Cognitive Distraction Research Articles

Design considerations for future affective automotive interfaces: a review of self-regulation strategies to manage affect behind the wheel

Like inattention, dysregulated emotions can seriously distract motorists and disrupt their driving performance. The current review examined the literature on emotion regulation to find relevant strategies for managing intense emotions while driving a motor vehicle. Next, we considered whether those relevant strategies could be used to design future affective automotive interfaces. Results suggested that problem-solving, task-focused coping, mindfulness, and relaxation effectively regulate emotions while driving. These findings highlight that some strategies may be effective but costly to implement while driving (cognitive reappraisal and distraction), which need to be better understood before implementing them into automotive interfaces. Together, these findings suggest the potential benefits of embedding self-regulatory interventions in future automotive interfaces that can help maintain an optimal affective state to reduce distraction and improve safe driving.

Impact of Texting-Induced Distraction on Driving Behavior Based on Field Operation Tests

Driver distraction has proven to be among the top contributory factors in road crashes worldwide. The involvement of drivers in secondary activities, such as phone usage, conversation with co-passengers, reaching for objects, eating, and so forth, have been shown to be significant causes of in-vehicle driver distraction. Text messaging using mobile phones while driving can be detrimental to the primary driving task as it invokes manual, visual, and cognitive distractions. Numerous studies in the past have analyzed the effect of texting on driver distraction using driving simulators. This study followed a field operation test–based approach to simulate real road conditions and evaluate the impact of texting on driving behavior. The study was conducted at the connected autonomous vehicle testbed at the Indian Institute of Technology Hyderabad, using an instrumented test vehicle. Data on gaze parameters and vehicle kinematics were recorded using eye-tracker glasses and a high-end global positioning system (GPS) data logger. Thirty-one participants drove on the pre-defined path at the testbed under baseline and texting conditions. The findings demonstrated that the texting task significantly affected fixation count, mean speed, and lateral acceleration. The texting task led to a reduction in mean fixation counts, mean speed, and mean lateral acceleration by 44.37%, 34%, and 46.72%, respectively. The age and driving experience of the participants had a significant effect on their behavior. The results indicate the critical potential of texting-based driver distraction and suggest the enforcement of stringent rules for texting while driving to create a safer road environment.

Distraction impact of concurrent conversation on event-related potential based brain-computer interfaces

Objective.This study investigates the impact of conversation on the performance of visual event-related potential (ERP)-based brain-computer interfaces (BCIs), considering distractions in real life environment. The research aims to understand how cognitive distractions from speaking and listening activities affect ERP-BCI performance.Approach.The experiment employs a dual-task paradigm where participants control a smart light using visual ERP-BCIs while simultaneously conducting speaking or listening tasks.Main results.The findings reveal that speaking notably degrades BCI accuracy and the amplitude of ERP components, while increases the latency variability of ERP components and occipital alpha power. In contrast, listening and simple syllable repetition tasks have a lesser impact on these variables. The results suggest that speaking activity significantly distracts visual attentional processes critical for BCI operationSignificance. This study highlights the need to take distractions by daily conversation into account of the design and implementation of ERP-BCIs.

Beyond Distracted Eating: Cognitive Distraction Downregulates Odor Pleasantness and Interacts with Weight Status.

Considering the widespread issue of distracted eating, our study investigates how cognitive distraction influences the sensory perception of food-related odors among individuals with varying weight statuses. We conducted an exploratory, randomized, and cross-sectional experimental study, using the Tetris game to simulate real-life cognitive distraction, incorporating two distraction levels (low and high) and presenting five distinct odors. A total of 59 participants, categorized into a lean (n = 30) and overweight/obese group (n = 29) based on their body mass index (BMI), received odor stimuli while playing Tetris at low and high difficulty, corresponding to low and high distraction levels, respectively. Participants subsequently rated odor intensity and pleasantness under the two cognitive distraction conditions. Respiratory movements were monitored to ensure accurate olfactory stimulation. Our findings revealed no significant difference in odor intensity ratings across distraction levels (p = 0.903). However, there was a significant reduction in odor pleasantness under high cognitive distraction (p = 0.007), more pronounced in lean participants compared to those with an overweight status (p = 0.035). Additionally, an interaction between gender and cognitive distraction effects was observed in odor pleasantness perception. The differential effects of distraction across weight-status groups and genders are discussed in the context of hedonic motivation and compensatory mechanisms. This study sheds light onto the sensory mechanisms underlying distracted eating and could inform more personalized strategies for promoting healthier eating habits in a world dominated by distractions.

Classifying the Cognitive Performance of Drivers While Talking on Hands-Free Mobile Phone Based on Innovative Sensors and Intelligent Approach

The use of mobile phones while driving is restricted to hands-free mode. But even in the hands-free mode, the use of mobile phones while driving causes cognitive distraction due to the diverted attention of the driver. By employing innovative machine-learning approaches to drivers’ physiological signals, namely electroencephalogram (EEG), heart rate (HR), and blood pressure (BP), the impact of talking on hands-free mobile phones in real time has been investigated in this study. The cognitive impact was measured using EEG, HR, and BP data. The authors developed an intelligent model that classified the cognitive performance of drivers using physiological signals that were measured while drivers were driving and reverse bay parking in real time and talking on hands-free mobile phones, considering all driver ages as a complete cohort. Participants completed two numerical tasks varying in difficulty while driving and reverse bay parking. The results show that when participants did the hard tasks, their theta and lower alpha EEG frequency bands increased and exceeded those when they did the easy tasks. The results also show that the BP and HR under phone condition were higher than the BP and HR under no-phone condition. Participants’ cognitive performance was classified using a feedforward neural network, and 97% accuracy was achieved. According to qualitative results, participants experienced significant cognitive impacts during the task completion.

Under pressure: Effects of distraction and reappraisal on adolescents' psychophysiological stress responses

Although cognitive reappraisal and distraction are generally both beneficial to down-regulate negative affect, it remains unknown whether one may be more effective in helping adolescents handle stressful situations. Therefore, this study compared the effects of both strategies on adolescent's psychophysiological stress responses. Belgian adolescents (N = 82, Mage = 13.99 years, SDage = 0.62; 38% males) received a 100-min training on cognitive reappraisal or distraction to ensure adolescents could use the strategies when instructed; subsequently they were exposed to a standardized interpersonal stressor after which they were instructed to use the learned technique. As compared to participants in the cognitive reappraisal condition, participants in the distraction condition reported larger increases in positive affect during the initial minutes of stress recovery. However, no clear differences emerged when examining negative affect and respiratory sinus arrythmia recovery. These findings provide new insights into the effectiveness of cognitive reappraisal and distraction in adolescents.

Driving Attention State Detection Based on GRU-EEGNet.

The present study utilizes the significant differences in θ, α, and β band power spectra observed in electroencephalograms (EEGs) during distracted versus focused driving. Three subtasks, visual distraction, auditory distraction, and cognitive distraction, were designed to appear randomly during driving simulations. The θ, α, and β band power spectra of the EEG signals of the four driving attention states were extracted, and SVM, EEGNet, and GRU-EEGNet models were employed for the detection of the driving attention states, respectively. Online experiments were conducted. The extraction of the θ, α, and β band power spectrum features of the EEG signals was found to be a more effective method than the extraction of the power spectrum features of the whole EEG signals for the detection of driving attention states. The driving attention state detection accuracy of the proposed GRU-EEGNet model is improved by 6.3% and 12.8% over the EEGNet model and PSD_SVM method, respectively. The EEG decoding method combining EEG features and an improved deep learning algorithm, which effectively improves the driving attention state detection accuracy, was manually and preliminarily selected based on the results of existing studies.

The Effects of Auditory, Visual, and Cognitive Distractions on Cybersickness in Virtual Reality.

Cybersickness (CS) is one of the challenges that has hindered the widespread adoption of Virtual Reality (VR). Consequently, researchers continue to explore novel means to mitigate the undesirable effects associated with this affliction, one that may require a combination of remedies as opposed to a solitary stratagem. Inspired by research probing into the use of distractions as a means to control pain, we investigated the efficacy of this countermeasure against CS, studying how the introduction of temporally time-gated distractions affects this malady during a virtual experience featuring active exploration. Downstream of this, we studied how other aspects of the VR experience are affected by this intervention. We discuss the results of a between-subjects study manipulating the presence, sensory modality, and nature of periodic and short-lived (5-12 seconds) distractor stimuli across four experimental conditions: 1) no-distractors (ND); 2) auditory distractors (AD); 3) visual distractors (VD); 4) cognitive distractors (CD). Two of these conditions (VD and AD) formed a yoked control design wherein every matched pair of 'seers' and 'hearers' was periodically exposed to distractors that were identical in terms of content, temporality, duration, and sequence. In the CD condition, each participant had to periodically perform a 2-back working memory task, the duration and temporality of which was matched to distractors presented in each matched pair of the yoked conditions. These three conditions were compared to a baseline control group featuring no distractions. Results indicated that the reported sickness levels were lower in all three distraction groups in comparison to the control group. The intervention also increased the amount of time users were able to endure the VR simulation and avoided causing detriments to spatial memory and virtual travel efficiency. Overall, it appears that it may be possible to make users less consciously aware and bothered by the symptoms of CS, thereby reducing its perceived severity.

Unveiling the Impact of Cognitive Distraction on Cyclists Psycho-Behavioral Responses in an Immersive Virtual Environment

Unveiling the Impact of Cognitive Distraction on Cyclists Psycho-Behavioral Responses in an Immersive Virtual Environment

Effectiveness of cognitive reappraisal and distraction for induced acute pain: A laboratory study.

Cognitive reappraisal and distraction modulate pain; however, little is known about their effectiveness at different levels of pain intensity. Thus, the aim of this study has been to analyze the differential efficacy of both strategies to reduce perceived pain intensity and pain unpleasantness in low and moderate pain levels. 3 (emotion regulation strategy: cognitive reappraisal, distraction, and control) × 2 (intensity of the painful stimuli: low and moderate intensity) × 2 (time: pretest and posttest) mixed factorial design. Ninety healthy adults were randomly assigned to one of six experimental conditions. Pain-heat stimuli were administered with an advanced thermal stimulator. All participants completed the experimental pretest and posttest phases; in each phase, 12 pain stimuli were administered. Participants received brief training on how to apply cognitive reappraisal, distraction, and the control condition for the posttest phase. Data were collected from May 2022 to November 2022. Analyses of repeated-measure analysis of variance showed that at posttest cognitive reappraisal and distraction were equally effective in reducing perceived pain intensity in low pain levels, while distraction was more effective than cognitive reappraisal in decreasing perceived pain intensity in moderate pain levels. Both distraction and cognitive reappraisal were effective in decreasing pain unpleasantness regardless of the intensity of the painful stimuli. These findings highlighted the beneficial use of both strategies in the short term for pain relief, distraction being more effective in moderate pain levels. Applying both strategies to everyday situations that may cause short-term acute pain could be of great clinical relevance. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The impact of cognitive distraction on gustatory perception in volunteers with obesity

Obesity, a global health challenge, is influenced by biological, behavioral, socioeconomical, and environmental factors. In our technology-driven world, distracted eating is prevalent, yet neurocognitive mechanisms behind it remain poorly understood. This study targets individuals with overweight and obesity, exploring taste perception under distraction comprehensively. Participants formed two distinct groups based on their Body Mass Index (BMI), lean and overweight/obese. During the experiment participants received gustatory stimuli while playing a Tetris game of various difficulty levels. Participants rated taste intensity and pleasantness, with linear mixed models analyzing distraction effects. Results confirmed that high distraction levels reduced perception of taste intensity (p = 0.017) and taste pleasantness (p = 0.022), with variations influenced by gender and weight status. Individuals in the overweight/obese group exhibited most profound intensity changes during distraction (p = 0.01). Taste sensitivity ratings positively correlated with BMI interacting with gender (male r = 0.227, p < 0.001; female r = 0.101, p < 0.001). Overall across both groups, female participants demonstrated higher taste sensitivity compared to male participants (p < 0.001). This study highlights the impact of cognitive distraction during consumption on taste perception, particularly in relation to weight status and gender, underscoring their significant roles in this interplay.

An exploratory randomized controlled trial of virtual reality as a non-pharmacological adjunctive intervention for adults with chronic cancer-related pain

BackgroundThe growing popularity and affordability of immersive virtual reality (VR), as adjunctive non-pharmacological interventions (NPIs) for chronic pain, has resulted in increasing research, with mixed results of its effectiveness reported. This randomized controlled superiority trial explored the effects of a home-based adjunctive 3D VR NPI for chronic pain in cancer patients, compared to the same NPI experienced through a two-dimensional (2D) medium.MethodsThe NPI used four different applications experienced for 30 min for six days a week at home for four weeks using established cognitive distraction and mindfulness meditation techniques. Participants were randomly assigned (N = 110) into two arms: a VR group (n = 57) where the NPI was delivered through a VR system, and a control group (n = 53) which used a computer screen for delivery. Participants were blinded to which arm of the study they were in, and sequence of the NPI applications experienced was randomized. Primary outcomes of daily pre/post/during exposure, and weekly average pain scores were assessed via the Visual Analog Scale (VAS) and the Short Form McGill Pain Questionnaire (SF-MPQ), and secondary outcomes of weekly Quality of Life (SF-12), and sleep quality (Pittsburgh Sleep Quality Index) were measured.ResultsFindings indicate VR applications were not significantly superior to the 2D group, but both VR and control NPIs provided clinically important pain reduction for participants when experiencing significant daily pain of a VAS ≥ 4. No significant adverse effects were encountered, although many of the participants in the VR group reported some cybersickness in certain applications (VR group n = 46 vs 2D group n = 28).ConclusionsOverall, VR did not provide superiority as an NPI for pain relief compared to 2D computer-based applications. For those experiencing significant pain, cognitive distractive applications appeared superior for VR-based pain reduction during exposure, whilst meditative applications supplied better pain relief post-exposure. Findings from this trial support some clinical efficacy of home-based VR immersive experiences as NPIs for chronic cancer-related pain but in this context the 2D computer-based applications demonstrated similar value.Trial registrationClinicaltrials.gov, identifier NCT02995434, registered 2017–07-31.

The development of a novel scale to assess intra- and interpersonal emotion regulation strategies: The Emotion Regulation Strategy Scale (ERSS).

Existing emotion regulation research focuses on how individuals use different strategies to manage their own emotions-also called intra-personal emotion regulation. However, people often leverage connections with others to regulate their own emotions-interpersonal emotion regulation. The goal of the present studies was to develop a comprehensive and efficient scale-the Emotion Regulation Strategies Scale (ERSS)-to assess nine specific emotion regulation strategies that individuals use both intra-personally and interpersonally. These emotion regulation strategies were cognitive reappraisal, distraction, situation selection, problem solving, acceptance, calming, savoring, rumination, and expressive suppression. Data were collected between 2020 and 2022. Study 1 adopted a qualitative approach to establish original scale items. Results of the confirmatory factor analysis in Study 2 confirmed a nine-factor solution for both the intra- and the interpersonal scales and finalized scale items. A second confirmatory factor analysis in Study 3 found the ERSS for both the intra-personal and interpersonal scale models to possess good model fit. Correlations from Study 3 showed the ERSS subscales to be related in expected ways to existing emotion regulation scales, yet not redundant with these scales. The degree to which individuals used the range of intra- and interpersonal emotion regulation strategies assessed on the ERSS also related to the levels of clinical symptoms. The ERSS represents a comprehensive novel scale that can flexibly assess a range of specific emotion regulation strategies used both intra- and interpersonally. Future work should be conducted using the ERSS cross culturally and in clinical samples. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Trait hedonic capacity correlates with sexual pleasure and motives for sexualized drug use in young adults

Although pleasure is a primary motivator for sexual activity, research into the mechanisms facilitating pleasurable sexual experiences is limited. The present research adopts a self-regulatory perspective on sexual pleasure, investigating individuals’ capacity to shield hedonic activities from distracting thoughts (trait hedonic capacity) as a correlate of sexual pleasure and sexualized drug use. Study 1 (N = 247) demonstrates that young adults with higher trait hedonic capacity experience more sexual pleasure and are less prone to cognitive distraction during partnered sexual activities. Pre-registered Study 2 replicates these findings while accounting for demand effects (N = 182, n = 86). Expanding on these findings, pre-registered Study 3 (N = 903) shows that young adults with lower trait hedonic capacity are more inclined to use alcohol as a means of coping with cognitive distraction during sexual activity. Exploratory moderation analyses suggest that this is particularly true for women and individuals with higher levels of stress. In summary, low trait hedonic capacity is associated with lower sexual pleasure and a tendency to use alcohol with the motivation to cope with distracting thoughts during partnered sexual activity.

Augmented Recognition of Distracted Driving State Based on Electrophysiological Analysis of Brain Network.

In this study, we propose an electrophysiological analysis-based brain network method for the augmented recognition of different types of distractions during driving. Driver distractions, such as cognitive processing and visual disruptions during driving, lead to distinct alterations in the electroencephalogram (EEG) signals and the extracted brain networks. We designed and conducted a simulated experiment comprising 4 distracted driving subtasks. Three connectivity indices, including both linear and nonlinear synchronization measures, were chosen to construct the brain network. By computing connectivity strengths and topological features, we explored the potential relationship between brain network configurations and states of driver distraction. Statistical analysis of network features indicates substantial differences between normal and distracted states, suggesting a reconfiguration of the brain network under distracted conditions. Different brain network features and their combinations are fed into varied machine learning classifiers to recognize the distracted driving states. The results indicate that XGBoost demonstrates superior adaptability, outperforming other classifiers across all selected network features. For individual networks, features constructed using synchronization likelihood (SL) achieved the highest accuracy in distinguishing between cognitive and visual distraction. The optimal feature set from 3 network combinations achieves an accuracy of 95.1% for binary classification and 88.3% for ternary classification of normal, cognitively distracted, and visually distracted driving states. The proposed method could accomplish the augmented recognition of distracted driving states and may serve as a valuable tool for further optimizing driver assistance systems with distraction control strategies, as well as a reference for future research on the brain-computer interface in autonomous driving.

HOW DOES MENTAL DISTRACTION INDUCED BY AN ADDITIONAL TASK AFFECT THE SEVERITY OF SIMULATOR SICKNESS SYMPTOMS IN PILOTS: A SPATIAL DISORIENTATION SIMULATOR STUDY

Introduction: To improve the effectiveness of spatial disorientation (SD) training in a flight simulator, pilots are recommended to perform an additional task that induces a mental distraction. The presented study explored how the inclusion of an additional task that may enhance the effectiveness of SD training changes the severity of simulator sickness symptoms reported after exposure in the Gyro-IPT simulator. Methods: We compared the incidence of simulator sickness symptoms in pilots across four setups of flight scenarios (varying according to cognitive load distraction) collected during our previous studies. A total of 77 male military pilots (age 28.3±6.2) with flight experience (810.72 ±969.43 hours) were randomly assigned to one of four groups and then exposed to a 60-min long flight session (12 flight profiles, six involved an SD-conflict) with active control in the Gyro IPT simulator. In addition to the primary flying task, in three flight scenarios, pilots were asked to perform an additional visual (a change detection flicker task [CDFT]), auditory (an auditory N-back task [NBT]), or duration-discrimination task (DDT)). To measure simulator sickness symptoms, the Simulator Sickness Questionnaire (SSQ) was administered pre- and post-simulator exposure. Results: The severity of simulator sickness symptoms due to visual and motion cues did not significantly change when the pilot performed a non-sickening cognitive task (additional visual or auditory task). The total SSQ score and scores for nausea, oculomotor disturbance, and disorientation in the CDFT and DDT were slightly higher than in the control condition (flight without additional task). Despite the observed differences, according to the SSQ scoring criteria, the simulator sickness symptoms reported by the pilots were negligible. Conclusions: The additional tasks (CDFT, auditory NBT, or DDT) applied to improve the effectiveness of SD training in the Gyro-IPT simulator do not significantly change unwanted effects, such as simulator sickness.

Investigating the impact of greenery elements in office environments on cognitive performance, visual attention and distraction: An eye-tracking pilot-study in virtual reality

The human-nature connection is one of the main aspects determining supportive and comfortable office environments. In this context, the application of eye-tracking-equipped Virtual Reality (VR) devices to support an evaluation on the effect of greenery elements indoors on individuals’ efficiency and engagement is limited. A new approach to investigate visual attention, distraction, cognitive load and performance in this field is carried out via a pilot-study comparing three virtual office layouts (Indoor Green, Outdoor Green and Non-Biophilic). 63 participants completed cognitive tasks and surveys while measuring gaze behaviour. Sense of presence, immersivity and cybersickness results supported the ecological validity of VR. Visual attention was positively influenced by the proximity of users to the greenery element, while visual distraction from tasks was negatively influenced by the dimension of the greenery. In the presence of greenery elements, lower cognitive loads and more efficient information searching, resulting in improved performance, were also highlighted.

Cognitive-Motor Dual-Task Performance of the Landing Error Scoring System.

The Landing Error Scoring System (LESS) is a common assessment used to determine biomechanical landing errors. However, this assessment is completed as a single motor task, which does not require additional attentional resources. It is unclear if the LESS can be used to detect cognitive-motor interference (i.e., dual-task cost) in biomechanical errors associated with lower extremity injury. To determine if the LESS is a suitable clinical assessment of dual-task performance in uninjured females and to evaluate whether specific landing criteria are more affected by an additional cognitive load than others. Observational Cross-Sectional Design. Setting: University research laboratory. Twenty uninjured, physically active females participated. Intervention(s): Participants performed the LESS under three different conditions: baseline landing with no cognitive distraction (Single), a visual-based dual-task (Visual), and a number-based dual-task (Number). Mean sagittal, frontal, and total LESS scores were compared between conditions using a one-way repeated measures analysis of variance with Tukey post hoc corrections. Cohen's d effect sizes with 95% confidence intervals were used to determine the magnitude of differences. The frequency of errors for each individual LESS item under the three conditions were compared using Chi-Squared analyses. Participants exhibited greater sagittal plane (P=.013, d=0.91 [0.26, 1.56]) and total (P=.008, d=1.03 [0.37, 1.69]) errors during the Visual condition compared to the Single condition. Frontal plane errors were significantly greater during the Number condition compared to the Single condition (P=.008, d=1.03 [0.37, 1.69]). The frequency of errors observed for each LESS item did not statistically differ between conditions (all P>.05). The LESS was able to detect a dual-task cost in landing errors during both the Visual and Number conditions. We recommend developing clinically-oriented solutions to incorporate similar dual- task paradigms in traditional injury risk reduction programs.

Driving Distraction Evaluation Model of In-Vehicle Infotainment Systems Based on Driving Performance and Visual Characteristics

With the rapid development of automotive electronic technology, increasingly car enterprises choose to carry touchscreen in-vehicle infotainment systems (IVISs) in smart cars. The integration of navigation, music, telephone, and other functions into touchscreen IVISs has greatly enriched the driving experience. However, the design of touchscreen IVISs, which lacks consideration of driver human–computer interaction leads to increased driving distraction. The current discussion is limited to evaluating the overall distractions of the secondary task, and there is a lack of research on classifying and summarizing the types of driving distractions. Therefore, this paper proposes a new method to evaluate the degree of driving distraction during the interaction with touchscreen IVISs based on driving performance and visual characteristics. A driving simulation environment was built to conduct psychological experiments on three types of driving distraction, namely visual, manual, and cognitive distraction, respectively, to obtain the impact of different types of driving distraction by using touchscreen IVISs. Combining the criteria importance through intercriteria correlation method with fuzzy comprehensive evaluation to establish a driving distraction evaluation method, we quantify the driving distraction caused by the touch screen IVIS. The results of this study indicate that the proposed driving distraction evaluation model by using driving performance and visual characteristics can effectively evaluate the degree of driving distraction caused by the touchscreen IVIS and provide reference and specification for IVIS safety design from a human–computer interaction perspective.

Additional functional symptoms in Parkinson's disease and tremor syndromes

Patients with Parkinson's Disease or a tremor syndrome may present with additional functional movement disorders. The differential diagnosis is particularly difficult. In some cases, functional symptoms occur either before the manifestation of the organic disease or can emerge as an additional symptom after Parkinson's disease or tremor became apparent. In patients with Parkinson's disease the prevalence for additional functional symptoms is 7 %. In the case that patients with Parkinson's diseases have one side that is more severely affected, additional functional motor symptoms such as functional rest tremor also occur on that same, predominantly affected side. Functional gait disorders occur frequently. Clinically, patients appear notably slow in automatized, daily tasks. Their speech is more whispering than hypophonic, bradykinesia during finger tapping manifest without a decrement. The Dopamintransporterszintigraphy (123) I FP-CIT SPECT; DaTSCANTM) may be helpful to differentiate between functional Parkinsonism and Parkinson's disease. Functional tremor in patients with an organic tremor syndrome is diagnosed with the same distraction techniques as in solely functional tremor. This includes cognitive, motor, and suggestive distraction maneuvers. In some cases, additional neurophysiological investigations such as accelerometry are useful for the differential diagnosis. It is most important to identify patients with additional functional symptoms in non-functional movement disorders, because the therapeutic approach differs and a multi professional team is required to initiate effective treatment strategies.