The Effects of Emotional Working Memory Training on Worry Symptoms and Error-Related Negativity of Individuals with High
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ORIGINAL ARTICLE
The Effects of Emotional Working Memory Training on Worry Symptoms and Error‑Related Negativity of Individuals with High Trait Anxiety: A Randomized Controlled Study Salahadin Lotfi1 · Richard T. Ward1 · Maryam Ayazi1 · Ken P. Bennett1 · Christine L. Larson1 · Han‑Joo Lee1 Accepted: 1 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Trait anxiety is characterized by impaired gating of threat from working memory (WM), allowing unnecessary maintenance of anxious cognitions. Improving filtering efficiency of threatening information through computerized WM training might reduce intrusive, worrisome thoughts. Methods We randomized high-trait anxious individuals to 9 sessions of high-potency n-back (n = 19) or low-potency 1-back (n = 18) training to examine their effects on various neurocognitive indices of WM functioning and emotional symptoms. Results Following the interventions, multilevel modeling analyses revealed both training conditions resulted in significant improvements in attentional (Flanker), WM capacity (operation and spatial span tasks), and WM filtering efficiency (change detection task) measures, and increased N2 amplitudes. However, the high-potency training produced more favorable results at post-training, indexed by larger ERN amplitudes. We also observed significant reductions in trait anxiety and worry symptoms for the high-potency training following the intervention, although, low-potency training caught up at follow-up with comparably reduced symptoms. Conclusions These results show that emotional WM training can improve neurocognitive processes of attention and WM as well as symptoms of worrying. Overall, this study encourages the development of a standalone or adjunctive cognitive intervention focused on WM for vulnerable populations with high trait anxiety or worry symptoms. Keywords Emotional working memory training · Trait anxiety · N2 · ERN · n-back
Introduction Anxiety disorders are associated with several societal and economic costs (Collins et al. 2011; Kessler et al. 2012; Lee and Lotfi 2017), many of which are likely the result of disruptions in normal cognitive functioning (Johnston et al. 2009; Lépine 2002; Robinson et al. 2013; Vytal et al. 2013). Given that evidence suggests these alterations in cognitive functioning serve as a potential risk factor for the development and maintenance of anxiety disorders (Beck and Clark 1997; Mathews and MacLeod 2005; Ouimet et al. 2009), it is likely that treatments aimed at alleviating these cognitive deficits may also reduce anxious symptomology. As such, * Han‑Joo Lee [email protected] 1
Department of Psychology, University of WisconsinMilwaukee, Milwaukee, WI 53201, USA
it is critical to investigate the effects cognitive training has on improving overall cognitive functioning and alleviating anxious symptomology. Attention is one domain of cognition that has consistently been shown to be affected by anxiety (Bar-Haim et al. 2007; Berggren and Derakshan 2013; Bishop
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