Abstract:Background
Previous research has suggested that worry is negatively associated with working memory performance. However, it is unclear whether these findings would replicate across different worry levels and in individuals with anxiety and depressive disorders (i.e. clinical statuses).
Method
One-hundred-thirty-eight participants performed a two-block working memory task (150 trials per block). Based on participants` current clinical… Show more
“…Uncontrollable worry as a primary symptom of GAD can be seen as a dysfunctional cognitive strategy to cope with anxiety (Borkovec et al, 2004; Newman, & Llera, 2011; Roemer et al, 2005) resulting in a positive feedback circuit between pathological worrying and mental health problems (e.g., Mennin et al, 2009). Moreover, the worrisome thoughts may drain an individual’s available cognitive resources (Held et al, 2020; Hirsch & Mathews, 2012). Individuals suffering from GAD may experience physiological arousal even in calm situations.…”
Objective: There is little evidence-based knowledge of how psychotherapists should handle both sudden gains and more gradual session-by-session changes, either in general or in individuals suffering from generalized anxiety disorder. Methods: Using an ABAB crossed-therapist randomized clinical implementation trial design (N = 80 patients and 20 therapists), we contrasted a Prolonged Focus on Change (PFC, N = 40) implementation with a State-Of-The-Art (SOTA, N = 40) implementation. Both implementations were based on a widely used cognitive behavioral therapy approach (Mastery of your Anxiety and Worry package) with the only difference that in the PFC implementation, the therapists were instructed to systematically explore eventual changes at the beginning of the therapy sessions. Results: Based on a 3-level hierarchical linear model, PFC implementation showed faster symptom reduction in worry over therapy (i.e., linear change) and a decelerated (quadratic) change until 12-month follow-up in comparison to the SOTA implementation. Conclusion: These findings provide clinically useful information about potential short-term and long-term effects of exploring occurring change in GAD populations. Randomized clinical implementation trial designs are a step forward allowing to experimentally investigate basic psychotherapeutic strategies in process-based psychotherapy.What is the public health significance of this article? This randomized clinical implementation trial provides empirical evidence for good clinical wisdom that exploring occurring change is helpful to facilitate further change during therapy. These results underscore the relevance of understanding patient's proactive engagement in change behaviors, competences, skills, and behavioral preferences in individuals that suffer from generalized anxiety disorder to positively impact worry outcomes.
“…Uncontrollable worry as a primary symptom of GAD can be seen as a dysfunctional cognitive strategy to cope with anxiety (Borkovec et al, 2004; Newman, & Llera, 2011; Roemer et al, 2005) resulting in a positive feedback circuit between pathological worrying and mental health problems (e.g., Mennin et al, 2009). Moreover, the worrisome thoughts may drain an individual’s available cognitive resources (Held et al, 2020; Hirsch & Mathews, 2012). Individuals suffering from GAD may experience physiological arousal even in calm situations.…”
Objective: There is little evidence-based knowledge of how psychotherapists should handle both sudden gains and more gradual session-by-session changes, either in general or in individuals suffering from generalized anxiety disorder. Methods: Using an ABAB crossed-therapist randomized clinical implementation trial design (N = 80 patients and 20 therapists), we contrasted a Prolonged Focus on Change (PFC, N = 40) implementation with a State-Of-The-Art (SOTA, N = 40) implementation. Both implementations were based on a widely used cognitive behavioral therapy approach (Mastery of your Anxiety and Worry package) with the only difference that in the PFC implementation, the therapists were instructed to systematically explore eventual changes at the beginning of the therapy sessions. Results: Based on a 3-level hierarchical linear model, PFC implementation showed faster symptom reduction in worry over therapy (i.e., linear change) and a decelerated (quadratic) change until 12-month follow-up in comparison to the SOTA implementation. Conclusion: These findings provide clinically useful information about potential short-term and long-term effects of exploring occurring change in GAD populations. Randomized clinical implementation trial designs are a step forward allowing to experimentally investigate basic psychotherapeutic strategies in process-based psychotherapy.What is the public health significance of this article? This randomized clinical implementation trial provides empirical evidence for good clinical wisdom that exploring occurring change is helpful to facilitate further change during therapy. These results underscore the relevance of understanding patient's proactive engagement in change behaviors, competences, skills, and behavioral preferences in individuals that suffer from generalized anxiety disorder to positively impact worry outcomes.
“…+ 2 ) and participants were asked to perform the arithmetic operation and type in the result ( 7 4 5 in the present example). After eight additional arithmetic operations participants were asked to type in the last number they recall (see Held et al, 2020 for a more precise description of the task).…”
BackgroundThere is cumulating evidence that working memory (WM) processing is impaired in individuals suffering from a psychosomatic and a psychological disorder. However, it is unclear how repetitive negative thinking (RNT), depressive symptoms, and patient characteristics (i.e., age and incapability to work) contribute to WM impairments. The present study examines how these factors affect WM performance in highly distressed adult psychosomatic inpatients.MethodsSeventy-six inpatients (Mage = 52.7, SD = 8.4) from a psychosomatic rehabilitation clinic performed a two-block WM updating task, with accuracy and reaction time as indicators of WM functioning.ResultsMultivariate mixed effect model results show that accuracy and reaction time significantly decreased from WM Block 1 to WM Block 2. Higher levels of RNT, more severe depressive symptoms and higher age were associated with worse WM accuracy in Block 1. None of these variables were significantly associated with WM reaction time (in Block 1).ConclusionFrom a clinical perspective, the results suggest that screening for the presence of high RNT levels, severe depressive symptoms or higher age may help to identify patients with impaired WM functioning and to intervene on these important patient characteristics early in the rehabilitation process.
“…Indeed, older adults are more likely to perceive their memory as functioning more poorly as compared to when they were younger, and they are also less likely to perceive that they have control over their cognitive functioning, in particular, memory and learning. Such negative views impact actual performance, which further leads to less confidence, self-efficacy, and motivation towards engaging in effortful cognitive tasks [27] , [29] .…”
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