I was recently shocked to discover that the world health organisation has estimated that 50 million years of work, an annual global loss of £651bn, will be lost to anxious and depressive disorders between now and 2030. Although I was aware that emotional disorders such as anxiety and depression are on the increase, I found this figure particularly alarming not only for the state of the economy, but more importantly for the future psychological well-being of individuals, their families, and the society we live in.
As it stands, current pharmacological and psychotherapeutic treatments have been shown to be only modestly effective in both the treatment and prevention of emotional disorder. To me, it seems critical then that more research is carried out in order to better understand the underlying mechanisms involved in these conditions.
By achieving this, there is hope that we can develop effective interventions to not only treat emotional vulnerability, but further to build resilience against its onset and recurrence.
So, how do we become more resilient? How do we continue to cope with the ever demanding stresses that society and life place upon us?
It is these questions that motivated me to embark upon a PhD exploring how we can develop appropriate interventions to build resilience in vulnerable populations. Luckily, Professor Nazanin Derakshan at Birkbeck University of London, Director of the Laboratory for the study of Risk and Resilience in Mental Well-Being, and Director of the Centre for Building Psychological Resilience in Breast Cancer, is of a similar mind-set, and agreed to supervise me throughout this journey.
For many years Derakshan has investigated the cognitive mechanisms that are involved in emotional disorder. Derakshan is of the mind that our ability to flexibly direct where we place our attention, is the key mechanism in regulating our emotions and boosting our psychological resilience. In other words, the better we are at paying attention to our current goal (e.g. Writing this blog post), the less distracted we are at the expense of irrelevant intrusions and worrisome and ruminative thoughts that can quickly lead to cognitive and emotional fatigue (e.g. 'What if I fail my PhD?!'). We can refer to this ability as 'attentional control'.
Backing up this claim, research has shown that people with high anxiety and depression are poor at exercising attentional control, they find it difficult to focus, concentrate, and get easily distracted. Research shows that when there are possible faulty brain connections between 'emotional' and 'cognitive' systems they can lead to problems in regulating attentional control and using it more effectively when we need it.
If then attentional control is the key mechanism by which emotional vulnerability can be moderated, how then can this process be targeted?
It was many years ago that I first became aware of online 'cognitive training' games in psychological science, at the time being investigated for its reversal effects on cognitive degeneration through ageing. However, it is only recently that I have discovered a line of research investigating the effects of these games on emotional disorder, led by Derakshan. Can training our attentional control through cognitive training games better our ability to stop intruding and ruminative thoughts from occupying brain space? Further, is the training applicable to other circumstances, such as improving anxious states that can interrupt sports performance? Preliminary findings show great promise. As yet, compared to control groups, a course of adaptive attentional control training has shown to reduce anxiety, increase cognitive efficiency leading to better performance and improve sports performance under high pressure.
I am a firm believer in always considering the potential directions and clinical relevance of new interventions for emotional disorder. So, what is the future for cognitive training in psychological health? I think it is fair to say that a number of current psychological therapies such as mindfulness and cognitive behavioural therapy are of varied success. Yes, for many patients they have wonderful effects, however many others fail to engage at all. This may in part be due to the lack of attentional resources that severely depressed and anxious individuals possess. If one's attention is poor, how can one easily engage in a 10 week course of psychological therapy which requires focus and concentration? It can often be problematic.
Therefore, cognitive training may be beneficial as a complimentary treatment to current therapies. If attentional control processes are improved through training, individuals will be better enabled to pay attention and gain the most value from their treatment.
So improving our cognitive flexibility and ability to adaptively pay attention to our current goals may, in effect, help to our build resilience and protect against emotional vulnerability. This research is in its infancy and there is a long journey ahead, but I am excited by our initial findings and am keen to build developing cognitive interventions that may help alleviate and prevent emotional distress.
PhD candidate in the Department of Psychological Sciences, Birkbeck University of London
Laboratory for Risk and Resilience in Psychopathology and Mental Well-Being
Centre for Building Psychological Resilience in Breast Cancer