Gegamificeerde werkgeheugentraining bij adolescenten met verslaving

Although current treatment programs for adolescents with substance use disorders show beneficial outcomes, post-treatment relapse rates remain high and leave room for further improvement. Cognitive enhancement by training patients’ working memory capacity is regarded as a promising new approach that might contribute to the effectiveness of current addiction therapies. Patients with an addiction show neurocognitive deficits and low levels of impulse control which can impede their ability to remain abstinent.

Furthermore, cognitive impairments might hamper the processing of information during regular therapy sessions, which can potentially diminish the effectiveness of regular addiction treatment.

According to previous cognitive and clinical research, a working memory training can enhance working memory capacity leading to beneficial outcomes, such as improved executive functioning and reduced complaints in individuals with ADHD, depression, schizophrenia and also problem drinkers and stimulant dependent patients. An important drawback of most working memory training programs is that they involve repetitious and often tedious exercises. As addicted adolescents might be less motivated to comply with these types of interventions, we developed a working memory training in game-format. Results from a small pilot study among adolescents in an addiction care unit, showed very positive evaluations and high completion rates confirming the feasibility of providing a ‘gamified’ working memory training to this clinical population.



The proposed research project will examine the potential benefits of a ‘gamified’ working memory training for adolescents in addiction care. The primary objective is to test whether a gamified working memory training will lead to improved working memory capacity in addicted adolescents. As a secondary aim of this project we wil explore the potentially advantageous effects of the gamified working memory training on addicted adolescents’ capacities on other aspects of working memory, craving, mood states, relapse rates, delay discounting, and substance use patterns. Finally, in an additional research question, we will examine whether addicted patients show less working memory capacity compared to non-addicted adolescents.

In a randomized controlled trial (RCT) with a pre-post design, 68 patients with a Substance Use Disorder (SUD) who receive inpatient treatment for their addiction will be randomly assigned to either a working memory training or a placebo-training (i.e., working memory exercises with low difficulty and not customized to participants’ ability levels). In addition, 64 healthy, non-addicted peers will be recruited outside the treatment setting and will be asked to perform only the baseline assessment of the RCT. This non-addicted non-patient group will function as a reference group to examine differences in working memory capacity at baseline between addicted adolescents and healthy controls.

Although current treatment programs for adolescents with substance use disorders show beneficial outcomes, post-treatment relapse rates remain high and leave room for further improvement. Patients with an addiction show neurocognitive deficits and low levels of impulse control which can impede their ability to remain abstinent. Furthermore, cognitive impairments might hamper the processing of information during regular therapy sessions, which can potentially diminish the effectiveness of regular addiction treatment. According to previous cognitive and clinical research, a working memory training can enhance working memory capacity leading to beneficial outcomes, such as improved executive functioning and reduced complaints in individuals with ADHD, depression, schizophrenia and also problem drinkers and stimulant dependent patients. An important drawback of most working memory training programs is that they involve repetitious and often tedious exercises. As addicted adolescents might be less motivated to comply with these types of interventions, we developed a working memory training in game-format.



The primary objective of present study is to test whether a gamified working memory training will lead to improved working memory capacity in addicted adolescents. As a secondary aim we will explore the potentially advantageous effects of the gamified working memory training on addicted adolescents’ craving, mood states, relapse rates and substance use patterns. Finally, we will examine whether addicted patients show less working memory capacity compared to non-addicted adolescents.

Start.

Immediate post-test: after 12 weeks of training.

Post-test 2: at the end of usual clinical treatment program.

The intervention consists of 8 working memory exercises that are integrated in a computer game. This computer game can be characterized as a role-playing game (rpg) where players can develop and upgrade their playing character during the game. The game depicts an island where players can move their avatar freely. The goal of the game is make your playing character strong enough to escape from the island. The upgrade their character, players have to battle against different enemies. The battle consist of working memory exercises. To win a battle, the playing character has to train in the training room. Here, players can choose which working memory exercise they want to practice. For participants who receive the working memory training (in contract to those who receive the placebo-training) the task will become more difficult as soon as participants become better, to increase the training effect. The participants trains twelve sessions of 30 minutes. The training contains the following tasks: two versions of the Simon task, two versions of the Digit span, the N-back task, the Symmetry span task, the Operation span task and the Figure task.