Predictors of Effective Working Memory Training in Individuals with Alcohol Use Disorders

Abstract

Background: Low working memory (WM) capacity is associated with alcohol use disorders (AUDs). The importance of WM to adaptive functioning has led to a recent influx of studies attempting to improve individual WM capacity using various cognitive training methods. The present study aimed to examine the efficacy of complex WM training for improving WM capacity among individuals with AUD.

Methods: Individuals were randomized to complete either adaptive WM training or active control training. We applied a methodologically rigorous and structured approach, including a battery of near and moderate transfer measures in those with AUDs and a control group. Additionally, we examined cognitive factors (at baseline) and other predictors of adherence, training task improvement, and transfer.

Results: Results suggest improved WM in individuals with AUDs and controls, as evidenced by improved scores on several transfer measures, after adaptive WM training. However, individuals with AUDs showed poorer adherence and less improvement on the training tasks themselves. Neither IQ, WM, sex, nor condition predicted adherence. Level of training task performance, baseline WM, and IQ predicted transfer task improvement.

Conclusions: This is the first study to rigorously examine both the efficacy of WM training in those with AUDs, and predictors of successful training program adherence and transfer in a large sample. Among study completers, results suggest that AUD status does not predict training improvement and transfer. However, AUD status did predict lower program adherence. WM training was more effective in those with higher cognitive ability at baseline. This study provides direct translation to the development of cognitive interventions for treating AUD.

Keywords: Alcohol Use Disorders; Cognitive Training; Executive Cognitive Functioning; Working Memory Training.

© 2018 by the Research Society on Alcoholism.

Figures

Figure 1:

Note. Average training task (z-score) for each training task (Panel A) and averaged across group (Panel B) at each training session. Control training tasks are represented by VS- H = Visual Search- Hands, VS-L= Visual Search- Letters, and active training tasks are represented by OS = Operation Span, SS = Symmetry Span.

Figure 2:

Note. Figure displays average total score for each near (A-C) and moderate (D-F) transfer measures at each session by condition across both groups. ACT = Auditory Consonant Trigram, RDS = Reading Span, RTS = Rotation Span, RLS = Running Letter Span, RSS = Running Spatial Span, KT = Keep Track Task; AT = Active Training Condition; VS= Visual Search Condition. Error bars represent 95% CI.