The Effects of Emotional Working Memory Training on Worry Symptoms and Error-Related Negativity of Individuals with High Trait Anxiety: A Randomized Controlled Study

Background Trait anxiety is characterized by impaired gating of threat from working memory (WM), allowing unnecessary maintenance of anxious cognitions. Improving filtering efficiency of threatening information through computerized WM training might reduce intrusive, worrisome thoughts. Methods We randomized high-trait anxious individuals to 9 sessions of high-potency n-back (n = 19) or low-potency 1-back (n = 18) training to examine their effects on various neurocognitive indices of WM functioning and emotional symptoms. Results Following the interventions, multilevel modeling analyses revealed both training conditions resulted in significant improvements in attentional (Flanker), WM capacity (operation and spatial span tasks), and WM filtering efficiency (change detection task) measures, and increased N2 amplitudes. However, the high-potency training produced more favorable results at post-training, indexed by larger ERN amplitudes. We also observed significant reductions in trait anxiety and worry symptoms for the high-potency training following the intervention, although, low-potency training caught up at follow-up with comparably reduced symptoms. Conclusions These results show that emotional WM training can improve neurocognitive processes of attention and WM as well as symptoms of worrying. Overall, this study encourages the development of a standalone or adjunctive cognitive intervention focused on WM for vulnerable populations with high trait anxiety or worry symptoms.