工作记忆训练对焦虑情绪的改善:效果及机制
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摘要
研究发现,工作记忆训练可以降低焦虑患者以及健康个体的焦虑水平。研究者们采用行为测量和自我报告的方式发现,经过工作记忆训练的个体,焦虑水平明显下降,其抑制功能、注意控制能力以及工作记忆容量都得到了显著的提升,对威胁性刺激的注意偏向也明显的下降。工作记忆训练缓解焦虑情绪的原因可能是因为训练提升了个体的工作记忆容量,从而增强了注意控制能力并降低了对威胁性刺激的注意偏向,最终使个体焦虑情绪得到改善。未来的研究要进一步增强研究的可信度,并采取更加多元且客观的手段探索训练效果潜在的起效机制,同时探讨训练对特定类型的焦虑障碍的作用。
The studies showed that working memory training can reduce the anxiety level in anxious patients and healthy individuals. Researchers found that the people who adopted working memory training, by means of behavioral measure and self-report, their anxiety symptom had been alleviated. In addition, the inhibitory function, attentional control and working memory capacity of them got significantly increased, but the attentional bias to threat declined. After training, the promoted working memory capacity led to higher attentional control and lower attentional bias to threat, and this may be the underlying mechanism of how working memory training eases the anxiety symptom. Future researches should take the more diversified and objective means to seek the potential effect mechanism, thus improve the credibility of the studies. And also,to explore the effect of working memory training on certain types of anxiety disorders is a valuable research direction.
The studies showed that working memory training can reduce the anxiety level in anxious patients and healthy individuals. Researchers found that the people who adopted working memory training, by means of behavioral measure and self-report, their anxiety symptom had been alleviated. In addition, the inhibitory function, attentional control and working memory capacity of them got significantly increased, but the attentional bias to threat declined. After training, the promoted working memory capacity led to higher attentional control and lower attentional bias to threat, and this may be the underlying mechanism of how working memory training eases the anxiety symptom. Future researches should take the more diversified and objective means to seek the potential effect mechanism, thus improve the credibility of the studies. And also,to explore the effect of working memory training on certain types of anxiety disorders is a valuable research direction.
引文
1 Insel T,Cuthbert B,Garvey M,et al.Research domain criteria(rdoc):toward a new classification framework for research on mental disorders.American Journal of Psychiatry,2010,167(7):748-751
2 Endler NS,Kocovski NL.State and trait anxiety revisited.Journal of Anxiety Disorders,2001,15(3):231-245
3 Endler NS,Edwards JM,Vitelli R,et al.Assessment of state and trait anxiety:Endler Multidimensional Anxiety Scales.Anxiety Research,1989,2:1-14
4 Mesman J,Koot HM.Early preschool predictors of preadolescent internalizing and externalizing dsm-iv diagnoses.Journal of the American Academy of Child and Adolescent Psychiatry,2001,40(9):1029-1036
5 Rapee RM,Schniering CA,Hudson JL.Anxiety disorders during childhood and adolescence:origins and treatment.Annual Review of Clinical Psychology,2009,5(5):311-341
6 Wood JJ,Lynne-Landsman SD,Langer DA,et al.School Attendance Problems and Youth Psychopathology:Structural Cross-Lagged Regression Models in Three Longitudinal Data Sets.Child Development,2012,83(1):351-366
7 Asendorpf JB,Denissen JJ,van Aken MA.Inhibited and aggressive preschool children at 23 years of age:personality and social transitions into adulthood.Developmental Psychology,2008,44(4):997-1011
8 Roza SJ,Hofstra MB,Ende JVD,et al.Stable prediction of mood and anxiety disorders based on behavioral and emotional problems in childhood:a 14-year follow-up during childhood,adolescence,and young adulthood.American Journal of Psychiatry,2003,160(12):2116-2121
9 Bennebroek FE,Sprangers M,Sitnikova K,et al.Effective ness of cognitive-behavioral therapy on quality of life,anxiety,and depressive symptoms among patients with inflammatory bowel disease:a multicenter randomized controlled trial.Journal of Consulting and Clinical Psychology,2017,85(9):918-925
10 Crowe K,Mckay D.Efficacy of cognitive-behavioral therapy for childhood anxiety and depression.Journal of Anxiety Disorders,2017,49:76-87
11 Silk JS,Tan PZ,Ladouceur CD,et al.A randomized clinical trial comparing individual cognitive behavioral therapy and child-centered therapy for child anxiety disorders.Journal of Clinical Child and Adolescent Psychology,2016,16:1-13
12 Wood JJ,Ehrenreichmay J,Alessandri M,et al.Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety:a randomized,controlled trial.Behavior Therapy,2015,46(1):7-19
13 White LK,Sequeira S,Britton JC,et al.Complementary features of attention bias modification therapy and cognitivebehavioral therapy in pediatric anxiety disorders.American Journal of Psychiatry,2017,174(8):775-784
14 Hall J,Kellett S,Berrios R,et al.Efficacy of cognitive behavioral therapy for generalized anxiety disorder in older adults:systematic review,meta-analysis,and meta-regression.American Journal of Geriatric Psychiatry Official Journal of the American Association for Geriatric Psychiatry,2016,24(11):1063-1073
15 Wang K.Cognitive behavioral therapy combined with pharmaco therapy for generalized anxiety disorder in china:a meta-analysis.China Journal of Health Psychology,2017,25(4):481-485
16 Craske MG,Niles AN,Burklund LJ,et al.Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia:outcomes and moderators.Journal of Consulting and Clinical Psychology,2014,82(6):1034-1048
17 Leichsenring F,Salzer S,Beutel ME,et al.Long-term outcome of psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder.American Journal of Psychiatry,2014,171(10):1074-1082
18 Mckay D,Sookman D,Neziroglu F,et al.Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder.Psychiatry Research,2015,225(3):236-246
19 Sánchezmeca J,Rosaalcázar AI,Iniestasepúlveda M,et al.Differential efficacy of cognitive-behavioral therapy and pharmacological treatments for pediatric obsessive-compulsive disorder:a meta-analysis.Journal of Anxiety Disorders,2014,28(1):31-44
20 Carpenter JK,Andrews LA,Witcraft SM,et al.Cognitive behavioral therapy for anxiety and related disorders:a metaanalysis of randomized placebo-controlled trials.Depression and Anxiety,2018,16:1-13
21 Kuwert P,Boettche M,Knaevelsrud C.Results of an internet-based cognitive-behavioral therapy for PTSD in older adults.Innovation in Aging,2017,1(Suppl.1):58-58
22 Hadwin JA,Richards HJ.Working memory training and CBT reduces anxiety symptoms and attentional biases to threat:a preliminary study.Frontiers in Psychology,2016,7(150):47
23刘春雷,周仁来.工作记忆训练对认知功能和大脑神经系统的影响.心理科学进展,2012,20(7):1003-1011
24 Baddeley A.Working memory:looking back and looking forward.Nature Reviews Neuroscience,2003,4(10):829-839
25 Osaka M,Nishizaki Y.How working memory works in the central executive.In:Osaka,N.(Ed.),Brain and Working Memory,Kyoto:Kyoto University Press,2000.203-223
26 Maleki B,Mousavi MV,Ghasemi A.The effect of working memory training on working memory capacity and performance of novice karateka.Journal of Practice in Clinical Psychology,2016,4(2):113-120
27 Z·elechowska D,Sarzyńska J,N?cka E.Working memory training for schoolchildren improves working memory,with no transfer effects on intelligence.Journal of Intelligence,2017,5(4):36
28 Klein K,Boals A.The relationship of life event stress and working memory capacity.Applied Cognitive Psychology,2001,15(5):565-579
29 Schmeichel BJ,Volokhov RN,Demaree HA.Working memory capacity and the self-regulation of emotional expression and experience.Journal of Personality and Social Psychology,2008,95(6):1526-1540
30 Sorg BA,Whitney P.The effect of trait anxiety and situational stress on working memory capacity.Journal of Research in Personality,1992,26(3):235-241
31 Weiland-Fiedler P,Erickson K,Waldeck T,et al.Evidence for continuing neuropsychological impairments in depression.Journal of Affective Disorders,2004,82(2):253-258
32 Qi S,Zeng Q,Luo Y,et al.Impact of working memory load on cognitive control in trait anxiety:an erp study.Plos One,2014,9(11):e111791
33 Aasvik JK,Woodhouse A,Stiles TC,Jacobs et al.Effectiveness of working memory training among subjects currently on sick leave due to complex symptoms.Frontiers in Psychology,2016,7:2003
34 Course-Choi J,Saville H,Derakshan N.The effects of adaptive working memory training and mindfulness meditation training on processing efficiency and worry in high worriers.Behaviour Research and Therapy,2017,89:1-13
35 Klingberg T,Fernell E,Olesen PJ,et al.Computerized training of working memory in children with ADHD-a randomized,controlled trial.Journal of the American Academy of Child and Adolescent Psychiatry,2005,44(2):177-186
36 Spencer-Smith M,Klingberg T.Benefits of a working memory training program for inattention in daily life:a systematic review and meta-analysis.Plos One,2015,10(3):e0119522
37 Shinaver 3rd CS,Entwistle PC,Soderqvist S.Cogmed WMtraining:reviewing the reviews.Applied Neuropsychology Child,2014,3(3):163-172
38 Jaeggi SM,Buschkuehl M,Jonides J,et al.Short-and longterm benefits of cognitive training.Proceedings of the National Academy of Sciences of the United States of America,2011,108(25):10081-10086
39 Lilienthal L,Tamez E,Shelton JT,et al.Dual n-back training increases the capacity of the focus of attention.Psychonomic Bulletin and Review,2013,20(1):135-141
40 Owens M,Koster EH,Derakshan N.Improving attention control in dysphoria through cognitive training:transfer effects on working memory capacity and filtering efficiency.Psychophysiology,2013,50(3):297-307
41 Schweizer S,Grahn J,Hampshire A,et al.Training the emotional brain:improving affective control through emotional working memory training.Journal of Neuroscience,2013,33(12):5301-5311
42 Sari BA,Koster EHW,Pourtois G,et al.Training working memory to improve attentional control in anxiety:a proof-ofprinciple study using behavioral and electrophysiological measures.Biological Psychology,2016,121:203-212
43 Shipstead Z,Lindsey DRB,Marshall RL,et al.The mechanisms of working memory capacity:primary memory,secondary memory,and attention control.Journal of Memory and Language,2014,72(1):116-141
44 Luo X,Zhang L,Wang J.The benefits of working memory capacity on attentional control under pressure.Frontiers in Psychology,2017,8:11
45 Unsworth N,Robison MK.The influence of lapses of attention on working memory capacity.Memory and Cognition,2016,44:188-196
46 Unsworth N,Schrock JC,Engle RW.Working memory capacity and the antisaccade task:individual differences in voluntary saccade control.Journal of Experimental Psychology:Learning Memory and Cognition,2004,30:1302-1321
47 Bar-Haim Y,Lamy D,Pergamin L,et al.Threat-related attentional bias in anxious and nonanxious individuals:A metaanalytic study.Psychological Bulletin,2007,133:1-24
48 Edwards EJ,Edwards MS,Lyvers M.Cognitive trait anxiety,situational stress,and mental effort predict shifting efficiency:implications for attentional control theory.Emotion,2015,15:350-359
49 Susa G,Pitic?I,Benga O,et al.The self regulatory effect of attentional control in modulating the relationship between attentional biases toward threat and anxiety symptoms in children.Cognition and Emotion,2012,26(6):1069-1083
50 Derryberry D,Reed MA.Anxiety-related attentional biases and their regulation by attentional control.Journal of Abnormal Psychology,2002,111:225-236
51 Reinholdt-Dunne ML,Mogg K,Bradley BP.Effects of anxiety and attention control on processing pictorial and linguistic emotional information.Behaviour Research and Therapy,2009,47:410-417
52 Grol M,Schwenzfeier AK,Stricker J,et al.The worrying mind in control:an investigation of adaptive working memory training and cognitive bias modification in worry-prone individuals.Behaviour Research and Therapy,2018,103:1-11
53 Takeuchi H,Taki Y,Rui N,et al.Working memory training improves emotional states of healthy individuals.Frontiers in Systems Neuroscience,2014,8(64):200
54 Siegle GJ,Price RB,Jones NP,et al.You gotta work at it:pupillary indices of task focus are prognostic for response to a neurocognitive intervention for rumination in depression.Clinical Psychological Science,2014,2(4):455-471
55 Eysenck MW,Derakshan N,Santos R,et al.Anxiety and cognitive performance:attentional control theory.Emotion,2007,7:336-353
56赵鑫,张鹏,陈玲.注意偏向训练对社交焦虑的干预:方法、效果与机制.心理科学进展,2014,22(8):1246-1257
57 Heeren A,Mogoase C,Philippot P,et al.Attention bias modification for social anxiety:a systematic review and metaanalysis.Clinical Psychology Review,2015,40(40):76-90
58 Lowther H,Newman E.Attention bias modification(abm)as a treatment for child and adolescent anxiety:a systematic review.Journal of Affective Disorders,2014,168:125-135
59 Lonigan CJ,Vasey MW.Negative affectivity,effortful control,and attention to threat-relevant stimuli.Journal of Abnormal Child Psychology,2009,37(3):387-399
2 Endler NS,Kocovski NL.State and trait anxiety revisited.Journal of Anxiety Disorders,2001,15(3):231-245
3 Endler NS,Edwards JM,Vitelli R,et al.Assessment of state and trait anxiety:Endler Multidimensional Anxiety Scales.Anxiety Research,1989,2:1-14
4 Mesman J,Koot HM.Early preschool predictors of preadolescent internalizing and externalizing dsm-iv diagnoses.Journal of the American Academy of Child and Adolescent Psychiatry,2001,40(9):1029-1036
5 Rapee RM,Schniering CA,Hudson JL.Anxiety disorders during childhood and adolescence:origins and treatment.Annual Review of Clinical Psychology,2009,5(5):311-341
6 Wood JJ,Lynne-Landsman SD,Langer DA,et al.School Attendance Problems and Youth Psychopathology:Structural Cross-Lagged Regression Models in Three Longitudinal Data Sets.Child Development,2012,83(1):351-366
7 Asendorpf JB,Denissen JJ,van Aken MA.Inhibited and aggressive preschool children at 23 years of age:personality and social transitions into adulthood.Developmental Psychology,2008,44(4):997-1011
8 Roza SJ,Hofstra MB,Ende JVD,et al.Stable prediction of mood and anxiety disorders based on behavioral and emotional problems in childhood:a 14-year follow-up during childhood,adolescence,and young adulthood.American Journal of Psychiatry,2003,160(12):2116-2121
9 Bennebroek FE,Sprangers M,Sitnikova K,et al.Effective ness of cognitive-behavioral therapy on quality of life,anxiety,and depressive symptoms among patients with inflammatory bowel disease:a multicenter randomized controlled trial.Journal of Consulting and Clinical Psychology,2017,85(9):918-925
10 Crowe K,Mckay D.Efficacy of cognitive-behavioral therapy for childhood anxiety and depression.Journal of Anxiety Disorders,2017,49:76-87
11 Silk JS,Tan PZ,Ladouceur CD,et al.A randomized clinical trial comparing individual cognitive behavioral therapy and child-centered therapy for child anxiety disorders.Journal of Clinical Child and Adolescent Psychology,2016,16:1-13
12 Wood JJ,Ehrenreichmay J,Alessandri M,et al.Cognitive behavioral therapy for early adolescents with autism spectrum disorders and clinical anxiety:a randomized,controlled trial.Behavior Therapy,2015,46(1):7-19
13 White LK,Sequeira S,Britton JC,et al.Complementary features of attention bias modification therapy and cognitivebehavioral therapy in pediatric anxiety disorders.American Journal of Psychiatry,2017,174(8):775-784
14 Hall J,Kellett S,Berrios R,et al.Efficacy of cognitive behavioral therapy for generalized anxiety disorder in older adults:systematic review,meta-analysis,and meta-regression.American Journal of Geriatric Psychiatry Official Journal of the American Association for Geriatric Psychiatry,2016,24(11):1063-1073
15 Wang K.Cognitive behavioral therapy combined with pharmaco therapy for generalized anxiety disorder in china:a meta-analysis.China Journal of Health Psychology,2017,25(4):481-485
16 Craske MG,Niles AN,Burklund LJ,et al.Randomized controlled trial of cognitive behavioral therapy and acceptance and commitment therapy for social phobia:outcomes and moderators.Journal of Consulting and Clinical Psychology,2014,82(6):1034-1048
17 Leichsenring F,Salzer S,Beutel ME,et al.Long-term outcome of psychodynamic therapy and cognitive-behavioral therapy in social anxiety disorder.American Journal of Psychiatry,2014,171(10):1074-1082
18 Mckay D,Sookman D,Neziroglu F,et al.Efficacy of cognitive-behavioral therapy for obsessive-compulsive disorder.Psychiatry Research,2015,225(3):236-246
19 Sánchezmeca J,Rosaalcázar AI,Iniestasepúlveda M,et al.Differential efficacy of cognitive-behavioral therapy and pharmacological treatments for pediatric obsessive-compulsive disorder:a meta-analysis.Journal of Anxiety Disorders,2014,28(1):31-44
20 Carpenter JK,Andrews LA,Witcraft SM,et al.Cognitive behavioral therapy for anxiety and related disorders:a metaanalysis of randomized placebo-controlled trials.Depression and Anxiety,2018,16:1-13
21 Kuwert P,Boettche M,Knaevelsrud C.Results of an internet-based cognitive-behavioral therapy for PTSD in older adults.Innovation in Aging,2017,1(Suppl.1):58-58
22 Hadwin JA,Richards HJ.Working memory training and CBT reduces anxiety symptoms and attentional biases to threat:a preliminary study.Frontiers in Psychology,2016,7(150):47
23刘春雷,周仁来.工作记忆训练对认知功能和大脑神经系统的影响.心理科学进展,2012,20(7):1003-1011
24 Baddeley A.Working memory:looking back and looking forward.Nature Reviews Neuroscience,2003,4(10):829-839
25 Osaka M,Nishizaki Y.How working memory works in the central executive.In:Osaka,N.(Ed.),Brain and Working Memory,Kyoto:Kyoto University Press,2000.203-223
26 Maleki B,Mousavi MV,Ghasemi A.The effect of working memory training on working memory capacity and performance of novice karateka.Journal of Practice in Clinical Psychology,2016,4(2):113-120
27 Z·elechowska D,Sarzyńska J,N?cka E.Working memory training for schoolchildren improves working memory,with no transfer effects on intelligence.Journal of Intelligence,2017,5(4):36
28 Klein K,Boals A.The relationship of life event stress and working memory capacity.Applied Cognitive Psychology,2001,15(5):565-579
29 Schmeichel BJ,Volokhov RN,Demaree HA.Working memory capacity and the self-regulation of emotional expression and experience.Journal of Personality and Social Psychology,2008,95(6):1526-1540
30 Sorg BA,Whitney P.The effect of trait anxiety and situational stress on working memory capacity.Journal of Research in Personality,1992,26(3):235-241
31 Weiland-Fiedler P,Erickson K,Waldeck T,et al.Evidence for continuing neuropsychological impairments in depression.Journal of Affective Disorders,2004,82(2):253-258
32 Qi S,Zeng Q,Luo Y,et al.Impact of working memory load on cognitive control in trait anxiety:an erp study.Plos One,2014,9(11):e111791
33 Aasvik JK,Woodhouse A,Stiles TC,Jacobs et al.Effectiveness of working memory training among subjects currently on sick leave due to complex symptoms.Frontiers in Psychology,2016,7:2003
34 Course-Choi J,Saville H,Derakshan N.The effects of adaptive working memory training and mindfulness meditation training on processing efficiency and worry in high worriers.Behaviour Research and Therapy,2017,89:1-13
35 Klingberg T,Fernell E,Olesen PJ,et al.Computerized training of working memory in children with ADHD-a randomized,controlled trial.Journal of the American Academy of Child and Adolescent Psychiatry,2005,44(2):177-186
36 Spencer-Smith M,Klingberg T.Benefits of a working memory training program for inattention in daily life:a systematic review and meta-analysis.Plos One,2015,10(3):e0119522
37 Shinaver 3rd CS,Entwistle PC,Soderqvist S.Cogmed WMtraining:reviewing the reviews.Applied Neuropsychology Child,2014,3(3):163-172
38 Jaeggi SM,Buschkuehl M,Jonides J,et al.Short-and longterm benefits of cognitive training.Proceedings of the National Academy of Sciences of the United States of America,2011,108(25):10081-10086
39 Lilienthal L,Tamez E,Shelton JT,et al.Dual n-back training increases the capacity of the focus of attention.Psychonomic Bulletin and Review,2013,20(1):135-141
40 Owens M,Koster EH,Derakshan N.Improving attention control in dysphoria through cognitive training:transfer effects on working memory capacity and filtering efficiency.Psychophysiology,2013,50(3):297-307
41 Schweizer S,Grahn J,Hampshire A,et al.Training the emotional brain:improving affective control through emotional working memory training.Journal of Neuroscience,2013,33(12):5301-5311
42 Sari BA,Koster EHW,Pourtois G,et al.Training working memory to improve attentional control in anxiety:a proof-ofprinciple study using behavioral and electrophysiological measures.Biological Psychology,2016,121:203-212
43 Shipstead Z,Lindsey DRB,Marshall RL,et al.The mechanisms of working memory capacity:primary memory,secondary memory,and attention control.Journal of Memory and Language,2014,72(1):116-141
44 Luo X,Zhang L,Wang J.The benefits of working memory capacity on attentional control under pressure.Frontiers in Psychology,2017,8:11
45 Unsworth N,Robison MK.The influence of lapses of attention on working memory capacity.Memory and Cognition,2016,44:188-196
46 Unsworth N,Schrock JC,Engle RW.Working memory capacity and the antisaccade task:individual differences in voluntary saccade control.Journal of Experimental Psychology:Learning Memory and Cognition,2004,30:1302-1321
47 Bar-Haim Y,Lamy D,Pergamin L,et al.Threat-related attentional bias in anxious and nonanxious individuals:A metaanalytic study.Psychological Bulletin,2007,133:1-24
48 Edwards EJ,Edwards MS,Lyvers M.Cognitive trait anxiety,situational stress,and mental effort predict shifting efficiency:implications for attentional control theory.Emotion,2015,15:350-359
49 Susa G,Pitic?I,Benga O,et al.The self regulatory effect of attentional control in modulating the relationship between attentional biases toward threat and anxiety symptoms in children.Cognition and Emotion,2012,26(6):1069-1083
50 Derryberry D,Reed MA.Anxiety-related attentional biases and their regulation by attentional control.Journal of Abnormal Psychology,2002,111:225-236
51 Reinholdt-Dunne ML,Mogg K,Bradley BP.Effects of anxiety and attention control on processing pictorial and linguistic emotional information.Behaviour Research and Therapy,2009,47:410-417
52 Grol M,Schwenzfeier AK,Stricker J,et al.The worrying mind in control:an investigation of adaptive working memory training and cognitive bias modification in worry-prone individuals.Behaviour Research and Therapy,2018,103:1-11
53 Takeuchi H,Taki Y,Rui N,et al.Working memory training improves emotional states of healthy individuals.Frontiers in Systems Neuroscience,2014,8(64):200
54 Siegle GJ,Price RB,Jones NP,et al.You gotta work at it:pupillary indices of task focus are prognostic for response to a neurocognitive intervention for rumination in depression.Clinical Psychological Science,2014,2(4):455-471
55 Eysenck MW,Derakshan N,Santos R,et al.Anxiety and cognitive performance:attentional control theory.Emotion,2007,7:336-353
56赵鑫,张鹏,陈玲.注意偏向训练对社交焦虑的干预:方法、效果与机制.心理科学进展,2014,22(8):1246-1257
57 Heeren A,Mogoase C,Philippot P,et al.Attention bias modification for social anxiety:a systematic review and metaanalysis.Clinical Psychology Review,2015,40(40):76-90
58 Lowther H,Newman E.Attention bias modification(abm)as a treatment for child and adolescent anxiety:a systematic review.Journal of Affective Disorders,2014,168:125-135
59 Lonigan CJ,Vasey MW.Negative affectivity,effortful control,and attention to threat-relevant stimuli.Journal of Abnormal Child Psychology,2009,37(3):387-399