A randomized controlled trial of computerized cognitive training to improve working memory in individuals with elevated repetitive negative thinking: Behavioral and neural outcomes

Abstract

Individuals with mood, anxiety, and traumatic stress disorders frequently experience distressing repetitive negative thinking (RNT) symptoms, which are characterized by pervasive, uncontrollable negative thoughts. Dysfunction in executive functioning processes, particularly the ability to regulate the contents of working memory, are implicated in the development and maintenance of RNT. Guided by the National Institute of Mental Health experimental therapeutics framework, this study aimed to investigate the cognitive effects and effects of two doses of a novel working memory training (WMT) intervention in individuals with elevated RNT across mood, anxiety, and traumatic stress disorders. We conducted a three-arm randomized controlled trial with 8-session and 16-session WMT interventions and a waitlist control group (N = 73). Our primary goal was to establish target engagement of WMT as measured by behavioral and neural indicators of working memory performance. Results revealed that WMT significantly improved working memory performance and resulted in reduced frontoparietal neural activity during a working memory task compared to the waitlist control group, providing evidence of target engagement. Exploratory analyses revealed a potential transfer of training effects to fluid intelligence, a construct related to but distinct from working memory, suggesting broader cognitive benefits of WMT. These data provide evidence that WMT can enhance working memory performance in individuals with RNT. This intervention holds promise as a transdiagnostic approach for ameliorating RNT-related clinical burden, with the 8-session regimen showing pragmatic advantages. Further research is needed to elucidate its impact on clinical symptoms and explore potential cognitive benefits beyond working memory.