The effect of electronic cognitive training incorporating bilateral eye movements and response inhibition on anxiety in vocational college students

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The intervention uniquely combined bilateral eye movements, drawing on principles of EMDR, with inhibitory control training. Fifty-four students with elevated anxiety were randomly assigned to either the integrated training or a waitlist control. Results indicated that participants in the experimental group exhibited significantly greater reductions in anxiety compared to controls. Longitudinal analyses further revealed that improvements in self-control partially mediated the intervention’s anxiolytic effects, highlighting the role of self-regulatory mechanisms. These findings suggest that combining response inhibition training with bilateral eye movements constitutes a promising and accessible approach for reducing anxiety in educational contexts. Anxiety Cognitive Training Bilateral Eye Movements Response Inhibition Self-Control Figures Figure 1 Figure 2 Figure 3 1. Introduction Anxiety disorders affect approximately 264 million individuals worldwide (WHO, 2017), with students representing a particularly vulnerable group. Recent studies indicate that a significant portion of vocational and community college students experience anxiety (Julianto et al., 2023 ). Chronic anxiety undermines learning, quality of life, and increases the risk of depression and cardiovascular diseases (Zeng et al., 2019 ). These figures highlight the urgent need for effective interventions, particularly in educational settings, motivating research into strategies to alleviate anxiety in student populations. With the advancement of information technology, digital cognitive training has emerged as a promising psychological intervention (Chellappa & Aeschbach, 2022 ), attracting growing research attention. This approach, delivered via computer or mobile devices, has demonstrated benefits for cognitive functions such as attention, memory, and response inhibition (Liebherr et al., 2024 ), and can enhance emotional regulation through “far transfer” effects (Matsuzaki et al., 2023 ). Mechanistically, digital training strengthens the dorsal attention network (DAN), enhancing working memory and fluid intelligence, which in turn supports emotional regulation (Greenwood & Parasuraman, 2016 ). Evidence from targeted interventions such as working memory training indicates that emotional regulation is malleable through improvements in attentional control (Xiu et al., 2018 ). Building on these theoretical insights, specific interventions provide practical support for behavioral outcomes. For instance, electronic Working Memory Training (eWMT) reduces impulsivity, risky decision-making, and problematic internet use while improving cognitive emotion regulation (CER) (Emadi Chashmi et al., 2023 ). Likewise, studies with children show that executive function (EF) training can enhance emotional control (EC), with improvements in inhibition control and working memory contributing to better emotional regulation and comprehension (Li et al., 2020 ). These findings suggest that both adults and children can benefit from cognitive training programs targeting attentional and executive processes. Response inhibition—the ability to suppress inappropriate or goal-conflicting responses—is a key component of self-control, which allows individuals to regulate their behaviors, emotions, and thoughts. Strong inhibitory control supports effective stress management and lowers vulnerability to anxiety. Chronic stress, however, can impair prefrontal cortex functioning, weakening inhibitory control and disrupting emotion regulation and social adjustment. Longitudinal evidence shows that adolescents’ inhibitory control mediates the link between perceived stress and secure parent–child relationships, emphasizing its role in socioemotional development (Herd et al., 2018 ). Evidence from experimental studies further supports the emotional benefits of response inhibition training. For example, Fontana et al. ( 2021 ) found that training enhanced performance in a stop-signal task and reduced negative emotional responses to aversive images by strengthening cognitive control. Similarly, interventions targeting response inhibition and working memory have been shown to decrease emotion-driven impulsivity, improve the use of cognitive reappraisal, and strengthen inhibitory control, suggesting that enhancing these capacities may help individuals better manage stress and maintain emotional well-being (Peckham & Johnson, 2018 ). Beyond cognitive training, behavioral interventions such as bilateral eye movement (BEM) have also shown potential for emotion regulation. BEM, a rhythmic horizontal eye movement, can influence the processing of emotional memories by reducing the vividness and emotional intensity of traumatic memories, thereby alleviating PTSD symptoms (Meentken et al., 2021 ). This effect is thought to arise from bilateral brain activation, which facilitates interhemispheric communication and emotional integration (Gainer et al., 2020 ). Empirical evidence further supports the therapeutic value of BEM. For example, Every-Palmer et al. ( 2023 ) found that EMDR-based BEM activates information-processing pathways that reduce trauma-related emotional distress. Moreover, the direction of eye movement appears to matter, with horizontal movements playing a particularly important role in emotional regulation and memory consolidation (Jeffries & Davis, 2013 ). These findings suggest that BEM may have potential applications beyond PTSD, including the regulation of anxiety. This study aims to develop and evaluate an electronic cognitive training program that integrates response inhibition tasks with bilateral eye movements (BEM), a combination not previously explored. We further examine whether self-control mediates the intervention’s effect on anxiety, thereby connecting its cognitive training component to emotional regulation outcomes and clarifying the underlying mechanism. By merging these two intervention approaches—cognitive training and BEM—this research introduces a novel cognitive-emotional strategy, offering both theoretical insights and practical implications for enhancing mental well-being among vocational college students. 2. Methods 2.1 Participants This study recruited 54 students with elevated anxiety levels from a vocational college in Yunnan Province, China. The participant pool consisted of 24 males and 30 females, with ages ranging from 16 to 21 years (M = 18.53, SD = 0.87). All participants met the inclusion criteria based on an initial mental health screening, confirming the presence of anxiety symptoms. To ensure comparability between groups, participants were randomly assigned to either the experimental group or the control group using a random number generator. This randomization procedure effectively ensured that there were no significant differences between the two groups in demographic variables such as gender and age ( p > 0.05), thereby minimizing the influence of potential confounding factors on the study results. The experimental group received the electronic cognitive training program integrating bilateral eye movements and response inhibition. In contrast, the control group members did not receive any specific intervention during the study period. However, as an ethical consideration, control group participants were granted access to the training program after the waiting period to ensure fairness and ethical integrity. Tthe study protocol was reviewed and approved by the Institutional Review Board of Beijing Language and Culture University (Approval No.: 2024BYLL50). Prior to the commencement of the study, all participants were fully informed about the purpose, procedures, and potential risks and benefits of their participation. Freely-given, informed consent to participate in the study was obtained from all participants. For participants under 18 years of age, informed consent was obtained from their parent or legal guardian. Each participant signed a detailed informed consent form, indicating their voluntary participation and understanding of their right to withdraw from the study at any time without penalty. In addition, all participants received compensation for their participation. 2.2 Measurements To comprehensively evaluate the effects of the study, several validated questionnaires and scales were used to measure participants' trait anxiety, self-control capacity, childhood trauma experiences, and posttraumatic stress disorder (PTSD) symptoms. The specific details of each measurement tool, along with its reliability and validity analyses, are provided below. Trait Anxiety Inventory (TAI) : The TAI, developed by Spielberger et al., is a widely used psychometric instrument designed to assess an individual's long-term tendency to experience anxiety across various situations.The questionnaire consists of 20 items, each requiring participants to select the response that best reflects their feelings, using a 4-point Likert scale (ranging from "Almost Never" to "Almost Always") (Spielberger, 1980 ). Higher total scores indicate higher levels of trait anxiety. Numerous studies have demonstrated good internal consistency for the TAI (Cronbach's α coefficients typically ranging from 0.85 to 0.90), indicating highly stable results across different samples. Self-Control Scale (SCS) : The SCS, developed by Tangney et al., aims to measure an individual's ability to manage and regulate their own behavior, emotions, and impulses. The questionnaire consists of 13 items, also scored using a 4-point Likert scale, with higher scores representing greater self-control capacity (Tangney et al., 2004 ). The SCSC exhibits excellent internal consistency (Cronbach's α coefficient approximately 0.86) and has maintained high stability across multiple tests, indicating that it is a reliable measurement tool. Through exploratory and confirmatory factor analyses, the SCSC has been shown to have good construct validity. It is not only positively correlated with other self-control-related variables but also associated with actual behavioral performance on tasks such as delayed gratification, further confirming its criterion-related validity. Childhood Trauma Questionnaire (CTQ) : The CTQ, developed by Bernstein et al, is a brief self-report scale used to screen for five types of adverse experiences suffered during childhood: physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect. The CTQ consists of 28 items, divided into five subscales, with five items per subscale, plus three questions about overall trauma experiences(Bernstein et al., 1997 ; Bernstein et al., 2003 ). Participants rate each statement according to frequency or severity, using a 5-point Likert scale. The CTQ has demonstrated strong internal consistency (Cronbach's α coefficients for each subscale ranging from 0.70 to 0.90) and has maintained good reliability across different cultural and linguistic backgrounds. Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) : The PCL-5, developed by Weathers et al. based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is a self-report scale used to assess PTSD symptoms experienced by individuals in the past month. The PCL-5 contains 20 items, corresponding to the four core symptom clusters of PTSD defined in the DSM-5: re-experiencing, avoidance, negative alterations in cognition and mood, and hyperarousal(Weathers et al., 1993 ; Weathers et al., 2013 ). Each item is rated on a scale from 0 (Not at all) to 4 (Extremely), with total scores ranging from 0 to 80. Higher scores indicate more severe PTSD symptoms. 2.3 Intervention Program The CogniMove program, short for Cognitive Movement Integration , was developed using the Godot 4.0 game engine. This name reflects the program's core function: integrating cognitive training with targeted eye movements to facilitate emotional processing. The engine was chosen for its multi-platform support and ability to seamlessly integrate visual and auditory elements, crucial for delivering effective bilateral stimulation and response inhibition training. CogniMove is structured around a series of interactive modules designed to guide users through a process of identifying, processing, and reframing distressing thoughts and emotions. The program's core mechanism involves the strategic combination of bilateral horizontal eye movements (BEM) and response inhibition . Bilateral Eye Movements : These are implemented by requiring users to visually track a moving icon across the screen. Points are awarded only when the icon reaches the left or right edges of the screen, ensuring consistent horizontal eye movements. This BEM component is designed to activate both hemispheres of the brain, facilitating information processing and emotional integration. Response Inhibition : This is incorporated by requiring users to press a specific key (F for left, J for right) only when the icon reaches the edge of the screen. Premature key presses result in a point deduction, forcing users to actively inhibit impulsive responses and exercise cognitive control. By referencing Fig. 1 , we provide a visual anchor for the reader to understand the core mechanics of the CogniMove program. The CogniMove program also includes the following phases, which are adapted from the EMDR protocol: Assessment Phase : Users identify a distressing event, associated image, and negative cognition, and rate their level of distress (SUDs). Desensitization Phase : Users visualize the distressing event while tracking the moving icon and responding with the appropriate key press, simultaneously engaging in BEM and response inhibition. Installation Phase : Users formulate a positive cognition and rate their belief in it (VOCs). They then visualize the distressing event and the positive cognition while continuing the BEM and response inhibition task. Body Scan : Users perform an imagery exercise, focusing on bodily sensations associated with the event. Closure Phase : A comforting video provides closure and encourages reflection. Throughout its use, CogniMove strictly adheres to data protection regulations, ensuring user information security and privacy. Built-in data collection functions save user records during the treatment process, stored solely on the user's device. The technical validation of the CogniMove program involves a multi-stage process, including developer and user perspectives, to ensure effectiveness, usability, and user satisfaction. This includes evaluating technical performance, usability, and gathering user feedback through pilot studies, focus groups, and interviews. The program is iteratively improved based on this feedback, and mental health experts provide professional opinions to ensure scientific validity. 2.4 Experimental Procedure First, the official versions of the questionnaires relevant to this study were obtained from CNKI (China National Knowledge Infrastructure). All participants received pre-measurement instructions according to the official guidelines before completing the Trait Anxiety Inventory (TAI), Self-Control Scale (SCSC), Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), and Childhood Trauma Questionnaire (CTQ). Questionnaires that were completed incorrectly or exceeded the time limit were excluded. After a one-month interval, participants in the intervention group installed the training app and entered a six-digit password to access the training interface. Following the instructions within the training app, they engaged in digital bilateral eye movement training. One month after completing the intervention, this group underwent a post-test using the same questionnaires as the pre-test. Participants in the control group received no intervention. One month after completing the pre-test, they underwent a post-test using the same questionnaires. 2.5 Statistical Methods Independent samples t-tests and chi-square tests were used to examine whether the basic demographic information of the two groups of participants was matched. A mixed-design analysis of variance (ANOVA) was conducted, with group (control group/intervention group) as the between-subjects variable and time (pre-test/post-test) as the within-subjects variable, to analyze the various measurement indicators and examine changes in emotional states between the two groups. Regression analysis and mediation analysis were used to examine whether changes in anxiety were influenced by cognitive control variables, clarifying the underlying mechanisms of the training benefits. Statistical analyses were performed using SPSS 27 software and the associated macro program PROCESS. Partial eta-squared (ηp2) was reported as the effect size, and alpha was set at 0.05. 3. Results 3.1 Demographic Statistics This study included two groups: a control group (n = 36, age range: 16–20, male: female ratio = 4:5) and an intervention group (n = 18, age range: 18–21, male: female ratio = 5:4). At baseline, the mean self-control scores were 59.78 for the control group and 53.11 for the intervention group. Detailed demographic data are presented in Table 1 . Table 1 Demographic Information Control Training t/x2 p M(SD) M(SD) Age(year) 18.39(0.84) 18.82(0.88) 1.73 .089 Gender (male/female) 16/20 8/10 ~ 0 .99 SCSC 59.78(10.68) 53.11(12.98) -2.01 .06 3.2 Changes in emotional state before and after training We used a mixed-design ANOVA with time (pre/post) as a within-subjects factor and group (control/training) as a between-subjects factor. For the Childhood Trauma Questionnaire (CTQ), we found significant main effects for both time [F(1, 49) = 5.81, p = 0.02, η² = 0.11] and group [F(1, 49) = 5.81, p = 0.02, η² = 0.11]. Similarly, the Posttraumatic Stress Disorder Checklist (PCL) also revealed significant main effects for time [F(1, 49) = 5.81, p = 0.02, η² = 0.11] and group [F(1, 49) = 5.81, p = 0.02, η² = 0.11]. However, no significant time × group interaction effects were found for either questionnaire (ps > 0.05). For trait anxiety, we found a significant main effect of time [F(1, 49) = 46.05, p < 0.001, η² = 0.48], a significant main effect of group [F(1, 49) = 5.81, p = 0.02, η² = 0.11], and a significant time × group interaction [F(1, 49) = 15.90, p < 0.001, η² = 0.25]. Post-hoc comparisons indicated that the intervention group showed a significantly greater reduction in anxiety levels compared to the control group [t(49) = 3.99, p < 0.001], suggesting that the intervention can significantly improve individuals' anxiety levels. Changes in emotional state before and after the intervention are illustrated in Fig. 2 . 3.3 Regression models and sources of training benefits To examine the factors influencing the anxiety reduction resulting from the intervention, we calculated a "training benefit" score [Pre-Test Anxiety - Post-Test Anxiety]. An independent samples t-test revealed no significant difference in training benefit scores between males and females [t (49) = 1.18, p = 0.246]. Correlation analysis showed no significant relationship between training benefit and age [r = -0.07, p = 0.630]. However, notably, a significant positive correlation was found between training benefit and baseline self-control levels [r = 0.30, p = 0.035]. Higher baseline self-control was associated with greater anxiety reduction following the training. Further analysis was conducted using PROCESS macro (Model 8) to examine a moderated mediation model. This analysis tested whether the effect of pre-test anxiety on post-test anxiety was moderated by training group assignment, and whether self-control mediated this relationship. The results indicated that the effect of pre-test anxiety on post-test anxiety was significantly moderated by group assignment [t = -2.15, p = 0.037]. A significant direct effect of pre-test anxiety on post-test anxiety was observed only in the training group [b = 0.66, t = 3.03, p = 0.004], but not in the control group (p = 0.09). Furthermore, the change in anxiety scores was mediated by self-control. Specifically, in the training group, baseline anxiety influenced post-test anxiety through self-control, with a significant indirect effect of 0.17 (95% CI [0.02, 0.30]). The confidence interval did not include 0, indicating a significant indirect effect, suggesting that self-control partially mediated the intervention-induced improvement in anxiety. The model explained 39% of the variance in post-test anxiety (R² = 0.39, p < 0.001). The model is illustrated in Fig. 3 . 4. Discussions Recent research has explored various interventions for alleviating anxiety and promoting mental health among students. One study investigated the effectiveness of a novel electronic cognitive training program integrating bilateral eye movements (BEM) with response inhibition, finding that participants in the experimental group experienced a significant reduction in anxiety compared to controls, suggesting that this integrated approach may serve as an effective intervention for vocational college students. More broadly, self-guided digital cognitive training has been shown to produce small but positive effects on mental health, with greater benefits observed when combined with cognitive rehabilitation or virtual reality interventions, indicating modest improvements in psychological outcomes alongside cognitive enhancement (Cabreira et al., 2024 ). In addition, the combination of cognitive-behavioral therapy (CBT) with mindfulness-based stress reduction (MBSR) has demonstrated efficacy in reducing test anxiety, improving academic performance, and enhancing students’ well-being in TVET settings, highlighting that dual-modality approaches can help students manage anxiety and support personal growth (Nwadi et al., 2025 ). Recent studies have investigated mechanisms and interventions for alleviating anxiety and depressive symptoms. Changes in self-control capacity were found to partially mediate the effect of cognitive training on anxiety reduction, highlighting self-control as a key mechanism through which individuals regulate their behaviors, emotions, and thoughts. Similarly, bilateral eye movements (EM) selectively disrupt the perceptual representation of trauma-related memories without affecting semantic memory. Using a trauma film paradigm, EM interventions reduced perceptual memory recognition, decreased the frequency and vividness of memory intrusions over one week, and attenuated psychophysiological and subjective affective responses, indicating their effectiveness in diminishing both the perceptual and emotional impact of traumatic memories (Xu et al., 2023 ). In the domain of depression, cognitive restructuring has been shown to reduce depressive symptoms and improve interpretative biases, whereas working memory training produced no significant effects; changes in interpretative bias and executive function did not mediate symptom improvements (MacLellan et al., 2025 ). Anxiety is a pervasive issue among vocational college students, significantly impacting their learning and overall well-being (Chellappa & Aeschbach, 2022 ; Julianto et al., 2023 ). While traditional interventions exist, the increasing prevalence of digital technology offers innovative opportunities for psychological support. Digital cognitive training, delivered via computer or mobile devices, has emerged as a promising approach for enhancing cognitive functions and, in turn, emotional regulation (Liebherr et al., 2024 ; Matsuzaki et al., 2023 ). Building on this, the present study developed an electronic tool that integrates response inhibition training with bilateral eye movements (BEM), making the intervention accessible and scalable for vocational college students. The observed reduction in anxiety is consistent with prior evidence demonstrating the emotional benefits of both response inhibition training and BEM (Fontana et al., 2021 ; Meentken et al., 2021 ; Every-Palmer et al., 2023 ). Response inhibition training enhances cognitive control and reduces emotional reactivity, whereas BEM—a core component of EMDR therapy—facilitates emotional processing and integration, diminishing the intensity of negative emotions. By combining these two elements, the current study suggests that the intervention may produce additive or synergistic effects on anxiety reduction, offering a practical and theoretically grounded approach to improving mental health among vocational college students. It is noteworthy that the study did not observe significant improvements in Childhood Trauma Questionnaire (CTQ) or Posttraumatic Stress Disorder Checklist (PCL) scores, which may be due to several factors. First, the intervention was primarily designed to target general anxiety rather than trauma-specific symptoms. Although BEM is a core component of EMDR therapy (Laliotis et al., 2021 ), the current program may not have been intensive or comprehensive enough to affect deeply rooted trauma memories. Second, the relatively short intervention period (one month) may have been insufficient to produce measurable changes in these more stable and complex constructs. Future research could adopt a longitudinal design or implement higher-intensity, trauma-focused interventions to better evaluate the efficacy of this integrated training program for trauma-related symptoms. The finding that self-control partially mediated the anxiety reduction effect underscores the critical role of this cognitive function in mental well-being (Baumeister et al., 2007 ). Self-control, encompassing impulse regulation, maintenance of healthy habits, goal-directed behaviors, and adaptive leisure regulation, is a key executive function that enables individuals to manage their behaviors and emotions effectively (Hofmann et al., 2012 ). The present study suggests that the integrated cognitive training program enhances self-control, which in turn facilitates better coping with stressors and more effective anxiety regulation. This is consistent with prior research linking strong response inhibition abilities and robust self-control to greater resilience against anxiety (Hofmann et al., 2012 ). Moreover, the study highlights the potential of digital psychological interventions to target specific cognitive functions such as self-control. The accessibility and engaging nature of digital tools may further enhance the effectiveness and appeal of self-control training, particularly among younger populations. While several interventions show promise for improving cognitive and emotional outcomes, their effectiveness and generalizability remain limited. For example, adding EMDR therapy to medication for adolescents with depression and stressful life events has been shown to reduce the impact of stressors, alleviate depressive symptoms, and decrease rumination (Zheng et al., n.d.). However, targeted response inhibition training in children, although improving trained functions, produced limited long-term effects on brain structure, neural connectivity, or broader cognitive and behavioral outcomes, suggesting that its impact may be less extensive than anticipated in certain populations (Ganesan et al., 2024 ). Moreover, methodological limitations such as small sample sizes and reliance on self-report measures may constrain the generalizability of findings and introduce bias. Future research should replicate these interventions with larger, more diverse samples and incorporate objective cognitive and physiological measures. Refinement of digital cognitive tools, including personalized feedback and adaptive difficulty levels, may further enhance engagement and optimize training outcomes. The findings provide preliminary evidence that an electronic cognitive training program integrating bilateral eye movements (BEM) and response inhibition can effectively reduce anxiety in vocational college students (Nwadi et al., 2025 ; Xu et al., 2023 ). This intervention may exert its effects by enhancing self-control capacity, highlighting the role of cognitive regulation in anxiety management. Importantly, it offers a feasible and scalable framework for digital mental health interventions, with practical implications for educational institutions and vocational colleges seeking accessible strategies to support students' mental well-being. While further research is needed to address study limitations and explore the intervention's full potential, these results underscore the promise of targeted digital cognitive training in promoting psychological health. Statements and Declarations Authors disclose non-financial interests. Consent to publish All participants consented to the use of their data (including task performance, etc.) for research and publication purposes (in an anonymized form). For participants under 18, informed consent was obtained from a parent and/or legal guardian. The manuscript does not contain any personally identifiable data. All figures, tables, and materials included in this article are original. Where third-party material has been used, permission for its use and reproduction has been obtained, and the source has been properly acknowledged. Ethical Approval The study protocol was reviewed and approved by the Institutional Review Board of Beijing Language and Culture University (Approval No.: 2024BYLL50), in accordance with the ethical guidelines and regulations of the Beijing Language and Culture University Institutional Review Board. Prior to the commencement of the study, all participants were fully informed about the purpose, procedures, and potential risks and benefits of their participation. Freely-given, informed consent to participate in the study was obtained from all participants (for participants under 18, informed consent was obtained from a parent and/or legal guardian). Each participant signed a detailed informed consent form, indicating their voluntary participation and understanding of their right to withdraw from the study at any time without penalty. In addition, all participants received compensation for their participation. Authorship All authors contributed substantially to the conception and design of the study, data collection, analysis, and manuscript preparation. All authors have read and approved the final version of the manuscript and agree to be accountable for all aspects of the work. Data Availability The datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request. Research Funding This research was supported by the Science Foundation of Beijing Language and Culture University, funded by “the Fundamental Research Funds for the Central Universities” (Grant No. 24QN28) for Dong-ni Pan. Acknowledgements The authors sincerely thank all participating schools, teachers, and students for their active cooperation and support during data collection. We also express our gratitude to colleagues and reviewers who provided valuable suggestions for improving the quality of this research. References Baumeister, R. F., Vohs, K. D., & Tice, D. M. 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(2025). Investigating the Effectiveness of Digital Cognitive Training at Improving Mental Health and Social Engagement in an ‘at Risk’ Population. Cognitive Therapy and Research. https://doi.org/10.1007/s10608-025-10636-8 Matsuzaki, Y., Nouchi, R., Sakaki, K., Dinet, J., & Kawashima, R. (2023). The Effect of Cognitive Training with Neurofeedback on Cognitive Function in Healthy Adults: A Systematic Review and Meta-Analysis. Healthcare, 11(6), 843. https://www.mdpi.com/2227-9032/11/6/843 Meentken, M. G., van der Mheen, M., van Beynum, I. M., Aendekerk, E. W. C., Legerstee, J. S., van der Ende, J., Del Canho, R., Lindauer, R. J. L., Hillegers, M. H. J., Helbing, W. A., Moll, H. A., & Utens, E. (2021). Long-term effectiveness of eye movement desensitization and reprocessing in children and adolescents with medically related subthreshold post-traumatic stress disorder: a randomized controlled trial. Eur J Cardiovasc Nurs, 20(4), 348-357. https://doi.org/10.1093/eurjcn/zvaa006 Nwadi, C. L., Edeh, N. I., Ugwunwoti, E. P., Nwokike, F. O., Nneji, O. S., Anamezie, R. C., Uguru, T. O., Onubueze, F. K., Chukwu, P. N., Eya, G. M., Ikpenwa, J. N., Nsude, A. O., Ozoagu, C. G., Aka, C. P., Nwobodo, P., Animba, I. E., & Okoli, S. N. (2025). Impact of cognitive-behavioral therapy and mindfulness-based stress reduction in mitigating test anxiety and enhancing academic achievement among vocational education students at Nigerian universities. BMC Medical Education, 25(1), 578. https://doi.org/10.1186/s12909-025-07130-w Peckham, A. D., & Johnson, S. L. (2018). Cognitive control training for emotion-related impulsivity. Behaviour research and therapy, 105, 17–26. https://doi.org/10.1016/j.brat.2018.03.009 Spielberger, C. D. (1980). Test Anxiety Inventory: Preliminary Professional Manual. Palo Alto, CA: Consulting Psychologists Press. Tangney, J. P., Baumeister, R. F., & Boone, A. L. (2004). High Self-Control Predicts Good Adjustment, Less Pathology, Better Grades, and Interpersonal Success. Journal of Personality, 72(2), 271–322. https://doi.org/10.1111/j.0022-3506.2004.00263.x Weathers FW, Litz BT, Herman DS, Huska JA, & Keane TM (1993). The PTSD Checklist (PCL): Reliability, validity, and diagnostic utility. International Society for Traumatic Stress Studies, San Antonio, TX (Vol. 462). Weathers FW, Litz BT, Keane TM, Palmieri PA, Marx BP, & Schnurr PP (2013). The PTSD Checklist for DSM-5 (PCL-5). Xiu, L., Wu, J., Chang, L., & Zhou, R. (2018). Working Memory Training Improves Emotion Regulation Ability. Scientific Reports, 8(1), 15012. https://doi.org/10.1038/s41598-018-31495-2 Xu, Z., Hu, J., & Wang, Y. (2023). Bilateral eye movements disrupt the involuntary perceptual representation of trauma-related memories. Behaviour Research and Therapy, 165, 104311. https://doi.org/10.1016/j.brat.2023.104311 Zeng, Y., Wang, G., Xie, C., Hu, X., & Reinhardt, J. D. (2019). Prevalence and correlates of depression, anxiety and symptoms of stress in vocational college nursing students from Sichuan, China: a cross-sectional study. Psychol Health Med, 24(7), 798-811. https://doi.org/10.1080/13548506.2019.1574358 Zheng, S., Shen, Y., Geng, F., Ye, M., Song, S., Wang, R., Zhang, S., Ou, Y., & Zhou, X. (n.d.). Effects of eye movement desensitisation and reprocessing on depressive symptoms, stress and rumination in adolescents with depression: A randomised controlled trial. European Journal of Psychotraumatology, 16(1), 2488558. https://doi.org/10.1080/20008066.2025.2488558 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Under Review Version 1 posted Editorial decision: Revision requested 02 Jan, 2026 Reviews received at journal 19 Dec, 2025 Reviewers agreed at journal 15 Dec, 2025 Reviews received at journal 11 Dec, 2025 Reviewers agreed at journal 10 Dec, 2025 Reviewers agreed at journal 05 Dec, 2025 Reviewers invited by journal 04 Dec, 2025 Editor assigned by journal 26 Nov, 2025 Submission checks completed at journal 05 Nov, 2025 First submitted to journal 05 Nov, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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12:22:53","extension":"xml","order_by":9,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":93870,"visible":true,"origin":"","legend":"","description":"","filename":"6de27c13fab64c4ea5a231afb3c67ca31structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7946330/v1/871e0f85d52efa3192bdaeda.xml"},{"id":97700796,"identity":"1ef54314-8c07-4fda-9b1b-ba760573fb1d","added_by":"auto","created_at":"2025-12-08 12:22:53","extension":"html","order_by":10,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":102920,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7946330/v1/4f9671d0791a23810a5f0e7e.html"},{"id":97700785,"identity":"28c2dfdc-3d13-4619-9c14-649d3b04620e","added_by":"auto","created_at":"2025-12-08 12:22:53","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":220765,"visible":true,"origin":"","legend":"\u003cp\u003eCogniMove Program: Core Interface and Gameplay Mechanics\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7946330/v1/df287939fe47a1b473b07c0f.png"},{"id":97700782,"identity":"47d5c114-06b2-48e0-9efa-f406447643d6","added_by":"auto","created_at":"2025-12-08 12:22:53","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":31429,"visible":true,"origin":"","legend":"\u003cp\u003eChanges in Emotional State Before and After Intervention. Anxiety scores showed a significant time × group interaction, indicating that the training effect.\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-7946330/v1/2ecbdbfa0cc4bb4fecbc1b70.png"},{"id":97700783,"identity":"91f2b823-a910-475a-8a3d-20d64fc35484","added_by":"auto","created_at":"2025-12-08 12:22:53","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":29810,"visible":true,"origin":"","legend":"\u003cp\u003eModel of Variable Relationships with Standardized Coefficients\u003c/p\u003e","description":"","filename":"3.png","url":"https://assets-eu.researchsquare.com/files/rs-7946330/v1/1dfd142d116db9d9fc4e6596.png"},{"id":98421032,"identity":"ec6bc2fa-259d-4091-aba1-e2b1d5f1946b","added_by":"auto","created_at":"2025-12-17 16:22:35","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":973424,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7946330/v1/c9123a7f-8669-4755-a047-42e0fbce3189.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"The effect of electronic cognitive training incorporating bilateral eye movements and response inhibition on anxiety in vocational college students","fulltext":[{"header":"1. Introduction","content":"\u003cp\u003eAnxiety disorders affect approximately 264\u0026nbsp;million individuals worldwide (WHO, 2017), with students representing a particularly vulnerable group. Recent studies indicate that a significant portion of vocational and community college students experience anxiety (Julianto et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Chronic anxiety undermines learning, quality of life, and increases the risk of depression and cardiovascular diseases (Zeng et al., \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). These figures highlight the urgent need for effective interventions, particularly in educational settings, motivating research into strategies to alleviate anxiety in student populations.\u003c/p\u003e\u003cp\u003eWith the advancement of information technology, digital cognitive training has emerged as a promising psychological intervention (Chellappa \u0026amp; Aeschbach, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), attracting growing research attention. This approach, delivered via computer or mobile devices, has demonstrated benefits for cognitive functions such as attention, memory, and response inhibition (Liebherr et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2024\u003c/span\u003e), and can enhance emotional regulation through \u0026ldquo;far transfer\u0026rdquo; effects (Matsuzaki et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Mechanistically, digital training strengthens the dorsal attention network (DAN), enhancing working memory and fluid intelligence, which in turn supports emotional regulation (Greenwood \u0026amp; Parasuraman, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2016\u003c/span\u003e). Evidence from targeted interventions such as working memory training indicates that emotional regulation is malleable through improvements in attentional control (Xiu et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eBuilding on these theoretical insights, specific interventions provide practical support for behavioral outcomes. For instance, electronic Working Memory Training (eWMT) reduces impulsivity, risky decision-making, and problematic internet use while improving cognitive emotion regulation (CER) (Emadi Chashmi et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Likewise, studies with children show that executive function (EF) training can enhance emotional control (EC), with improvements in inhibition control and working memory contributing to better emotional regulation and comprehension (Li et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). These findings suggest that both adults and children can benefit from cognitive training programs targeting attentional and executive processes.\u003c/p\u003e\u003cp\u003eResponse inhibition\u0026mdash;the ability to suppress inappropriate or goal-conflicting responses\u0026mdash;is a key component of self-control, which allows individuals to regulate their behaviors, emotions, and thoughts. Strong inhibitory control supports effective stress management and lowers vulnerability to anxiety. Chronic stress, however, can impair prefrontal cortex functioning, weakening inhibitory control and disrupting emotion regulation and social adjustment. Longitudinal evidence shows that adolescents\u0026rsquo; inhibitory control mediates the link between perceived stress and secure parent\u0026ndash;child relationships, emphasizing its role in socioemotional development (Herd et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). Evidence from experimental studies further supports the emotional benefits of response inhibition training. For example, Fontana et al. (\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2021\u003c/span\u003e) found that training enhanced performance in a stop-signal task and reduced negative emotional responses to aversive images by strengthening cognitive control. Similarly, interventions targeting response inhibition and working memory have been shown to decrease emotion-driven impulsivity, improve the use of cognitive reappraisal, and strengthen inhibitory control, suggesting that enhancing these capacities may help individuals better manage stress and maintain emotional well-being (Peckham \u0026amp; Johnson, \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eBeyond cognitive training, behavioral interventions such as bilateral eye movement (BEM) have also shown potential for emotion regulation. BEM, a rhythmic horizontal eye movement, can influence the processing of emotional memories by reducing the vividness and emotional intensity of traumatic memories, thereby alleviating PTSD symptoms (Meentken et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). This effect is thought to arise from bilateral brain activation, which facilitates interhemispheric communication and emotional integration (Gainer et al., \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eEmpirical evidence further supports the therapeutic value of BEM. For example, Every-Palmer et al. (\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2023\u003c/span\u003e) found that EMDR-based BEM activates information-processing pathways that reduce trauma-related emotional distress. Moreover, the direction of eye movement appears to matter, with horizontal movements playing a particularly important role in emotional regulation and memory consolidation (Jeffries \u0026amp; Davis, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). These findings suggest that BEM may have potential applications beyond PTSD, including the regulation of anxiety.\u003c/p\u003e\u003cp\u003eThis study aims to develop and evaluate an electronic cognitive training program that integrates response inhibition tasks with bilateral eye movements (BEM), a combination not previously explored. We further examine whether self-control mediates the intervention\u0026rsquo;s effect on anxiety, thereby connecting its cognitive training component to emotional regulation outcomes and clarifying the underlying mechanism. By merging these two intervention approaches\u0026mdash;cognitive training and BEM\u0026mdash;this research introduces a novel cognitive-emotional strategy, offering both theoretical insights and practical implications for enhancing mental well-being among vocational college students.\u003c/p\u003e"},{"header":"2. Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003e2.1 Participants\u003c/h2\u003e\u003cp\u003eThis study recruited 54 students with elevated anxiety levels from a vocational college in Yunnan Province, China. The participant pool consisted of 24 males and 30 females, with ages ranging from 16 to 21 years (M\u0026thinsp;=\u0026thinsp;18.53, SD\u0026thinsp;=\u0026thinsp;0.87). All participants met the inclusion criteria based on an initial mental health screening, confirming the presence of anxiety symptoms. To ensure comparability between groups, participants were randomly assigned to either the experimental group or the control group using a random number generator. This randomization procedure effectively ensured that there were no significant differences between the two groups in demographic variables such as gender and age (\u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026gt;\u0026thinsp;0.05), thereby minimizing the influence of potential confounding factors on the study results. The experimental group received the electronic cognitive training program integrating bilateral eye movements and response inhibition. In contrast, the control group members did not receive any specific intervention during the study period. However, as an ethical consideration, control group participants were granted access to the training program after the waiting period to ensure fairness and ethical integrity.\u003c/p\u003e\u003cp\u003eTthe study protocol was reviewed and approved by the Institutional Review Board of Beijing Language and Culture University (Approval No.: 2024BYLL50). Prior to the commencement of the study, all participants were fully informed about the purpose, procedures, and potential risks and benefits of their participation. Freely-given, informed consent to participate in the study was obtained from all participants. For participants under 18 years of age, informed consent was obtained from their parent or legal guardian. Each participant signed a detailed informed consent form, indicating their voluntary participation and understanding of their right to withdraw from the study at any time without penalty. In addition, all participants received compensation for their participation.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec4\" class=\"Section2\"\u003e\u003ch2\u003e2.2 Measurements\u003c/h2\u003e\u003cp\u003eTo comprehensively evaluate the effects of the study, several validated questionnaires and scales were used to measure participants' trait anxiety, self-control capacity, childhood trauma experiences, and posttraumatic stress disorder (PTSD) symptoms. The specific details of each measurement tool, along with its reliability and validity analyses, are provided below.\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eTrait Anxiety Inventory (TAI)\u003c/b\u003e: The TAI, developed by Spielberger et al., is a widely used psychometric instrument designed to assess an individual's long-term tendency to experience anxiety across various situations.The questionnaire consists of 20 items, each requiring participants to select the response that best reflects their feelings, using a 4-point Likert scale (ranging from \"Almost Never\" to \"Almost Always\") (Spielberger, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e1980\u003c/span\u003e). Higher total scores indicate higher levels of trait anxiety. Numerous studies have demonstrated good internal consistency for the TAI (Cronbach's α coefficients typically ranging from 0.85 to 0.90), indicating highly stable results across different samples.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eSelf-Control Scale (SCS)\u003c/b\u003e: The SCS, developed by Tangney et al., aims to measure an individual's ability to manage and regulate their own behavior, emotions, and impulses. The questionnaire consists of 13 items, also scored using a 4-point Likert scale, with higher scores representing greater self-control capacity (Tangney et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2004\u003c/span\u003e). The SCSC exhibits excellent internal consistency (Cronbach's α coefficient approximately 0.86) and has maintained high stability across multiple tests, indicating that it is a reliable measurement tool. Through exploratory and confirmatory factor analyses, the SCSC has been shown to have good construct validity. It is not only positively correlated with other self-control-related variables but also associated with actual behavioral performance on tasks such as delayed gratification, further confirming its criterion-related validity.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eChildhood Trauma Questionnaire (CTQ)\u003c/b\u003e: The CTQ, developed by Bernstein et al, is a brief self-report scale used to screen for five types of adverse experiences suffered during childhood: physical abuse, emotional abuse, sexual abuse, physical neglect, and emotional neglect. The CTQ consists of 28 items, divided into five subscales, with five items per subscale, plus three questions about overall trauma experiences(Bernstein et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e1997\u003c/span\u003e; Bernstein et al., \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2003\u003c/span\u003e). Participants rate each statement according to frequency or severity, using a 5-point Likert scale. The CTQ has demonstrated strong internal consistency (Cronbach's α coefficients for each subscale ranging from 0.70 to 0.90) and has maintained good reliability across different cultural and linguistic backgrounds.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003ePosttraumatic Stress Disorder Checklist for DSM-5 (PCL-5)\u003c/b\u003e: The PCL-5, developed by Weathers et al. based on the criteria of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is a self-report scale used to assess PTSD symptoms experienced by individuals in the past month. The PCL-5 contains 20 items, corresponding to the four core symptom clusters of PTSD defined in the DSM-5: re-experiencing, avoidance, negative alterations in cognition and mood, and hyperarousal(Weathers et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e1993\u003c/span\u003e; Weathers et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2013\u003c/span\u003e). Each item is rated on a scale from 0 (Not at all) to 4 (Extremely), with total scores ranging from 0 to 80. Higher scores indicate more severe PTSD symptoms.\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec5\" class=\"Section2\"\u003e\u003ch2\u003e2.3 Intervention Program\u003c/h2\u003e\u003cp\u003eThe \u003cb\u003eCogniMove\u003c/b\u003e program, short for \u003cb\u003eCognitive Movement Integration\u003c/b\u003e, was developed using the Godot 4.0 game engine. This name reflects the program's core function: integrating cognitive training with targeted eye movements to facilitate emotional processing. The engine was chosen for its multi-platform support and ability to seamlessly integrate visual and auditory elements, crucial for delivering effective bilateral stimulation and response inhibition training.\u003c/p\u003e\u003cp\u003eCogniMove is structured around a series of interactive modules designed to guide users through a process of identifying, processing, and reframing distressing thoughts and emotions. The program's core mechanism involves the strategic combination of \u003cb\u003ebilateral horizontal eye movements (BEM)\u003c/b\u003e and \u003cb\u003eresponse inhibition\u003c/b\u003e.\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eBilateral Eye Movements\u003c/b\u003e: These are implemented by requiring users to visually track a moving icon across the screen. Points are awarded \u003cem\u003eonly\u003c/em\u003e when the icon reaches the left or right edges of the screen, ensuring consistent horizontal eye movements. This BEM component is designed to activate both hemispheres of the brain, facilitating information processing and emotional integration.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eResponse Inhibition\u003c/b\u003e: This is incorporated by requiring users to press a specific key (F for left, J for right) \u003cem\u003eonly\u003c/em\u003e when the icon reaches the edge of the screen. Premature key presses result in a point deduction, forcing users to actively inhibit impulsive responses and exercise cognitive control.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eBy referencing Fig.\u0026nbsp;\u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, we provide a visual anchor for the reader to understand the core mechanics of the CogniMove program. The CogniMove program also includes the following phases, which are adapted from the EMDR protocol:\u003c/p\u003e\u003cp\u003e\u003cul\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eAssessment Phase\u003c/b\u003e: Users identify a distressing event, associated image, and negative cognition, and rate their level of distress (SUDs).\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eDesensitization Phase\u003c/b\u003e: Users visualize the distressing event while tracking the moving icon and responding with the appropriate key press, simultaneously engaging in BEM and response inhibition.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eInstallation Phase\u003c/b\u003e: Users formulate a positive cognition and rate their belief in it (VOCs). They then visualize the distressing event and the positive cognition while continuing the BEM and response inhibition task.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eBody Scan\u003c/b\u003e: Users perform an imagery exercise, focusing on bodily sensations associated with the event.\u003c/p\u003e\u003c/li\u003e\u003cli\u003e\u003cp\u003e\u003cb\u003eClosure Phase\u003c/b\u003e: A comforting video provides closure and encourages reflection.\u003c/p\u003e\u003c/li\u003e\u003c/ul\u003e\u003c/p\u003e\u003cp\u003eThroughout its use, CogniMove strictly adheres to data protection regulations, ensuring user information security and privacy. Built-in data collection functions save user records during the treatment process, stored solely on the user's device.\u003c/p\u003e\u003cp\u003eThe technical validation of the CogniMove program involves a multi-stage process, including developer and user perspectives, to ensure effectiveness, usability, and user satisfaction. This includes evaluating technical performance, usability, and gathering user feedback through pilot studies, focus groups, and interviews. The program is iteratively improved based on this feedback, and mental health experts provide professional opinions to ensure scientific validity.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec6\" class=\"Section2\"\u003e\u003ch2\u003e2.4 Experimental Procedure\u003c/h2\u003e\u003cp\u003eFirst, the official versions of the questionnaires relevant to this study were obtained from CNKI (China National Knowledge Infrastructure). All participants received pre-measurement instructions according to the official guidelines before completing the Trait Anxiety Inventory (TAI), Self-Control Scale (SCSC), Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5), and Childhood Trauma Questionnaire (CTQ). Questionnaires that were completed incorrectly or exceeded the time limit were excluded. After a one-month interval, participants in the intervention group installed the training app and entered a six-digit password to access the training interface. Following the instructions within the training app, they engaged in digital bilateral eye movement training. One month after completing the intervention, this group underwent a post-test using the same questionnaires as the pre-test. Participants in the control group received no intervention. One month after completing the pre-test, they underwent a post-test using the same questionnaires.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec7\" class=\"Section2\"\u003e\u003ch2\u003e2.5 Statistical Methods\u003c/h2\u003e\u003cp\u003eIndependent samples t-tests and chi-square tests were used to examine whether the basic demographic information of the two groups of participants was matched.\u003c/p\u003e\u003cp\u003eA mixed-design analysis of variance (ANOVA) was conducted, with group (control group/intervention group) as the between-subjects variable and time (pre-test/post-test) as the within-subjects variable, to analyze the various measurement indicators and examine changes in emotional states between the two groups.\u003c/p\u003e\u003cp\u003eRegression analysis and mediation analysis were used to examine whether changes in anxiety were influenced by cognitive control variables, clarifying the underlying mechanisms of the training benefits. Statistical analyses were performed using SPSS 27 software and the associated macro program PROCESS. Partial eta-squared (ηp2) was reported as the effect size, and alpha was set at 0.05.\u003c/p\u003e\u003c/div\u003e"},{"header":"3. Results","content":"\u003cdiv id=\"Sec9\" class=\"Section2\"\u003e\u003ch2\u003e3.1 Demographic Statistics\u003c/h2\u003e\u003cp\u003eThis study included two groups: a control group (n\u0026thinsp;=\u0026thinsp;36, age range: 16\u0026ndash;20, male: female ratio\u0026thinsp;=\u0026thinsp;4:5) and an intervention group (n\u0026thinsp;=\u0026thinsp;18, age range: 18\u0026ndash;21, male: female ratio\u0026thinsp;=\u0026thinsp;5:4). At baseline, the mean self-control scores were 59.78 for the control group and 53.11 for the intervention group. Detailed demographic data are presented in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eDemographic Information\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eControl\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eTraining\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003et/x2\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003ep\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eM(SD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eM(SD)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eAge(year)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18.39(0.84)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18.82(0.88)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.089\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eGender (male/female)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e16/20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e8/10\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e~\u0026thinsp;0\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.99\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003eSCSC\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e59.78(10.68)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e53.11(12.98)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e-2.01\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e.06\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003e3.2 Changes in emotional state before and after training\u003c/h2\u003e\u003cp\u003eWe used a mixed-design ANOVA with time (pre/post) as a within-subjects factor and group (control/training) as a between-subjects factor. For the Childhood Trauma Questionnaire (CTQ), we found significant main effects for both time [F(1, 49)\u0026thinsp;=\u0026thinsp;5.81, p\u0026thinsp;=\u0026thinsp;0.02, η\u0026sup2; = 0.11] and group [F(1, 49)\u0026thinsp;=\u0026thinsp;5.81, p\u0026thinsp;=\u0026thinsp;0.02, η\u0026sup2; = 0.11]. Similarly, the Posttraumatic Stress Disorder Checklist (PCL) also revealed significant main effects for time [F(1, 49)\u0026thinsp;=\u0026thinsp;5.81, p\u0026thinsp;=\u0026thinsp;0.02, η\u0026sup2; = 0.11] and group [F(1, 49)\u0026thinsp;=\u0026thinsp;5.81, p\u0026thinsp;=\u0026thinsp;0.02, η\u0026sup2; = 0.11]. However, no significant time \u0026times; group interaction effects were found for either questionnaire (ps\u0026thinsp;\u0026gt;\u0026thinsp;0.05).\u003c/p\u003e\u003cp\u003eFor trait anxiety, we found a significant main effect of time [F(1, 49)\u0026thinsp;=\u0026thinsp;46.05, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, η\u0026sup2; = 0.48], a significant main effect of group [F(1, 49)\u0026thinsp;=\u0026thinsp;5.81, p\u0026thinsp;=\u0026thinsp;0.02, η\u0026sup2; = 0.11], and a significant time \u0026times; group interaction [F(1, 49)\u0026thinsp;=\u0026thinsp;15.90, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001, η\u0026sup2; = 0.25]. Post-hoc comparisons indicated that the intervention group showed a significantly greater reduction in anxiety levels compared to the control group [t(49)\u0026thinsp;=\u0026thinsp;3.99, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001], suggesting that the intervention can significantly improve individuals' anxiety levels. Changes in emotional state before and after the intervention are illustrated in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003e3.3 Regression models and sources of training benefits\u003c/h2\u003e\u003cp\u003eTo examine the factors influencing the anxiety reduction resulting from the intervention, we calculated a \"training benefit\" score [Pre-Test Anxiety - Post-Test Anxiety]. An independent samples t-test revealed no significant difference in training benefit scores between males and females [t (49)\u0026thinsp;=\u0026thinsp;1.18, p\u0026thinsp;=\u0026thinsp;0.246]. Correlation analysis showed no significant relationship between training benefit and age [r = -0.07, p\u0026thinsp;=\u0026thinsp;0.630]. However, notably, a significant positive correlation was found between training benefit and baseline self-control levels [r\u0026thinsp;=\u0026thinsp;0.30, p\u0026thinsp;=\u0026thinsp;0.035]. Higher baseline self-control was associated with greater anxiety reduction following the training.\u003c/p\u003e\u003cp\u003eFurther analysis was conducted using PROCESS macro (Model 8) to examine a moderated mediation model. This analysis tested whether the effect of pre-test anxiety on post-test anxiety was moderated by training group assignment, and whether self-control mediated this relationship. The results indicated that the effect of pre-test anxiety on post-test anxiety was significantly moderated by group assignment [t = -2.15, p\u0026thinsp;=\u0026thinsp;0.037]. A significant direct effect of pre-test anxiety on post-test anxiety was observed only in the training group [b\u0026thinsp;=\u0026thinsp;0.66, t\u0026thinsp;=\u0026thinsp;3.03, p\u0026thinsp;=\u0026thinsp;0.004], but not in the control group (p\u0026thinsp;=\u0026thinsp;0.09). Furthermore, the change in anxiety scores was mediated by self-control. Specifically, in the training group, baseline anxiety influenced post-test anxiety through self-control, with a significant indirect effect of 0.17 (95% CI [0.02, 0.30]). The confidence interval did not include 0, indicating a significant indirect effect, suggesting that self-control partially mediated the intervention-induced improvement in anxiety. The model explained 39% of the variance in post-test anxiety (R\u0026sup2; = 0.39, p\u0026thinsp;\u0026lt;\u0026thinsp;0.001). The model is illustrated in Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e.\u003c/p\u003e\u003cp\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"4. Discussions","content":"\u003cp\u003eRecent research has explored various interventions for alleviating anxiety and promoting mental health among students. One study investigated the effectiveness of a novel electronic cognitive training program integrating bilateral eye movements (BEM) with response inhibition, finding that participants in the experimental group experienced a significant reduction in anxiety compared to controls, suggesting that this integrated approach may serve as an effective intervention for vocational college students. More broadly, self-guided digital cognitive training has been shown to produce small but positive effects on mental health, with greater benefits observed when combined with cognitive rehabilitation or virtual reality interventions, indicating modest improvements in psychological outcomes alongside cognitive enhancement (Cabreira et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). In addition, the combination of cognitive-behavioral therapy (CBT) with mindfulness-based stress reduction (MBSR) has demonstrated efficacy in reducing test anxiety, improving academic performance, and enhancing students\u0026rsquo; well-being in TVET settings, highlighting that dual-modality approaches can help students manage anxiety and support personal growth (Nwadi et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eRecent studies have investigated mechanisms and interventions for alleviating anxiety and depressive symptoms. Changes in self-control capacity were found to partially mediate the effect of cognitive training on anxiety reduction, highlighting self-control as a key mechanism through which individuals regulate their behaviors, emotions, and thoughts. Similarly, bilateral eye movements (EM) selectively disrupt the perceptual representation of trauma-related memories without affecting semantic memory. Using a trauma film paradigm, EM interventions reduced perceptual memory recognition, decreased the frequency and vividness of memory intrusions over one week, and attenuated psychophysiological and subjective affective responses, indicating their effectiveness in diminishing both the perceptual and emotional impact of traumatic memories (Xu et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In the domain of depression, cognitive restructuring has been shown to reduce depressive symptoms and improve interpretative biases, whereas working memory training produced no significant effects; changes in interpretative bias and executive function did not mediate symptom improvements (MacLellan et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAnxiety is a pervasive issue among vocational college students, significantly impacting their learning and overall well-being (Chellappa \u0026amp; Aeschbach, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Julianto et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). While traditional interventions exist, the increasing prevalence of digital technology offers innovative opportunities for psychological support. Digital cognitive training, delivered via computer or mobile devices, has emerged as a promising approach for enhancing cognitive functions and, in turn, emotional regulation (Liebherr et al., \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Matsuzaki et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Building on this, the present study developed an electronic tool that integrates response inhibition training with bilateral eye movements (BEM), making the intervention accessible and scalable for vocational college students.\u003c/p\u003e\u003cp\u003eThe observed reduction in anxiety is consistent with prior evidence demonstrating the emotional benefits of both response inhibition training and BEM (Fontana et al., \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Meentken et al., \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Every-Palmer et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). Response inhibition training enhances cognitive control and reduces emotional reactivity, whereas BEM\u0026mdash;a core component of EMDR therapy\u0026mdash;facilitates emotional processing and integration, diminishing the intensity of negative emotions. By combining these two elements, the current study suggests that the intervention may produce additive or synergistic effects on anxiety reduction, offering a practical and theoretically grounded approach to improving mental health among vocational college students.\u003c/p\u003e\u003cp\u003eIt is noteworthy that the study did not observe significant improvements in Childhood Trauma Questionnaire (CTQ) or Posttraumatic Stress Disorder Checklist (PCL) scores, which may be due to several factors. First, the intervention was primarily designed to target general anxiety rather than trauma-specific symptoms. Although BEM is a core component of EMDR therapy (Laliotis et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2021\u003c/span\u003e), the current program may not have been intensive or comprehensive enough to affect deeply rooted trauma memories. Second, the relatively short intervention period (one month) may have been insufficient to produce measurable changes in these more stable and complex constructs. Future research could adopt a longitudinal design or implement higher-intensity, trauma-focused interventions to better evaluate the efficacy of this integrated training program for trauma-related symptoms.\u003c/p\u003e\u003cp\u003eThe finding that self-control partially mediated the anxiety reduction effect underscores the critical role of this cognitive function in mental well-being (Baumeister et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2007\u003c/span\u003e). Self-control, encompassing impulse regulation, maintenance of healthy habits, goal-directed behaviors, and adaptive leisure regulation, is a key executive function that enables individuals to manage their behaviors and emotions effectively (Hofmann et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2012\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eThe present study suggests that the integrated cognitive training program enhances self-control, which in turn facilitates better coping with stressors and more effective anxiety regulation. This is consistent with prior research linking strong response inhibition abilities and robust self-control to greater resilience against anxiety (Hofmann et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). Moreover, the study highlights the potential of digital psychological interventions to target specific cognitive functions such as self-control. The accessibility and engaging nature of digital tools may further enhance the effectiveness and appeal of self-control training, particularly among younger populations.\u003c/p\u003e\u003cp\u003eWhile several interventions show promise for improving cognitive and emotional outcomes, their effectiveness and generalizability remain limited. For example, adding EMDR therapy to medication for adolescents with depression and stressful life events has been shown to reduce the impact of stressors, alleviate depressive symptoms, and decrease rumination (Zheng et al., n.d.). However, targeted response inhibition training in children, although improving trained functions, produced limited long-term effects on brain structure, neural connectivity, or broader cognitive and behavioral outcomes, suggesting that its impact may be less extensive than anticipated in certain populations (Ganesan et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Moreover, methodological limitations such as small sample sizes and reliance on self-report measures may constrain the generalizability of findings and introduce bias. Future research should replicate these interventions with larger, more diverse samples and incorporate objective cognitive and physiological measures. Refinement of digital cognitive tools, including personalized feedback and adaptive difficulty levels, may further enhance engagement and optimize training outcomes.\u003c/p\u003e\u003cp\u003eThe findings provide preliminary evidence that an electronic cognitive training program integrating bilateral eye movements (BEM) and response inhibition can effectively reduce anxiety in vocational college students (Nwadi et al., \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Xu et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). This intervention may exert its effects by enhancing self-control capacity, highlighting the role of cognitive regulation in anxiety management. Importantly, it offers a feasible and scalable framework for digital mental health interventions, with practical implications for educational institutions and vocational colleges seeking accessible strategies to support students' mental well-being. While further research is needed to address study limitations and explore the intervention's full potential, these results underscore the promise of targeted digital cognitive training in promoting psychological health.\u003c/p\u003e"},{"header":"Statements and Declarations","content":"\u003cp\u003eAuthors disclose non-financial interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent to publish\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll participants consented to the use of their data (including task performance, etc.) for research and publication purposes (in an anonymized form). For participants under 18, informed consent was obtained from a parent and/or legal guardian. The manuscript does not contain any personally identifiable data.\u0026nbsp;All figures, tables, and materials included in this article are original. Where third-party material has been used, permission for its use and reproduction has been obtained, and the source has been properly acknowledged.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical Approval\u0026nbsp;\u003c/strong\u003eThe study protocol was reviewed and approved by the Institutional Review Board of Beijing Language and Culture University (Approval No.: 2024BYLL50), in accordance with the ethical guidelines and regulations of the Beijing Language and Culture University Institutional Review Board. Prior to the commencement of the study, all participants were fully informed about the purpose, procedures, and potential risks and benefits of their participation. Freely-given, informed consent to participate in the study was obtained from all participants (for participants under 18, informed consent was obtained from a parent and/or legal guardian). Each participant signed a detailed informed consent form, indicating their voluntary participation and understanding of their right to withdraw from the study at any time without penalty. In addition, all participants received compensation for their participation.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthorship\u0026nbsp;\u003c/strong\u003eAll authors contributed substantially to the conception and design of the study, data collection, analysis, and manuscript preparation. All authors have read and approved the final version of the manuscript and agree to be accountable for all aspects of the work.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Availability\u0026nbsp;\u003c/strong\u003eThe datasets generated and analyzed during the current study are available from the corresponding author upon reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResearch Funding\u0026nbsp;\u003c/strong\u003eThis research was supported by the Science Foundation of Beijing Language and Culture University, funded by “the Fundamental Research Funds for the Central Universities” (Grant No. 24QN28) for Dong-ni Pan.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u003c/strong\u003e\u0026nbsp; The authors sincerely thank all participating schools, teachers, and students for their active cooperation and support during data collection. We also express our gratitude to colleagues and reviewers who provided valuable suggestions for improving the quality of this research.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n \u003cli\u003eBaumeister, R. F., Vohs, K. D., \u0026amp; Tice, D. M. (2007). The strength model of self-control. CURRENT DIRECTIONS IN PSYCHOLOGICAL SCIENCE, 16(6), 351-355. https://doi.org/10.1111/j.1467-8721.2007.00534.x\u003c/li\u003e\n \u003cli\u003eBernstein, David P, Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., \u0026hellip; Zule, W. (2003). Development and validation of a brief screening version of the Childhood Trauma Questionnaire. Child Abuse \u0026amp; Neglect, 27(2), 169\u0026ndash;190. https://doi.org/10.1016/S0145-2134(02)00541-0\u003c/li\u003e\n \u003cli\u003eBernstein, David P., Ahluvalia, T., Pogge, D., \u0026amp; Handelsman, L. (1997). Validity of the Childhood \u0026nbsp;Trauma Questionnaire in an Adolescent Psychiatric Population. 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Behaviour Research and Therapy, 165, 104311. https://doi.org/10.1016/j.brat.2023.104311\u003c/li\u003e\n \u003cli\u003eZeng, Y., Wang, G., Xie, C., Hu, X., \u0026amp; Reinhardt, J. D. (2019). Prevalence and correlates of depression, anxiety and symptoms of stress in vocational college nursing students from Sichuan, China: a cross-sectional study. Psychol Health Med, 24(7), 798-811. https://doi.org/10.1080/13548506.2019.1574358\u0026nbsp;\u003c/li\u003e\n \u003cli\u003eZheng, S., Shen, Y., Geng, F., Ye, M., Song, S., Wang, R., Zhang, S., Ou, Y., \u0026amp; Zhou, X. (n.d.). Effects of eye movement desensitisation and reprocessing on depressive symptoms, stress and rumination in adolescents with depression: A randomised controlled trial. European Journal of Psychotraumatology, 16(1), 2488558. https://doi.org/10.1080/20008066.2025.2488558\u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"discover-mental-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"dimh","sideBox":"Learn more about [Discover Mental Health](https://www.springer.com/44192)","snPcode":"","submissionUrl":"","title":"Discover Mental Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Anxiety, Cognitive Training, Bilateral Eye Movements, Response Inhibition, Self-Control","lastPublishedDoi":"10.21203/rs.3.rs-7946330/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7946330/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003eThis study evaluated the efficacy of a novel electronic cognitive training program aimed at alleviating anxiety in vocational college students. The intervention uniquely combined bilateral eye movements, drawing on principles of EMDR, with inhibitory control training. Fifty-four students with elevated anxiety were randomly assigned to either the integrated training or a waitlist control. Results indicated that participants in the experimental group exhibited significantly greater reductions in anxiety compared to controls. Longitudinal analyses further revealed that improvements in self-control partially mediated the intervention\u0026rsquo;s anxiolytic effects, highlighting the role of self-regulatory mechanisms. These findings suggest that combining response inhibition training with bilateral eye movements constitutes a promising and accessible approach for reducing anxiety in educational contexts.\u003c/p\u003e","manuscriptTitle":"The effect of electronic cognitive training incorporating bilateral eye movements and response inhibition on anxiety in vocational college students","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-12-08 12:22:48","doi":"10.21203/rs.3.rs-7946330/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2026-01-02T11:14:45+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-19T13:01:10+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"92184085046773533878224808809877957203","date":"2025-12-15T13:46:16+00:00","index":"hide","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-12-11T09:48:50+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"324478977149285683772415623299211796748","date":"2025-12-10T10:21:54+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"85780508030217919204803978882122095343","date":"2025-12-06T00:19:49+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-12-04T16:59:58+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-11-26T10:36:26+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-11-06T01:39:01+00:00","index":"","fulltext":""},{"type":"submitted","content":"Discover Mental Health","date":"2025-11-06T01:36:16+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"discover-mental-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"dimh","sideBox":"Learn more about [Discover Mental Health](https://www.springer.com/44192)","snPcode":"","submissionUrl":"","title":"Discover Mental Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"Discover Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"18860cc1-ebd5-40e5-b4dc-c2c91ee5d886","owner":[],"postedDate":"December 8th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-04-30T16:38:48+00:00","versionOfRecord":[],"versionCreatedAt":"2025-12-08 12:22:48","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7946330","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7946330","identity":"rs-7946330","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}