Predictors of Effective Working Memory Training in Individuals with Alcohol Use Disorders

Abstract

Background: Low working memory (WM) capacity is associated with alcohol use disorders (AUDs). The importance of WM to adaptive functioning has led to a recent influx of studies attempting to improve individual WM capacity using various cognitive training methods. The present study aimed to examine the efficacy of complex WM training for improving WM capacity among individuals with AUD. Methods: Individuals were randomized to complete either adaptive WM training or active control training. We applied a methodologically rigorous and structured approach, including a battery of near and moderate transfer measures in those with AUDs and a control group. Additionally, we examined cognitive factors (at baseline) and other predictors of adherence, training task improvement, and transfer. Results: Results suggest improved WM in individuals with AUDs and controls, as evidenced by improved scores on several transfer measures, after adaptive WM training. However, individuals with AUDs showed poorer adherence and less improvement on the training tasks themselves. Neither IQ, WM, sex, nor condition predicted adherence. Level of training task performance, baseline WM, and IQ predicted transfer task improvement. Conclusions: This is the first study to rigorously examine both the efficacy of WM training in those with AUDs, and predictors of successful training program adherence and transfer in a large sample. Among study completers, results suggest that although AUD status does not predict training improvement and transfer. However, AUD status did predict lower program adherence. WM training was more effective in those with higher cognitive ability at baseline. This study provides direct translation to the development of cognitive interventions for treating AUD.

A systematic review of treatments for alcohol-related cognitive impairment: lessons from the past and gaps for future interventions

“…Nevertheless, authors state that there was a large variability among the results, as the group with the longer abstinence period benefitted less from this method ( r 2 = 0.37) (Goldman & Goldman, 1988). A working memory programme (Gunn et al, 2018) positively improved several working memory transfer measures in patients with moderate-to-severe alcohol use disorder. This improvement was maintained at 30-day follow-up.…”

“…This improvement was maintained at 30-day follow-up. A greater improvement was found for patients with higher baseline working memory and intellectual quotient levels (Cohen's D = 0.35) (Gunn et al, 2018).…”

“…Several techniques other than computerised interventions have been used to cope with cognitive impairments in ARCI. For instance, errorless learning was found to be a useful approach to learn (or relearn) skills (Kessels et al, 2007; Oudman et al, 2013; Rensen et al, 2017) as well as splitting the learning material into simpler components that are learned gradually (Goldman & Goldman, 1988; Gunn et al, 2018) and adding external feedback when teaching new procedures (Swinnen et al, 2005).…”

“…Two studies specifically explored a component method to improve visuospatial problem-solving skills (Goldman & Goldman, 1988) and working memory (Gunn, Gerst, Wiemers, Redick, & Finn, 2018). This strategy consists of splitting complex tasks into more simple components that are learned gradually and eventually combined into the complex task.…”

Brain Structure and Function in Recovery

“…Most of the recent alcohol-related training investigations have used working memory training. Gunn and colleagues 65 observed proximal transfer on three of six nontrained working memory tasks, two of which continued to display improvement at a 1-month follow-up assessment. Khemiri and colleagues 66 determined transfer in one verbal working memory task, but no improvement across several additional measures, including alternate working memory tasks.…”