An investigation of working memory deficits in depression using the n-back task: A systematic review and meta-analysis
Open accessAbstract
Background Depression is associated with cognitive deficits across multiple domains, including working memory. The n-back task, a convenient psychometric tool capable of computerised delivery and concurrent use with neuroimaging, can provide enhanced insight into working memory dysfunction in depression. This meta-analysis sought to investigate the n-back task under varying cognitive load conditions (i.e. different levels of 'n') to clarify the pattern of working memory deficits in depression.Methods We conducted a systematic review and meta-analysis of studies involving unipolar depressed participants and matched controls utilising the n-back task. Meta-analyses were performed for accuracy and response times at four levels of cognitive load (0-, 1-, 2-, and 3-back).Results 31 studies (total 1,666 participants) met inclusion criteria and were included for quantitative analyses. Depressed individuals had significantly reduced accuracy compared to controls for 1-, 2-, and 3-back tasks, but not the attentional 0-back task. Likewise, response latencies were prolonged for all task levels (0-, 1-, 2-, and 3-back). Additional meta-regression analyses indicated that participant age and clinical status (i.e. inpatient/outpatient) may exacerbate working memory deficits associated with depression.Limitations Our results indicate high levels of heterogeneity between studies, particularly for response times.Conclusions Accuracy impairments were worse at higher levels of n, with the largest effect size obtained on the 2-back task, suggesting deficits to higher executive functions. Response times were consistently prolonged at all cognitive loads in agreement with a pattern of generalised psychomotor retardation.
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Selective attention, interference processing, and working memory are cognitive domains all impacted in depression.
“cognitive domains that are all impacted in depression [93–96]”
From Personalized machine learning guided intervention for optimizing lifestyle behaviors in depression: a pilot study (2026) · cites this paper as [94]
The Discussion (page not provided) reports working-memory deficits in depression at higher n-back task loads. It says attentional subprocesses were relatively preserved in this analysis, while acknowledging other meta-analyses that found attentional impairments. The paper does not establish an impairment in interference processing, so it does not support all three domains as stated. (LLM, conf=0.85)
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- Authors
- Nikolin, S., Tan, Y. Y., Schwaab, A., Moffa, A., Loo, C. K., & Martin, D.
- Affiliations
- Black Dog Institute (AU)
- UNSW Sydney (AU)
- Corresponding author
- Nikolin, Stevan
- Venue
- Journal of Affective Disorders
- Publisher
- Elsevier BV
- Published
- 2021-04
- Volume
- 284
- Pages
- 1-8
- ISSN
- 0165-0327 (ISSN-L)
- OpenAlex
- W3127757974
- Cited by
- 205
- References
- 89
- Citations by year
- 2026: 32 · 2025: 60 · 2024: 46 · 2023: 36 · 2022: 24 · 2021: 7
- FWCI
- 4.17
- Type
- journal article
- Language
- en
- Open access
- green
- hdl.handle.net
- Licence
- Locations
- Journal of Affective Disorders (publishedVersion)
- PubMed (publishedVersion)
- UNSWorks (University of New South Wales, Sydney, Australia) (submittedVersion, cc-by-nc-nd)
- Topics
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Cognitive Abilities and Testing
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- depression, working memory deficits, n-back task, cognitive load, response latency, response accuracy, executive function, psychomotor retardation, major depressive disorder, age effects
- MeSH terms
- Cognition Disorders, Depression, Humans, Memory Disorders, Memory, Short-Term, Neuropsychological Tests, Executive Function
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