoinette Hodge
- Child Development Unit, The Children's Hospital, Westmead, Australia
| | - Nicola Gates
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Rachel Visontay
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Briana Lees
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
| | - Maree Teesson
- The Matilda Centre for Research in Mental Health and Substance Use, University of Sydney, Sydney, Australia
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Schweizer S, Gotlib IH, Blakemore SJ. The role of affective control in emotion regulation during adolescence. ACTA ACUST UNITED AC 2020; 20:80-86. [PMID: 31961183 PMCID: PMC6975522 DOI: 10.1037/emo0000695] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
In this review, we evaluate evidence for the hypothesis that developmental changes in emotion regulation tendencies during adolescence depend on the maturation of affective control. Affective control refers to the application of cognitive control to affective contexts, that is, the capacity to attend and respond to goal-relevant affective information, while inhibiting attention and responses toward distracting affective information. The evidence suggests that affective control develops throughout adolescence into adulthood. However, the developmental trajectory appears not to be uniform across different facets of affective control. In particular, the capacity to inhibit attention and responses to distracting affective information may be reduced during adolescence relative to childhood and adulthood. Focusing on the association between affective control and emotion regulation development in adolescence, the research reviewed supports the notion of affective control as a cognitive building block of successful emotion regulation. Good affective control appears related to fewer ruminative tendencies in adolescence as well as more frequent and successful reappraisal in older adolescents. Lower use of habitual suppression, itself a type of affective inhibition, shows an association with updating capacity. We conclude by discussing the implications of these findings for mental health and the potential mental health benefits associated with improving affective control. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Susanne Schweizer
- Developmental Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London
| | | | - Sarah-Jayne Blakemore
- Developmental Cognitive Neuroscience Group, Institute of Cognitive Neuroscience, University College London
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35
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Groves NB, Kofler MJ, Wells EL, Day TN, Chan ESM. An Examination of Relations Among Working Memory, ADHD Symptoms, and Emotion Regulation. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:525-537. [PMID: 31900835 PMCID: PMC7318097 DOI: 10.1007/s10802-019-00612-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Emotion regulation difficulties are present in many, if not most, children with attention-deficit/hyperactivity disorder (ADHD) and confer risk for a host of adverse outcomes. Little is known, however, regarding the neurocognitive and behavioral mechanisms that underlie these difficulties. A well-characterized, clinically evaluated sample of 145 children ages 8-13 years (M = 10.33, SD = 1.47; 55 girls; 69% White/non-Hispanic) were administered multiple, counterbalanced working memory tests and assessed for emotion dysregulation and ADHD symptoms via multiple-informant reports. Bias-corrected, bootstrapped conditional effects modeling indicated that underdeveloped working memory exerted significant direct effects on emotion regulation in all tested models as well as indirect effects on emotion regulation via parent-reported hyperactive/impulsive symptoms (95% CIs excluded zero). Interestingly, hyperactive/impulsive symptoms also predicted emotion dysregulation when controlling for the influence of working memory. Inattention failed to predict emotion regulation difficulties in all tested models (all 95% CIs included zero). This pattern of results replicated across parent and teacher models and were robust to control for mono-informant bias, age, and gender. These findings suggest that emotion dysregulation in ADHD reflects, in part, both a direct outcome of underdeveloped working memory and an affective outcome of hyperactive and/or impulsive symptomatology, both attributable to and independent of the role of underlying working memory deficits.
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Affiliation(s)
- Nicole B Groves
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Michael J Kofler
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA.
| | - Erica L Wells
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Taylor N Day
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
| | - Elizabeth S M Chan
- Department of Psychology, Florida State University, 1107 W. Call Street, Tallahassee, FL, 32306-4301, USA
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Barkus E. Effects of working memory training on emotion regulation: Transdiagnostic review. Psych J 2020; 9:258-279. [PMID: 32166891 DOI: 10.1002/pchj.353] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2019] [Revised: 10/20/2019] [Accepted: 11/19/2019] [Indexed: 12/18/2022]
Abstract
Working memory training is widely used transdiagnostically to improve cognition. However, more recently, studies using working memory training packages have targeted emotion-regulation outcomes to determine whether far transfer effects can be achieved. A narrative review is conducted of studies that have used standardized computerized working memory training packages across healthy volunteers, affect, anxiety, post-traumatic stress disorder (PTSD), and eating disordered populations with emotion-regulation outcomes. Working memory training has been used in children, adolescents, and adults to improve emotion regulation. Many studies have reported gains in mood as well as emotion-regulation strategies following working memory training, regardless of clinical indication and whether near transfer gains were achieved in cognitive domains. Significant emotion-regulation outcomes include: state and trait anxiety, rumination, brooding, positive appraisal, decreasing maladaptive emotion-regulation strategies, and decreasing intrusive thoughts. It is speculated that these far transfer outcomes from working memory training are possible due to the cognitive and neural overlap between cognitive and affective working memory, and emotion regulation. Working memory training could improve cognitive efficiency, which, in turn, increases the availability of cognitive resources during times when emotion regulation is taxed. Future studies need to consider the role of participant expectancy in predicting outcome measure performance, and including subjective and objective outcomes is paramount to study design. Furthermore, sample sizes require additional attention, given that the current review highlights that individual differences in non-clinical and clinical populations influence the outcomes from working memory training. Working memory training offers a possibility for improving emotion regulation transdiagnostically.
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Affiliation(s)
- Emma Barkus
- School of Psychology, University of Wollongong, Wollongong, Australia
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Krause-Utz A, Walther JC, Schweizer S, Lis S, Hampshire A, Schmahl C, Bohus M. Effectiveness of an Emotional Working Memory Training in Borderline Personality Disorder: A Proof-of-Principle Study. PSYCHOTHERAPY AND PSYCHOSOMATICS 2020; 89:122-124. [PMID: 31901902 PMCID: PMC7949222 DOI: 10.1159/000504454] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/01/2019] [Accepted: 10/30/2019] [Indexed: 11/19/2022]
Affiliation(s)
- Annegret Krause-Utz
- Institute of Psychology, Leiden Institute for Brain and Cognition, Leiden University, Leiden, The Netherlands,
| | - Julia-Caroline Walther
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Susanne Schweizer
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom,School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Stefanie Lis
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Adam Hampshire
- Division of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
| | - Christian Schmahl
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany,Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Martin Bohus
- Institute of Psychiatric and Psychosomatic Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany,Harvard Medical School and McLean Hospital, Belmont, Massachusetts, USA
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Schweizer S, Parker J, Leung JT, Griffin C, Blakemore SJ. Age-related differences in affective control and its association with mental health difficulties. Dev Psychopathol 2020; 32:329-341. [PMID: 30907719 PMCID: PMC6982534 DOI: 10.1017/s0954579419000099] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Revised: 12/05/2018] [Accepted: 12/09/2019] [Indexed: 12/30/2022]
Abstract
Difficulties in regulating affect are core characteristics of a wide range of mental health conditions and are associated with deficits in cognitive control, particularly in affective contexts, affective control. The current study explored how affective control relates to mental health over the course of adolescence. We developed an Affective Control Task, which was administered to young adolescents (11-14 years; n = 29); mid-adolescents (15-18 years; n = 31), and adults (22-30 years; n = 31). The task required individuals to sort cards according to continuously changing rules: color, number, or item type. There was a neutral condition in which items were shapes, and an affective condition, in which items were emotional facial expressions. Better affective control was associated with fewer mental health difficulties (p < .001, R2 = .15). Affective control partially accounted for the association between age group and mental health problems, z = 2.61, p = .009, Akaike information criterion = 484, with the association being strongest in young adolescents, r (27) = -.44, p = .018. Affective control further accounted for variance in the association between self-reported (but not experimental) emotion regulation and mental health (z = -3.44, p < .001, Akaike information criterion = 440). Poor affective control, especially in young adolescents, is associated with more mental health problems and higher levels of emotion regulation difficulties. Improving affective control therefore may constitute a promising target for prevention.
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Affiliation(s)
- Susanne Schweizer
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Jenna Parker
- Medical Research Council Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | - Jovita T. Leung
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Cait Griffin
- Institute of Cognitive Neuroscience, University College London, London, UK
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du Toit SA, Kade SA, Danielson CT, Schweizer S, Han J, Torok M, Wong QJJ. The effect of emotional working memory training on emotional and cognitive outcomes in individuals with elevated social anxiety. J Affect Disord 2020; 261:76-83. [PMID: 31605835 DOI: 10.1016/j.jad.2019.09.085] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 08/18/2019] [Accepted: 09/30/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Although cognitive-behavioural therapy is the gold standard psychological treatment for individuals with social anxiety disorder (SAD), it does not benefit everyone. Emotional working memory training (eWMT) is a promising alternative intervention. This study examined the effects of eWMT versus control training (CT) on emotional and cognitive outcomes in individuals with elevated social anxiety. METHODS Forty participants with elevated social anxiety were randomly allocated to eWMT (n = 21) or CT (n = 19), each consisting of six training sessions. At pre- and post-training, participants completed: a working memory task, an impromptu speech, and self-reported measures of emotional and cognitive outcomes (anticipatory processing, peak anxiety and attentional focus during the speech, post-event processing). RESULTS Participants in both training conditions exhibited performance improvements on their respective training tasks. As expected, there was a Time x Condition interaction for peak anxiety, reflecting a decrease in peak anxiety for the eWMT condition but not the CT condition. Exploratory analyses also indicated a Time x Condition interaction for an aspect of post-event processing, reflecting a decrease in thinking about the past for the eWMT condition but not the CT condition. LIMITATIONS Although the level of social anxiety of the current sample is comparable to that of samples of individuals diagnosed with SAD in the literature, participant diagnoses were not assessed in this study. CONCLUSIONS The findings suggest that eWMT has potential as an alternative intervention for individuals with elevated social anxiety.
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Affiliation(s)
- Simone A du Toit
- School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, Australia
| | - Saif A Kade
- School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, Australia
| | - Craig T Danielson
- School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, Australia
| | - Susanne Schweizer
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Jin Han
- Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Michelle Torok
- Black Dog Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Quincy J J Wong
- School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, Australia.
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Neural correlates of emotion-attention interactions: From perception, learning, and memory to social cognition, individual differences, and training interventions. Neurosci Biobehav Rev 2020; 108:559-601. [DOI: 10.1016/j.neubiorev.2019.08.017] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2019] [Revised: 07/02/2019] [Accepted: 08/21/2019] [Indexed: 12/12/2022]
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Schweizer S, Leung JT, Kievit R, Speekenbrink M, Trender W, Hampshire A, Blakemore SJ. Protocol for an app-based affective control training for adolescents: proof-of-principle double-blind randomized controlled trial. Wellcome Open Res 2019; 4:91. [PMID: 31289755 PMCID: PMC6600858 DOI: 10.12688/wellcomeopenres.15229.1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2019] [Indexed: 03/30/2024] Open
Abstract
Background: 75% of all mental health problems have their onset before the end of adolescence. Therefore, adolescence may be a particularly sensitive time period for preventing mental health problems. Affective control, the capacity to engage with goal relevant and inhibit distracting information in affective contexts, has been proposed as a potential target for prevention. In this study, we will explore the impact of improving adolescents' affective control capacity on their mental health. Methods: The proof-of-principle double-blind randomized controlled trial will compare the effectiveness of an app-based affective control training (AffeCT) to a placebo training (P-Training) app. In total, 200 (~50% females) adolescents (11-19 years) will train for 14 days on their training app. The AffeCT will include three different n-back tasks: visuospatial, auditory and dual (i.e., including both modalities). These tasks require participants to flexibly engage and disengage with affective and neutral stimuli (i.e., faces and words). The P-Training will present participants with a perceptual matching task. The three versions of the P-Training tasks vary in the stimuli included (i.e., shapes, words and faces). The two training groups will be compared on gains in affective control, mental health, emotion regulation and self-regulation, immediately after training, one month and one year after training. Discussion: If, as predicted, the proposed study finds that AffeCT successfully improves affective control in adolescents, there would be significant potential benefits to adolescent mental health. As a free app, the training would also be scalable and easy to disseminate across a wide range of settings. Trial registration: The trial was registered on December 10th 2018 with the International Standard Randomised Controlled Trial Number (Registration number: ISRCTN17213032).
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Affiliation(s)
- Susanne Schweizer
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Jovita T. Leung
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Rogier Kievit
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | | | - William Trender
- Department of Medicine & Centre for Neurotechnology Computational, Cognitive & Clinical Neuroimaging Laboratory, Imperial Collge London, London, UK
| | - Adam Hampshire
- Department of Medicine & Centre for Neurotechnology Computational, Cognitive & Clinical Neuroimaging Laboratory, Imperial Collge London, London, UK
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Schweizer S, Leung JT, Kievit R, Speekenbrink M, Trender W, Hampshire A, Blakemore SJ. Protocol for an app-based affective control training for adolescents: proof-of-principle double-blind randomized controlled trial. Wellcome Open Res 2019; 4:91. [PMID: 31289755 PMCID: PMC6600858 DOI: 10.12688/wellcomeopenres.15229.2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2019] [Indexed: 12/17/2022] Open
Abstract
Background: 75% of all mental health problems have their onset before the end of adolescence. Therefore, adolescence may be a particularly sensitive time period for preventing mental health problems. Affective control, the capacity to engage with goal relevant and inhibit distracting information in affective contexts, has been proposed as a potential target for prevention. In this study, we will explore the impact of improving adolescents’ affective control capacity on their mental health. Methods: The proof-of-principle double-blind randomized controlled trial will compare the effectiveness of an app-based affective control training (AffeCT) to a placebo training (P-Training) app. In total, 200 (~50% females) adolescents (11-19 years) will train for 14 days on their training app. The AffeCT will include three different
n-back tasks: visuospatial, auditory and dual (i.e., including both modalities). These tasks require participants to flexibly engage and disengage with affective and neutral stimuli (i.e., faces and words). The P-Training will present participants with a perceptual matching task. The three versions of the P-Training tasks vary in the stimuli included (i.e., shapes, words and faces). The two training groups will be compared on gains in affective control, mental health, emotion regulation and self-regulation, immediately after training, one month and one year after training. Discussion: If, as predicted, the proposed study finds that AffeCT successfully improves affective control in adolescents, there would be significant potential benefits to adolescent mental health. As a free app, the training would also be scalable and easy to disseminate across a wide range of settings. Trial registration: The trial was registered on December 10th 2018 with the International Standard Randomised Controlled Trial Number (Registration number:
ISRCTN17213032).
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Affiliation(s)
- Susanne Schweizer
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Jovita T Leung
- Institute of Cognitive Neuroscience, University College London, London, UK
| | - Rogier Kievit
- MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK
| | | | - William Trender
- Department of Medicine & Centre for Neurotechnology Computational, Cognitive & Clinical Neuroimaging Laboratory, Imperial Collge London, London, UK
| | - Adam Hampshire
- Department of Medicine & Centre for Neurotechnology Computational, Cognitive & Clinical Neuroimaging Laboratory, Imperial Collge London, London, UK
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van Schie K, van Veen SC, Hagenaars MA. The effects of dual-tasks on intrusive memories following analogue trauma. Behav Res Ther 2019; 120:103448. [PMID: 31398536 DOI: 10.1016/j.brat.2019.103448] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 07/02/2019] [Accepted: 07/26/2019] [Indexed: 02/05/2023]
Abstract
Patients with post-traumatic stress disorder frequently and involuntarily experience intrusions, which are strongly linked to the trauma hotspot. Voluntary memory characteristics (i.e., vividness and unpleasantness) of this hotspot can be reduced by performing a dual-task, such as making horizontal eye movements, which is frequently used in Eye Movement Desensitization and Reprocessing. We tested whether such dual-task interventions would also reduce involuntary memory (i.e., intrusions). Moreover, we examined if changes in hotspot vividness and unpleasantness predicted intrusion frequency. Additionally, we examined whether the effects were dependent on dual-task modality. We tested this in three experiments. Participants watched a trauma film and performed one of the interventions 10-min post-film (1) Recall + Eye movements, (2) Recall + Counting, or (3) No-Task Control. Before and after the intervention, participants rated the hotspot vividness and unpleasantness. They recorded intrusive memories about the film in a diary for a week. Unexpectedly, we found that hotspot vividness and unpleasantness ratings were not affected by the intervention. However, the prolonged (experiment 2), but not standard (experiment 1), dual-task interventions resulted in a lower number of intrusions, regardless of modality. However, this effect was not replicated in experiment 3. We discuss potential explanations and present suggestions for future research.
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Affiliation(s)
- Kevin van Schie
- Department of Psychology, Education & Child Studies, Erasmus School of Social and Behavioural Sciences, Erasmus University Rotterdam, Rotterdam, the Netherlands; Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands.
| | - Suzanne C van Veen
- Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands
| | - Muriel A Hagenaars
- Department of Clinical Psychology, Faculty of Social and Behavioural Sciences, Utrecht University, Utrecht, the Netherlands
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Attentional control abnormalities in posttraumatic stress disorder: Functional, behavioral, and structural correlates. J Affect Disord 2019; 253:343-351. [PMID: 31078834 PMCID: PMC6857173 DOI: 10.1016/j.jad.2019.04.098] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/19/2019] [Accepted: 04/30/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Attentional disruptions are common in PTSD, but findings across neuropsychological and neuroimaging studies have been variable. Few PTSD studies have investigated abnormalities in attention networks using a multi-modal imaging approach and attentional tasks that include emotionally-salient images. This study combined a behavioral task that included these images (emotional Stroop) with functional and structural neuroimaging (fMRI and diffusion tensor imaging; DTI) methods to comprehensively investigate attentional control abnormalities in a highly-traumatized civilian sample. METHODS 48 traumatized women with and without PTSD received clinical assessments, fMRI and DTI. During fMRI, the Affective Stroop (AS), an attentional control task that includes emotionally-salient distractor images (trauma-relevant, positive, neutral) and variable task demands, was administered. RESULTS In response to more difficult AS trials, participants with PTSD demonstrated lower activation in the dorsal and rostral anterior cingulate cortex and greater activation in the insula. This group also showed comparatively poorer performance on positive AS distractor trials, even after adjusting for trauma exposure. Performance on these trials inversely correlated with structural integrity of the cingulum bundle and uncinate fasciculus. CONCLUSIONS Even after adjusting for trauma exposure, participants with PTSD showed worse performance on an attentional control task in the context of emotional stimuli. They also showed relatively lower cognitive control network activation and greater salience network activation. Fronto-parietal and fronto-limbic white matter connectivity corresponded with AS performance. Our findings indicate that attentional control impairments in PTSD are most evident in the context of emotional cues, and are related to decrements in function and structure of cognitive control and salience networks.
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A pilot randomized trial of a dual n-back emotional working memory training program for veterans with elevated PTSD symptoms. Psychiatry Res 2019; 275:261-268. [PMID: 30939398 PMCID: PMC6508098 DOI: 10.1016/j.psychres.2019.02.015] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Revised: 02/06/2019] [Accepted: 02/06/2019] [Indexed: 11/20/2022]
Abstract
Anxiety is characterized by excessive attention to threatening information, leading to impaired working memory (WM) performance and elevated anxious thoughts. Preliminary research indicates that individuals with PTSD show particular difficulty with WM in emotional contexts (Schweizer et al., 2011). Although several studies show that computerized training can improve WM capacity for anxious individuals (Owens et al., 2013; Schweizer et al., 2011; 2013), there has been very little research on WM training for PTSD or with Veterans (Saunders et al., 2015). In a pilot randomized trial, we assigned Veterans with elevated PTSD symptoms to an online emotional WM training, either adaptive (n-back; n = 11) or a less potent training (1-back; n = 10). Overall, both groups showed significant decreases in PTSD symptoms. The n-back group showed a trend of outperforming the 1-back group in improving reexperiencing symptoms (which are likely to be associated with impaired WM functioning). This population anecdotally found the intervention quite challenging, which may be why even the less potent 1-back was still helpful. These preliminary findings justify the effort for developing new WM-focused PTSD intervention for complex, vulnerable populations, particularly as online training can improve accessibility.
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46
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Beloe P, Derakshan N. Adaptive working memory training can reduce anxiety and depression vulnerability in adolescents. Dev Sci 2019; 23:e12831. [DOI: 10.1111/desc.12831] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 01/17/2019] [Accepted: 03/18/2019] [Indexed: 12/29/2022]
Affiliation(s)
- Patricia Beloe
- Department of Psychological Sciences Birkbeck University of London London UK
| | - Nazanin Derakshan
- Department of Psychological Sciences Birkbeck University of London London UK
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Sheerin CM, Konig A, Eonta AM, Vrana SR. Effect of expressive and neutral writing on respiratory sinus arrhythmia response over time. J Behav Ther Exp Psychiatry 2018; 59:129-133. [PMID: 29408050 PMCID: PMC5866212 DOI: 10.1016/j.jbtep.2018.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Revised: 11/20/2017] [Accepted: 01/10/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND AND OBJECTIVES Parasympathetic activity, as indexed by respiratory sinus arrhythmia (RSA), underlies key aspects of emotional and cognitive self-regulation. Examining time-varying RSA response during expressive writing about trauma may help inform theory about mechanisms of this intervention. The present study investigated changes in RSA during expressive writing. METHODS Participants (N = 246, Mage = 21.5 years, 72% female) were randomly assigned to expressive or neutral writing conditions and wrote for three 20-min sessions. RSA was measured continuously during the first and third writing session. RESULTS Linear mixed model analyses of RSA changes within and across sessions by writing groups found that neutral writers, but not expressive writers, exhibited change in RSA. The overall RSA changes during expressive and neutral writing are consistent with theory about the relationship between cognitive and emotional processing mechanisms and vagal activation. LIMITATIONS As the present study was not a clinical sample selected on trauma exposure, findings should be considered preliminary. Additionally, engagement of affective and cognitive processes was only hypothesized, as manipulation checks were not performed. CONCLUSIONS The present study illustrates the benefits of examining changes in RSA over time. Future work with clinical samples should include additional measures and tasks to better define these mechanisms and rule out alternative hypotheses.
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Affiliation(s)
- Christina M Sheerin
- Virginia Institute for Psychiatric and Behavioral Genetics, 800 E Leigh Street, Richmond, VA, USA; Virginia Commonwealth University, 821 West Franklin St., Richmond, VA, USA.
| | - Andrea Konig
- St. Mary’s of Bon Secours Virginia Health System; 5801 Bremo Rd. Richmond, VA
| | - Alison M. Eonta
- Virginia Commonwealth University; 821 West Franklin St., Richmond VA
| | - Scott R. Vrana
- Virginia Commonwealth University; 821 West Franklin St., Richmond VA
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