Comparison of the Effectiveness of Emotional and Neutral Working Memory Training on Cognitive Flexibility and Intolerance of Uncertainty in People with OCD.

Document Type : Research Paper

Authors

1 . Ph. D Student of Psychology, Faculty of Humanities, Bojnourd Branch, Islamic Azad University, Bojnourd, Iran.

2 Professor, Department of Psychology, Faculty of Education and Psychology, Ferdowsi University of Mashhad, Mashhad, Iran.

3 Assistant Professor, Department of Psychology, University of Bojnord, Bojnord, Iran.

Abstract

The effect of COVID-19 pandemic in the world has posed a serious threat to the mental health of people with OCD. The aim of this study was to investigate the effect of emotional working memory training (EWMT) and neutral working memory training (WMT) on improving cognitive flexibility (CF) and intolerance of uncertainty (IU) in patients with practical obsession. The research design was quasi-experimental and consisted of two experimental groups, a control group, pre-test and post-test. The sample group consisted of 42 patients with obsessive-compulsive disorder referred to Heiman and Fooladi clinics in Mashhad in 1400 who were selected by convenience sampling method and then randomly divided into three groups of 14 people. CF Questionnaire and IU Questionnaire were administered as a pretest. Then EWMT for the first group and WMT for the second group were performed for 20 sessions each and the control group did not receive any intervention. After that, the post-test was performed. The results of MANCOVA indicate a significant effectiveness of EWMT and WMT on the variables of CF and IU in people with OCD (P <0.01). Also, EWMT was significantly more effective in improving IU than WMT (P <0.01) and the effectiveness of these two interventions was the same on the CF variable. According to the findings, it can be concluded that emotional processing of working memory has a decisive role in the IU and it seems that neutral processing of working memory forms the basis of cognitive function of CF.

Keywords


امینی، ه. و شریفی، و. و اسعدی، س. محمدی، م. کایانی، ح. سمنانی، ی. شعبانی، ا. شهریور، ز. داوری آشتیانی، ر. حکیم شوشتری، م. صدیق، ا. جلالی رودسری، م. (1386). روایی نسخه فارسی مصاحبه ساختار یافته تشخیصی برای اختلال های محور I در SCID-I) DSMIV). پایش. 7(1), 49-57.
 ایماندوست، ه. عیسی زادگان، ع. سلیمانی، ا. (1399). تحلیل ویژگیهای روانسنجی نسخه فارسی پرسشنامه وسواسی-جبری ونکوور. فصلنامه روانشناسی کاربردی. 14(55)، 245-267.
رضائی، ن. قمری، م. بزازیان، س. باباخانی، و. (1399). نقش انعطاف‌پذیری شناختی و ویژگی های شخصیتی در پیش بینی رفتار رانندگی پرخطر . مجله ارتقای ایمنی و پیشگیری از مصدومیت ها. 8(3): 149-157.
رنجبری، ت؛ حافظی، ا؛ محمدی، ا؛ رنجبرشیرازی، ف؛ غفاری، ا. (1397). مقایسه اضطراب، نگرانی و عدم تحمل بلاتکلیفی در افراد با اختلال وسواسی جبری و اختلال مصرف مواد. فصلنامه پژوهش در سلامت روان شناختی، 12(1)، 54-65.
سرداری، ب. (1400). اثربخشی آموزش راهبردهای حافظه‌کاری بر انعطاف‌پذیری شناختی و خودتنظیمی هیجانی در دانش آموزان ابتدایی. تفکر و کودک، 12(1), 103-124.
شرافتی، ح. طاهری، ا. اسمایی مجد، س. امیری، م. (1396). اثر بخشی درمان شناختی مبتنی بر مدل داگاس بر عدم تحمل بلاتکلیفی، اجتناب شناختی و باورهای مثبت نگرانی در بیماران مبتلا به اختلال اضطراب فراگیر. روانشناسی بالینی. 2(34).
شریفی، و. اسعدی، م. محمدی، م. امینی، ه. کاویانی، ح. سمنانی، ی. و همکاران. (1383). پایایی و قابلیت اجرای نسخۀ فارسی مصاحبۀ ساختار یافتۀ تشخیصی برای SCID) DSM-IV). تازه های علوم شناختی. ۶ (۱ و ۲) :۱۰-۲۲
صمیمی، ز. (1394). تاثیر آموزش حافظه‌کاری هیجانی بر راهبردهای تنظیم شناختی هیجان، کنترل شناختی و عاطفی نوجوانان مبتلا به اختلال استرس پس از سانحه. پایان نامه مقطع کارشناسی ارشد، رشته روانشناسی بالینی کودک و نوجوان، دانشگاه خوارزمی.
صمیمی، ز. حسنی، ج. (1395). تاثیر آموزش حافظه‌کاری هیجانی در راهبردهای تنظیم شناختی هیجان نوجوانان مبتلا به اختلال استرس پس از ضربه. فصلنامه مطالعات روانشناسی بالینی، 6(23): 113-132.
کاظمی رضایی، ع. سعیدپور، ص. صمیمی، ز. پارویی، م. افزون، ج. (۱۳۹۶). مقایسه عدم تحمل بلاتکلیفی و ظرفیت حافظه کوتاه‌مدت در افراد مبتلابه وسواس فکری - عملی و افراد بهنجار. فصلنامه روانشناسی شناختی. ۵ (۳) :۷۰-۶۱
نرگسی، ف. فتحی آشتیانی، ع. داوودی، ا. اشرفی، ع. (1398). اثربخشی درمان فراتشخیصی یکپارچه بر حساسیت اضطرابی, تحمل پریشانی و علائم وسواسی-اجباری در افراد دچار اختلال وسواسی اجباری. دست آوردهای روانشناختی (علوم تربیتی و روان شناسی)، 26(22)، 49-66.
Baddeley, A. Hitch, G. (1974). Gordon H. Bower, ed. Working Memory. The psychology of learning and motivation. 2. Academic Press. 47–89.
Barkus, E. (2020). Effects of working memory training on emotion regulation: Transdiagnostic review. PsyCh journal, 9(2), 258–279.
Baruah, U., Pandian, R. D., Narayanaswamy, J. C., Math, S. B., Kandavel, T., & Reddy, Y. J. (2018). A randomized controlled study of brief family-based intervention in obsessive compulsive disorder. Journal of affective disorders225, 137-146.‏
Baxter, L. R., Schwartz, J. M., Bergman, K. S., Szuba, M. P., Guze, B. H., Mazziotta, J. C., Alazraki, A., Selin, C. E., Ferng, H.-K., Munford, P., & Phelps, M. E. (1992). Caudate glucose metabolic rate changes with both drug and behavior therapy for obsessive-compulsive disorder. Archives of General Psychiatry, 49(9), 681–689. https://doi.org/10.1001/archpsyc.1992.01820090009002Brock, H., & Hany, M. (2021). Obsessive-Compulsive Disorder.‏
Chamberlain SR, Solly JE, Hook RW, Vaghi MM, Robbins TW. (2021). Cognitive Inflexibility in OCD and Related Disorders. Curr Top Behav Neurosci, 49, 125-145. doi: 10.1007/7854_2020_198.
Jalal, B., Brühl, A., O’Callaghan, C., Piercy, T., Cardinal, R. N., Ramachandran, V. S., & Sahakian, B. J. (2018). Novel smartphone interventions improve cognitive flexibility and obsessive-compulsive disorder symptoms in individuals with contamination fears. Scientific reports8(1), 1-11.‏
Johann, V., Könen, T., & Karbach, J. (2020). The unique contribution of working memory, inhibition, cognitive flexibility, and intelligence to reading comprehension and reading speed. Child Neuropsychology, 26(3), 324-344.
Kalanthroff, E., Steinman, S. A., Schmidt, A. B., Campeas, R., & Simpson, H. B. (2018). Piloting a personalized computerized inhibitory training program for individuals with obsessive-compulsive disorder. Psychotherapy and psychosomatics87(1), 52-55.‏
Key, B. L., Rowa, K., Bieling, P., McCabe, R., & Pawluk, E. J. (2017). Mindfulness‐based cognitive therapy as an augmentation treatment for obsessive–compulsive disorder. Clinical Psychology & Psychotherapy24(5), 1109-1120.‏
Lambrecq, V., Rotge, J. Y., Jaafari, N., Aouizerate, B., Langbour, N., Bioulac, B., ... & Guehl, D. (2014). Differential role of visuospatial working memory in the propensity toward uncertainty in patients with obsessive–compulsive disorder and in healthy subjects. Psychological medicine44(10), 2113-2124.
Li, Q., Yan, J., Liao, J., Zhang, X., Liu, L., Fu, X., ... & Yan, H. (2021). Distinct effects of social stress on working memory in obsessive-compulsive disorder. Neuroscience Bulletin37(1), 81-93.‏
Martínez-Esparza, I. C., Olivares-Olivares, P. J., Rosa-Alcázar, Á., Rosa-Alcázar, A. I., & Storch, E. A. (2021). Executive Functioning and Clinical Variables in Patients with Obsessive-Compulsive Disorder. Brain Sciences11(2), 267.‏
Miegel, F., Cludius, B., Hottenrott, B., Demiralay, C., Sure, A., & Jelinek, L. (2020). Session-specific effects of the metacognitive training for obsessive-compulsive disorder (MCT-OCD). Psychotherapy Research30(4), 474-486.‏
Miegel, F., Demiralay, C., Moritz, S., Wirtz, J., Hottenrott, B., & Jelinek, L. (2020). Metacognitive training for obsessive-compulsive disorder: a study protocol for a randomized controlled trial. BMC psychiatry20(1), 1-13.‏
Monaco, M. R. L., Di Stasio, E., Zuccalà, G., Petracca, M., Genovese, D., Fusco, D., ... & Nalborczyk, L., Banjac, S., Baeyens, C., Grandchamp, R., Koster, E. H., Perrone-Bertolotti, M., & Loevenbruck. (2021). Dissociating facial electromyographic correlates of visual and verbal induced rumination. International Journal of Psychophysiology, 159, 23-36.
Nweze, T., & Nwani, W. (2020). Contributions of working memory and inhibition to cognitive flexibility in Nigerian adolescents. Developmental neuropsychology, 45(3), 118-128
Musso, M. F., Boekaerts, M., Segers, M., & Cascallar, E. C. (2019). Individual differences in basic cognitive processes and self-regulated learning: Their interaction effects on math performance. Learning and Individual Differences, 71, 58-70.
Peris, T. S., Rozenman, M. S., Sugar, C. A., McCracken, J. T., & Piacentini, J. (2017). Targeted family intervention for complex cases of pediatric obsessive-compulsive disorder: a randomized controlled trial. Journal of the American Academy of Child & Adolescent Psychiatry56(12), 1034-1042.‏
Pinciotti, C. M., Riemann, B. C., & Abramowitz, J. S. (2021). Intolerance of uncertainty and obsessive-compulsive disorder dimensions. Journal of Anxiety Disorders, 102417.‏
Rosa-Alcázar, A. I., Rosa-Alcázar, Á., Martínez-Esparza, I. C., Storch, E. A., & Olivares-Olivares, P. J. (2021). Response Inhibition, Cognitive Flexibility and Working Memory in Obsessive-Compulsive Disorder, Generalized Anxiety Disorder and Social Anxiety Disorder. International journal of environmental research and public health, 18(7), 3642. https://doi.org/10.3390/ijerph18073642
P. J. (2021). Response Inhibition, Cognitive Flexibility and Working Memory in Obsessive-Compulsive Disorder, Generalized Anxiety Disorder and Social Anxiety Disorder. International Journal of Environmental Research and Public Health18(7), 3642.‏
Schweizer, S. & Dalgleish, T. (2011). Emotional working memory capacity in posttraumatic stress disorder (PTSD). Behaviour research and therapy, 49(8), 498-504.
Schweizer, S., Grahn, J., Hampshire, A., Mobbs, D., & Dalgleish, T. (2013). Training the emotional brain: improving affective control through emotional working memory training. Journal of Neuroscience33(12), 5301-5311.
Schweizer, S., Hampshire, A., & Dalgleish, T. (2011). Extending brain-training to the affective domain: increasing cognitive and affective executive control through emotional working memory training. PloS one6(9), e24372.
Studer-Luethi, B., Bauer, C., & Perrig, W. J. (2016). Working memory training in children: Effectiveness depends on temperament. Memory & Cognition, 44(2), 171-186.
Sulaimani, M. F., & Bagadood, N. H. (2020). Implication of coronavirus pandemic on obsessive-compulsive-disorder symptoms. Reviews on Environmental Health1(ahead-of-print).‏
Twohig, M. P., Abramowitz, J. S., Smith, B. M., Fabricant, L. E., Jacoby, R. J., Morrison, K. L., Bluett, E. J., Reuman, L., Blakey, S. M., & Ledermann, T. (2018). Adding acceptance and commitment therapy to exposure and response prevention for obsessive-compulsive disorder: A randomized controlled trial. Behaviour research and therapy, 108, 1–9. https://doi.org/10.1016/j.brat.2018.06.005
Van Oppen, P., & Arntz, A. (1994). Cognitive therapy for obsessive-compulsive disorder. Behaviour research and therapy32(1), 79-87.‏
Van Stockum Jr, C. A., & DeCaro, M. S. (2020). When working memory mechanisms compete: Predicting cognitive flexibility versus mental set. Cognition, 201,104313.
Velsor, S. F. (2016). The Roles of Emotion Regulation and Working Memory in the Relationship Between Depressive Symptoms and False Memory for Negative Information (Doctoral dissertation, Southern Illinois University at Edwardsville).
Wheaton, M. G., & Ward, H. E. (2020). Intolerance of uncertainty and obsessive-compulsive personality disorder. Personality Disorders: Theory, Research, and Treatment.‏
Wheaton, M. G., Messner, G. R., & Marks, J. B. (2021). Intolerance of uncertainty as a factor linking obsessive-compulsive symptoms, health anxiety and concerns about the spread of the novel coronavirus (COVID-19) in the United States. Journal of Obsessive-Compulsive and Related Disorders28, 100605.‏
Williams, B. M., & Levinson, C. A. (2021). Intolerance of uncertainty and maladaptive perfectionism as maintenance factors for eating disorders and obsessive‐compulsive disorder symptoms. European Eating Disorders Review29(1), 101-111.‏
Wu, H., Hariz, M., Visser-Vandewalle, V., Zrinzo, L., Coenen, V. A., Sheth, S. A., ... & Nuttin, B. (2021). Deep brain stimulation for refractory obsessive-compulsive disorder (OCD): emerging or established therapy?. Molecular psychiatry26(1), 60-65.‏
Xiu, L., Zhou, R., & Jiang, Y. (2016). Working memory training improves emotion regulation ability: Evidence from HRV. Physiology & behavior, 155, 25-29.
Yang, H., & Li, H. (2020). Training Positive Rumination in Expressive Writing to Enhance Psychological Adjustment and Working Memory Updating for Maladaptive Ruminators. Frontiers in Psychology, 11, 789.
Zhiyang, H. A. N. (2017). The effectiveness of a training programme in obsessive-compulsive patients' behavioral inhibition: improving emotional working memory. NeuroQuantology15(3).