Cognitive Training in Psychological Wellbeing

This post was contributed by Jessica Swainston, a PhD researcher under the supervision of Professor Nazanin Derakshan, investigating the effects of adaptive cognitive training on building resilience in breast cancer survivors. Jessica attended Professor Derakshan’s Birkbeck Science Week event on Thursday 14 April, titled ‘How can adaptive cognitive training improve resilience and mental well-being?’

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A Crisis in Psychological Health

Emotional disorders such as anxiety and depression are of increasing prevalence. The world health organisation has recently estimated that 50 million years of work, an annual global loss of £651bn, will be lost to anxious and depressive disorders between now and 2030. This figure is not only critical for the state of the economy, but more importantly is concerning for the future psychological wellbeing of individuals, their families, and the society we live in.

As it stands, current pharmacological and therapeutic treatments have been shown to be only modestly effective in both the treatment and prevention of such disorders. It is imperative then that more research is carried out in order to better understand the underlying mechanisms involved in these conditions. By achieving this, there is hope that we can develop effective interventions to not only treat psychopathology, but further to build resilience against its onset and recurrence.

Building Resilience

So, how do we become more resilient? How do we continue to cope with the ever demanding stresses that society and life place upon us?

Professor Nazanin Derakshan and her team are currently attempting to address this very issue, and was discussed in her captivating talk during the Birkbeck Science week.

Derakshan is of the mind that our ability to flexibly direct where we place our attention, is the key mechanism in regulating our emotions and boosting our psychological resilience. In other words, the better we are at paying attention to our current goal (e.g. Writing this blog post), the less cognitive resources we have available to attend to irrelevant intruding and ruminative thoughts (e.g. ‘What if I fail my PhD?!’). Accordingly, there has been a wealth of research to support this claim.

A multitude of behavioural studies have indicated that individuals with high levels of Anxiety and Depression have inefficient levels of attentional control, which is a critical component of our working memory, a system that monitors the incoming and temporary storage of information. In addition, anxious individuals have been shown to require recruitment of additional cognitive resources, in a compensatory manner, to reach the same performance levels as non-anxious individuals, thus indicating poor processing efficiency and filtering of irrelevant information. That is, anxious individuals must invest more effort in reaching required goals than non-anxious individuals, a factor that will more quickly lead to cognitive and emotional fatigue.

Of further importance, neuroimaging studies have indicated that anxiety and depression are associated with irregular connections between the limbic (emotional) and prefrontal (cognitive) systems of control in the brain. More explicitly, increased activity in the limbic areas have been linked to decreased activity in the prefrontal areas of the cortex, further highlighting the association between inefficient pre-frontal cognition and increased emotional activity.

How can we improve our Attentional Control?

If then attentional control is the key mechanism by which emotional vulnerability can be moderated, how then can this process be targeted?

In a new and exciting line of research, it transpires that there is potential to improve our levels of attentional control through adaptive cognitive techniques that train working memory. For example, a series of studies have shown that improvements in working memory on an adaptive n-back task, in which participants are required to remember the position of a visual or auditory target n-trials back, have been shown at both the behavioural and neural levels. Importantly, gains in working memory abilities have been shown to transfer to other tasks requiring attentional processes, indicating that the training may help to improve cognitive control across varying tasks, not just on the task itself.

Benefits of Cognitive Training in Psychological Health and Sports Performance

So, considering that the well documented link between emotion and cognitive function, can attentional control training decrease anxious and depressive symptomatology? Further, is the training applicable to other circumstances, such as improving anxious states that can interrupt sports performance? Professor Derakshan presented some preliminary findings that show great promise.

As yet, compared to control groups, a course of adaptive attentional control training has shown to result in:

  • Reduced levels of state anxiety
  • Reduced levels of depressive and ruminative symptomatology ( at behavioural and neural levels)
  • A decrease in cancer related thoughts in Breast Cancer survivors
  • Improved tennis performance in a high pressure environment

Cognitive Training as an aid to current therapies

Professor Nazanin Derakhshan

Professor Nazanin Derakhshan

Professor Derakshan raised an interesting point in relation to the future directions and clinical relevance of cognitive training in psychological health. A number of current psychological therapies such as mindfulness and cognitive behavioural therapy are of varied success. This may in part be due to the lack of attentional resources that severely depressed and anxious individuals possess. If one’s attention is poor, how can one easily engage in a 10 week course of psychological therapy which requires focus and concentration?

It can often be problematic. Thus if, as a complimentary treatment, attentional control processes are improved through training, patients will be better enabled to pay attention and gain the most value from their psychological therapy. In fact, one recent study by Course-Choi et al., (2016) showed just this. Results indicated that a combined course of mindfulness and attentional control training showed greater reductions in trait worry, compared to a course of mindfulness by itself.

In sum, Professor Derakshan presented a compelling theoretical framework for improving our cognitive flexibility as a means to build resilience and protect against emotional vulnerability. With this in mind, there is promise for improving psychological health in the coming years. As poignantly remarked by Derakshan,

‘It is not the strongest of the species that survives, nor the most intelligent, but the one most responsive to change’. – Charles Darwin, 1809.

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