Abstract
Background
Previous research has indicated a causal relationship between attentional control and anxiety with literature finding that attentional control training combined with mindfulness meditation may lead to cognitive improvements in high worriers. The current study investigates whether the practical application of Stoicism, a philosophy originating from the Hellenistic period, will provide similar self-report and cognitive improvement in a sample of high worriers.
Methods
45 high worriers were randomly allocated into one of three training groups: an active control 1-back, a combined adaptive dual n-back and Stoic training and a Stoic training only group. Participants were tested on anxiety and rumination as well as measures of attentional control and a nascent scale to measure Stoic ideation, pre- and post- an 8-session training period.
Results
Results found significant effects of Stoic training on rumination and self-efficacy. Text analyses of the Stoic training found reduced frequencies of anxious and negatively valenced words questions related to self-assessments and planning.
Conclusions
The study provides a positive foundation for the further research and development of Stoic training. The wider implications of these results are discussed.
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References
Aldao, A., Nolen-Hoeksema, S., & Schweizer, S. (2010). Emotion-regulation strategies across psychopathology: A meta-analytic review. Clinical Psychology Review, 30(2), 217–237. https://doi.org/10.1016/j.cpr.2009.11.004.
Andrews, V. H., & Borkovec, T. D. (1988). The differential effects of inductions of worry, somatic anxiety, and depression on emotional experience. Journal of Behavior Therapy and Experimental Psychiatry, 19(1), 21–26. https://doi.org/10.1016/0005-7916(88)90006-7.
Aue, T., & Okon-Singer, H. (2015). Expectancy biases in fear and anxiety and their link to biases in attention. Clinical Psychology Review, 42, 83–95. https://doi.org/10.1016/j.cpr.2015.08.005.
Baer. (2003). Mindfulness training as a clinical intervention: A conceptual and empirical review. Science and Practice, 10(2), 125–143. https://doi.org/10.1093/clipsy.bpg015.
Becker, E. S., Rinck, M., Margraf, J., & Roth, W. T. (2001). The emotional Stroop effect in anxiety disorders: General emotionality or disorder specificity? Journal of Anxiety Disorders, 15(3), 147–159. https://doi.org/10.1016/S0887-6185(01)00055-X.
Beloe, P., & Derakshan, N. (2019). Adaptive working memory training can reduce anxiety and depression vulnerability in adolescents. Developmental Science. https://doi.org/10.1111/desc.12831.
Berggren, N., & Derakshan, N. (2013). Attentional control deficits in trait anxiety: Why you see them and why you don’t. Biological Psychology, 92(3), 440–446. https://doi.org/10.1016/j.biopsycho.2012.03.007.
Birnbaum, M. H. (2004). Human research and data collection via the Internet. Annual Review of Psychology, 55, 803–832. https://doi.org/10.1146/annurev.psych.55.090902.141601.
Chisholm, D., Sweeny, K., Sheehan, P., Rasmussen, B., Smit, F., Cuijpers, P., & Saxena, S. (2016). Scaling-up treatment of depression and anxiety: A global return on investment analysis. The Lancet Psychiatry, 3(5), 415–424. https://doi.org/10.1016/S2215-0366(16)30024-4.
Cohen, N., Mor, N., & Henik, A. (2015). Linking executive control and emotional response: A training procedure to reduce rumination. Clinical Psychological Science, 3(1), 15–25. https://doi.org/10.1016/j.neuroimage.2015.10.069.
Cohen, N., Margulies, D. S., Ashkenazi, S., Schaefer, A., Taubert, M., Henik, A., et al. (2016). Using executive control training to suppress amygdala reactivity to aversive information. NeuroImage, 125, 1022–1031. https://doi.org/10.1016/j.neuroimage.2015.10.069.
Collins, N., & Corna, L. (2018). General practitioner referral of older patients to Improving Access to Psychological Therapies (IAPT): An exploratory qualitative study. BJPsych bulletin, 42(3), 115–118.
Course-Choi, J., Saville, H., & Derakshan, N. (2017). The effects of adaptive working memory training and mindfulness meditation training on processing efficiency and worry in high worriers. Behaviour Research and Therapy, 89, 1–13. https://doi.org/10.1016/j.brat.2016.11.002.
Diener, E., Wirtz, D., Tov, W., Kim-Prieto, C., Choi, D., Oishi, S., & Biswas-Diener, R. (2009). New measures of well-being: Flourishing and positive and negative feelings. Social Indicators Research, 39, 247–266.
Dresler, T., Mériau, K., Heekeren, H. R., & van der Meer, E. (2009). Emotional Stroop task: Effect of word arousal and subject anxiety on emotional interference. Psychological Research PRPF, 73(3), 364–371. https://doi.org/10.1007/s00426-008-0154-6.
Ehring, T., & Watkins, E. R. (2008). Repetitive negative thinking as a transdiagnostic process. International Journal of Cognitive Therapy, 1(3), 192–205. https://doi.org/10.1521/ijct.2008.1.3.192.
Eide, P., Kemp, A., Silberstein, R. B., Nathan, P. J., & Stough, C. (2002). Test-retest reliability of the emotional Stroop task: Examining the paradox of measurement change. The Journal of Psychology, 136(5), 514–520. https://doi.org/10.1080/00223980209605547.
Eriksen, B. A., & Eriksen, C. W. (1974). Effects of noise letters upon the identification of a target letter in a nonsearch task. Perception & Psychophysics, 16(1), 143–149. https://doi.org/10.3758/BF03203267.
Eysenck, M. W., Derakshan, N., Santos, R., & Calvo, M. G. (2007). Anxiety and cognitive performance: Attentional control theory. Emotion, 7(2), 336. https://doi.org/10.1037/1528-3542.7.2.336.
Farias, M., & Wikholm, C. (2016). Has the science of mindfulness lost its mind? BJPsych Bulletin, 40(6), 329–332. https://doi.org/10.1192/pb.bp.116.053686.
Faul, F., Erdfelder, E., Buchner, A., & Lang, A.-G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41, 1149–1160.
Graf, M. C., Gaudiano, B. A., & Geller, P. A. (2008). Written emotional disclosure: A controlled study of the benefits of expressive writing homework in outpatient psychotherapy. Psychotherapy Research, 18(4), 389–399. https://doi.org/10.1080/10503300701691664.
Grol, M., Schwenzfeier, A. K., Stricker, J., Booth, C., Temple-McCune, A., Derakshan, N., et al. (2018). The worrying mind in control: An investigation of adaptive working memory training and cognitive bias modification in worry-prone individuals. Behaviour Research and Therapy, 103, 1–11. https://doi.org/10.1016/j.brat.2018.01.005.
Haeffel, G. J. (2010). When self-help is no help: Traditional cognitive skills training does not prevent depressive symptoms in people who ruminate. Behaviour Research and Therapy, 48(2), 152–157. https://doi.org/10.1016/j.brat.2009.09.016.
Jaeggi, S. M., Buschkuehl, M., Jonides, J., & Perrig, W. J. (2008). Improving fluid intelligence with training on working memory. Proceedings of the National Academy of Sciences, 105(19), 6829–6833. https://doi.org/10.1073/pnas.0801268105.
Jones, N. P., Siegle, G. J., & Thase, M. E. (2008). Effects of rumination and initial severity on remission to cognitive therapy for depression. Cognitive Therapy and Research. https://doi.org/10.1007/s10608-008-9191-0.
Koster, E. H., Hoorelbeke, K., Onraedt, T., Owens, M., & Derakshan, N. (2017). Cognitive control interventions for depression: A systematic review of findings from training studies. Clinical Psychology Review, 53, 79–92.
Kruijt, A. W., Parsons, S., & Fox, E. (2019). A meta-analysis of bias at baseline in RCTs of attention bias modification: No evidence for dot-probe bias towards threat in clinical anxiety and PTSD. Journal of abnormal psychology, 128(6), 563. https://doi.org/10.1037/abn0000406.
LeBon, T., (2018). Stoic week 2018 report part 3: Impact on well-being by Tim LeBon. [Blog Post]. Retrieved July 7, 2020, from https://modernstoicism.com/stoic-week-2018-report-part-3-impact-on-well-being-by-tim-lebon/.
Lomas, T., Cartwright, T., Edginton, T., & Ridge, D. (2015). A qualitative analysis of experiential challenges associated with meditation practice. Mindfulness, 6(4), 848–860. https://doi.org/10.1007/s12671-014-0329-8.
Lyubomirsky, S., & Nolen-Hoeksema, S. (1995). Effects of self-focused rumination on negative thinking and interpersonal problem solving. Journal of Personality and Social Psychology, 69(1), 176. https://doi.org/10.1037//0022-3514.69.1.176.
McCrone, P. R., Dhanasiri, S., Patel, A., Knapp, M., & Lawton-Smith, S. (2008). Paying the price: the cost of mental health care in England to 2026. King's Fund. Retrieved July 7, 2020, from http://eprints.lse.ac.uk/id/eprint/23318.
Melby-Lervåg, M., Redick, T. S., & Hulme, C. (2016). Working memory training does not improve performance on measures of intelligence or other measures of “far transfer” evidence from a meta-analytic review. Perspectives on Psychological Science, 11(4), 512–534. https://doi.org/10.1177/1745691616635612.
Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28(6), 487–495. https://doi.org/10.1016/0005-7967(90)90135-6.
Moberly, N. J., & Watkins, E. R. (2008). Ruminative self-focus and negative affect: An experience sampling study. Journal of Abnormal Psychology, 117(2), 314–323. https://doi.org/10.1037/0021-843X.117.2.314.
National Collaborating Centre for Mental Health. (2018). The improving access to psychological therapies manual. UK: NCCMH. Retrieved July 7, 2020, from https://www.england.nhs.uk/wp-content/uploads/2019/12/iapt-manual-v3.pdf.
National IAPT Programme Team. (2011). The IAPT data handbook: Guidance on recording and monitoring outcomes to support local evidence-based practice. UK: IAPT. Retrieved July 7, 2020, from: https://webarchive.nationalarchives.gov.uk/20160302160058/http:/www.iapt.nhs.uk/silo/files/iapt-data-handbook-v2.pdf.
Nolen-Hoeksema, S., & Morrow, J. (1991). A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta Earthquake. Journal of Personality and Social Psychology, 61(1), 115. https://doi.org/10.1037/0022-3514.61.1.115.
Okon-Singer, H. (2018). The role of attention bias to threat in anxiety: Mechanisms, modulators and open questions. Current Opinion in Behavioral Sciences, 19, 26–30. https://doi.org/10.1016/j.cobeha.2017.09.008.
Owens, M., Koster, E. H., & Derakshan, N. (2013). Improving attention control in dysphoria through cognitive training: Transfer effects on working memory capacity and filtering efficiency. Psychophysiology, 50(3), 297–307. https://doi.org/10.1111/psyp.12010.
Park, D., Ramirez, G., & Beilock, S. L. (2014). The role of expressive writing in math anxiety. Journal of Experimental Psychology: Applied, 20(2), 103. https://doi.org/10.1037/xap0000013.
Pennebaker, J. W., Francis, M. E., & Booth, R. J. (2001). Linguistic inquiry and word count: LIWC 2001. Mahway: Lawrence Erlbaum Associates. Retrieved July 7, 2020, from http://liwc.wpengine.com/.
Price, M., & Anderson, P. L. (2011). The impact of cognitive behavioral therapy on post event processing among those with social anxiety disorder. Behaviour Research and Therapy, 49(2), 132–137.
Ramirez, G., & Beilock, S. L. (2011). Writing about testing worries boosts exam performance in the classroom. Science, 331(6014), 211–213. https://doi.org/10.1126/science.1199427.
Sari, B. A., Koster, E. H., Pourtois, G., & Derakshan, N. (2016). Training working memory to improve attentional control in anxiety: A proof-of-principle study using behavioral and electrophysiological measures. Biological Psychology, 121, 203–212. https://doi.org/10.1016/j.biopsycho.2015.09.008.
Schwarzer, R., & Jerusalem, M. (1995). Generalized self-efficacy scale. Measures in health psychology: A user’s portfolio. Causal and Control Beliefs, 1(1), 35–37.
Shipstead, Z., Lindsey, D. R., Marshall, R. L., & Engle, R. W. (2014). The mechanisms of working memory capacity: Primary memory, secondary memory, and attention control. Journal of Memory and Language, 72, 116–141. https://doi.org/10.1016/j.jml.2014.01.004.
Sibrava, N. J., & Borkovec, T. D. (2006). The cognitive avoidance theory of worry. Worry and its psychological disorders: Theory, Assessment and Treatment. https://doi.org/10.1002/9780470713143.ch14.
Siegle, G. J., Price, R. B., Jones, N. P., Ghinassi, F., Painter, T., & Thase, M. E. (2014). Yougotta work at it: Pupillary indices of task focus are prognostic for response to a neurocognitive intervention for rumination in depression. Clinical Psychological Science, 2(4), 455–471. https://doi.org/10.1016/j.brat.2016.12.015.
Spielberger, C. D., Gorsuch, R. L., Lushene, R., Vagg, P. R., & Jacobs, G. A. (1983). Manual for the state-trait anxiety inventory. Palo Alto, CA: Consulting Psychologists Press.
Strauss, G. P., Allen, D. N., Jorgensen, M. L., & Cramer, S. L. (2005). Test-retest reliability of standard and emotional stroop tasks: An investigation of color-word and picture-word versions. Assessment, 12(3), 330–337. https://doi.org/10.1177/1073191105276375.
Swainston, J., & Derakshan, N. (2018). Training cognitive control to reduce emotional vulnerability in breast cancer. Psycho-oncology, 27(7), 1780–1786. https://doi.org/10.1002/pon.4727.
Topper, M., Emmelkamp, P. M. G., Watkins, E., & Ehring, T. (2017). Prevention of anxiety disorders and depression by targeting excessive worry and rumination in adolescents and young adults: A randomized controlled trial. Behaviour Research and Therapy, 90, 123–136. https://doi.org/10.1016/j.brat.2016.12.015.
Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures of positive and negative affect: The PANAS scales. Journal of Personality and Social Psychology, 54(6), 1063. https://doi.org/10.1037/0022-3514.54.6.1063.
Wells, A. (2013). Cognitive therapy of anxiety disorders: A practice manual and conceptual guide. New York: Wiley.
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MacLellan, A., Derakshan, N. The Effects of Stoic Training and Adaptive Working Memory Training on Emotional Vulnerability in High Worriers. Cogn Ther Res 45, 730–744 (2021). https://doi.org/10.1007/s10608-020-10183-4
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DOI: https://doi.org/10.1007/s10608-020-10183-4