Cognitive Training Approaches Research Articles

Antonym and Oppositeness: A Cognitive Training Approach of Thinking in English Writing in the AI Era

Antonym and Oppositeness: A Cognitive Training Approach of Thinking in English Writing in the AI Era

Prenatal affective cognitive training to reduce the risk of postpartum depression (PACT): study protocol for a randomized controlled trial

BackgroundPostpartum depression (PPD) affects 30–50% of women with a history of previous depression or bipolar disorder and 8% of women with no history of depression. Negative cognitive biases in the perception of infant cues and difficulties with emotion regulation are replicated risk factors. Current interventions focus on detecting and treating rather than preventing PPD. The aim of this randomized controlled intervention trial is therefore to investigate the potential prophylactic effects of prenatal affective cognitive training for pregnant women at heightened risk of PPD.MethodsThe study will enrol a total of 292 pregnant women: 146 at high risk and 146 at low risk of PPD. Participants undergo comprehensive assessments of affective cognitive processing, clinical depressive symptoms, and complete questionnaires at baseline. Based on the responses, pregnant women will be categorized as either at high or low risk of PPD. High-risk participants will be randomized to either prenatal affective cognitive training (PACT) or care as usual (CAU) immediately after the baseline testing. The PACT intervention is based on emerging evidence for efficacy of affective cognitive training approaches in depression, including cognitive bias modification, attention bias modification, mindfulness-inspired emotion regulation exercises, and working memory training. Participants randomised to PACT will complete five individual computerised and virtual reality-based training sessions over 5 weeks. The primary outcome is the difference between intervention arms in the incidence of PPD, assessed with an interview 6 months after birth. We will also assess the severity of depressive symptoms, rated weekly online during the first 6 weeks postpartum.DiscussionThe results will have implications for future early prophylactic interventions for pregnant women at heightened risk of PPD. If the PACT intervention reduces the incidence of PPD, it can become a feasible, non-invasive prophylactic strategy during pregnancy, with positive mental health implications for these women and their children.Trial registrationClinicalTrials.gov NCT06046456 registered 21-09-2023, updated 08-07-2024.

A TWO-YEAR RCT EXAMINING SPEED OF PROCESSING TRAINING ON EVERYDAY FUNCTIONING IN ADULTS WITH HAND IN THE US DEEP SOUTH

Abstract Approximately 44% of people living with HIV (PLWH) experience HIV-associated neurocognitive disorders (HAND). Cognitive training approaches, such as speed of processing (SOP) training, may reduce the detrimental impact of HAND on everyday functioning. In this experimental design study, 216 participants 40 and older with HAND or borderline HAND (82% Black) were randomized to one of three groups: 1) 10 hours of SOP training (n=70); 2) 20 hours of SOP training (n=73), or 3) 10 hours of Internet Navigation Control Training (a contact control group; n=73). Participants completed several everyday functioning measures at baseline, posttest, and year 1 and year 2 follow ups. Everyday functioning measures included: 1) Modified Lawton and Brody Activities of Daily Living (ADL) Questionnaire; 2) Timed Instrumental Activities of Daily Living (TIADL) Test; 3) Patient’s Assessment of Own Functioning (PAOFI); 4) Medication Adherence Questionnaire (MAQ); and 5) Medication Adherence Visual Analog Scale (VAS). Linear mixed-effect models and generalized estimating equation models were fitted to estimate between group differences at all follow-up time points. At follow-up timepoints, those in the 10-hour and 20-hour training groups performed better on medication adherence measures (MAQ and VAS) than those in the control group, with effects (Cohen’s d) ranging from 0.13 to 0.41 for MAQ and 0.02 to 0.43 for VAS. In conclusion, SOP training improved some indicators of everyday functioning, specifically medication adherence; however, the therapeutic effects diminished over time. This is an interesting finding given the importance of medication adherence in viral suppression and overall survival in PLWH.

Harnessing neuroplasticity

Twenty years ago, cognitive impairments were recognized as an unmet treatment need in schizophrenia. Basic science discoveries in neuroplasticity had led to cognitive training approaches for dyslexia. We wondered whether a similar approach could target working memory deficits in schizophrenia by harnessing plasticity in the auditory cortex.Our per protocol experimental therapeutics studies tested the hypothesis that sharpening auditory cortical representations would result in better verbal learning and memory. We also later studied the effects of intensive training of basic social cognitive operations. Our training protocols were deliberately focused, effortful and intensive, since participants were often up against decades of cortical dysplasticity.In studies in different stages of illness, we demonstrated that neuroscience-informed cognitive training was associated with: (1) proximal psychophysical as well as distal cognitive improvements; (2) increases in serum BDNF levels; (3) negative effects of serum anticholinergic burden; (4) electrophysiologic responses and brain activation patterns consistent with restorative neuroplastic changes in cortex; (5) positive cortical and thalamic volumetric changes suggestive of neuroprotection; (6) better 6-month clinical functioning in those with a positive initial response.Taken together, this work indicates how much the field of psychiatry could benefit from a deep understanding of the basic science of cortical neuroplasticity processes and of how they can be deliberately and efficiently harnessed for therapeutic purposes.

Adding executive function training to cognitive behavioral therapy for binge eating disorder: A pilot randomized controlled trial

Evidence-based treatments for binge eating disorder (BED), such as cognitive behavioral therapy (CBT) lead to successful outcomes only about half the time. Individuals with BED often have measurable deficits in executive function (EF) that may challenge adherence to or impact of cognitive behavioral intervention components. The aim of this study was to evaluate the impact of adding EF training to CBT by combining CBT with a compensatory cognitive training approach (EF-CBT). Participants were 32 adults with BED, overweight/obesity, and comorbid anxiety or depression who were randomly assigned to four months of group treatment in either standard CBT or EF-CBT. Outcomes were assessed at baseline, post-treatment, and at 2-month follow-up. Results showed that EF-CBT was feasible and acceptable, comparable to CBT. Both groups significantly decreased loss of control (LOC) days, clinical impairment, and depression at post-treatment and 2-month follow-up; though there were no differences between groups. Neither group significantly reduced anxiety or weight. Exploratory analyses found that participants with lower EF treated with EF-CBT were less likely to have LOC at post-treatment than those with lower EF treated with CBT. Higher self-monitoring rates during treatment were associated with lower LOC at post-treatment and participants with lower EF were more likely to self-monitor in the EF-CBT arm relative to the CBT arm. These findings suggest that EF-CBT is feasible, acceptable and efficacious, although larger scale research is needed. EF-CBT may be particularly suited for individuals with BED who have lower EF.

Two-year clinical trial examining the effects of speed of processing training on everyday functioning in adults with human immunodeficiency virus-associated neurocognitive disorder (HAND) and borderline HAND in the U.S. Deep South: Findings of the Think Fast Study

Many people living with human immunodeficiency virus (HIV) (PLWH) experience cognitive decline that impairs everyday functioning. Cognitive training approaches, such as speed of processing (SOP) training, may reduce the impact of HIV-Associated Neurocognitive Disorder (HAND) on everyday functioning. In this experimental design study called the Think Fast Study, 216 participants age 40 and older with HAND or borderline HAND were randomized to one of three groups: (1) 10 h of SOP training (n = 70); (2) 20 h of SOP training (n = 73); or (3) 10 h of Internet Navigation Control Training (a contact control group; n = 73). Participants completed several everyday functioning measures at baseline, posttest, and year 1 and year 2 follow ups, which included: (a) Modified Lawton and Brody Activities of Daily Living (ADL) Questionnaire; (b) Timed Instrumental Activities of Daily Living (TIADL) Test; (c) Patient’s Assessment of Own Functioning (PAOFI); (d) Medication Adherence Questionnaire (MAQ); and (e) Medication Adherence Visual Analog Scale (VAS). Linear mixed-effect models and generalized estimating equation models were fitted to estimate between group differences at all follow-up time points. At follow-up timepoints, those in the 10-h and 20-h training groups had better scores on medication adherence measures (MAQ and VAS) than those in the control group, with effects (Cohen’s d) ranging 0.13–0.41 for MAQ and 0.02–0.43 for VAS. In conclusion, SOP training improved some indicators of everyday functioning, specifically medication adherence; however, the therapeutic effects diminished over time. Implications for practice and research are posited.

Applications of EEG-Based Brain-Computer Interface Devices in Rehabilitation

BCI techniques narrow the gap between the human brain and external devices. Previous investigation using Brain-Machine Interfaces to control devices such as wheelchairs has shown that the technology could be effective in limb rehabilitation. There has been limited research on using BCI in performing a grasp and reach task using a prosthetic arm. The authors of this paper thus sought to determine how possible and effective the procedure can be performed considering the multiple degrees of freedom of the human arm. Moreover, stroke is among the leading causes of death globally. Stroke events, in most cases, leave the patient with severe brain damage that usually includes impaired motor functions. BCI-based techniques have shown the capacity to restore the motor functions of patients. However, there is a need for the BCI methods to be coupled with cognitive training approaches to improve other bodily functions of stroke patients. Also, since the first electroencephalography (EEG) and electromyography (EMG) were implemented in the 1920s, their clinical applications, theories, and testing techniques have improved tremendously. Generally, brain imaging techniques have evolved rapidly since the 1920s. This paper explores the applications of EEG-based Brain-Computer Interfaces in medical rehabilitation.

From “prepare for the unknown” to “train for what's coming”: A digital twin-driven and cognitive training approach for the workforce of the future in smart factories

Despite on-the-job assistance technology is getting popular in the Smart Operator 4.0 literature, non-routine work also requires highly-skilled and pre-trained workers to prevent serious errors and keep high efficiency and safety levels. The question that motivates this study is: ‘is it possible to train industrial workers for what exactly is coming instead of preparing them for a large set of scenarios - even very unlikely ones?’. This work proposes: (i) a structured On-the-Job Training strategy for non-routine tasks, called ‘training-on-the-go’ or ‘prescriptive training’, according to which a Prescriptive Analytics module schedules the training sessions not long before the actual performance, but only when and if needed; (ii) a proof-of-concept of a game-based training system where virtual scenes and context of an industrial site are faithfully recreated thanks to digital twin data and models; (iii) the use of evolutionary-based fuzzy cognitive maps (E-FCM) for the extraction of the workers’ implicit procedural knowledge and for the comparison of mental models of experienced vs. inexperienced workers to assess potential misconceptions or flaws in their decision-making process. This work contributes to the evolution of worker training paradigms and systems from the perspective of human-centric cyber-physical production systems and aims for current gaps in workforce training, i.e. poor timeliness and effectiveness, limited context and industrial information integration, and scarce focus on the experts’ implicit knowledge. An application study with a non-routine task on an offshore oil platform demonstrates how the proposed system facilitates knowledge transfer, offers situational awareness and sustains the workforce competence development process.

Lisbon Intensive Falls Trampoline Training (LIFTT) Program for people with Parkinson’s for balance, gait, and falls: study protocol for a randomized controlled trial

BackgroundFalling and gait difficulties in people with Parkinson’s disease (PD) are associated with impaired reactive postural adjustments and impairments in attentional resources. Combined intensive balance motor and cognitive exercise can be beneficial. However, uncertainties persist regarding the true effects and safety when applying such training. Using trampoline beds may be a favorable safe environment for a highly intensive, cognitive, and balancing training approach. The primary goal of this randomized controlled trial is to assess the effects of an intensive cognitive-motor training program in a safe trampoline environment in addition to usual care on balance impairment, gait, physical capacity, fear of falling, falls frequency and severity, cognition, and clinical impairments in people with mild or moderate PD.MethodsSixty participants diagnosed with idiopathic PD, in stage 2–4 Hoehn and Yahr, with a clinical history of gait deficits and a fall history (at least one fall in the last 6 months) will be recruited and randomly allocated to an intervention group receiving cognitive-motor trampoline training or a control group undergoing their usual care. The intervention will consist of 8-week individual training sessions (1-h training, 3 days per week) led by specialized physiotherapists that will provide progressive, challenging training, and guarantee safety. Assessment will be conducted prior to and immediately after the 8-week intervention and at 3 months follow-up after participating in the study. Primary outcome measures will be balance performance (assessed using the Mini-BEST Test and nonlinear analysis) and change in gait parameters (Motor and Cognitive Timed-Up-Go and nonlinear analysis). Secondary outcomes will be change in clinical improvement (Movement Disorder Society Unified Parkinson’s Disease Rating Scale), falls (falls weekly registry), fear of falling (assessed using the Falls Efficacy Scale), physical capacity (6-min walk test), and cognition (Montreal Cognitive Assessment).DiscussionThis study will provide new evidence on the benefits of intensive cognitive-motor balance training on a trampoline for people living with PD. Better guidance on how professionals can apply safer dual-task balance and gait training in rehabilitation is needed.Trial registrationISRCTN Registry ISRCTN13160409. Retrospectively registered on February 23, 2022

Evidence-based interventions for people with mild cognitive impairment (MCI): Where are we now?

As increasing attention is focused on the experiences of people living with mild cognitive impairment (MCI), this paper reviews where we stand regarding evidence-based interventions. From simpler offers of information, psychoeducation, and ‘living well’ programmes, to more structured approaches that include cognitive stimulation, rehabilitation, and training, mindfulness, and mind-body exercise. Amongst studies of varying quality, there are notable trends emerging: evidence supports cognitive stimulation and combined mind-body programmes to improve neurocognitive function, yet there is still no clear picture regarding the efficacy of rehabilitation, cognitive training, or mindfulness-based approaches. Increasingly, it is multi-component interventions that are currently associated with more positive outcomes for cognitive health and wellbeing. However, it remains challenging to know what will work for whom when implementing these interventions in clinical practice.

Effects of Cognitively Stimulating Activities on the Cognitive Functioning of Older People with Mild Cognitive Impairment: A Meta-Analysis

Background. The number of individuals with mild cognitive impairment (MCI), or those people without dementia who are experiencing age-related cognitive decline, has increased in recent years. Conveniently, several interventions to delay cognitive decline exist, where cognitively stimulating activities (CSA) have been receiving too much attention. However, its beneficial effects have not been well established among older people with MCI due to conflicting findings.Objectives. This study aimed to assess and summarize the available evidence on the effects of CSA on the overall cognitive functioning of older people with MCI. Specifically, it sought to answer the PICO question, “In older people with MCI, does engagement in cognitively stimulating activities improve cognitive function?”Methods. A systematic review and meta-analysis of randomized controlled trials examining the effects of CSA onolder people with MCI were conducted. Three studies met the inclusion criteria from the 1,328 records from BioMed Central, CINAHL, Cochrane Library, Health Source: Nursing/Academic Edition, MEDLINE, and PubMed databases and 156 articles from WorldCat, DSpace Saint Louis University, and Google Scholar databases and catalogs. Effect size values were inspected using the random-effects model. Data were summarized as standardized mean difference (SMD) with corresponding 95% confidence intervals in the forest plot.Results. This meta-analysis which compared studies that employed similar methodologies, found that CSA has asignificant, large effect in improving cognitive functioning among older people with MCI, evidenced by an SMDof 0.798 (95% CI = 0.510-1.085, p = 0.001). While its superiority over other interventions that improve cognitivefunction was not observed in this study, it was still found that using CSA was helpful in terms of its cost-effectiveness. Also, heterogeneity across studies was non-significant (Cochran’s Q = 0.151, df = 2, p = 0.927, I2 = 0.00%). These results mean that clinical heterogeneity was absent even though a diverse range of CSA was employed. Additionally, methodological diversity was not present since there were no variations in the study design and minimal variability in the risk of bias assessment.Conclusion. Overall, it is acknowledged that CSA are effective and practical, inexpensive, non-pharmacologic cognitive training approaches to delay cognitive decline among older people with MCI. However, interpreting this study’s significant, large effect, and non-significant heterogeneity warrants caution. &nbsp

Cognitive Remediation and Social Recovery in Early Psychosis (CReSt-R): protocol for a pilot randomised controlled study

BackgroundPsychosis, even in its early stages, is associated with significant disability, causing it to be ranked ahead of paraplegia and blindness in those aged 18–35 in terms of years lived with disability. Current pharmacological and psychological interventions intervention have focused primarily on the reduction of positive symptoms (hallucinations and delusions), with little benefit to domains of psychosis such as cognitive difficulties and social and occupational functioning.Methods/designThe CReSt-R intervention trial is a single center, pilot randomised controlled study based at the National University of Ireland (NUI), Galway. The trial will recruit participants from four clinical sites with assessment and intervention completed by the primary NUI Galway team. The trial will explore the feasibility, acceptability, and effectiveness of a novel psychosocial intervention for early psychosis based on a combined cognitive remediation training and cognitive behavioural therapy approach focused on social recovery. Participants, aged 16–35 within the first 5 years of a diagnosed psychotic disorder, will be recruited from the Children and Adolescent Mental Health Service and the Adult Mental Health Services in the region.DiscussionCognitive remediation training (for improving cognition) and social recovery focused cognitive behavioural therapy, have both separately demonstrated effectiveness. This trial will evaluate the feasibility, acceptability, and explore the efficacy of a treatment approach that combines both approaches as part of an integrated, multicomponent intervention.Trial registrationCognitive Remediation & Social Recovery in Early Psychosis (CReSt-R): ClincialTrials.gov Identifier NCT04273685. Trial registered Feb 18th, 2020. Last updated April 14th, 2021.

A Feasibility Study of Two Cognitive Training Programs for Urban Community-Dwelling Older Adults

Cognitive training approaches are promising to manage the effects of normal cognitive decline for the aging adult, especially with the development and integration of computerized cognitive training. Supportive community models for older adults, such as senior centers, may provide engagement opportunities for occupation-based cognitive training programming. Fourteen older adults (n = 13 Black) from an urban older adult community center participated. This feasibility trial used a two-group, pretest-posttest design to examine differences between an occupation-based computerized cognitive training (CCT) program (n = 7) and a traditional cognitive training (TCT) program (n = 7), as assessed by participants’ perceptions of the perceived benefits, tolerance of time of sessions, and on executive functioning measures. There were no significant differences in the tolerance of time of sessions (p = 0.81) between CCT (average session time = 43.64 min) and TCT (average session time = 44.27 min). Additionally, there were no significant differences in how the two program groups perceived the training based on helpfulness (p = 1.00), positive opinions (p = 0.46), and executive functioning measurement changes. All participants reported “enjoyment” of the training. Including occupation-based CCT and TCT programming is feasible and positive within community-based programming focusing on a diverse population. Short-term improvements in executive functioning should not be expected but are worthy of longer-term observation, considering a socialization component, telehealth integrations, and expansion of supportive technology-based models.

Developing the Rationale for Including Virtual Reality in Cognitive Rehabilitation and Exercise Training Approaches for Managing Cognitive Dysfunction in MS

Cognitive impairment is a common and detrimental consequence of multiple sclerosis (MS) and current rehabilitation methods are insufficient. Cognitive rehabilitation (CR) and exercise training (ET) are the most promising behavioral approaches to mitigate cognitive deficits, but effects are small and do not effectively translate to improvements in everyday function. This article presents a conceptual framework supporting the use of virtual reality (VR) as an ideal, common adjuvant traditional CR and ET in MS. VR could strengthen the effects of CR and ET by increasing sensory input and promoting multisensory integration and processing during rehabilitation. For ET specifically, VR can also help incorporate components of CR into exercise sessions. In addition, VR can enhance the transfer of cognitive improvements to everyday functioning by providing a more ecologically valid training environment. There is a clear interest in adding VR to traditional rehabilitation techniques for neurological populations, a stronger body of evidence of this unique approach is needed in MS. Finally, to better understand how to best utilize VR in rehabilitation for cognitive deficits in MS, more systematic research is needed to better understand the mechanism(s) of action of VR with CR and ET.

Obsessive Doubting as a Philosophical-Psychopathological Phenomenon

Obsessive doubting (OD) is a rather forgotten and underestimated psychopathological phenomenon, although clinically it seems to exist in many patients with e. g. obsessive-compulsive disorder. The few primary psychoanalytic and cognitive-scientific studies in the literature concerning OD do not explain the phenomenon completely, nor do they offer treatment perspectives. Here, another way is proposed. Doubting whether one's perception of objects, other people and one's own self is correct, which is part of human nature, can reach pathological dimensions as in OD. Doubting is regarded as an existential problem of human beings, and is one of the major questions of philosophy from very early times, but is especially central to scepticism. If grounds against such doubting can be found, mental solution strategies within the framework of theoretical depth psychotherapy including cognitive training approaches can be established for treatment of patients with OD.

Ameliorating cognitive control in patients with binge eating disorder by electrical brain stimulation: study protocol of the randomized controlled ACCElect pilot trial

BackgroundThe current first-line treatment for binge eating disorder (BED), which is psychotherapy, is moderately effective in terms of abstinence from binge-eating. Neurobiological evidence suggests that people affected by BED show difficulties along the spectrum of impulsivity, including inhibitory control impairments and highlights the potential of novel treatment approaches directly targeting inhibitory control, including cognitive training approaches and non-invasive brain stimulation.MethodsACCElect is a prospective, randomized controlled pilot trial investigating a novel, food-related inhibitory control training combined with transcranial direct current stimulation (tDCS). 40 patients with BED will be randomly assigned to receive the training either combined with verum or with sham stimulation (control condition). The inhibitory control training is based on principles of the antisaccade paradigm and comprises six training sessions over two weeks. Core aims are the investigation of feasibility and clinically relevant effects of a tDCS-enhanced inhibitory control training in BED patients and the establishment of a data basis for a larger efficacy trial. The primary clinical endpoint is binge-eating (BE) frequency in terms of changes in BE episodes four weeks after treatment termination as compared to baseline. Key secondary outcomes comprise ED pathology and general psychopathology, inhibitory control capacities, quality of life as well as acceptability and satisfaction with the intervention.DiscussionThe results of the present trial will contribute to the development of novel neurobiologically informed treatment approaches for patients suffering from BED.Trial registration The ACCElect trial was prospectively registered on October 1, 2020, under the registration number NCT04572087 at ClinicalTrials.gov (https://clinicaltrials.gov/ct2/show/NCT04572087).

Can We "Brain-Train" Emotional Intelligence? A Narrative Review on the Features and Approaches Used in Ability EI Training Studies.

Recent studies had demonstrated that specific emotional intelligence (EI) abilities (as measured using the MSCEIT) were related to better performance on cognitive tasks that involved emotional information but not on their non-emotional counterparts. These findings suggest that cognitive control and other executive functioning processes (e.g., working memory) contribute to EI abilities. A well-functioning EI ability is crucial for a number of everyday activities and life outcomes. However, the evidence for training ability EI remains vague as to how these improvements occur. The purpose of this narrative review was to synthesize findings from past EI training research, specifically focusing on their methodology. This was to identify key aspects of the interventions used, to determine the prototypical features between them, as well as to propose a compelling research agenda for future EI training studies. Based on the features found in these studies, we identified two possible approaches in which EI improvements occurred. The first approach was through increasing emotional knowledge and related competencies through teaching and practice. These features were found in the majority of training interventions using a workshop-style training format, reflections, role-plays, and practice with other participants. The second approach used brain-training principles to improve basic cognitive processes, such as executive control or emotional inhibition. Using a cognitive training approach to EI training can provide several advantages, such as allowing researchers to examine EI improvements using the theories of (1) transfer; (2) plasticity; and (3) process-specific changes.

Tracking of Mental Workload with a Mobile EEG Sensor.

The aim of the present investigation was to assess if a mobile electroencephalography (EEG) setup can be used to track mental workload, which is an important aspect of learning performance and motivation and may thus represent a valuable source of information in the evaluation of cognitive training approaches. Twenty five healthy subjects performed a three-level N-back test using a fully mobile setup including tablet-based presentation of the task and EEG data collection with a self-mounted mobile EEG device at two assessment time points. A two-fold analysis approach was chosen including a standard analysis of variance and an artificial neural network to distinguish the levels of cognitive load. Our findings indicate that the setup is feasible for detecting changes in cognitive load, as reflected by alterations across lobes in different frequency bands. In particular, we observed a decrease of occipital alpha and an increase in frontal, parietal and occipital theta with increasing cognitive load. The most distinct levels of cognitive load could be discriminated by the integrated machine learning models with an accuracy of 86%.

Why Does Cognitive Training Yield Inconsistent Benefits? A Meta-Analysis of Individual Differences in Baseline Cognitive Abilities and Training Outcomes.

Despite growing interest in improving cognitive abilities across the lifespan through training, the benefits of cognitive training are inconsistent. One powerful contributor may be that individuals arrive at interventions with different baseline levels of the cognitive skill being trained. Some evidence suggests poor performers benefit the most from cognitive training, showing compensation for their weak abilities, while other evidence suggests that high performers benefit most, experiencing a magnification of their abilities. Whether training leads to compensation or magnification effects may depend upon the specific cognitive domain being trained (such as executive function or episodic memory) and the training approach implemented (strategy or process). To clarify the association between individual differences in baseline cognitive ability and training gains as well as potential moderators, we conducted a systematic meta-analysis of the correlation between these two variables. We found evidence of a significant meta-correlation demonstrating a compensatory effect, a negative association between initial ability on a trained cognitive process and training gains. Too few papers met our search criteria across the levels of proposed moderators of cognitive domain and training approach to conduct a reliable investigation of their influence over the meta-analytic effect size. We discuss the implications of a compensatory meta-correlation, potential reasons for the paucity of qualifying papers, and important future directions for better understanding how cognitive trainings work and for whom.

Virtual Reality Cognitive Training Among Individuals With Alcohol Use Disorder Undergoing Residential Treatment: Pilot Randomized Controlled Trial.

BackgroundAlcohol use disorder (AUD) has been associated with diverse physical and mental morbidities. Among the main consequences of chronic and excessive alcohol use are cognitive and executive deficits. Some of these deficits may be reversed in specific cognitive and executive domains with behavioral approaches consisting of cognitive training. The advent of computer-based interventions may leverage these improvements, but randomized controlled trials (RCTs) of digital interactive-based interventions are still scarce.ObjectiveThe aim of this study is to explore whether a cognitive training approach using VR exercises based on activities of daily living is feasible for improving the cognitive function of patients with AUD undergoing residential treatment, as well as to estimate the effect size for this intervention to power future definitive RCTs.MethodsThis study consisted of a two-arm pilot RCT with a sample of 36 individuals recovering from AUD in a therapeutic community; experimental group participants received a therapist-guided, VR-based cognitive training intervention combined with treatment as usual, and control group participants received treatment as usual without cognitive training. A comprehensive neuropsychological battery of tests was used both at pre- and postassessments, including measurement of global cognition, executive functions, attention, visual memory, and cognitive flexibility.ResultsIn order to control for potential effects of global cognition and executive functions at baseline, these domains were controlled for in the statistical analysis for each individual outcome. Results indicate intervention effects on attention in two out of five outcomes and on cognitive flexibility in two out of six outcomes, with effect sizes in significant comparisons being larger for attention than for cognitive flexibility. Patient retention in cognitive training was high, in line with previous studies.ConclusionsOverall, the data suggest that VR-based cognitive training results in specific contributions to improving attention ability and cognitive flexibility of patients recovering from AUD.Trial RegistrationClinicalTrials.gov NCT04505345; https://clinicaltrials.gov/show/NCT04505345