Computerized Working Memory Training in Remission From Major Depressive Disorder: Effects on Emotional Working Memory, Processing Speed, Executive Functions, and Associations With Symptoms

Ronold, Eivind Haga; Joormann, Jutta; Hammar, Åsa · 2022 · OpenAlex-citations

DOI: 10.3389/fnbeh.2022.887596

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Summary

This study investigated the effects of computerized working memory training (CWMT) on cognitive functions and their associations with depressive symptoms and rumination in individuals in remission from major depressive disorder (MDD). The research was motivated by the persistence of cognitive deficits, particularly in executive functions (EF) and processing speed (PS), even after symptom remission, which contributes to functional impairment and relapse risk. The authors aimed to determine if CWMT could improve these residual deficits and alter the relationships between emotional working memory (e-WM), rumination, and symptoms. The study employed a pre-post pilot design with 29 participants recruited from an outpatient clinic, of whom 20 completed the intervention and follow-up assessments. Participants underwent a 5-week online CWMT program (Cogmed) consisting of 25 sessions targeting working memory span. Assessments included neuropsychological tests for EF and PS (Trail Making Test, Color Word Interference Test), an e-WM paradigm involving the manipulation of emotional facial stimuli, and self-report measures for depression (MADRS) and rumination (Ruminative Responses Scale, Rumination Reflection Questionnaire). Hypotheses were preregistered, and statistical analyses included paired t-tests and correlation analyses to evaluate changes and associations. Results indicated that cognitive functioning improved in most conditions, with the largest effects observed in executive functions. Specifically, e-WM performance improved significantly for both negative and positive stimuli under high working memory load. However, depressive symptoms and rumination levels did not change significantly in the remitted sample. Pre-intervention, neurotic rumination showed a moderate negative association with e-WM performance for negative stimuli, but this association disappeared post-intervention. Improvements in CWMT performance were associated with gains in certain EF and PS measures but also correlated with worse self-reported attention. Additionally, a history of depression was linked to less improvement in executive functioning. The findings suggest that CWMT can enhance cognitive functions, particularly executive control and emotional working memory, in individuals recovered from MDD. The disruption of the pre-existing link between e-WM and rumination implies that such training may help decouple cognitive processing from maladaptive thought patterns, potentially mitigating functional impairment. Despite the small sample size and lack of a control group, the study highlights CWMT as a promising intervention for addressing residual cognitive deficits that persist after mood symptom remission, offering a potential avenue for reducing relapse risk and improving quality of life.

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• cognitive capacity variation