A pilot randomized trial of a dual n-back emotional working memory training program for veterans with elevated PTSD symptoms

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.

Change of disease distribution in pediatric neurology inpatients during the COVID-19 outbreak in southwest China

“…We all know that the onset of migraine and epilepsy is closely related to mood [15][16][17] . During COVID-19 outbreak, children were restricted in home, their patients would ask them to take some measures to prevent infection, and they also heard a good deal of disaster-related information, which brought anxiety and panic to them 18 .Thus we supposed that the increasing of these diseases was associated with the emotional instability caused by COVID-19. Studies also proposed that epilepsy patients showed signi cantly higher 6-item Kessler Psychological Distress Scale scores than healthy controls, suffering from psychological distress, in turn, can induce seizure attack 19 .…”

Evaluating the Effects of Online tDCS with Emotional n-back Training on Working Memory and Associated Cognitive Abilities

“…Following randomization, the tDCS apparatus was attached, and participants completed 60 min of WMT. This training period was approximately two to three times the regular dose of one WMT session typically used in the literature (Larsen et al, 2019;Schweizer et al, 2013). Participants in the tWMT condition received 30 min of current stimulation while training WM processes, and participants in the sWMT only received 30 s of stimulation (ramp-up) to induce the feeling of stimulation (i.e., tingling).…”

“…WM was trained with an emotionally adaptive dual nback task. This WMT involved a presentation of emotionally salient faces and words to target constant updating of information in WM and shifting between two different modes of stimuli (Larsen et al, 2019). In each trial, one of eight fearful faces (4 males and 4 females) was presented within a 3×3 grid while a negative spoken word (female voice; disaster, cancer, etc.)…”

“…Deficits in WM function have been linked to failure in real-world tasks (Beilock & Carr, 2005) and in potentiating emotional problems such as depression and anxiety symptoms (Matsuo et al, 2007;Moran, 2016). posttraumatic stress disorder (Larsen et al, 2019;Owens, Koster, & Derakshan, 2013;Sari, Koster, Pourtois, & Derakshan, 2016;Schweizer et al, 2017).…”

“…For instance, memory processes for emotional stimuli may be enhanced due to connections between the amygdala and cortical regions (Dolcos, LaBar, & Cabeza, 2004), and conversely diminished during aggravation of negative affective and anxiety states (Figueira et al, 2017;Moon & Jeong, 2015). Recent work suggests that WMT programs can be enhanced by training WM processes using emotional stimuli (Larsen et al, 2019;Schweizer et al, 2013). Despite the potent link between WM and emotional content, very few studies utilize emotional WMT in conjunction with tDCS (Martin et al, 2018;Schmidt, Wolkenstein, & Plewnia, 2015).…”