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Blame through my eyes: How first-person perspective shapes social attention and attribution in harmful interactions - a comparative eye tracking study.

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Rigid attributional patterns are a key component of social cognitive deficits linked to aggression. Prior eye-tracking research using a third-person perspective revealed that, compared to community adults, incarcerated violent offenders oriented less to faces and showed a stronger correlation between perceived intentionality and assigned blame (Intentionality/Blame isomorphism), a metric of attributional inflexibility. The present study investigated how adopting an immersive first-person victim perspective affects both I/B isomorphism and facial attention. A total of 184 adults participated in our study, including 119 community members (60 female, 59 male) and 65 incarcerated violent offenders (32 female, 33 male). During the eye-tracking task, participants viewed 27 static visual scenes depicting ambiguous interpersonal harm between two actors - a harm doer and a victim - and were instructed to imagine themselves as the victim in each scenario. The scenes included both hostile (e.g., a harmful act) and non-hostile (e.g., mitigating expressions or gestures) cues. Independent samples t-tests were used to compare group differences in I/B isomorphism and face dwell time, and Pearson's correlations were used to examine the relationships between variables. Consistent with our hypothesis and contrary to findings from third-person studies, incarcerated violent offenders exhibited significantly lower I/B isomorphism than community adults under a first-person perspective. Furthermore, no significant differences in face dwell time were observed between these two groups. These results suggest that, among incarcerated violent offenders, adopting a victim's perspective may disrupt rigid attributional patterns and normalize attention to social cues. These findings suggest that perspective-taking interventions could support improvements in empathy, cognitive flexibility, and overall interpersonal functioning.

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  • Research Article
  • Cite Count Icon 30
  • 10.1186/s12877-024-04666-2
The relationship between social frailty and loneliness in community-dwelling older adults: a cross-sectional study
  • Jan 18, 2024
  • BMC geriatrics
  • Zhixiao Li + 9 more

BackgroundSocial frailty (SF) is associated with multiple adverse health outcomes, yet there has been an inadequate focus on social frailty. The convoy model portrays the social networks through the perspective of the life course, thus providing a framework to explain the occurrence of social frailty. This study aimd to figure out the prevalence of social frailty and loneliness among community-dwelling older adults and to explore their correlations based on convoy model.MethodsThis was a cross-sectional study, and 295 older adults from 10 communities of Zhengzhou in Henan Province participated in the study. Social frailty and loneliness were assessed separately with the Social Frailty Scale and University of California at Los Angeles-Loneliness Scale. The scores of social frailty of the older adults in different characteristic communities were compared by independent sample t-test and single factor analysis of variance. The influencing factors of social frailty were analysed by multiple stepwise linear regression and the structural equation model. The correlation between social frailty and loneliness was analysed by Pearson correlation analysis.ResultsThe total scores of social frailty and loneliness of the older adults in the community were (2.09 ± 1.53) and (43.19 ± 8.91), respectively. There was a moderate positive correlation between social frailty and loneliness (r = 0.621, P < 0.01). The results of multiple stepwise linear regression analysis showed that age, living styles, balance of payments, and loneliness were the main influencing factors of the social frailty of older adults in the community (F = 27.180, P < 0.001). The structural equation model of social frailty fitted well (χ2 = 47.292, df = 26, χ2/df = 1.819, P = 0.007; RMSEA = 0.053, 95%CI (0.028, 0.076), P = 0.359; GFI = 0.971; AGFI = 0.939; NFI = 0.904; IFI = 0.955; TLI = 0.918; CFI = 0.953; SRMR = 0.0466).ConclusionsThe convoy model had certain applicability in explanation of the relationship between loneliness and social frailty among older adults in community. The incidence of social frailty among the older adults in the community was high, and loneliness was at a medium level. It is necessary to strengthen the intervention of social frailty and loneliness of the older adults in the community, improve the quality of life of the older adults, and promote the development of healthy aging.

  • Research Article
  • 10.53434/gbesbd.1835127
Cognitive Flexibility and Creativity in Athletes
  • Mar 30, 2026
  • Gazi Beden Eğitimi ve Spor Bilimleri Dergisi
  • Nazlı Can İnci + 1 more

This study aims to examine the levels of cognitive flexibility and creativity among individual and team athletes in relation to various variables and to determine the relationship between these two concepts. A correlational survey model was employed, and the study group consisted of 583 athletes (274 women, 309 men) who had been actively participating in different sports branches for at least three years. Data were collected using the Personal Information Form, the Athlete Cognitive Flexibility Inventory, and the Creativity Scale for Athletes. Descriptive statistics, independent samples t-test, Pearson correlation, and regression analyses were used in the analysis process. The findings revealed no significant differences in cognitive flexibility or creativity levels based on gender. Team athletes scored higher on the control sub-dimension of cognitive flexibility. Additionally, national athletes and those who engaged in mental training demonstrated higher scores in certain sub-dimensions of cognitive flexibility as well as in creativity, with small to moderate effect sizes (Cohen’s d= 0.18–0.32). Both age and sporting age showed positive correlations with cognitive flexibility and creativity, indicating that increased experience contributes to the development of these abilities. Weekly training frequency, however, was significantly related only to creativity levels. Furthermore, a strong and positive correlation was found between cognitive flexibility and creativity, suggesting that athletes with greater cognitive adaptability tend to produce more creative responses in sport-related contexts (r= .66, p &amp;lt; .001; R²= .436). Overall, the study concludes that cognitive flexibility and creativity are closely interconnected and influenced by factors such as athletic level, engagement in mental training, and experience in sport.

  • Research Article
  • 10.71317/rjsa.004.03.0815
The Psychology of Bouncing Back: Cognitive Flexibility and Resilience among Young Adults
  • Mar 27, 2026
  • Research Journal for Social Affairs
  • Aiman Khan + 1 more

Amid rising global stressors and uncertainties, understanding the factors that promote resilience has gained significant importance. The current study focused on exploring the connection between cognitive flexibility and resilience among young adults. Cognitive flexibility means the capability to shift thinking and behavior with the changing environmental needs, and resilience is the ability to bounce back after stress and adversity. The relationship between these two psychological constructs was studied using a quantitative correlational research design. A total of 250 young adults (125 males and 125 females) aged 18–25 years, who were chosen from various colleges and universities located in the district of Mardan, were used as the sample using the purposive sampling technique. Resilience and cognitive flexibility respectively were measured with the help of resilience scale (α =.85) and cognitive flexibility inventory (α =.76). Demographic analysis, pearson product moment correlation and independent sample t-test were used to analyze the data. The findings showed that there is a strong positive association between cognitive flexibility and resilience (r = .63, p &lt; .01) and thus, people having higher cognitive flexibility would show higher resilience. Moreover, the independent samples t-test indicated that there was no statistically significant gender difference in cognitive (t (248) = 0.72, p = 0.42, Cohen’s d = 17.71). However, a statistically significant gender difference was found in resilience (t (248) = 3.31, p = 0.01), Cohen’s d = 20.03), where females reported higher resilience scores compared to males. The research is a contribution to the existing literature because it highlights the concept of cognitive flexibility as a psychological aspect that can be used to improve adaptive functioning and coping in the presence of stress and life problems.

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  • Cite Count Icon 5
  • 10.1016/j.cegh.2023.101442
Prevalence and determinants of dyslipidemia among adults in the community: A cross-sectional study in a selected province, Sri Lanka
  • Oct 20, 2023
  • Clinical Epidemiology and Global Health
  • Hapugahapitiye Mohottalalage Renu Kalhari Geethani Nandasena + 2 more

Prevalence and determinants of dyslipidemia among adults in the community: A cross-sectional study in a selected province, Sri Lanka

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  • Cite Count Icon 1
  • 10.25307/jssr.1409943
Investigation of the Relationship Between the Self-Efficacy and Cognitive Flexibility of Karate Referees
  • Feb 29, 2024
  • Spor Bilimleri Araştırmaları Dergisi
  • Musab Çağin + 3 more

The present study aims to examine the relationship between the self-efficacy and cognitive flexibility of karate referees. A total of 138 referees, 88 male and 50 female, working in the Turkish Karate Federation participated in the study. The mean age of the referees was 38.09±13.43 years, mean body weight was 74.33±13.46 kg, mean height was 170.23±8.09 cm, and mean active refereeing period was 9.95±8.84 years. The Referee Self-Efficacy Scale developed by Myers et al. (2012) and adapted into Turkish by Karaçam and Pulur (2017) as well as the Cognitive Flexibility Scale developed by Bilgin (2009) were applied to the referees. Independent Samples T-test, One-Way ANOVA test, Pearson correlation test and descriptive statistics were applied to the data obtained. According to the results of the Pearson correlation analysis, a significant positive correlation was found between the referees' self-efficacy and cognitive flexibility levels (p&amp;lt;0.05). The results of the independent samples t-test showed that there was a significant difference in the level of self-efficacy between the males and females (p&amp;lt;0.05). Moreover, self-efficacy level was found to be significant in relation to refereeing class (p&amp;lt;0.05). In conclusion, it was determined in the study that the self-efficacy levels of the karate referees increased in parallel with their cognitive flexibility levels, the male participants had higher self-efficacy levels compared to the female participants, and self-efficacy levels increased in parallel with refereeing class.

  • Research Article
  • Cite Count Icon 18
  • 10.1108/dta-09-2021-0236
Analyzing students' attention by gaze tracking and object detection in classroom teaching
  • Jan 25, 2023
  • Data Technologies and Applications
  • Hui Xu + 4 more

PurposeAttention is one of the most important factors to affect the academic performance of students. Effectively analyzing students' attention in class can promote teachers' precise teaching and students' personalized learning. To intelligently analyze the students' attention in classroom from the first-person perspective, this paper proposes a fusion model based on gaze tracking and object detection. In particular, the proposed attention analysis model does not depend on any smart equipment.Design/methodology/approachGiven a first-person view video of students' learning, the authors first estimate the gazing point by using the deep space–time neural network. Second, single shot multi-box detector and fast segmentation convolutional neural network are comparatively adopted to accurately detect the objects in the video. Third, they predict the gazing objects by combining the results of gazing point estimation and object detection. Finally, the personalized attention of students is analyzed based on the predicted gazing objects and the measurable eye movement criteria.FindingsA large number of experiments are carried out on a public database and a new dataset that is built in a real classroom. The experimental results show that the proposed model not only can accurately track the students' gazing trajectory and effectively analyze the fluctuation of attention of the individual student and all students but also provide a valuable reference to evaluate the process of learning of students.Originality/valueThe contributions of this paper can be summarized as follows. The analysis of students' attention plays an important role in improving teaching quality and student achievement. However, there is little research on how to automatically and intelligently analyze students' attention. To alleviate this problem, this paper focuses on analyzing students' attention by gaze tracking and object detection in classroom teaching, which is significant for practical application in the field of education. The authors proposed an effectively intelligent fusion model based on the deep neural network, which mainly includes the gazing point module and the object detection module, to analyze students' attention in classroom teaching instead of relying on any smart wearable device. They introduce the attention mechanism into the gazing point module to improve the performance of gazing point detection and perform some comparison experiments on the public dataset to prove that the gazing point module can achieve better performance. They associate the eye movement criteria with visual gaze to get quantifiable objective data for students' attention analysis, which can provide a valuable basis to evaluate the learning process of students, provide useful learning information of students for both parents and teachers and support the development of individualized teaching. They built a new database that contains the first-person view videos of 11 subjects in a real classroom and employ it to evaluate the effectiveness and feasibility of the proposed model.

  • Research Article
  • Cite Count Icon 1
  • 10.1097/sih.0000000000000825
Evaluating the Value of Eye-Tracking Augmented Debriefing in Medical Simulation—A Pilot Randomized Controlled Trial
  • Oct 29, 2024
  • Simulation in Healthcare
  • Heather Braund + 11 more

IntroductionDebriefing after simulation facilitates reflective thinking and learning. Eye-tracking augmented debriefing (ETAD) may provide advantages over traditional debriefing (TD) by leveraging video replay with first-person perspective. This multisite randomized controlled trial compared the impact of ETAD with TD (without eye-tracking and without video) after simulation on 4 outcomes: (1) resident metacognitive awareness (the primary outcome), (2) cognitive load (CL) of residents and debriefers, (3) alignment of resident self-assessment and debriefer assessment scores, and (4) resident and debriefer perceptions of the debriefing experience.MethodFifty-four emergency medicine residents from 2 institutions were randomized to the experimental (ETAD) or the control (TD) arm. Residents completed 2 simulation stations followed by debriefing. Before station 1 and after station 2, residents completed a Metacognition Awareness Inventory (MAI). After each station, debriefers and residents rated their CL and completed an assessment of performance. After the stations, residents were interviewed and debriefers participated in a focus group.ResultsThere were no statistically significant differences in mean MAI change, resident CL, or assessment alignment between residents and debriefers. Debriefer CL was lower in the experimental arm. Interviews identified 4 themes: (1) reflections related to debriefing approach, (2) eye-tracking as a metacognitive sensitizer, (3) translation of metacognition to practice, and (4) ETAD as a strategy to manage CL. Residents reported that eye tracking improved the specificity of feedback. Debriefers relied less on notes, leveraged video timestamps, appreciated the structure of the eye-tracking video, and found the video useful when debriefing poor performers.ConclusionsThere were no significant quantitative differences in MAI or resident CL scores; qualitative findings suggest that residents appreciated the benefits of the eye-tracking video review. Debriefers expended less CL and reported less perceived mental effort with the new technology. Future research should leverage longitudinal experimental designs to further understand the impact of eye-tracking facilitated debriefing.

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  • Cite Count Icon 38
  • 10.3390/brainsci11111503
The Potential of Naturalistic Eye Movement Tasks in the Diagnosis of Alzheimer's Disease: A Review.
  • Nov 12, 2021
  • Brain Sciences
  • Megan Rose Readman + 4 more

Extensive research has demonstrated that eye-tracking tasks can effectively indicate cognitive impairment. For example, lab-based eye-tracking tasks, such as the antisaccade task, have robustly distinguished between people with Alzheimer’s disease (AD) and healthy older adults. Due to the neurodegeneration associated with AD, people with AD often display extended saccade latencies and increased error rates on eye-tracking tasks. Although the effectiveness of using eye tracking to identify cognitive impairment appears promising, research considering the utility of eye tracking during naturalistic tasks, such as reading, in identifying cognitive impairment is limited. The current review identified 39 articles assessing eye-tracking distinctions between people with AD, mild cognitive impairment (MCI), and healthy controls when completing naturalistic task (reading, real-life simulations, static image search) or a goal-directed task involving naturalistic stimuli. The results revealed that naturalistic tasks show promising biomarkers and distinctions between healthy older adults and AD participants, and therefore show potential to be used for diagnostic and monitoring purposes. However, only twelve articles included MCI participants and assessed the sensitivity of measures to detect cognitive impairment in preclinical stages. In addition, the review revealed inconsistencies within the literature, particularly when assessing reading tasks. We urge researchers to expand on the current literature in this area and strive to assess the robustness and sensitivity of eye-tracking measures in both AD and MCI populations on naturalistic tasks.

  • Research Article
  • Cite Count Icon 140
  • 10.1007/s10072-020-04310-y
Eye tracking metrics to screen and assess cognitive impairment in patients with neurological disorders.
  • Mar 3, 2020
  • Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology
  • Ling Tao + 5 more

Eye tracking is a powerful method to investigate the relationship between behavior and neural mechanisms. In recent years, eye movement analysis has been used in patients with neurological disorders to assess cognitive function. In this review, we explore the latest eye tracking researches in neurological disorders that are commonly associated with cognitive deficits, specifically, amyotrophic lateral sclerosis (ALS), Alzheimer's disease (AD), Parkinson's disease (PD), multiple sclerosis (MS), and epilepsy. We focus on the application of ocular measures in these disorders, with the goal of understanding how eye tracking technology can be used in the clinical setting. Eye tracking tasks (especially saccadic tasks) are often used as an adjunct to traditional scales for cognitive assessment. Eye tracking data confirmed that executive dysfunction is common in PD and ALS, whereas AD and MS are characterized by attention deficits. Research in evaluating cognitive function in epilepsy using eye tracking is still in its early stages, but this approach has shown advantages as a sensitive quantitative method with high temporal and spatial resolution. Eye tracking technology can facilitate the assessment of cognitive impairment with higher temporal resolution and finer granularity than traditional cognitive assessment. Oculomotor data collected during cognitive tasks can provide insight into biological processes. Eye tracking provides a nonverbal and less cognitively demanding method of measuring disease progression in cognitively impaired patients.

  • Research Article
  • 10.24294/jipd.v8i12.5172
Assessing cognitive flexibility in adaptive learning technologies for special education
  • Oct 31, 2024
  • Journal of Infrastructure Policy and Development
  • Mohmmad Ahmad Saleem Khasawneh

This study used quantitative methods to examine the correlation between adaptive learning technology and cognitive flexibility in kids receiving special education. The study included a cohort of 120 kids, ages 8–12, who were diagnosed with particular learning difficulties, ADHD, or autism spectrum disorder. Cognitive flexibility was evaluated using the Wisconsin Card Sorting Test (WCST), while the utilization of adaptive learning technologies was quantified using self–report questionnaires. The data was analyzed using several statistical methods, such as independent samples t-tests, regression, Pearson correlation coefficients, ANOVA, and ANCOVA. The findings revealed a noteworthy and favorable correlation between the utilization of adaptive technology and the scores of cognitive flexibilities. This correlation remained significant even after accounting for demographic characteristics. Moreover, it was shown that the diagnostic status had a moderating effect on the correlation between the utilization of adaptive technology and cognitive flexibility. The results emphasize the capacity of adaptive learning technologies to improve cognitive flexibility abilities in kids with special needs, offering significant knowledge for educators, legislators, and technology developers.

  • Research Article
  • 10.35826/ijoess.4469
INVESTIGATION OF CANDIDATE TEACHERS ACADEMIC PERFECTIONISM WITH COGNITIVE FLEXI
  • Jan 1, 2024
  • International Journal Of Eurasia Social Sciences
  • Selim Asan

University education necessitates students to undertake many academic responsibilities. Multiple individual factors influence the successful accomplishment of these responsibilities. Cognitive flexibility and academic perfectionism can be shown among these variables. Cognitive flexibility is closely related to responding to problems encountered in and out of the classroom and producing multiple solutions. On the other hand, academic perfectionism is the ability of individuals to fulfil their academic responsibilities in the shortest time and in the best way. In line with this information, the research aims to examine the academic perfectionism with cognitive flexibility levels of pre-service teachers in terms of different variables. The research included 276 prospective physical education teachers, 159 female and 117 male, aged between 20 and 25 (M= 22.14 ± 1.31), studying at the Faculty of Sport Sciences of two state universities. "Personal Information Form," "Academic Perfectionism Scale," and "Cognitive Flexibility Scale" were used as data collection tools. The study data were analyzed using the Pearson Correlation Test and the Independent Sample T-Test from descriptive statistics. According to the data acquired from the study, It was determined that there was a significant positive correlation between candidate teachers' age, academic perfectionism scores and their cognitive flexibility scores. It was determined that there were no significant differences between cognitive flexibility scores according to gender and academic achievement. Still, there were significant differences between cognitive flexibility scores according to age. At the same time, although there were no significant differences between the academic perfectionism scores of the participants according to their academic achievement and age, it was determined that there were significant differences between academic perfectionism scores and gender. As a result, It was determined that the candidate teachers' mean cognitive flexibility score (4.29±.502) was high, whereas the mean academic perfectionism score (2.53±.721) was close to the middle level. it was determined that candidate teachers' academic perfectionism and cognitive flexibility levels increased as their age increased, and women were found to be more academic perfectionists than men.

  • Research Article
  • Cite Count Icon 7
  • 10.17220/ijpes.2020.02.013
Investigation of the Relationship between Cognitive Flexibility Levels and Personal Features of University Students
  • May 1, 2020
  • International Journal of Psychology and Educational Studies
  • Seda Tüfekçi̇başi + 1 more

The purpose of this study was to examine the relationship between cognitive flexibility levels and personality traits of university students and whether these variables differ according to gender, education department, cigarette and alcohol use. The research was carried out with 151 students studying in the English language education, physical education and sports, science education, public relations and advertising departments of Karadeniz Technical University. "Cognitive Flexibility Scale" was used to measure the level of cognitive flexibility, "Eysenck Personality Questionnaire Short Form" to measure personality characteristics and "Personal Information Form" created by the researcher was used for personal information. Independent Sample T-Test, One Way Variance Analysis (ANOVA) and Pearson Correlation Coefficient were used in the analysis of the data. The analyses were carried out in SPSS 22.0 program. The results of the research showed that there was a negative relationship between cognitive flexibility and neuroticism and a positive relationship between cognitive flexibility and extraversion. According to another result only estraversion scores differ by gender. Women's extraversion scores were higher than men's scores. The variables don't differ according to the education department. Cognitive flexibility and psychoticism scores differ between smokers and non-smokers. In addition neuroticism and psychoticism scores differ between individuals who consume alcohol and do not consume alcohol. The findings were discussed based on the literature and suggestions for future research were presented.&#x0D;

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  • Cite Count Icon 2
  • 10.47391/jpma.7788
Childhood Adverse Experiences, Cognitive Flexibility And Goal Orientation In Adolescents.
  • Aug 15, 2023
  • Journal of the Pakistan Medical Association
  • Maryaum Bashir + 1 more

To investigate correlation among childhood adverse experiences, cognitive flexibility, and goal orientation in adolescents, a cross-sectional study was conducted at the Riphah International University, Lahore, Pakistan, from July 2021 to March 2022, while data was collected from students of both private and governmentschools/colleges of Lahore. Non-Probability Purposive Sampling was carried out to recruit the sample of 250 participants, within the age range of 15-18 years. Sample size was determined by G Power Analysis and Greens Formula by Kang H (2021). Adverse Childhood Experience Scale, Cognitive Flexibility Scale, and Achievement Goal Questionnaire were used as toolsfor data collection. Data was analysed in SPSS version 21, using descriptive analysis, independent sample t-test, Pearson Product Moment Correlation and Multiple Regression Analysis. Results showed significant difference among males and females, results also revealed significant correlation among childhood adverse experiences, cognitive flexibility, and goal orientation in adolescents. It was also noted that childhood adverse experiences and cognitive flexibility are good predictors of goal orientation in adolescents. It was concluded that early adversity can negatively affect goal orientation and cognitive flexibility, whereas cognitive flexibility positively affects goal orientation in adolescents. It is also worth noting that females have complex cognitive flexibility which enhances their goal orientation as compared to males, in spite of their childhood adverse experience.

  • Research Article
  • 10.47626/2237-6089-2025-1273
Exploring Psilocybin-Assisted Schema Therapy: A Conceptual Framework for Potential Therapeutic Synergies in Personality Disorders.
  • Apr 25, 2026
  • Trends in psychiatry and psychotherapy
  • Alberto Barbieri

Personality disorders (PDs) are characterized by rigid and maladaptive patterns of self- and interpersonal functioning, leading to high clinical burden and limited treatment outcomes. Schema Therapy (ST), an integrative psychotherapy rooted in cognitive-behavioral principles, conceptualizes PDs in terms of Early Maladaptive Schemas (EMS)-pervasive cognitive-affective structures formed through unmet emotional needs-and schema modes, dynamic states organizing emotion, belief, and behavior. Evidence indicates moderate efficacy of ST, mainly for borderline personality disorder, with limited research on other Cluster B and C PDs. Emerging evidence suggests that psilocybin, a serotonergic psychedelic, can induce enduring personality change, supporting its potential use in treating PDs. Within a predictive coding framework, the REBUS ("Relaxed Beliefs Under Psychedelics") and REBAS ("Revised Beliefs After Psychedelics") models propose that psilocybin relaxes high-level priors, facilitating cognitive flexibility and revision of maladaptive self-beliefs. Conceptual parallels between EMS and high-level priors suggest that psychedelic-induced relaxation of entrenched beliefs may enhance responsiveness to ST's experiential and cognitive interventions. Psilocybin-Assisted Schema Therapy (PAST) is proposed as a model in which psilocybin sessions are followed by integration combining psychedelic-induced cognitive flexibility with ST techniques, aimed at strengthening adaptive modes and reducing dysfunctional EMS and dysfunctional modes. PAST could be relevant in the future for enhancing outcomes and potentially reducing treatment duration in Cluster B and C PDs, pending empirical validation. Although current literature is insufficient to recommend psilocybinassisted interventions for PDs, this theoretical article bridges computational neuroscience and clinical psychotherapy, outlining a framework for future studies on PAST feasibility, safety, and efficacy.

  • Research Article
  • Cite Count Icon 3
  • 10.1186/s12888-025-06523-x
Cognitive control in individuals with heroin use disorder after prolonged methadone maintenance treatment
  • Jan 28, 2025
  • BMC Psychiatry
  • Wei Zhao + 16 more

BackgroundAlthough impaired cognitive control is common during the acute detoxification phase of substance use disorders (SUD) and is considered a major cause of relapse, it remains unclear after prolonged methadone maintenance treatment (MMT). The aim of the present study was to elucidate cognitive control in individuals with heroin use disorder (HUD) after prolonged MMT and its association with previous relapse.MethodsA total of 63 HUD subjects (41 subjects with previous relapse and 22 non-relapse subjects, mean MMT duration: 12.24 ± 2.92 years) and 31 healthy controls were enrolled in this study. Eye tracking tasks, prospective memory tasks, the Behavior Rating Inventory of Executive Function-Adult Version (BRIEF-A) and the Prospective and Retrospective Memory Questionnaire (PRMQ) were used to assess cognitive control.ResultsHUD individuals exhibited worse saccade error rate and executive dysfunction but showed no significant impairment in prospective memory. Additionally, the relapsers performed worse in terms of antisaccade amplitude and velocity at higher difficulty gradients (11° or 16°). Antisaccade performance in terms of amplitude and velocity was negatively correlated with executive function scores. Deficits in inhibition, cognitive flexibility, and self-monitoring were found to mediate the relationship between previous relapse and impaired antisaccade performance.ConclusionsEven after prolonged MMT, HUD individuals still show partial impairments in cognitive control and antisaccade performance. Previous relapse exacerbates cognitive control deficits through executive dysfunction in inhibition, cognitive flexibility and self-monitoring, which can be screened by higher difficulty of antisaccade amplitude and velocity. More importantly, saccade error rate can reflect impaired inhibitory control in HUD individuals, whereas antisaccade amplitude and velocity appear to have potential diagnostic value for relapse.

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