Strategic Memory Research Articles

라포형성 수사기법을 통한 수사 면담과 메타기억이 증언의 정보량과 정확도에 미치는 영향: 대인존재감의 조절효과를 중심으로

This study investigated the moderating effect of mattering on the relationship between rapport formation and the quantity of information in their testimonies during investigative interviews, and whether testimony accuracy correlates with meta-memory. 95 participants, whose levels of mattering and meta-memory were pre-measured, watched a mock crime video and then provided testimony following a 10-minute rapport formation process A rapport questionnaire was used to measure participants' perceived degree of rapport, and the recorded testimonies were evaluated for information quantity and accuracy. Results showed that the moderating effect of mattering on the degree of rapport formation and the quantity of information in the testimonies was not significant (p=.060), but the Johnson-Neyman technique identified a reinforcing effect of mattering, with better rapport formation leading to sharply higher utterance volumes in the interval below the mean (67.347; SD=9.608). Furthermore, the total meta-memory score was not significantly related to testimony accuracy, the sub-factor 'memory strategies' was positively related to accuracy. This suggests that witnesses with low levels of mattering benefit most from a good rapport with the investigator, and that assessing how effectively witnesses utilise strategic memory methods can provide important clues for assessing the reliability of their testimony.

The Effectiveness of Memory Strategies to Improve Students' Speaking Skills

This research studies the memory strategies used by the second semester STAI Ma’arif Magetan students to improve their speaking skills through involvement in English vocabulary. The purpose of this research is to find out the types of strategies and students' preferences in using strategic memory to improve their speaking skills. The data consists of memory strategies used by STAI Ma’arif Magetan students. The data source consisted of 30 second semester students. The memory strategy questionnaire was carried out for the data collection process. Data analysis was carried out using several steps such as data reduction, displaying data, and drawing conclusions. The research results showed: (1) students used ten indicators of strategic memory (grouping, associating, placing new words into a context, using images, semantic solvers, using keywords, representing sounds in memory, structural displays, using physical responses or sensation, and using mechanical techniques); (2) students' preferences in using memory strategies to place new words into context.

Serial and strategic memory processes in younger and older adults

ABSTRACT We investigated age-related differences in serial and strategic processing during the encoding and retrieval of high-value words. Younger and older adults were presented with word triads positioned left, center, and right, with one word being more valuable than the others. In Experiment 1, younger adults more effectively recalled the middle, high-value word, demonstrating enhanced strategic memory. Younger adults were more likely to initiate recall with a high-value word whereas older adults were equally likely to initiate recall with a left and high-value word. Additionally, older adults were more likely to recall words in their presented order while younger adults strategically recalled successive high-value words. However, both age groups demonstrated strategic processing in Experiments 2 and 3, even without prior knowledge of the high-value word’s location. Thus, serial and strategic processing may differ based on age and task demands, but strategic processing is preserved in older adults in certain contexts.

Chanwuyi Lifestyle Medicine Program Improves Memory and Executive Functions of Older Adults With Mild Cognitive Impairment.

The Chanwuyi Lifestyle Medicine Program (CLMP) was found to enhance the memory and executive functions of older adults with or without subjective memory complaints. The present study investigated whether similar beneficial effects can be extended to mild cognitive impairment (MCI). Twenty-four older adults with MCI were randomly assigned to receive the CLMP (the experimental group) or strategic memory training (SMT; the active control group) for 10 weeks. They were assessed by neuropsychological tests at baseline and post-intervention. Older adults showed similar visual and verbal memory improvements after receiving the CLMP and SMT. Yet, only those who received the CLMP showed distinct improvements in planning/organization, working memory, and attention in terms of accuracy, with greater cognitive gains associated with older age and lower levels of education and baseline cognitive functions. This study provides preliminary evidence for the effects of the CLMP on improving memory, attention, and executive functions in MCI.

3 Optimizing Cognitive Rehabilitation of the Injured Warfighter

Objective:Many individuals who experienced a mild traumatic brain injury (mTBI) have persistent cognitive complaints. Traditional cognitive rehabilitation (TCR) interventions were primarily developed for severe neurological injury which has limited effectiveness in rehabilitation of active duty military personnel who have the goal of returning to full military operational status. To remain on active duty, warfighters must have sufficient mental competency to safely and effectively function in complex environments such as combat. There is need for a cognitive rehabilitation approach that addresses demands of military personnel to expedite return to duty. The Strategic Memory Advanced Reasoning Training (SMART) program is novel alternative to TCR. SMART is an evidence-based advanced reasoning protocol that enhances cognitive domains essential to military readiness (e.g., mental agility, strategic learning, problem solving, and focus) and requires less than half of the treatment time. The objective of this study was to assess the efficacy of SMART compared to TCR in terms of overall recovery as well as change in specific cognitive domains.Participants and Methods:Participants were recruited from a military treatment facility. All patients had at least one diagnosed mTBI as well as persistent cognitive complaints. Participants completed the Rey-15 to ensure performance validity. Final sample was SMART n = 28 and SCORE n = 19. Primary dependent measure was the Global Deficit Scale (GDS). GDS was calculated from: Hopkins Verbal Learning Test-Revised (HVLT-R); Delis Kaplan Executive Functioning System Color Word (CW) and Trail Making (TM), Paced Auditory Serial Addition Test (PASAT), and the Symbol Digit Modality Test (SDMT). Demographically corrected t-scores were converted to deficit scores as follows: >40 = 0, 35-39 = 1, 30-34 = 2, 25-29 = 3, 20-24 = 4, <20 = 5. Deficit scores were averaged to calculate GDS. For each measure, Hohen’s g was analyzed for effect size comparisons pre-post treatment.Results:Average number of treatment hours was significantly lower in the SMART condition (SMART: M = 18.47 hours, SD = 2.17; TCR: M = 42.42 hours, SD = 3.79, p <.001). A repeated measures ANOVA showed a significant change on GDS post-treatment (F = 30.25, p < .001) with a large effect size (n2 = .402); however, the interventions did not differ on GDS change. Impact on cognitive domains was relatively equivalent for processing speed (SMART h = 0.67 vs TCR h = -.54) and executive function (SMART h = -0.92 vs TCR h = -.85); however, SMART had a larger impact on memory (SMART h = -0.81 vs TCR h = -.39). SMART resulted in large improvements in retention and recognition memory which were minimally impacted by TCR.Conclusions:Both TCR and SMART had comparable effectiveness in improving cognitive impairment, though SMART was completed in less than half of the treatment time. Both interventions had large effect sizes on processing speed and executive functioning; however, SMART was more effective in improving long-term memory. Memory is an integral part of military readiness. Further investigation is required to determine the relative effectiveness of these two approaches to improving cognitive readiness of the warfighter.

Symposium 11: Military TBI: Neural and Clinical Correlates of Cognitive Function

Summary Abstract:This symposium will highlight recent advances in understanding, assessment, and treatment of the effect traumatic brain injury has on cognitive functioning in military Service Members and Veterans. Since 2000, U.S. Service Members have sustained over 450,000 brain injuries, the majority of which are mild. Although TBI mechanisms and characteristics among Service Members can differ from civilians in significant ways, research being conducted at Department of Defense and Veterans Affairs sites to address this problem can also yield benefits to civilians with TBI. Four presentations will focus on various aspects of TBI evaluation and treatment based on findings from their own research. Dr. Mark Ettenhofer will present findings relating to promising new eye tracking measures and their relationship to standardized cognitive test results among Service Members with mild traumatic brain injury. Next, Dr. Victoria Merritt will examine the role of symptom attribution on treatment-seeking Veterans with a remote history of traumatic brain injury. In particular, Dr. Merritt will be examining both self-reported symptoms as well as performance on objective neurocognitive tests. Dr. Jason Bailie will describe an ongoing study comparing a novel approach to cognitive rehabilitation, Strategic Memory Advanced Reasoning Training (SMART), to traditional cognitive rehabilitation interventions in Active Duty Service Members. The results of this study have significant implications for treatment of all individuals with chronic symptoms following mTBI, regardless of military status. Finally, Dr. Jared Rowland will present findings on the influence of mild traumatic brain injury and blast exposure on the relationship between brain function, cognitive outcomes, and symptom severity in a sample of Iraq and Afghanistan combat veterans. This study will demonstrate how the relationship between aspects of the functional connectome and cognitive function are changed by TBI and blast. Overall, these studies highlight novel approaches to the understanding, assessment, and treatment of TBI being implemented in the Department of Defense and Veterans Affairs that have high applicability to the civilian population.

Effects of online brain training on self-reported mental health symptoms for generally healthy adults during the Covid-19 pandemic.

The cognitive training Strategic Memory Advanced Reasoning Training (SMART) has been shown to improve symptoms of depression, anxiety, and stress when completed using in-person delivery, but mental health outcomes have not yet been studied for online delivery of SMART. Data was analyzed from 145 generally healthy adults participating in the BrainHealth Project pilot study who had access to 12 weeks of online self-paced SMART and self-reported mental health symptoms on the Depression Anxiety Stress Scale (DASS-21) pre- and post-training. We utilized linear models to examine the change in self-reported symptoms of depression, anxiety, and stress following the 12-week training period and to explore the influence of age, gender, and education on changes in symptomatology. Data from 44 participants who completed a follow-up DASS-21 6 months after completing SMART was used to explore the lasting impact of the training. Improvements in depression, anxiety, and stress symptoms were observed following online SMART, evidenced by a significant decrease in self-reported symptoms on the DASS-21. Improvement in self-reported mental health symptomatology was maintained or continued to improve 6-month post-training. No significant effect of gender was observed, but findings motivate additional exploration of the effects of education and age. Online SMART should be considered a low-cost, high-impact approach for supporting public mental health for generally healthy adults.

Repeat tourists’ perceived unfavorable changes and their effects on destination loyalty

PropósitoLos turistas que repiten son muy valiosos para los destinos turísticos. Sin embargo, sus percepciones y reacciones ante los cambios desfavorables en el destino han sido poco exploradas. Esta investigación tiene como objetivo responder dos preguntas importantes y no resueltas: ¿Cómo reaccionan los turistas que repiten un destino ante los cambios desfavorables percibidos? ¿Cuáles son los principales cambios desfavorables en el destino para los turistas que repiten?Diseño/metodología/enfoqueEsta investigación se fundamenta en la teoría de la protección estratégica de la memoria. Consta de dos estudios (uno cuantitativo y otro cualitativo) realizados en China. El estudio cuantitativo propuso y evaluó un modelo de ecuación estructural que vincula los cambios desfavorables percibidos, los recuerdos contaminados, la satisfacción de la revisita y la lealtad al destino. Los datos se recopilaron a través de un cuestionario distribuido en una plataforma de encuestas en línea con 416 respuestas válidas. El estudio cualitativo se realizó para determinar los cambios desfavorables en el destino que perciben los turistas. Se utilizaron noventa y cinco respuestas válidas para el análisis.ResultadosEsta investigación demuestra empíricamente que los cambios desfavorables percibidos disminuyen la lealtad de los turistas que repiten un destino, al empañar sus recuerdos iniciales y reducir la satisfacción de la revisita. Esta mediación total confirma la importancia de los recuerdos personales y la psicología en las experiencias turísticas. Esta investigación descubre, además, dos tipos principales de cambios desfavorables en el destino: mala gestión del destino (es decir, comercialización excesiva, instalaciones insuficientes, mala administración, precios excesivos y disminución de la calidad del servicio) y cambios ambientales negativos (turistificación excesiva, cambios en los entornos naturales y sociales, y cambios en los sitios y actividades turísticas).Originalidad/valorEsta investigación contribuye a la literatura sobre la lealtad al destino, al desvelar las percepciones de los turistas que repiten visita, y sus procesos psicológicos hacia los cambios desfavorables en los destinos. También identifica los cambios desfavorables típicos percibidos por los turistas que vuelven a un destino.

Serial and strategic memory processes in goal-directed selective remembering

People often rely on habitual, serial processing when presented with to-be-learned information. We tested how strategic processing can override more bottom-up, serial processes when remembering information by having participants study a list of word triads (e.g., “dollar phone pizza”). Participants' goal was manipulated by maximizing either (i) their recall for each of the studied words or (ii) their total score associated with recalling certain words in each triad that were more valuable (worth more points) to engage either serial or strategic processing and retrieval mechanisms. Results revealed that when learners were told to maximize their total recall, they frequently engaged in serial remembering—remembering guided by an item's location within the study phase (i.e., words were retrieved according to a habitual reading bias). However, when words were paired with point values that counted towards participants' scores if recalled, participants were not only selective for high-value words but also attempted to overcome the tendency to engage in serial remembering; instead, they appeared to engage in strategic remembering whereby retrieval is guided by value. Thus, to maximize memory utility, it may be beneficial to override habitual processes and initiate retrieval with high-value words, and when making recall transitions, to recall high-value words together. Importantly, when certain to-be-remembered words were more valuable than their neighbors, participants still demonstrated some serial processing of the to-be-remembered words, indicating that even when engaging in strategic memory, some habitual processes can persist.

Indirect Associations Between Self-Rated Alertness and Recall via Strategic and Nonstrategic Factors

Abstract Excessive daytime sleepiness is associated with reduced cognitive functioning in children and adolescents. The present study was an initial examination of direct and indirect associations between sleep and recall via strategic and nonstrategic memory processes in a sample of 66 participants from grades 1, 3, 5, and college. Stimuli varied in familiarity and presence of a strategy prompt. Strategy use during encoding and during recall were measured separately. The present study predicted that alertness would be associated with both strategic and nonstrategic factors related to memory, alertness would predict recall indirectly via strategic and nonstrategic factors (controlling for grade and gender), and this indirect path would be moderated by grade. The first 2 hypotheses were partially supported; the third was not. Self-reported alertness associated weakly with speed of tapping and with strategy use during encoding on the first trial (familiar words, no strategy cue). Analysis indicated an indirect effect via strategy use during encoding on Trial 1 but via speed of tapping on Trial 3. Tests of moderated mediation were not significant on any trial, indicating that the indirect pathways were not moderated by grade. Alertness may influence recall via strategic or nonstrategic processes, and its role may depend on familiarity and availability of strategy cues. Several proposed research directions are suggested for future exploration.

Enhancing Patient Understanding of Medication Risks and Benefits.

ObjectiveTo evaluate the effectiveness of 2 interventions, including the DrugFactsBox format for presenting written medication information and the SMART (Strategic Memory Advanced Reasoning Training) program designed to enhance gist (i.e., “bottom‐line” meaning) reasoning ability.MethodsWe used a 2 × 2 factorial research design. A total of 286 patients with rheumatoid arthritis were randomly assigned to 1 of 4 groups, including DrugFactsBox with the SMART program, DrugFactsBox without the SMART program, other consumer medication information (CMI) with the SMART program, and other CMI without the SMART program. Data were collected via telephone interviews and online questionnaires at 4 time points, including baseline and 6‐week, 3‐month, and 6‐month time points following baseline. The primary outcome variable was informed decision‐making, which was defined as making a value‐consistent decision concerning use of disease‐modifying antirheumatic drugs based on adequate knowledge.ResultsWe found no main effects for the 2 interventions, either alone or in combination. However, there was a significant interaction between assignment to the SMART/no SMART groups and informed decision‐making at baseline. Among participants in the SMART groups who did not meet the criteria for informed decision‐making at baseline, 42.5% met the criteria at the 6‐month follow‐up, compared to 23.6% of participants in the no SMART groups (mean difference 18.9 [95% confidence interval 5.6, 32.2]; P = 0.007). This difference was driven by increased knowledge in the SMART groups. Among participants who met the criteria for informed decision‐making at baseline, the difference between the SMART and no SMART groups was not statistically significant.ConclusionParticipation in a theory‐driven program to enhance gist reasoning may have a beneficial effect on informed decision‐making among patients with inadequate knowledge concerning therapeutic options.

A-117 Strategic Memory and Advanced Reasoning Training for Rehabilitation of Warfighters with Mild Traumatic Brain Injury

Abstract Background Military personnel require a level of cognitive readiness that ensures they function safely and effectively in high-stress situations. Warfighters who experienced a mild traumatic brain injury (mTBI) often complain of persistent cognitive issues that may impact those abilities. This study presents preliminary data on the efficacy of a 4-week Strategic Memory Advanced Reasoning Training (SMART) for warfighter rehabilitation. SMART improves executive functioning in order to enhance overall cognitive abilities. Methods This is part of a randomized clinical trial (Validation of Cognitive Enhancement Therapy for mTBI). 22 Marines with prior mTBI and current cognitive complaints; 7 of whom completed SMART and were included in the analysis. Cognitive tests of interest included the Delis-Kaplan Executive Function System Color Word (CW) and Trail Making (TM). Results Improvements were observed on TM Number Sequencing (Pre: M = 9.71, SD = 2.06; Post: M = 11.86, SD = 1.35, p = 0.011, d = 1.37) and approached significance on Letter Sequencing (Pre: M = 10.29, SD = 1.81; Post: M = 12.57, SD = 1.13, p = 0.066, d = 1.26). Though non-significant, a large clinically-relevant effect size was found for Number-Letter Switching (Pre: M = 8.14, SD = 1.95; Post: M = 9.57, SD = 2.15, p = 0.106, d = 0.72). CW performance improved on Inhibition (Pre: M = 5.29, SD = 3.86; Post: M = 8.86, SD = 2.34, p = 0.034, d = 1.03) and Inhibition/Switching (Pre: M = 4.86, SD = 4.06; Post: M = 8.43, SD = 4.12, p = 0.015, d = 1.26). Conclusions The SMART program resulted in large improvements in the executive functioning of a small sample of warfighters with persistent cognitive complaints following a mTBI. The results support further examination of the efficacy of SMART for warfighter rehabilitation.

The role of strategic memory in the successful use of the COSO model for auditing human resource management

The main purpose of the research is to diagnose the importance of the role that strategic memory plays with its three variables (content, structure, and processes) in helping the human resource department to use the COSO model with its five components (culture and governance, strategy and objectives, performance, communications and information, and feedback) in auditing activities and tasks Her own. As the research problem emphasized the existence of a lack of cognitive perception, of the importance of strategic memory, and the investment of its components in the rationalization of the application of the COSO model. and therefore it can be emphasized that the importance of the research is to provide treatments for problems related to the variables that have been studied within the research organization. As for the objectives of the research, they are represented by conducting a descriptive analysis of the investigated variables and tests of the relationship between them. To achieve the objectives of the research, use the descriptive-analytical approach. As the questionnaire was built using international indicators and standards, and it was distributed to a sample consisting of (97) members of the staff of Al-Rafidain University College. The researchers relied on some statistical tools available in the statistical program (SPSS-V23) in order to enter and process data, and the results confirmed the validity of the main and sub-research hypotheses. Accordingly, the researchers recommended the necessity of preparing all the requirements necessary to build strategic memory and then employing it in providing the human resources department with information that enables it to apply the COSO model in auditing its activities

Using Virtual Reality to Assess and Promote Transfer of Memory Training in Older Adults With Memory Complaints: A Randomized Controlled Trial.

In this proof-of-concept study, we assessed the potential for immersive virtual reality (VR) to measure transfer following strategic memory training, and whether efficacy and transfer are increased when training is complemented by practice in an immersive virtual environment. Forty older adults with subjective memory complaints were trained with the method of loci. They were randomized to either a condition where they practiced the strategy in VR (n = 20) or a control condition where they were familiarized with VR using a non-memory task (n = 20). Training efficacy was measured with word recall, and transfer of the training benefit was measured with a recall task completed in two VR tasks (primary outcomes) as well as a self-report memory questionnaire (secondary outcomes). Testing was administered before (PRE), midway (POST 3), and after (POST 6) training. Participants improved their scores on word recall. Regarding transfer measures, participants improved their performance in the two VR recall tasks but not on the self-report memory questionnaire. No significant group effect was observed. Improvement was found when comparing PRE to POST 3 with no further improvement at POST 6. Thus, strategic memory training improved the memory of seniors with memory complaints on word recall and a transfer task relying on a VR scenario that resembles real-life. However, no evidence supporting an increase in transfer effects was found when enriching training with VR memory exercises.

Efficacy of Cognitive Training When Translated From the Laboratory to the Real World.

Research shows that cognitive performance and emotional well-being can be significantly strengthened. A high-performance brain training protocol, Strategic Memory Advanced Reasoning Training (SMART), was developed by cognitive neuroscientists at The University of Texas at Dallas Center for BrainHealth based on 25-plus years of scientific study. Randomized controlled trials with various populations have shown that training and use of nine "SMART" strategies for processing information can improve cognitive performance and psychological health. However, the multi-week intensive training used in the laboratory is not practical for widespread use outside the laboratory. This article examines the efficacy of SMART when translated outside the laboratory to two populations (military/veterans and law enforcement) that received SMART in condensed time frames. In two translation studies with healthy military personnel and veterans, 425 participants received between 6 and 10 hours of SMART over 2 days. In a third translation study, 74 healthy police officers received 9 hours of SMART over 3 days. Training was conducted by clinicians who taught the nine "SMART" strategies related to three core areas-strategic attention, integrated reasoning, and innovation-to groups of up to 25 participants. In all three translation studies, cognitive performance and psychological health data were collected before and immediately following the training. In one of the military/veteran studies, psychological health data were also collected 1 and 4 months following the training. In both translations to military personnel and veterans, there were improvements in the complex cognitive domains of integrated reasoning (P < .0001) and innovation (P < .0001) immediately after undergoing SMART. In the translation to police officers, there were improvements in the cognitive domains of innovation (P = .02) and strategic attention (P = .005). Participants in all three translations saw statistically significant improvements in self-reported symptoms of psychological health. The improvements continued among a subset of participants who responded to the later requests for information. The results of translating to these two populations provide evidence supporting the efficacy of SMART delivered in an abbreviated time frame. The improvements in two major domains of cognitive function demonstrate that strategies can be taught and immediately applied by those receiving the training. The immediate psychological health improvements may be transient; however, the continued improvements in psychological health observed in a subset of the participants suggest that benefits may be sustainable even at later intervals.

The power of appraisals in predicting PTSD symptom improvement following cognitive rehabilitation: A randomized clinical trial

BackgroundPatients with PTSD often voice concern over their perceived change in cognitive functioning. However, these negative appraisals do not always align with objective neuropsychological performance, yet are strongly predictive of PTSD symptom severity and self-reported functional impairment. MethodsThe present study involves a secondary analysis examining the role of appraisals of a subsample of 81 adults with full or subthreshold PTSD on treatment outcomes in a randomized controlled trial investigating the effectiveness of a cognitive rehabilitation treatment, Strategic Memory and Reasoning Training (n = 38), compared to a psychoeducation control arm, the Brain Health Workshop (n = 43). Neither condition addressed PTSD symptoms, focusing instead on cognitive skills training and psychoeducation about the brain. ResultsIntent-to-treat models showed statistically significant improvements for both groups on composite scores of executive functioning and memory. Additionally, both groups experienced clinically significant reductions in PTSD symptoms (assessed via the Clinician-Administered PTSD Interview) and the SMART group showed fewer negative appraisals about cognitive functioning following training. Change in appraisals of cognitive functioning was associated with change in PTSD as well as change in quality of life, with no differential associations based on group status. In contrast, neurocognitive test score changes were not associated with change in symptoms or functional outcomes. LimitationsWe did not collect data on other appraisals (e.g., self-efficacy), which could have further elucidated pathways of change. ConclusionsOur findings suggest that interventions that do not directly target PTSD symptoms can lead to PTSD symptom change via change in appraisals of functioning.

Eyewitness memory in the news can affect the strategic regulation of memory reporting

ABSTRACT The public is increasingly exposed to news about eyewitness memory errors. This study draws from the strategic memory regulation framework [Goldsmith, M., Koriat, A., & Weinberg-Eliezer, A. (2002). Strategic regulation of grain size memory reporting. Journal of Experimental Psychology: General, 131(1), 73–95. https://doi.org/10.1037/0096-3445.131.1.73] to make predictions about how eyewitness memory reporting is affected by exposure to such reports. In Experiment 1, participants (n = 226) viewed a mock crime, were exposed to a fictitious news report about eyewitness memory accuracy (memory is accurate, memory is inaccurate, or a control condition), and then recalled the mock crime. Participants who read that eyewitness memory is inaccurate were less confident in their memory accuracy and reported less information about the mock crime compared to those in the other conditions. The specificity and accuracy of recall did not vary across conditions, however. In Experiment 2, participants (n = 2,491) watched a mock crime and were asked to identify the perpetrator from a simultaneous lineup. Participants who read that eyewitness memory is inaccurate evaluated their memory for the mock crime as relatively poorer but their lineup decisions did not differ compared to other participants. This suggests that news about eyewitness memory inaccuracy affects how people evaluate their memory capability, and differentially affects memory output depending on the memory task.

Cognitive Training for Mild Traumatic Brain Injury and Posttraumatic Stress Disorder.

Although there is evidence of mild cognitive impairments for many individuals with mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD), little research evaluating the effectiveness of cognitive training interventions has been conducted. This randomized controlled trial examined the effectiveness of a 9-h group cognitive training targeting higher-order functions, Strategic Memory Advanced Reasoning Training (SMART), compared to a 9-h psychoeducational control group in improving neurocognitive functioning in adults with mTBI and PTSD. A sample of 124 adults with histories of mild TBI (n = 117) and/or current diagnoses of PTSD (n = 84) were randomized into SMART (n = 66) or Brain Health Workshop (BHW; n = 58) and assessed at three time points: baseline, following training, and 6 months later. Participants completed a battery of neurocognitive tests, including a test of gist reasoning (a function directly targeted by SMART) as well as tests of verbal, visual, and working memory and executive functioning, functions commonly found to be mildly impaired in mTBI and PTSD. The two groups were compared on trajectories of change over time using linear mixed-effects models with restricted maximum likelihood (LMM). Contrary to our hypothesis that SMART would result in superior improvements compared to BHW, both groups displayed statistically and clinically significant improvements on measures of memory, executive functioning, and gist reasoning. Over 60% of the sample showed clinically significant improvements, indicating that gains can be found through psychoeducation alone. A longer SMART protocol may be warranted for clinical samples in order to observe gains over the comparison group.

Use of a randomized clinical trial design to study cognitive rehabilitation approaches to enhance warfighter performance

Within the military, cognitive readiness is essential to ensure the warfighter can return to highly demanding combat training and deployment operations. The warfighter must be able to make split second decisions and adapt to new tools and environments. After a traumatic brain injury, clinicians helping the warfighter must have techniques that address warfighter cognitive readiness. Current rehabilitation for cognitive complaints used in military medicine are modeled after civilian therapies which focus on remediating moderate to severe impairment through building compensatory strategies. This traditional approach to cognitive rehabilitation does not translate well to mild traumatic brain injury (mTBI) where impairments are subtle, nor does it meet the needs of our warfighters in deployed and combat training environments. Challenging our current methods is critical in adapting to the needs of this highly valued population to ensure that our warfighters are able to carry out mission critical decision making. Here we present a review of our best current practices for cognitive rehabilitation, describe the limitations our traditional approaches impose for mTBI in military personnel, and present an alternative treatment called Strategic Memory Advanced Reasoning Training (SMART) that can be adopted through a randomized clinical trial design. We propose directly comparing traditional treatment approaches with a novel cognitive rehabilitation strategy which has been well validated outside of the military setting. Procedures were developed to execute this clinical trial in a way that is most relevant to the study population by establishing ecologically valid outcome metrics.

Mental imagery training in older adults: Which are benefits and individual predictors?

Strategic memory training involves explicit instructions in mnemonic methods to improve recall. Mental imagery is considered among the most effective encoding strategies. The aim of the present study was to assess the benefits of a strategic memory training based on mental imagery (originally proposed by Carretti et al., 2007) and to further investigate its potentials. The study represents a replication in a new and independent cultural setting and features valuable methodological amendments, while it also examines individual predictors of training efficacy. A sample of 91 older volunteers (age 61-88), divided in training and control group, participated in the training. Specific training gain in the immediate word list recall (criterion task), as well as transfer effects on Letter-Number Sequencing (working memory [WM] task), long-term recall and recognition (LTM tasks) were tested at the pretest and at the posttest. Analysis of variance showed posttraining effects in immediate word recall and long-term verbal recall, but no effects in WM task and long-term recognition. Regression analysis showed age to be the only significant predictor in one task, the immediate word recall. Overall, proposed training can improve some aspects of memory performance by aiding in strategic use of mental imagery. Transfer to other tasks and contribution of individual predictors to training efficacy results limited, however. It seems that training benefits are evident when task similarity enables transfer-appropriate processing (as evidenced in gains of both recall tasks), while training efficacy relies on individual characteristics which contribute to the execution of some task components.