Dataset Information

Examining the Impact of Motivation on Working Memory Training in Youth With ADHD.

ABSTRACT: Objective:Working memory (WM) is often a deficit in children with attention deficit hyperactivity disorder (ADHD) and is related to other impairments within this clinical population. Cogmed, a computerized WM training program, is sometimes prescribed as a treatment for ADHD youth - although the efficacy of this intervention remains controversial. Our main objective was to explore whether ADHD youths' motivational style predicted training engagement or performance on outcome measures. A second objective was to obtain a more nuanced understanding of potential benefits of the program via interviews. Method:The current study focuses on 10 ADHD youth (age 8 - 14 years) randomized to a modified 30-session Cogmed protocol, as part of a larger clinical trial. Youth completed an adapted Self-Regulation Questionnaire (SRQ) and participated in a semi-structured interview at three-month follow-up. Results:All youth showed adherence to the modified Cogmed protocol. More externally motivated youth started training at a higher level of performance and also reached higher peak performance. At follow-up, higher levels of external forms of motivation correlated with better spatial working memory but worse academic performance. In addition, greater endorsement of external motivation was associated with lower self-concept. Qualitative analyses suggested that youth displayed multiple motivational styles with regard to participation and noted subjective improvements in their everyday lives. Conclusions:Youth endorsed both extrinsic and intrinsic motivation and reported that training was useful. Larger studies should consider assessing individual differences in motivational style and incorporating qualitative methodology to identify additional intervention outcome variables to consider amongst ADHD youth.

SUBMITTER: Sadeghi M

PROVIDER: S-EPMC7065563 | biostudies-literature | 2020 Mar

REPOSITORIES: biostudies-literature

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Examining the Impact of Motivation on Working Memory Training in Youth With ADHD.

Sadeghi Mahsa M McAuley Tara T Sandberg Sol S

Journal of the Canadian Academy of Child and Adolescent Psychiatry = Journal de l'Academie canadienne de psychiatrie de l'enfant et de l'adolescent 20200301 1

<h4>Objective</h4>Working memory (WM) is often a deficit in children with attention deficit hyperactivity disorder (ADHD) and is related to other impairments within this clinical population. Cogmed, a computerized WM training program, is sometimes prescribed as a treatment for ADHD youth - although the efficacy of this intervention remains controversial. Our main objective was to explore whether ADHD youths' motivational style predicted training engagement or performance on outcome measures. A s ...[more]

PMID: 32194647

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Project description:ObjectivesTo determine whether standard-length computerized training enhances working memory (WM), transfers to other cognitive domains and shows sustained effects, when controlling for motivation, engagement, and expectancy.Methods97 post-secondary students (59.8% female) aged 18-35 years with Attention-Deficit/Hyperactivity Disorder, were randomized into standard-length adaptive Cogmed WM training (CWMT; 45-min/session), a shortened-length adaptive version of CWMT (15 min/session) that controlled for motivation, engagement and expectancy of change, or into a no training group (waitlist-control group). All three groups received weekly telephone calls from trained coaches, who supervised the CWMT and were independent from the research team. All were evaluated before and 3 weeks post-training; those in the two CWMT groups were also assessed 3 months post-training. Untrained outcome measures of WM included the WAIS-IV Digit Span (auditory-verbal WM), CANTAB Spatial Span (visual-spatial WM) and WRAML Finger Windows (visual-spatial WM). Transfer-of-training effects included measures of short-term memory, cognitive speed, math and reading fluency, complex reasoning, and ADHD symptoms.ResultsPerformance on 5/7 criterion measures indicated that shortened-length CWMT conferred as much benefit on WM performance as did standard-length training, with both CWMT groups improving more than the waitlist-control group. Only 2 of these findings remained robust after correcting for multiple comparisons. Follow-up analyses revealed that post-training improvements on WM performance were maintained for at least three months. There was no evidence of any transfer effects but the standard-length group showed improvement in task-specific strategy use.ConclusionsThis study failed to find robust evidence of benefits of standard-length CWMT for improving WM in college students with ADHD and the overall pattern of findings raise questions about the specificity of training effects.Trial registrationClinicalTrials.gov NCT01657721.

Project description:OBJECTIVE:Working memory deficits have been linked experimentally and developmentally with attention-deficit/hyperactivity disorder (ADHD)-related symptoms/impairments. Unfortunately, substantial evidence indicates that extant working memory training programs fail to improve these symptoms/impairments. We hypothesized that this discrepancy may reflect insufficient targeting, such that extant protocols do not adequately engage the specific working memory components linked with the disorder's behavioral/functional impairments. METHOD:The current study describes the development, empirical basis, and initial testing of central executive training (CET) relative to gold-standard behavioral parent training (BPT). Children with ADHD ages 8-13 (M = 10.43, SD = 1.59; 21 girls; 76% Caucasian/non-Hispanic) were treated using BPT (n = 27) or CET (n = 27). Detailed data analytic plans for the pre/post design were preregistered. Primary outcomes included phonological and visuospatial working memory, and secondary outcomes included actigraphy during working memory testing and two distal far-transfer tasks. Multiple feasibility/acceptability measures were included. RESULTS:The BPT and CET samples did not differ on any pretreatment characteristics. CET was rated as highly acceptable by children and was equivalent to BPT in terms of feasibility/acceptability as evidenced by parent-reported high satisfaction, low barriers to participation, and large ADHD symptom reductions. CET was superior to BPT for improving working memory (Group × Time d = 1.06) as hypothesized. CET was also superior to BPT for reducing actigraph-measured hyperactivity during visuospatial working memory testing and both distal far-transfer tasks (Group × Time d = 0.74). CONCLUSIONS:Results provide strong support for continued testing of CET and, if replicated, would support recent hypotheses that next-generation ADHD cognitive training protocols may overcome current limitations via improved targeting. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Project description:Background: Working memory (WM) deficits and impaired decision making are among the characteristic symptoms of patients affected by attention deficit/hyperactivity disorder (ADHD). The inattention associated with the disorder is likely to be due to functional deficits of the neural networks inhibiting irrelevant sensory input. In the presence of unnecessary information, a good decisional process is impaired and ADHD patients tend to take risky decisions. This study is aimed to test the hypothesis that the level of difficulty of a WM training (WMT) is affecting the top-down modulation of the attentional processes in a probabilistic gambling task. Methods: Event-related potentials (ERP) triggered by the choice of the amount wagered in the gambling task were recorded, before and after WMT with a the dual n-back task, in young ADHD adults and matched controls. For each group of participants, randomly assigned individuals were requested to perform WMT with a fixed baseline level of difficulty. The remaining participants were trained with a performance-dependent adaptive n-level of difficulty. Results: We compared the ERP recordings before and after 20 days of WMT in each subgroup. The analysis was focused on the time windows with at least three recording sites showing differences before and after training, after Bonferroni correction ( p < 0.05 ). In ADHD, the P1 wave component was selectively affected at frontal sites and its shape was recovered close to controls' only after adaptive training. In controls, the strongest contrast was observed at parietal level with a left hemispheric dominance at latencies near 900 ms, more after baseline than after adaptive training. Conclusion: Partial restoration of early selective attentional processes in ADHD patients might occur after WMT with a high cognitive load. Modified frontal sites' activities might constitute a neural marker of this effect in a gambling task. In controls, conversely, an increase in late parietal negativity might rather be a marker of an increase in transfer effects to fluid intelligence.

Dataset Information

Examining the Impact of Motivation on Working Memory Training in Youth With ADHD.

Publications

Examining the Impact of Motivation on Working Memory Training in Youth With ADHD.

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