Improving cognitive control in adolescents with post-traumatic stress disorder (PTSD)

Abstract

The adverse impact of posttraumatic stress disorder (PTSD) on the developing mind in adolescence can extend well into adulthood. The developmental malleability of cognitive control capacity in this age group, however, may hold particular promise for cognitive training interventions. The present study investigated the effects of affective working memory (aWMT) compared to placebo-training on cognitive and affective functioning in adolescents with PTSD. 30 treatment-seeking adolescents trained for 20 days on either an affective dual n-back task (aWMT; n = 15) or a feature match task (placebo; n = 15). The aWMT group showed greater pre-to post-training increases in cognitive control as measured by the GoNogo task as well as improvements in symptoms of PTSD and increased use of adaptive emotion regulation strategies. These preliminary findings are promising given the potential for free and easy dissemination of the aWMT in schools and online.

Effects of working memory training on emotion regulation: Transdiagnostic review

“…Of the studies reviewed, some achieved positive gains in accuracy for cognitive outcomes (Hoorelbeke & Koster, ; Houben, Dassen, & Jansen, ; Peckham & Johnson, ; Schweizer et al, ; Xiu, Wu, Chang, & Zhou, ; Zhang et al, ), while others did not (Hitchcock & Westwell, ; Hoorelbeke et al, ; Li, Xiao, et al, ). Others demonstrated decreases in response times (Course‐Choi, Saville, & Derakshan, ; Xiu, Zhou, & Jiang, ).…”

“…Working memory training was associated with improvements in reappraisal (Peckham & Johnson, ), positive emotion regulation (Schweizer et al, ), and positive thoughts when challenged (Hoorelbeke et al, ). There were also decreases in brooding (Hoorelbeke et al, ; Hoorelbeke & Koster, ; Peckham & Johnson, ), post‐traumatic stress disorder symptoms (Schweizer et al, ), depressive symptoms (Hoorelbeke & Koster, ; Zhang et al, ), maladaptive emotion regulation (Hoorelbeke & Koster, ), rumination (Hoorelbeke et al, ), intrusive thoughts (Hotton et al, ), and worry (Course‐Choi et al, ). Following working memory training, those with social anhedonia displayed increased preferences for reward (Li, Li et al, ), which could be viewed as diminishing one problematic aspect of social anhedonia.…”

“…These studies would provide information about when working memory training packages could be most effective in improving emotion‐regulation outcome measures. For example, increased working memory capacity is associated with increased rejection of maladaptive emotion‐regulation strategies (Peckham & Johnson, ; Schweizer et al, ), which preserves affect in the medium and longer term. Working memory training could serve to provide further cognitive resources for the application of positive emotion‐regulation strategies; however, from the studies reviewed here, the evidence for this is mixed.…”

Adaptive working memory training can reduce anxiety and depression vulnerability in adolescents

“…Neither study featured robust controls and sample size was limited in one case. However, in a recent well-controlled study, Schweizer et al (2017) found emotional WM training led to significant reductions in post-traumatic stress disorder symptoms (PTSD) in adolescents awaiting treatment for PTSD.…”

Protocol for an App-Based Affective Control Training for Adolescents

“…Power was established with time as withinsubjects factor, training group as fixed factor and participants as random factors. The effect size for the interaction was estimated as small to medium d = .40, based on our previous training studies in adolescents (35) and adults (21,34). The calculator used was https://jakewestfall.shinyapps.io/pangea/.…”