Monday, February 25, 2013

Working Memory Training

I was asked in Intro Psych the other day if working memory training actually worked, and I had to defer my response because I didn't know. I did say that I had never recommended such a program to a patient with ADHD because 1) they cost money, and 2) I don't know that they work. I would add, 3) they seem incredibly tedious. I had seen products and programs which make claims in that direction, and which cite research (usually their own) that purports to establish its efficacy. But, with very nearly perfect timing, here is the fullest possible answer from the journal Developmental Psychology(Melby-Lervag & Hulme, 2013). From the abstract:

"Meta-analyses indicated that the programs produced reliable short-term improvements in working memory skills. For verbal working memory, these near-transfer effects were not sustained at follow-up, whereas for visuospatial working memory, limited evidence suggested that such effects might be maintained. More importantly, there was no convincing evidence of the generalization of working memory training to other skills (nonverbal and verbal ability, inhibitory processes in attention, word decoding, and arithmetic). The authors conclude that memory training programs appear to produce short-term, specific training effects that do not generalize."

So spending a few hours practicing memorizing and repeating increasingly longer chains of random digits will probably improve your ability to memorize and repeat chains of digits, at least for a while. But that improvement, such as it is, won't translate into any useful gains in any other tasks requiring working memory.

An article from Wired magazine in 2008 fueled the hype machine on this sort of stuff. Claims to increase IQ should make any reasonable person skeptical, but most of us seem to be willing to suspend disbelief on this issue because we all secretly want to be as smart as we pretend to be. If you really need to try the dual n-back working memory training, here is a site that doesn't look like a blatant scam.

This seems like a good opportunity to recommend Neuroskeptic, a particularly reliable blog on matters neurosciency, psychiatric, psychological, etc. The author has a good sense of humor and probably knows as much as anyone about the problems intrinsic to brain imaging (e.g., fMRI) studies. The mysterious author of Neuroskeptic appears to be a British brain imaging researcher. He also reports being a long-time sufferer of clinical depression, managed with antidepressants. If you spend some time browsing through his blogpost archives, you can't help but to learn a lot.

Anyway, Neuroskeptic recently criticized a fellow for "profiteering from anxiety" for offering for sale an online anxiety retraining program. Part of the criticism is that the training program wasn't entirely original, so there's that. But I have no problem with anyone making a profit selling a product or service that alleviates anxiety (as long as it works). And neither does the pharmaceutical industry, or the alcohol industry. If a psychologist develops a web-training that actually alleviates the suffering associated with a mental health problem, I utterly fail to see a problem with monetizing that innovation.

Now here's a program that I have recommended, and that my patients seem to benefit from: If you know anyone suffering from insomnia and want to make them indebted to you for life, treat them to the $34.95 price of the program. From the website:

  • A 5-week, 5-session online cognitive-behavioral therapy (CBT) program for insomnia that was developed by Dr. Gregg Jacobs based on his 25 years of extensive research and clinical practice at Harvard Medical School and the University of Massachusetts Memorial Medical Center involving over 10,000 insomnia patients.

  • Was developed from Dr. Jacobs's research that was funded by the National Institutes of Health, and published in the Archives of Internal Medicine, demonstrating that a similar CBT program was more effective than Ambien. Learn more...

  • Recommended by Dr. Oz, Good Housekeeping, Psychology Today, and as a selected resource by Harvard Women’s Health Watch. Learn more...

  • Includes weekly individualized guidelines and feedback from Dr. Jacobs on CBT sleep techniques.

  • Also includes a library of over 100 insomnia focus articles, study reviews, blogs, and sleep and relaxation tips.

  • Also available in compact disc format. Learn more...

  • Highly effective for increasing total sleep time and reducing or eliminating sleep medication. Read results here and read testimonials here.

Key Features of the online CONQUERING INSOMNIA program …

  • For problems falling asleep and waking during the night/early morning

  • For individuals who are not, and those who are, using sleeping pills

  • Replicates the 5 session CBT program for insomnia and sleep disorders developed and tested at Harvard Medical School

  • No other CBT for insomnia program provides weekly personalized feedback and CBT guidelines directly from a recognized CBT for insomnia sleep expert, contains techniques for reducing sleep medications, and offers a simple, easy-to-use format for a nominal price of $34.95.

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