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At-home cognitive training shown to reduce anxiety in breast cancer survivors

Results of new Birkbeck study suggest emotional upheaval of diagnosis and treatment can be lessened.

New research from Birkbeck, University of London has shown simple brain-training exercises done at home can reduce emotional vulnerability in female breast cancer survivors.

Advances in medical treatment have enabled a significant proportion of women diagnosed with breast cancer to live longer lives, but the psychological cost of the illness and the physical and mental impact of surgery, chemotherapy and radiotherapy have a lasting effect for many years. Many women suffer symptoms of post-traumatic stress, anxiety and depression for an extensive period following treatment. Often confidence and self-esteem are severely affected while for many women the fear of recurrence causes a major impact in everyday life.

Birkbeck’s Professor Nazanin Derakhshan led a study comparing anxious and depressive symptoms in two groups of women, who had undergone breast cancer treatment, after they undertook different types of cognitive-training tasks for 12 days.

Both groups undertook simple training tasks (known as adaptive dual n-back training) which required them to remember a sequence of spoken letters and a sequence of positions of a square at the same time, then identify when a letter or position matched one that occurred earlier.

For the first, experimental group the task became more challenging and difficult as their competence increased, but for the second, control group, who trained on the same task,  the difficulty level remained the same throughout the training period.

The anxious/depressive symptoms of the groups were then examined three times to assess their emotional vulnerability – firstly, immediately after the training, then at one month and finally after 15-18 months, to assess the long-term effectiveness.

The findings – published in the journal Psycho-Oncology – showed a significant, 16% reduction in anxiety and distress-related symptoms in the experimental group when compared to the control group. These reductions were sustained at one month and all the way through to the final assessment. Similarly, training reduced ‘rumination’ by 14% compared to the control group, a causal factor for depression which includes a tendency to get stuck in cycles of negative thinking. 

Professor Derakhshan, a professor of experimental psychopathology in Birkbeck’s Department of Psychological Sciences, said: “Recent advances in cognitive and affective neuroscience indicate that by building new neural connections in the brain, we can pave the way towards resilience and cognitive flexibility improving neural efficiency. We have previously identified impairment in attentional control and cognitive flexibility as a cause of anxiety and depressive-related vulnerability – by strengthening these neurological functions, we can reduce these negative symptoms.

“Training-related gains in the experimental group resulted in a reduction in emotional vulnerability following the cognitive tasks. On the other hand, the control group who stayed at a ‘practice’ level did not show this reduction in emotional vulnerability.”

Jessica Swainston, Professor Derakhshan’s PhD student who conducted the study, said:  “This research has huge implications for not only improving cognitive flexibility in breast cancer but also other chronic conditions and cancers that affect cognitive function and emotional wellbeing. The training has further potential to increase the efficacy of other available therapies such as CBT and mindfulness by improving attentional engagement. We are currently running two more studies looking at the combined effects of n-back training with mindfulness and expressive writing to establish whether these treatments are enhanced when used in addition to cognitive training.”

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