Training Working Memory in Adolescents Using Serious Game Elements: Pilot Randomized Controlled Trial

Background Working memory capacity has been found to be impaired in adolescents with various psychological problems, such as addictive behaviors. Training of working memory capacity can lead to significant behavioral improvements, but it is usually long and tedious, taxing participants’ motivation to train. Objective This study aimed to evaluate whether adding game elements to the training could help improve adolescents’ motivation to train while improving cognition. Methods A total of 84 high school students were allocated to a working memory capacity training, a gamified working memory capacity training, or a placebo condition. Working memory capacity, motivation to train, and drinking habits were assessed before and after training. Results Self-reported evaluations did not show a self-reported preference for the game, but participants in the gamified working memory capacity training condition did train significantly longer. The game successfully increased motivation to train, but this effect faded over time. Working memory capacity increased equally in all conditions but did not lead to significantly lower drinking, which may be due to low drinking levels at baseline. Conclusions We recommend that future studies attempt to prolong this motivational effect, as it appeared to fade over time.

[1]  J. Raven,et al.  Manual for Raven's progressive matrices and vocabulary scales , 1962 .

[2]  H. Akaike,et al.  Information Theory and an Extension of the Maximum Likelihood Principle , 1973 .

[3]  G. Schwarz.  Estimating the Dimension of a Model , 1978 .

[4]  B. Milner,et al.  Deficits on subject-ordered tasks after frontal- and temporal-lobe lesions in man , 1982, Neuropsychologia.

[5]  L C Sobell,et al.  The reliability of a timeline method for assessing normal drinker college students' recent drinking history: utility for alcohol research. , 1986, Addictive behaviors.

[6]  S. Dickman,et al.  PERSONALITY PROCESSES AND INDIVIDUAL DIFFERENCES Functional and Dysfunctional Impulsivity: Personality and Cognitive Correlates , 1990 .

[7]  O. Aasland,et al.  Development of the Alcohol Use Disorders Identification Test (AUDIT): WHO Collaborative Project on Early Detection of Persons with Harmful Alcohol Consumption--II. , 1993, Addiction.

[8]  C. Carver,et al.  Behavioral inhibition, behavioral activation, and affective responses to impending reward and punishment: The BIS/BAS Scales , 1994 .

[9]  R. Wiers,et al.  High- and low-dose alcohol-related expectancies and the differential associations with drinking in male and female adolescents and young adults. , 1997, Addiction.

[10]  P. Sillanaukee,et al.  Five-shot questionnaire on heavy drinking. , 1998, Alcoholism, clinical and experimental research.

[11]  E. Deci,et al.  A meta-analytic review of experiments examining the effects of extrinsic rewards on intrinsic motivation. , 1999, Psychological bulletin.

[12]  R. Engle,et al.  The role of prefrontal cortex in working-memory capacity, executive attention, and general fluid intelligence: An individual-differences perspective , 2002, Psychonomic bulletin & review.

[13]  H. Forssberg,et al.  Computerized training of working memory in children with ADHD--a randomized, controlled trial. , 2005, Journal of the American Academy of Child and Adolescent Psychiatry.

[14]  P. Muris,et al.  Psychometric Properties of the Dutch BIS/BAS Scales , 2005 .

[15]  S. Hogg-Johnson,et al.  A meta-analysis of working memory impairments in children with attention-deficit/hyperactivity disorder. , 2005, Journal of the American Academy of Child and Adolescent Psychiatry.

[16]  B. Pennington,et al.  Validity of the Executive Function Theory of Attention-Deficit/Hyperactivity Disorder: A Meta-Analytic Review , 2005, Biological Psychiatry.

[17]  R. Singleton.  Collegiate alcohol consumption and academic performance. , 2007, Journal of studies on alcohol and drugs.

[18]  Emily Calhoun,et al.  The reliability and validity of the self-ordered pointing task. , 2007, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[19]  L. Steinberg,et al.  CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE Risk Taking in Adolescence New Perspectives From Brain and Behavioral Science , 2022 .

[20]  Jerry L. Grenard,et al.  Automatic and controlled processes and the development of addictive behaviors in adolescents: A review and a model , 2007, Pharmacology Biochemistry and Behavior.

[21]  Matt Field,et al.  Experimental manipulation of attentional biases in heavy drinkers: do the effects generalise? , 2007, Psychopharmacology.

[22]  Jerry L. Grenard,et al.  Interactions between implicit and explicit cognition and working memory capacity in the prediction of alcohol use in at-risk adolescents. , 2008, Drug and alcohol dependence.

[23]  Jerry L. Grenard,et al.  Working memory capacity moderates the predictive effects of drug-related associations on substance use. , 2008, Psychology of addictive behaviors : journal of the Society of Psychologists in Addictive Behaviors.

[24]  L. Clark,et al.  Impulsivity as a vulnerability marker for substance-use disorders: Review of findings from high-risk research, problem gamblers and genetic association studies , 2008, Neuroscience & Biobehavioral Reviews.

[25]  M. D’Esposito.  Working memory. , 2008, Handbook of clinical neurology.

[26]  Joni Holmes,et al.  Adaptive training leads to sustained enhancement of poor working memory in children. , 2009, Developmental science.

[27]  R. Wiers,et al.  Response inhibition moderates the relationship between implicit associations and drinking behavior. , 2009, Alcoholism, clinical and experimental research.

[28]  Colin MacLeod,et al.  Introduction to the special section on cognitive bias modification in emotional disorders. , 2009, Journal of abnormal psychology.

[29]  H. de Wit.  Impulsivity as a determinant and consequence of drug use: a review of underlying processes , 2009, Addiction biology.

[30]  T. Klingberg.  Training and plasticity of working memory , 2010, Trends in Cognitive Sciences.

[31]  Reinout W Wiers,et al.  Clinical effectiveness of attentional bias modification training in abstinent alcoholic patients. , 2010, Drug and alcohol dependence.

[32]  Reinout W. Wiers,et al.  Getting a Grip on Drinking Behavior , 2011, Psychological science.

[33]  Reinout W. Wiers,et al.  Addiction, adolescence, and the integration of control and motivation , 2011, Developmental Cognitive Neuroscience.

[34]  Pier J. M. Prins,et al.  Does Computerized Working Memory Training with Game Elements Enhance Motivation and Training Efficacy in Children with ADHD? , 2011, Cyberpsychology Behav. Soc. Netw..

[35]  Alexandra B. Morrison,et al.  Does working memory training work? The promise and challenges of enhancing cognition by training working memory , 2011, Psychonomic bulletin & review.

[36]  T. Bjarnason,et al.  The 2011 ESPAD report: substance use among students in 36 European countries. , 2012 .

[37]  R. Wiers,et al.  How do alcohol cues affect working memory? Persistent slowing due to alcohol-related distracters in an alcohol version of the Sternberg task , 2012 .

[38]  Reinout W. Wiers,et al.  Can Motivation Normalize Working Memory and Task Persistence in Children with Attention-Deficit/Hyperactivity Disorder? The Effects of Money and Computer-Gaming , 2011, Journal of Abnormal Child Psychology.

[39]  R. Wiers,et al.  Automatic processes in at-risk adolescents: the role of alcohol-approach tendencies and response inhibition in drinking behavior. , 2012, Addiction.

[40]  R. Wiers,et al.  Automatic processes and the drinking behavior in early adolescence: a prospective study. , 2013, Alcoholism, clinical and experimental research.

[41]  Reinout W. Wiers,et al.  Cognitive Bias Modification and Cognitive Control Training in Addiction and Related Psychopathology , 2013 .

[42]  C. Braet,et al.  Executive function training with game elements for obese children: a novel treatment to enhance self-regulatory abilities for weight-control. , 2013, Behaviour research and therapy.

[43]  Filip Smit,et al.  Web-based cognitive bias modification for problem drinkers: protocol of a randomised controlled trial with a 2x2x2 factorial design , 2013, BMC Public Health.

[44]  David Coghill,et al.  Nonpharmacological interventions for ADHD: systematic review and meta-analyses of randomized controlled trials of dietary and psychological treatments. , 2013, The American journal of psychiatry.

[45]  Sebastiaan Dovis,et al.  "Braingame Brian": Toward an Executive Function Training Program with Game Elements for Children with ADHD and Cognitive Control Problems. , 2013, Games for health journal.

[46]  H. Geurts,et al.  A Pilot Study of the Efficacy of a Computerized Executive Functioning Remediation Training With Game Elements for Children With ADHD in an Outpatient Setting , 2014, Journal of attention disorders.

[47]  Reinout W Wiers,et al.  Exploring Elements of Fun to Motivate Youth to Do Cognitive Bias Modification. , 2015, Games for health journal.

[48]  R. Wiers,et al.  Weaknesses in executive functioning predict the initiating of adolescents’ alcohol use , 2015, Developmental Cognitive Neuroscience.

[49]  R. Wiers,et al.  Executive Functions and Motivation as Moderators of the Relationship Between Automatic Associations and Alcohol Use in Problem Drinkers Seeking Online Help. , 2015, Alcoholism, clinical and experimental research.

[50]  R. Wiers,et al.  Validation of the Amsterdam Beverage Picture Set: A Controlled Picture Set for Cognitive Bias Measurement and Modification Paradigms , 2015, Alcoholism, clinical and experimental research.

[51]  Reinout W. Wiers,et al.  Improving Executive Functioning in Children with ADHD: Training Multiple Executive Functions within the Context of a Computer Game. A Randomized Double-Blind Placebo Controlled Trial , 2015, PloS one.

[52]  Reinout W Wiers,et al.  Cognitive Bias Modification for adolescents with substance use problems--Can serious games help? , 2015, Journal of behavior therapy and experimental psychiatry.

[53]  R. Wiers,et al.  On the Development of Implicit and Control Processes in Relation to Substance Use in Adolescence , 2015, Current Addiction Reports.

[54]  J. Hadwin,et al.  Working Memory Training and CBT Reduces Anxiety Symptoms and Attentional Biases to Threat: A Preliminary Study , 2016, Front. Psychol..

[55]  R. Wiers,et al.  Emotional working memory training as an online intervention for adolescent anxiety and depression: A randomised controlled trial , 2016, Australian journal of psychology.

[56]  R. Veltkamp,et al.  Training Behavioral Control in Adolescents Using a Serious Game. , 2017, Games for health journal.

[57]  Alexandre N. Tuch,et al.  Towards understanding the effects of individual gamification elements on intrinsic motivation and performance , 2017, Comput. Hum. Behav..