Cognitive Flexibility Training Research Articles

Cognitive flexibility training for chronic pain: a randomized clinical study.

Previous studies suggest an association between cognitive flexibility and development of chronic pain after surgery. It is not known whether cognitive flexibility can be improved in patients with chronic pain. This study tested whether a neurocognitive training program results in improved cognitive flexibility and pain in patients with chronic pain. We conducted a single-center, prospective, randomized study investigating 5-week daily neurocognitive training in patients with chronic pain. Participants (n = 145) were randomized into neurocognitive training or care as usual, and they completed assessments at baseline, posttreatment, and 3 months. The treatment group was asked to spend 35 minutes daily completing a program with tasks on cognitive flexibility, memory, attention, and speed. The primary outcome was performance on the neurocognitive performance test (NCPT). Secondary outcomes included levels of pain interference and severity. At 5 weeks, the treatment group showed greater improvements on NCPT compared with the control group (d = 0.37); effect size was smaller at 3 months (d = 0.18). The treatment group reported lower pain severity at 5 weeks (d = 0.16) and 3 months (d = 0.39) than the control group, but pain interference was only lower at 3 months (d = 0.20). Outcomes suggest that using neurocognitive training to modify cognitive flexibility in patients with chronic pain may improve pain severity. This study provided effect size estimates to inform sample size calculations for randomized controlled trials to test the effectiveness of neurocognitive interventions for the prevention and treatment of chronic pain.

Preschoolers' cognitive flexibility and emotion understanding: a developmental perspective.

Cognitive flexibility is the ability to adapt to changing tasks or problems, while emotion understanding is the ability to interpret emotional cues and information in different contexts. Both abilities are crucial for preschoolers' socialization. This study selected 532 preschool children aged 3-6 years from two kindergartens in a central province of China. The Dimensional Change Card Sorting (DCCS) task and emotion understanding tasks were used to investigate the developmental characteristics of cognitive flexibility, emotion understanding abilities, and their relationship. The results showed: (1) For cognitive flexibility, children older than 5 years scored significantly higher than younger children, and girls scored higher than boys. (2) For facial emotion recognition: (i) Children's recognition scores for happy, sad, and angry expressions were significantly higher than fear; children could accurately recognize happy, sad, and angry emotions by age 3, while fear recognition developed rapidly after age 5; (ii) Girls scored higher in recognizing fearful faces than boys. (3) For situational emotion understanding: (i) Children's development followed the hierarchical order of external, desire, clue, and belief-based understanding. Situational and desire-based understanding already reached high levels by age 3, while clue and belief-based understanding developed quickly after age 5; (ii) Girls scored higher than boys in belief-based emotion understanding. (4) Cognitive flexibility significantly predicted children's facial emotion recognition, external and desire-based emotion understanding. Parents and teachers should cultivate children's cognitive flexibility and provide personalized support. They should also fully grasp the characteristics of children's emotion understanding development, systematically nurture their emotion understanding abilities, and leverage cognitive flexibility training to improve their emotion understanding.

Trajectories of cognitive flexibility through kindergarten and first grade: Implications for externalizing and internalizing behavior problems in the second grade.

Developmental delays in cognitive flexibility early in elementary school can potentially increase vulnerability for subsequent externalizing and internalizing psychopathology. The first goal of the current study was to identify latent subgroups of children characterized by different developmental trajectories of cognitive flexibility throughout kindergarten and first grade using data from the Early Childhood Longitudinal Study, Kindergarten Class of 2010-2011 dataset. The second goal was to examine whether identified longitudinal developmental trajectories of cognitive flexibility could be associated with internalizing and externalizing behaviors in the second grade, while accounting for background child (age, gender, and Spanish-speaking) and family (family income and mother's education) covariates. The analytic sample consisted of 15,827 kindergarteners (51.20% male; 48.50% White, 13.5% Black/African American, 24.3% Hispanic/Latino, 7.60% Asian, and 6.1% other), who were approximately 5.62 years old (SD = 4.48 months) at the study's outset. Most children lived in households with medium family income of approximately $50,000-$55,000. Using a growth mixture modeling approach, our analyses identified normative (91.05%; 50.4% male) and delayed (8.95%; 59.4% male) cognitive flexibility groups and demonstrated that delayed developers have higher levels of externalizing and internalizing behaviors in the second grade, even after adjusting for background covariates. Our findings, in conjunction with research on cognitive flexibility training, suggest that caregivers may lower the risk for externalizing and internalizing behaviors in delayed developers by correcting inflexible thinking, encouraging alternative solutions, and providing emotional support when children face challenging problems. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

How performing several task segments simultaneously affects cognitive flexibility training in an assembly task

ABSTRACT The fourth industrial revolution and the rise of collaborative robots (cobots) in industrial assembly lines are changing the traditional role of human operators in assembly tasks from following a sequence of operations to working together with a cobot and being able to intervene at different stages of the assembly process. Hence, it is important to focus on cognitive flexibility training, instead of on procedural skill training. The current research examined the effect of performing several task segments simultaneously on cognitive flexibility training in an assembly task. We used a novel 3D simulation system to train participants in three between-participants groups. The three groups together – One Segment, Two Segments, and Nine Segments – comprised 29 participants. Following training, participants were required to assemble the model including having to switch between different sequences. The results demonstrate that the Nine Segments group required significantly longer training time compared to the One Segment group. For the Two Segments group, the switching time was shorter and the mean number of errors after switching was higher compared to the other groups. To conclude, only performing the task in two segments simultaneously improved both the cognitive flexibility and the subjective feeling of competence regarding participants’ cognitive flexibility.

Differences in Creative Personality and Attitude, Creative Problem Solving, and Convergence Thinking of College Students According to Self-Regulation and Cognitive Flexibility Training VR Program Participation

This study used a cognitive flexibility training VR program that can view and solve problems from various perspectives, self-regulation, and self-regulation with the super cognitive ability required for creativity to improve college students' creative personality and attitude, creative problem solving, and convergence thinking ability. In addition, differences in creative personality and attitude, creative problem solving, and convergence thinking ability were analyzed before and after participation in the program. In this study, 55 students were recruited voluntarily among four-year E University students in Gyeonggi-do. The experimental tool is VR content developed by FNI Co., Ltd. The main contents are mainly composed of improving self-control ability, strengthening positivity, and enhancing interpersonal relationships. The IBM SPSS Statistics 25 program was used to analyze the collected data to test the research question. First, frequency analysis and descriptive statistical analysis were performed to examine the mean and standard deviation of the sociodemographic factors and measurement variables of the subjects. Moreover, to determine how consistently the measuring instrument was used, the reliability was validated by calculating the Cronbach's coefficient value. Furthermore, factor analysis was utilized to minimize the number of items in the developed measurement tool by removing variables unrelated to the component to be studied. Factor analysis has the purpose of reducing variables, removing unnecessary variables, identifying variable characteristics, evaluating the validity of measurement items, and creating variables using factor scores. In addition, to confirm the statistical significance of the average values of creative personality and attitude, creative problem solving, and convergence thinking before and after participating in the VR program, a matched-sample t-test was performed. As a result of the study, it was found that participation in the self-regulation and cognitive flexibility VR program had a positive effect after participation compared to before participation in creative personality and attitude, creative problem solving, and convergence thinking.

Temporally and functionally distinct large-scale brain network dynamics supporting task switching

ObjectiveOur daily activities require frequent switches among competing responses at the millisecond time scale. We determined the spatiotemporal characteristics and functional significance of rapid, large-scale brain network dynamics during task switching. MethodsThis cross-sectional study investigated patients with drug-resistant focal epilepsy who played a Lumosity cognitive flexibility training game during intracranial electroencephalography (iEEG) recording. According to a given task rule, unpredictably switching across trials, participants had to swipe the screen in the direction the stimulus was pointing or moving. Using this data, we described the spatiotemporal characteristics of iEEG high-gamma augmentation occurring more intensely during switch than repeat trials, unattributable to the effect of task rule (pointing or moving), within-stimulus congruence (the direction of stimulus pointing and moving was same or different in a given trial), or accuracy of an immediately preceding response. Diffusion-weighted imaging (DWI) tractography determined whether distant cortical regions showing enhanced activation during task switch trials were directly connected by white matter tracts. Trial-by-trial iEEG analysis deduced whether the intensity of task switch-related high-gamma augmentation was altered through practice and whether high-gamma amplitude predicted the accuracy of an upcoming response among switch trials. ResultsThe average number of completed trials during five-minute gameplay was 221.4 per patient (range: 171–285). Task switch trials increased the response times, whereas later trials reduced them. Analysis of iEEG signals sampled from 860 brain sites effectively elucidated the distinct spatiotemporal characteristics of task switch, task rule, and post-error-specific high-gamma modulations. Post-cue, task switch-related high-gamma augmentation was initiated in the right calcarine cortex after 260 ms, right precuneus after 330 ms, right entorhinal after 420 ms, and bilateral anterior middle-frontal gyri after 450 ms. DWI tractography successfully showed the presence of direct white matter tracts connecting the right visual areas to the precuneus and anterior middle-frontal regions but not between the right precuneus and anterior middle-frontal regions. Task-related high-gamma amplitudes in later trials were reduced in the calcarine, entorhinal and anterior middle-frontal regions, but increased in the precuneus. Functionally, enhanced post-cue precuneus high-gamma augmentation improved the accuracy of subsequent responses among switch trials. ConclusionsOur multimodal analysis uncovered two temporally and functionally distinct network dynamics supporting task switching. High-gamma augmentation in the visual-precuneus pathway may reflect the neural process facilitating an attentional shift to a given updated task rule. High-gamma activity in the visual-dorsolateral prefrontal pathway, rapidly reduced through practice, may reflect the cost of executing appropriate stimulus-response translation.

Does cognitive inflexibility predict violent extremist behaviour intentions? A registered direct replication report of Zmigrod et al., 2019

AbstractPurposeZmigrod et al. (2019a, Frontiers in Psychology, 10, 989) demonstrated that lower levels of cognitive flexibility predict a higher willingness to fight and die for the national in‐group. We conducted a registered direct replication of their Study 1. Extending the original study, we examined whether the documented relationship held when a self‐report measure for cognitive flexibility was introduced and when identity fusion was controlled for. We also investigated whether cognitive inflexibility predicts normative pro‐group behaviour intentions.MethodsParticipants (N = 1378) reported in a cross‐sectional survey study their willingness to fight, die and sacrifice themselves for the in‐group and completed the Remote Associates (RAT) as and Wisconsin Card Sorting (WCST) tests. Afterwards, self‐reported cognitive flexibility, identity fusion and normative pro‐group behaviour intentions were assessed.ResultsResults showed a small negative relationship between RAT accuracy rates and willingness to fight and die. WCST accuracy rates were positively related with willingness to die but not correlated with willingness to fight. Self‐report measures of cognitive flexibility were partially positively and partially negatively associated with support for violent extremism. There was further evidence that lower cognitive flexibility predicts higher normative pro‐group behaviour intentions. A mini meta‐analysis, which synthesized findings from the original study and our replication, demonstrated a relatively small negative correlation between cognitive flexibility and support for violent extremism.ConclusionsIn summary, even though not all individual results could be replicated, we confirmed the overall conclusion of the original study: lower cognitive flexibility predicted stronger willingness to fight and die for an in‐group. The findings highlight that it is important to integrate cognitive style in multi‐level frameworks of risk factors of violent extremism. Additionally, our results point out that the validity of different measures of cognitive flexibility, including self‐report tools, must be further examined. Future research that evaluates cognitive flexibility training in the context of CVE/PVE interventions is also encouraged.

The Effect of Cognitive Flexibility Training on Reduction of Cognitive Problems in Adolescents with Intellectual Disabilities

Background Children and adolescents with intellectual disabilities are the most challenging groups of individuals among exceptional people. In this regard, the main responsibility lies with the parents, tutors, psychologists, and nurses. The present study aimed to evaluate the effect of cognitive flexibility training on reducing cognitive problems in adolescents with intellectual disabilities.Methods The present quasi-experimental study used a pretest-posttest design with a control group. The participants included 40 female students aged 13-18 years who attended special schools in the city of Shiraz, Iran. Data were collected using the Wisconsin Card Scoring Test (WCST) and the Test for Severe Impairment (TSI). The data were analyzed through SPSS software (version 18.0), using descriptive statistics and inferential statistics of covariance analysis.Results After moderating the pretest scores, cognitive flexibility training showed to have a significant effect (P 0.05) on reduction of impairment in abstract conceptualization.Conclusion It was revealed that 13-18-year-old adolescents with intellectual disabilities who attended a total of 15 training sessions had fewer cognitive problems such as motor function, language comprehension, language processing, memory, and general knowledge.

Spontaneous Eye Blinks Predict Executive Functioning in Seniors

As the world’s population is aging rapidly, cognitive training is an extensively used approach to attempt improvement of age-related cognitive functioning. With increasing numbers of older adults required to remain in the workforce, it is important to be able to reliably predict future functional decline, as well as the individual advantages of cognitive training. Given the correlation between age-related decline and striatal dopaminergic function, we investigated whether eye blink rate (EBR), a non-invasive, indirect indicator of dopaminergic activity, could predict executive functioning (response inhibition, switching and working memory updating) as well as trainability of executive functioning in older adults. EBR was collected before and after a cognitive flexibility training, cognitive training without flexibility, or a mock training. EBR predicted working memory updating performance on two measures of updating, as well as trainability of working memory updating, whereas performance and trainability in inhibition and switching tasks could not be predicted by EBR. Our findings tentatively indicate that EBR permits prediction of working memory performance in older adults. To fully interpret the relationship with executive functioning, we suggest future research should assess both EBR and dopamine receptor availability among seniors.

Brain Dynamics Underlying Cognitive Flexibility Across the Lifespan.

The neural mechanisms contributing to flexible cognition and behavior and how they change with development and aging are incompletely understood. The current study explored intrinsic brain dynamics across the lifespan using resting-state fMRI data (n = 601, 6-85years) and examined the interactions between age and brain dynamics among three neurocognitive networks (midcingulo-insular network, M-CIN; medial frontoparietal network, M-FPN; and lateral frontoparietal network, L-FPN) in relation to behavioral measures of cognitive flexibility. Hierarchical multiple regression analysis revealed brain dynamics among a brain state characterized by co-activation of the L-FPN and M-FPN, and brain state transitions, moderated the relationship between quadratic effects of age and cognitive flexibility as measured by scores on the Delis-Kaplan Executive Function System (D-KEFS) test. Furthermore, simple slope analyses of significant interactions revealed children and older adults were more likely to exhibit brain dynamic patterns associated with poorer cognitive flexibility compared with younger adults. Our findings link changes in cognitive flexibility observed with age with the underlying brain dynamics supporting these changes. Preventative and intervention measures should prioritize targeting these networks with cognitive flexibility training to promote optimal outcomes across the lifespan.

The Effectiveness of Cognitive Flexibility Training Program on Cognitive Functions and Activities of Daily Living in Patients with Ischemic Stroke

Objective: To evaluate the effectiveness of a cognitive flexibility training program on cognitive functions and activities of daily living (ADLs) in patients with ischemic stroke. Methods: A single blind randomized controlled trial study was conducted in a stroke unit of a tertiary hospital in a Bangkok setting. The sample size was 80 participants of both genders, aged 18 – 80 years. The sample size was stratified by age. Randomization was generated by a computer program dividing 40 participants into the experiment and 40 into the control group. Eleven participants dropped out during data collection. Therefore, 34 participants in the experimental group received cognitive flexibility training four days a week for 30-40 minutes per day over a period of 4 weeks in addition to usual care. There were 35 participants in the control group who received diary recording and usual care. The study used various instruments for data collection, including a Thai version of the Montreal Cognitive Assessment and Barthel’s Index of Activities of Daily Living. Data were analyzed by multivariate analysis of covariance (MANCOVA). Results: The experiment group had higher cognitive functions and abilities in performing activities of daily living than the control group with statistical significance (p < .05). Conclusion: The study suggested that the program can be used to increase both cognitive functions and activities of daily living. Nurses and healthcare staff should apply this program in patients with acute ischemic stroke for nervous system recovery.

Cognitive flexibility and strategy training allow young children to overcome transfer-Utilization Deficiencies

Despite children’s successful transfer of memory strategies to new, similar tasks, strategy effectiveness often decreases at transfer, resulting in lower recall than on the original task (transfer-Utilization Deficiency, t-UD). Two experiments showed t-UDs in two different tasks and three strategies. Moreover, executive function was related to t-UDs. Experiments 1 (N = 68) and 2 (N = 72) showed that cognitive flexibility predicted recall at transfer with a rehearsal strategy and two organization strategies--sorting at encoding and clustering at recall. Furthermore, explicit memory-strategy training prevented the emergence of t-UDs in Experiment 1 and, somewhat, in Experiment 2. Thus, t-UDs emerge across various tasks and strategies, and are decreased by cognitive flexibility and strategy training. These results contribute to our understanding of the development of transfer and of strategy development.

Cognitive flexibility training has direct and near transfer effects, but no far transfer effects, in preschoolers

The current project studied the direct, near transfer, and far transfer effects of cognitive flexibility training in two experiments with 117 3-year-olds. In both Experiments 1 and 2, children performed three Dimensional Change Card Sorting (DCCS) tasks in a pre-training/training/post-training design. The training consisted of giving corrective feedback in the training DCCS task. In Experiment 2, in addition, three other executive control tasks were administered during pre-training and post-training. Results showed a direct effect of feedback in the training DCCS task and transfer of this effect to the post-training DCCS task after 1 week with different sorting rules and different stimuli. These findings show that preschoolers learned to switch sorting rules in the context of the DCCS task, independent of the specific sorting rules, and that this effect is not transient. No support was found for transfer to the other executive control tasks. A possible explanation is that the feedback mainly improved rule switching, an ability that is specifically required for performing a cognitive flexibility task but not the other executive control tasks.

Insights from a deradicalization program in Indonesian prisons: The potential benefits of psychological intervention prior to ideological discussion

Discussions that are based on religious understanding and aimed at reducing terrorists' hostility have been used as a central part of terrorist deradicalization programs in many countries where acts of Islamic terrorism are prevalent. Currently, various psychological approaches such as presenting social support and providing counseling sessions are being applied alongside religious discussions. Observers of these programs have reported benefits and positive responses to the psychological approaches, but there is still a lack of empirical evidence confirming this. In the current study, we examine the effects of two psychological interventions—emotional expression training and cognitive flexibility training—in predicting detainees’ acceptance of the idea of democratic life. We investigated the observational records taken during the psychological interventions and religious discussions. Results showed no main effect of emotional expression and cognitive flexibility in predicting one’s acceptance of democratic civil life, but there was a significant interaction between the two predictors. Among those who scored high in cognitive flexibility, detainees who scored also high in emotional expression were significantly more agreeable towards the state’s sovereignty over belief in an Islamic caliphate during religious discussions. Our findings suggest that psychological interventions do indeed offer benefits for detainees’ deradicalization programs.

Cognitive Flexibility Training Improves Extinction Retention Memory and Enhances Cortical Dopamine With and Without Traumatic Stress Exposure.

Stress exposure can cause lasting changes in cognition, but certain individual traits, such as cognitive flexibility, have been shown to reduce the degree, duration, or severity of cognitive changes following stress. Both stress and cognitive flexibility training affect decision making by modulating monoamine signaling. Here, we test the role cognitive flexibility training, and high vs. low cognitive flexibility at the individual level, in attenuating stress-induced changes in memory and monoamine levels using the single prolonged stress (SPS) rodent model of traumatic stress in male Sprague-Dawley rats. Exposure to SPS can heighten fear responses to conditioned cues (i.e., freezing) after a fear association has been extinguished, referred to as a deficit in extinction retention. This deficit is thought to reflect an impairment in context processing that is characteristic of posttraumatic stress disorder (PTSD). During a cognitive flexibility training we assessed individual variability in cognitive skills and conditioned rats to discriminately use cues in their environment. We found that cognitive flexibility training, alone or followed by SPS exposure, accelerated extinction learning and decreased fear responses over time during extinction retention testing, compared with rats not given cognitive flexibility training. These findings suggest that cognitive flexibility training may improve context processing in individuals with and without traumatic stress exposure. Individual performance during the reversal phase of the cognitive flexibility training predicted subsequent context processing; individuals with high reversal performance exhibited a faster decrease in freezing responses during extinction retention testing. Thus, high reversal performance predicted enhanced retention of extinction learning over time and suggests that cognitive flexibility training may be a strategy to promote context processing. In a brain region vital for maintaining cognitive flexibility and fear suppression, the prelimbic cortex (PLC), cognitive flexibility training also lastingly enhanced dopamine (DA) and norepinephrine (NE) levels, in animals with and without traumatic stress exposure. In contrast, cognitive flexibility training prior to traumatic stress exposure decreased levels of DA and its metabolites in the striatum, a region mediating reflexive decision making. Overall, our results suggest that cognitive flexibility training can provide lasting benefits by enhancing extinction retention, a hallmark cognitive effect of trauma, and prelimbic DA, which can maintain flexibility across changing contexts.

Does cognitive flexibility training enhance subjective mental functioning in healthy older adults?

ABSTRACTDeclining cognitive abilities in older adults can contribute to significant changes in socioemotional health and substantially reduce their perception of well-being. Whereas much attention has been dedicated to creating cognitive training programs to improve cognitive health in old age, there is little emphasis on the consequences of such interventions for subjective mental functioning. We created a randomized controlled trial in which we evaluated the effects of an adaptive computerized cognitive flexibility training. Healthy older adults (60–80 years old) were assigned to one of three conditions (frequent or infrequent switching or active control group) and performed 58 half-hour sessions within a period of 12 weeks. We measured effects on subjective cognitive failures and executive dysfunctioning, everyday functioning, depressive symptoms, anxiety, and quality of life, before, and after training. Additionally, participants’ proxies rated their cognitive failures and executive dysfunctioning. Subjective cognitive failures and executive dysfunctioning improved 4 weeks posttraining in all groups, although effect sizes were low (ɳp2 = .058 and .079, respectively) and there were no differences between groups (all p’s > .38). No significant changes in subjective reports were seen directly after training, which was the case in all groups. Proxies did not report any functional changes over time, yet their evaluations were significantly more favorable than those of the participants, both pretraining (p < .0005) and posttraining (p = .004). Although we found no evidence of improvement on subjective mental functioning, we adduce several factors that encourage further research into the effects of computerized cognitive training on subjective performance.

Cognitive flexibility training in three-year-old children

The Dimensional Change Card-Sorting task (DCCS) is frequently used to assess preschool-children’s executive abilities. Children are asked to sort bidimensional cards (a blue boat) first according to one dimension (color) and then according to the other (shape). Redescription theory argues that 3-year-olds’ failure in the DCCS is linked to their difficulties in flexibly describing an object on two perceptual dimensions successively when they are integrated within the same object. 103 3-year-old children were tested with the DCCS and 53 were placed in a redescription-training group with two versions of the DCCS. Two separated unidimensional objects on the same card were used for the spatially distinct DCCS. In the interlaced DCCS, color and shape could be separated or superimposed within a single object. Results showed an improvement in DCCS performance after training, particularly when using the interlaced DCCS, underlying the role of redescription in the development of cognitive flexibility.

The influence of computer-based cognitive flexibility training on subjective cognitive well-being after stroke: A multi-center randomized controlled trial.

BackgroundStroke can result in cognitive complaints that can have a large impact on quality of life long after its occurrence. A number of computer-based training programs have been developed with the aim to improve cognitive functioning. Most studies investigating their efficacy used only objective outcome measures, whereas a reduction of subjective cognitive complaints may be equally important for improving quality of life. A few studies used subjective outcome measures but were inconclusive, partly due to methodological shortcomings such as lack of proper active and passive control groups.ObjectiveThe aim of the current study was to investigate whether computer-based cognitive flexibility training can improve subjective cognitive functioning and quality of life after stroke.MethodsWe performed a randomized controlled double blind trial (RCT). Adults (30–80 years old) who had a stroke 3 months to 5 years ago, were randomly assigned to either an intervention group (n = 38), an active control group (i.e., mock training; n = 35), or a waiting list control group (n = 24). The intervention and mock training consisted of 58 half-hour sessions within 12 weeks. The primary subjective outcome measures were cognitive functioning (Cognitive Failure Questionnaire), executive functioning (Dysexecutive Functioning Questionnaire), quality of life (Short Form Health Survey), instrumental activities of daily living (IADL; Lawton & Brody IADL scale), and participation in society (Utrecht Scale for Evaluation of Rehabilitation-Participation). Secondary subjective outcome measures were recovery after stroke, depressive symptoms (Hospital Anxiety Depression Scale—depression subscale), fatigue (Checklist Individual Strength—Fatigue subscale), and subjective cognitive improvement (exit list). Finally, a proxy of the participant rated the training effects in subjective cognitive functioning, subjective executive functioning, and IADL.Results and conclusionsAll groups improved on the two measures of subjective cognitive functioning and subjective executive functioning, but not on the other measures. These cognitive and executive improvements remained stable 4 weeks after training completion. However, the intervention group did not improve more than the two control groups. This suggests that improvement was due to training-unspecific effects. The proxies did not report any improvements. We, therefore, conclude that the computer-based cognitive flexibility training did not improve subjective cognitive functioning or quality of life after stroke.

Cognitive Flexibility Training: A Large-Scale Multimodal Adaptive Active-Control Intervention Study in Healthy Older Adults.

As aging is associated with cognitive decline, particularly in the executive functions, it is essential to effectively improve cognition in older adults. Online cognitive training is currently a popular, though controversial method. Although some changes seem possible in older adults through training, far transfer, and longitudinal maintenance are rarely seen. Based on previous literature we created a unique, state-of-the-art intervention study by incorporating frequent sessions and flexible, novel, adaptive training tasks, along with an active control group. We created a program called TAPASS (Training Project Amsterdam Seniors and Stroke), a randomized controlled trial. Healthy older adults (60–80 y.o.) were assigned to a frequent- (FS) or infrequent switching (IS) experimental condition or to the active control group and performed 58 half-hour sessions over the course of 12 weeks. Effects on executive functioning, processing- and psychomotor speed, planning, verbal long term memory, verbal fluency, and reasoning were measured on four time points before, during and after the training. Additionally, we examined the explorative question which individual aspects added to training benefit. Besides improvements on the training, we found significant time effects on multiple transfer tasks in all three groups that likely reflected retest effects. No training-specific improvements were detected, and we did not find evidence of additional benefits of individual characteristics. Judging from these results, the therapeutic value of using commercially available training games to train the aging brain is modest, though any apparent effects should be ascribed more to expectancy and motivation than to the elements in our training protocol. Our results emphasize the importance of using parallel tests as outcome measures for transfer and including both active and passive control conditions. Further investigation into different training methods is advised, including stimulating social interaction and the use of more variable, novel, group-based yet individual-adjusted exercises.

Cognitive flexibility training intervention among children with autism: a longitudinal study

Autism is defined by persistent deficits in social communication and social interaction in multiple contexts as well as restricted and repetitive patterns of behavior. There are also reported difficulties in the dynamic activation and modification of cognitive processes in response to changes in tasks’ demands. Such difficulties are believed to be due to poor flexible cognition. This research aimed to assess and intervene in cognitive flexibility in subjects with autism.Ten subjects diagnosed with autism by psychiatrists, aged 5 years to 13 years and 5 months, were assessed in non-verbal intelligence through Raven’s Progressive Matrices in pretest. They were also assessed in cognitive flexibility through Wisconsin Card Sorting Test (WCST) and in patterns of social interactions, behaviors, and communication through Autism Diagnostic Interview-Revised (ADI-R). An intervention program of 14 to 21 sessions was established to enhance cognitive flexibility. In posttest, they were assessed in WCST and ADI-R.All measures of cognitive flexibility improved in posttest except for failure to maintain set. Among the measures improved in posttest, perseverative errors and responses improved in posttest with statistical significance as well as categories completed. Total scores on ADI-R were lower in posttest as well as scores on communication abilities.The qualitative improvement showed by the individuals of this research concerning cognitive flexibility and also patterns of restricted behavior, social interaction, and communication abilities suggests that individuals with autism can benefit from the development of strategies for the enhancement of cognitive flexibility. Nevertheless, more research is suggested with a larger sample among subjects on the autism spectrum.