Working Memory Training and CBT Reduces Anxiety Symptoms and Attentional Biases to Threat: A Preliminary Study.

Julie A Hadwin,Helen J Richards

doi:10.3389/fpsyg.2016.00047

Abstract

Research indicates that cognitive processes linked to the detection of threat stimuli are associated with poor attentional control, placing children and adolescents at increased risk for the development of anxious affect. The current study aimed to provide preliminary data to assess whether an intervention designed to improve attentional control (via working memory; WM) would lead to better performance in tests of WM and would be associated with positive changes in symptoms of trait and test anxiety, increased inhibitory control and reduced attention to threat. Forty adolescents aged 11–14 years who reported elevated anxiety and low attentional control were randomly allocated to a WM training or an active cognitive behavioural therapy (CBT) control group. Post intervention, WM training was associated with greater improvements (versus. CBT) in trained WM tasks. Both groups, however, reported fewer anxiety symptoms, demonstrated increased inhibitory control and a reduction in attentional biases to threat post intervention and these results were maintained at follow up. The study provides indicative evidence which suggests that WM training has similar benefits to a more traditional CBT intervention on reduced anxiety and attentional biases for threat. Future research should aim to replicate the findings in a large sample size and explore the broader impact of training on day-to-day functioning. In addition, further research is needed to identify which participants benefit most from different interventions (using baseline characteristics) on treatment compliance and outcome.

Highlights

Research suggests that clinical levels of anxiety are experienced by 2–15% of children and adolescents (Rapee et al, 2009)
We expected that the WM intervention should increase performance in WM tasks and that it would have a broader positive impact on key measures of attention, as well as feelings of anxious affect
They are consistent with research which has shown that young people with social and emotional behavioral difficulties who showed increased performance on WM tasks, better inhibitory control and fewer symptoms of test anxiety after completing a WM training intervention compared with a passive control group (Roughan and Hadwin, 2011)

Summary

Introduction

Research suggests that clinical levels of anxiety are experienced by 2–15% of children and adolescents (Rapee et al, 2009). Attentional Control Theory (Eysenck et al, 2007; Eysenck and Derakshan, 2011) for example, proposes that anxiety impacts core cognitive processes linked to inhibitory control (to resist interference from non-relevant distractors), set shifting (to move attention between relevant information or location) and updating information in WM (to remember and revise material for further processing). It suggests that the negative association between anxiety and cognition is most evident when attentional resources are directed toward external or internal threatening stimuli. Researchers have argued that the allocation of attention to threat in anxiety leads to subsequent avoidance that works to help individuals regulate feelings of negative affect in the short term (Mogg and Bradley, 1998)

Results

Discussion

Conclusion