Language facilitates introspection: Verbal mind-wandering has privileged access to consciousness.

Introspection and language are the cognitive prides of humankind, but their interactions in healthy cognition remain unclear. Episodes of mind-wandering, where personal thoughts often go unnoticed for some time before being introspected, offer a unique opportunity to study the role of language in introspection. In this paper, we show that inner speech facilitates awareness of mind-wandering. In two experiments, we either interfered with verbal working memory, via articulatory suppression (Exp. 1), or entrained it, via presentation of verbal material (Exp. 2), and measured the resulting awareness of mind-wandering. Articulatory suppression decreased the likelihood to spontaneously notice mind-wandering, whereas verbal material increased retrospective awareness of mind-wandering. In addition, an ecological study using smartphones confirmed that inner speech vividness positively predicted mind-wandering awareness (Exp. 3). Together, these findings support the view that inner speech facilitates introspection of one's thoughts, and therefore provides empirical evidence for a positive relation between language and consciousness.

RESOLUTION OF SUBRETINAL FLUID AND OUTER RETINAL CHANGES IN PATIENTS TREATED WITH OCRIPLASMIN.

PURPOSE: To evaluate the aftermarket efficacy of ocriplasmin for vitreomacular adhesion (VMA) and identify the frequency and duration of structural changes on optical coherence tomography. METHODS: The authors conducted a retrospective case series of 36 eyes treated with ocriplasmin for symptomatic VMA at a single center between February 2013 and September 2013. Eyes were evaluated for release of VMA at 1 month postinjection, preinjection adhesion size, postinjection closure of macular hole, presence of subretinal fluid after release of adhesion, size of subretinal fluid, outer retinal structural change, and visual acuity at 1 month, 6 months, and 1 year. RESULTS: Fifteen eyes (42%) had complete release of VMA at 1 month postinjection, and 78% of eyes had closure of the macular hole. Eyes that did not have an epiretinal membrane that had a smaller initial adhesion size and a smaller macular hole size were more likely to have complete release of VMA. Subretinal fluid was present after release in 73.3% of treated eyes, and ellipsoid zone changes were present in 66.7% of treated eyes. At the end of 1 year, complete resolution of subretinal fluid occurred in 87% of treated eyes with only trace subretinal fluid remaining in 2 eyes. Complete resolution of ellipsoid zone changes was found in all eyes. Best-corrected visual acuity improved throughout the first year after treatment. CONCLUSION: Ocriplasmin is effective in the treatment of patients with symptomatic VMA. Results can be improved with patient selection based on specific criteria. Subretinal fluid and ellipsoid zone changes are common after treatment but mostly resolve over 1 year.

Mindfulness training improves working memory capacity and GRE performance while reducing mind wandering.

Given that the ability to attend to a task without distraction underlies performance in a wide variety of contexts, training one's ability to stay on task should result in a similarly broad enhancement of performance. In a randomized controlled investigation, we examined whether a 2-week mindfulness-training course would decrease mind wandering and improve cognitive performance. Mindfulness training improved both GRE reading-comprehension scores and working memory capacity while simultaneously reducing the occurrence of distracting thoughts during completion of the GRE and the measure of working memory. Improvements in performance following mindfulness training were mediated by reduced mind wandering among participants who were prone to distraction at pretesting. Our results suggest that cultivating mindfulness is an effective and efficient technique for improving cognitive function, with wide-reaching consequences.

Inspired by distraction: mind wandering facilitates creative incubation.

Although anecdotes that creative thoughts often arise when one is engaged in an unrelated train of thought date back thousands of years, empirical research has not yet investigated this potentially critical source of inspiration. We used an incubation paradigm to assess whether performance on validated creativity problems (the Unusual Uses Task, or UUT) can be facilitated by engaging in either a demanding task or an undemanding task that maximizes mind wandering. Compared with engaging in a demanding task, rest, or no break, engaging in an undemanding task during an incubation period led to substantial improvements in performance on previously encountered problems. Critically, the context that improved performance after the incubation period was associated with higher levels of mind wandering but not with a greater number of explicitly directed thoughts about the UUT. These data suggest that engaging in simple external tasks that allow the mind to wander may facilitate creative problem solving.

fMRI characterization of the language formulation area.

Participants read sentences presented one word at a time, half of which ended with a semantically incongruent ending. 1.5T functional magnetic resonance imaging data were collected from 11 participants, showing that the left posterior inferior temporal region, which has previously been termed the Language Formulation Area (LFA), responded to cloze probability. It is suggested, based on anatomical positioning and a literature review, that the responsiveness of the LFA to cloze probabilities may reflect a role in coordinating the lexical and non-lexical reading pathways. Finally, it is noted that previous studies have implicated this region in dyslexia and some speculations are made in this regard.

Conducting multilevel analyses in medical education.

A significant body of education literature has begun using multilevel statistical models to examine data that reside at multiple levels of analysis. In order to provide a primer for medical education researchers, the current work gives a brief overview of some issues associated with multilevel statistical modeling. To provide an example of this technique, we then present a multilevel analysis examining the relationship between two individual-level variables and the "cross-level" interaction between this relationship and a school-level variable. In offering this discussion and example of multilevel modeling, we hope to provide medical educators with a basic introduction to multilevel statistics, including the advantages of utilizing these techniques.

Semantic priming modulates the N400, N300, and N400RP.

OBJECTIVE: To determine whether ERP components can differentiate between the semantic priming mechanisms of automatic spreading activation, expectancy, and semantic matching. METHODS: The present study manipulated two factors known to differentiate semantic priming mechanisms: associations between words (forward, backward, and symmetrical) and prime-target stimulus onset asynchrony (SOA). Twenty-six participants were tested in each SOA condition while high-density 128-channel data were collected. Principal components analysis was applied to separate the ERP components. RESULTS: Priming was observed for all conditions. Three semantic components were present: (1) the standard N400 effect for symmetric and forward priming pairs at both short and long SOAs, (2) an N300 for the long SOA symmetric priming pairs, and (3) a right-lateralized posterior N400RP for long SOA backward priming pairs. CONCLUSIONS: Results suggest that the N300 reflects expectancy, but only for categorical and/or semantic similarity priming. Results further suggest that the N400RP is a replicable ERP component that responds to semantic matching. There is also some evidence that the N400 indirectly responds to both ASA and expectancy, perhaps as part of a post-lexical updating process and that backward priming at short SOAs is different from that at long SOAs. SIGNIFICANCE: Improved understanding of the semantic properties of the N400 and related ERP components may increase their utility for understanding language processes and for diagnostic purposes.

Tracking Distraction.

OBJECTIVE: Although earlier work has shown a link between mind-wandering and ADHD symptoms, this relationship has not been further investigated by taking into account recent advances in mind-wandering research. METHOD: The present study provides a comprehensive assessment of the relationship between mind-wandering and ADHD symptomatology in an adult community sample ( N = 105, 71 females, M age = 23.1) using laboratory measures and experience sampling during daily life. RESULTS: Mind-wandering and detrimental mind-wandering were positively associated with ADHD symptoms. Meta-awareness of mind-wandering mediated the relationship between ADHD symptomatology and detrimental mind-wandering, suggesting that some of the negative consequences can be ameliorated by strategies that facilitate meta-awareness. Interestingly, participants with low ADHD scores showed a positive relationship between detrimental mind-wandering and useful mind-wandering; however, participants with high ADHD scores failed to engage in this type of "strategic" mind-wandering. CONCLUSION: These results provide new insights into the relationship between ADHD symptomatology and mind-wandering that could have important clinical implications.

Mind wandering during attention performance: Effects of ADHD-inattention symptomatology, negative mood, ruminative response style and working memory capacity.

OBJECTIVE: In adulthood, depressive mood is often comorbid with ADHD, but its role in ADHD-inattentiveness and especially relations with mind wandering remains to be elucidated. This study investigated the effects of laboratory-induced dysphoric mood on task-unrelated mind wandering and its consequences on cognitive task performance in college students with high (n = 46) or low (n = 44) ADHD-Inattention symptomatology and Hyperactivity/Impulsivity symptoms in the normal range. METHODS: These non-clinical high/low ADHD-Inattention symptom groups underwent negative or positive mood induction after which mind wandering frequency was measured in a sustained attention (SART), and a reading task. Effects of ruminative response style and working memory capacity on mind wandering frequency were also investigated. RESULTS: Significantly higher frequencies of self -reported mind wandering in daily life, in the SART and reading task were reported in the ADHD-Inattention symptom group, with detrimental effects on text comprehension in the reading task. Induced dysphoric mood did specifically enhance the frequency of mind wandering in the ADHD-Inattention symptom group only during the SART, and was related to their higher self-reported intrusive ruminative response styles. Working memory capacity did not differ between high/low attention groups and did not influence any of the reported effects. CONCLUSIONS: These combined results suggest that in a non-clinical sample with high ADHD-inattention symptoms, dysphoric mood and a ruminative response style seem to be more important determinants of dysfunctional mind wandering than a failure in working memory capacity/executive control, and perhaps need other ways of remediation, like cognitive behavioral therapy or mindfulness training.

Is "Blank" a suitable neutral prime for event-related potential experiments?

We report an experiment that evaluates whether BLANK or an unrelated prime is a more suitable baseline for assessing priming for an ERP study. Sixteen subjects performed a lexical decision task with a 1 s prime-target stimulus onset asynchrony. Increased amplitude for the N400 was observed for targets in the unrelated prime condition whereas targets in the BLANK prime condition evoked activity that was more like that in the related prime condition. Theoretically, we conclude that the N400 reflects semantic integration. Pragmatically, we conclude that the BLANK prime is a better neutral prime but that unrelated primes yield stronger N400 effects.

Unaware yet reliant on attention: Experience sampling reveals that mind-wandering impedes implicit learning.

Although implicit learning has been widely studied, controversy remains regarding its reliance on attentional resources. A central issue in this controversy is the question of how best to manipulate attention. The usual approach of comparing implicit learning in a serial reaction time (SRT) task under single- versus dual-task conditions is known to be problematic, because the secondary task may not only divert attention away from the primary task, but also interfere with the implicit-learning process itself. To address this confound, in the present study we used an experience-sampling instead of a dual-task approach. We assessed lapses of attention (mind-wandering) with experience-sampling thought probes during a standard implicit-learning SRT task. The results revealed a significant negative correlation between mind-wandering and implicit learning. Thus, greater task focus was associated with improved implicit sequence learning. This result suggests that, at least in the context of this SRT task, optimal implicit learning relies on attention.

Receiver operating characteristic curve to predict anti-VEGF resistance in retinal vein occlusions and efficacy of Ozurdex.

PURPOSE: Current treatment paradigms for macular edema associated with retinal vein occlusions (RVO) often involve initial treatment with anti-vascular endothelial growth factor (VEGF) agents, then switching to intravitreal dexamethasone implant (IDI; Ozurdex, Allergan, Parsippany, NJ) for poor responders. However, many patients undergo multiple injections prior to being declared a nonresponder. We devised a method for prediction of poor anti-VEGF response after one injection, and show that these patients subsequently respond well to IDI. METHODS: This study is a retrospective consecutive interventional case series of patients with RVO receiving anti-VEGF agents that were switched to IDI. Patients were categorized as nonresponders to anti-VEGF agents (edema did not improve) or responders (edema improved, but switched to IDI for longer treatment duration). Receiver operating characteristics (ROC) curve analysis was used to determine cutoffs of reduction in central retinal thickness (CRT) to predict poor response to anti-VEGF treatment. RESULTS: Twenty-three patients met inclusion criteria. There were 14 nonresponders and 9 responders. The ROC curve analysis found that the maximal sensitivity and specificity in correctly identifying responders to anti-VEGF therapy was those with >25% reduction in CRT 1 month after 1 anti-VEGF treatment (sensitivity 0.89, specificity 0.79, area under the curve 0.93). After IDI placement, anti-VEGF nonresponders showed significant improvement in visual acuity (VA) (p = 0.02) and CRT (p = 0.01). CONCLUSIONS: In patients with macular edema secondary to RVOs, a reduction in CRT by ≤25%, 1 month after 1 anti-VEGF injection, is predictive of poor response to anti-VEGF treatment. These patients may benefit from earlier conversion to IDI treatment, which in our study, resulted in improved VA and CRT.

Early event-related brain potentials and hemispheric asymmetries reveal mind-wandering while reading and predict comprehension.

The electroencephalogram (EEG) of mind-wandering (MW) was examined in event-related potentials (ERPs) and pre-stimulus alpha (8-12 Hz), over lateral-posterior sites of left and right brain hemispheres, while individuals read text passages. After controlling for individual differences in general intelligence (g), P1-asymmetry was greater (right-minus- left) and N1 amplitudes were more negative, when individuals were not MW (i.e., they were reading attentively). Approximately 82% of variance in reading comprehension was accounted for by the predictors: g, pre-stimulus alpha, left- and right-hemisphere P1, and left-hemisphere N1 (when individuals were not MW). Together, individual differences in MW-sensitive ERPs uniquely accounted for approximately 38% of the variance in reading comprehension, over and above prediction by g and pre-stimulus alpha. The within-person effect of MW on P1-asymmetry was estimated to account for an additional 4.6% of criterion variance. Implications for EEG/ERP research into attention, language processing, hemispheric asymmetries, and individual differences are discussed.

Thinking one thing, saying another: the behavioral correlates of mind-wandering while reading aloud.

Although mind-wandering during silent reading is well documented, to date no research has investigated whether similar processes occur during reading aloud. In the present study, participants read a passage either silently or aloud while periodically being probed about mind-wandering. Although their comprehension accuracies were similar for both reading conditions, participants reported more mind-wandering while they were reading aloud. These episodes of mindless reading were associated with nearly normal prosody, but were nevertheless distinguished by subtle fluctuations in volume that were predictive of both overall comprehension accuracy and individual sentence comprehension. Together, these findings reveal that previously hidden within the common activity of reading aloud lies: (1) a demonstration of the remarkable automaticity of speech, (2) a situation that is surprisingly conducive to mind-wandering, (3) subtle vocal signatures of mind-wandering and comprehension accuracy, and (4) the promise of developing useful interventions to improve reading.

Young and restless: validation of the Mind-Wandering Questionnaire (MWQ) reveals disruptive impact of mind-wandering for youth.

Mind-wandering is the focus of extensive investigation, yet until recently there has been no validated scale to directly measure trait levels of task-unrelated thought. Scales commonly used to assess mind-wandering lack face validity, measuring related constructs such as daydreaming or behavioral errors. Here we report four studies validating a Mind-Wandering Questionnaire (MWQ) across college, high school, and middle school samples. The 5-item scale showed high internal consistency, as well as convergent validity with existing measures of mind-wandering and related constructs. Trait levels of mind-wandering, as measured by the MWQ, were correlated with task-unrelated thought measured by thought sampling during a test of reading comprehension. In both middle school and high school samples, mind-wandering during testing was associated with worse reading comprehension. By contrast, elevated trait levels of mind-wandering predicted worse mood, less life-satisfaction, greater stress, and lower self-esteem. By extending the use of thought sampling to measure mind-wandering among adolescents, our findings also validate the use of this methodology with younger populations. Both the MWQ and thought sampling indicate that mind-wandering is a pervasive-and problematic-influence on the performance and well-being of adolescents.

Window to the wandering mind: pupillometry of spontaneous thought while reading.

Mind-wandering is both pervasive and detrimental to task performance. As such, identifying covert physiological measures that are associated with this off-task state could inform theories of mind-wandering and lead to interventions that improve task focus. Although previous work suggests that pupil dilation (PD) may vary between on- and off-task states, no studies have examined whether PD systematically varies within a subject as they report becoming disengaged from a task-a key step in developing useful mind-wandering prediction algorithms. In the present study, PD was measured while participants advanced through a passage one word at a time. Spontaneous mind-wandering was assessed during reading using standard thought probe methodology. Results revealed higher PD prior to off-task than prior to on-task reading. This newly discovered relationship between momentary fluctuations of attention and PD offers promise for future innovations that use these systematic changes in PD to predict and better control mind-wandering.

Disentangling decoupling: comment on Smallwood (2013).

Smallwood (2013) made important contributions to the science of mind wandering by distinguishing between 2 aspects of the mind-wandering experience: (a) how the mind wanders, which entails the process of maintaining the continuity of a mind-wandering episode, and (b) why the mind wanders, which refers to those mechanisms that lead to the occurrence of a mind-wandering episode. This new process-occurrence framework offers a way to compare and contrast existing theories of mind wandering and highlights key questions to be addressed in future work; however, we suggest that in characterizing one of the core mechanisms of mind wandering, Smallwood conflated the occurrence of a phenomenon with its explanation. Specifically, the occurrence of perceptual decoupling (i.e., that mind wandering is associated with reduced attention to external stimuli) was conflated with an explanation for its occurrence (i.e., in order to insulate the internal train of thought). Disentangling the theory of perceptual decoupling raises questions regarding both its role in insulating the internal train of thought in mind wandering and its unique theoretical contributions to the how/process of mind wandering.

The silver lining of a mind in the clouds: interesting musings are associated with positive mood while mind-wandering.

The negative effects of mind-wandering on performance and mood have been widely documented. In a recent well-cited study, Killingsworth and Gilbert (2010) conducted a large experience sampling study revealing that all off-task episodes, regardless of content, have equal to or lower happiness ratings, than on-task episodes. We present data from a similarly implemented experience sampling study with additional mind-wandering content categories. Our results largely conform to those of the Killingsworth and Gilbert (2010) study, with mind-wandering generally being associated with a more negative mood. However, subsequent analyses reveal situations in which a more positive mood is reported after being off-task. Specifically when off-task episodes are rated for interest, the high interest episodes are associated with an increase in positive mood compared to all on-task episodes. These findings both identify a situation in which mind-wandering may have positive effects on mood, and suggest the possible benefits of encouraging individuals to shift their off-task musings to the topics they find most engaging.

The role of mind-wandering in measurements of general aptitude.

Tests of working memory capacity (WMC) and fluid intelligence (gF) are thought to capture variability in a crucial cognitive capacity that is broadly predictive of success, yet pinpointing the exact nature of this capacity is an area of ongoing controversy. We propose that mind-wandering is associated with performance on tests of WMC and gF, thereby partially explaining both the reliable correlations between these tests and their broad predictive utility. Existing evidence indicates that both WMC and gF are correlated with performance on tasks of attention, yet more decisive evidence requires an assessment of the role of attention and, in particular, mind-wandering during performance of these tests. Four studies employing complementary methodological designs embedded thought sampling into tests of general aptitude and determined that mind-wandering was consistently associated with worse performance on these measures. Collectively, these studies implicate the capacity to avoid mind-wandering during demanding tasks as a potentially important source of success on measures of general aptitude, while also raising important questions about whether the previously documented relationship between WMC and mind-wandering can be exclusively attributed to executive failures preceding mind-wandering (McVay & Kane, 2010b).

Insulation for daydreams: a role for tonic norepinephrine in the facilitation of internally guided thought.

Although consciousness can be brought to bear on both perceptual and internally generated information, little is known about how these different cognitive modes are coordinated. Here we show that between-participant variance in thoughts unrelated to the task being performed (known as task unrelated thought, TUT) is associated with longer response times (RT) when target presentation occurs during periods when baseline Pupil Diameter (PD) is increased. As behavioral interference due to high baseline PD can reflect increased tonic activity in the norepinephrine system (NE), these results might implicate high tonic NE activity in the facilitation of TUTs. Based on these findings, it is hypothesised that high tonic mode NE leads to a generalised de-amplification of task relevant information that prioritses internally generated thought and insulates it from the potentially disruptive events taking place in the external environment.