Sensitivity to the emotional tone of verbal commands: Executive-function and chemotherapy effects

Abstract

Treatment adherence requires complying with verbal commands (“quit smoking!”) issued to impede or instigate behaviors, and a lenient or stern emotional voice tone (VT) calls for optional or mandatory adherence. The ability to identify the commands VT in conditions imposing executive-function (EF) demands could estimate the likelihood of achieving adherence. Prior to chemotherapy and between cycles 3–4 of gynecological cancer, we assessed VT identification under three EF demands. 1) Inhibitory control trials presented the cue word “left” or “right” followed by impeding commands in lenient or stern tone, mapped onto a left or right response; the cue and ear side could be congruent or in conflict with the correct response side. Trials presenting instigating commands (“go!”) mapped lenient or stern onto a right or left response. 2) Response-mapping switching conditions interleaved impeding and instigating commands within the same trial block, and required switching the mapping rule depending on the command, impeding or instigating. 3) Working-memory conditions asked whether the command presented on the current trial was equal to or different from the one presented two trials back. Without EF demands, VT identification errors were few, but increased significantly with EF demands, being largest in condition 2; chemotherapy effects were small.