The Breakfast and Dressing Conflict Task: Preliminary Evidence of Its Validity to Measure Online Self-Awareness After Acquired Brain Injury.

IMPORTANCE: Impaired self-awareness (SA) of deficits after an acquired brain injury (ABI) severely affects patients' independence in activities of daily living (ADLs). However, any assessment tool permits an exhaustive evaluation of SA in the context of ADLs. OBJECTIVE: To study the validity of the Breakfast and Dressing Conflict Task (BD Conflict Task) to assess online SA (awareness of performance in the context of a given task) in patients with ABI; to study its interactions with offline SA (general awareness); and to test the validity of a simplified measure of performance monitoring, the ADL Conflict-Monitoring Index. DESIGN: Convergent validity and correlational study. SETTING: Research laboratory, hospitals, and homes. PARTICIPANTS: Thirty patients with ABI and 28 neurologically healthy controls. OUTCOMES AND MEASURES: Using the BD Conflict Task, measures of emergent awareness, self-regulation, anticipatory awareness, and self-evaluation were assessed and their convergent validity and relationship with offline SA were analyzed. The ADL Conflict-Monitoring Index was calculated, and its convergent validity was tested. RESULTS: The online SA variables of the BD Conflict Task showed convergent validity with traditional online SA measures. Offline SA correlated with emergent and anticipatory awareness in the Breakfast Task. The ADL Conflict-Monitoring Index proved to be a valid measure of patients' performance monitoring. CONCLUSIONS AND RELEVANCE: These preliminary findings suggest that the BD Conflict Task is a valid tool to assess online SA in patients with ABI and provide further understanding of the online SA-offline SA interaction. Furthermore, the ADL Conflict-Monitoring Index may be a valid and easy-to-use monitoring measure in clinical settings. Plain-Language Summary: Patients with acquired brain injury (ABI) and reduced awareness of their cognitive deficits face problems performing activities of daily living (ADLs) and may show signs of unsafe behaviors. Being aware of one's own abilities involves anticipating problems before starting a task, detecting and correcting errors during the task, and evaluating performance afterward. This study provides preliminary validity for the Breakfast and Dressing Conflict Task, a new tool that assesses aspects of self-awareness simultaneously in the context of familiar and significant ADLs. Furthermore, the tool simplifies the assessment of detecting and correcting errors with an easy-to-use index, making it suitable for use in clinical settings.

Developing Resilience During the COVID-19 Pandemic: Yoga and Mindfulness for the Well-Being of Student Musicians in Spain.

Here, we report on a quasi-experimental study to explore the applicability and perceived benefits of the CRAFT program, which is based on mindfulness, yoga, positive psychology, and emotional intelligence, to improve higher education student musicians' health and well-being during the lockdown. A subset of student musicians at a Higher Conservatory of Music in Spain followed the CRAFT program during the academic year 2019/2020, 1 h per week as part of their curriculum. Students enrolled in CRAFT-based elective subjects formed the CRAFT program group (n = 40), while other students represented the control group (n = 53). The onset of the national lockdown elicited by the COVID-19 pandemic occurred halfway through the program, which was subsequently delivered in an online format. We administered an online survey to explore the effect that the exposure to the CRAFT program had in terms of how participants dealt with various health and well-being concerns arising from the COVID-19 lockdown. There was a significantly higher proportion of proactive participants in the CRAFT program group, 92%, than in the control group, 58%, in terms of implementing practices to improve their health and well-being during the lockdown. Additionally, significantly more participants acknowledged perceived benefits from their practices in the CRAFT program group, 78%, than in the control group, 52%. Among proactive participants, yoga/meditation was the most implemented in the CRAFT program group, followed by exercise, and other yoga/meditation practices, whereas in the control group, exercise and Alexander technique-based practices were the most applied. In the CRAFT program group, the highest rate of perceived benefits was from yoga/meditation CRAFT-based practices, 51%, followed by exercise, 32%, and other yoga/meditation practices, 27%, whereas in the control group, benefits were reported by 29% of exercising participants and 16% for those having practiced the Alexander technique. A similar pattern was observed when excluding participants with previous yoga/meditation experience. This study revealed how participants can independently apply learned skills from the CRAFT program in response to a naturally occurring life event of unprecedented global impact, suggesting that previous exposure to mindfulness and yoga is likely to have a beneficial effect on how young adults react towards exceptionally stressful conditions.

When do fearful faces override inhibition of return?

Inhibition of return (IOR) occurs when more than about 300 ms elapses between the cue and the target in atypical peripheral cueing task: reaction times (RTs) become longer when the cue and target locations are the same versus different. IOR could serve the adaptive role of optimizing visual search by discouraging the re-inspection of previously attended locations. As such, IOR should not reduce our chances of noticing relevant event information and emotional stimuli, in particular. However, previous studies have led to inconsistent results. The present study offers a systematic investigation of the conditions under which target fearful faces can modulate either the magnitude or the time course of the IOR effect. Notably, we manipulated the depth of facial processing required to perform the task and/or the task relevance of the facial expressions. When participants localized target faces (Experiment 1) or discriminated them from non-face stimuli (Experiment 2), their emotional expression had no impact on IOR whatsoever. However, IOR occurred later for fearful versus neutral faces when the participants performed emotion (Experiment 3) or gender (Experiment 4) discrimination tasks. These findings are discussed with regard to the mechanisms responsible for IOR and to the processing of emotional facial expressions.

Comparing neural substrates of emotional vs. non-emotional conflict modulation by global control context.

The efficiency with which the brain resolves conflict in information processing is determined by contextual factors that modulate internal control states, such as the recent (local) and longer-term (global) occurrence of conflict. Local "control context" effects can be observed in trial-by-trial adjustments to conflict (congruency sequence effects: less interference following incongruent trials), whereas global control context effects are reflected in adjustments to the frequency of conflict encountered over longer sequences of trials ("proportion congruent effects": less interference when incongruent trials are frequent). Previous neuroimaging and lesion studies suggest that the modulation of conflict-control processes by local control context relies on partly dissociable neural circuits for cognitive (non-emotional) vs. emotional conflicts. By contrast, emotional and non-emotional conflict-control processes have not been contrasted with respect to their modulation by global control context. We addressed this aim in a functional magnetic resonance imaging (fMRI) study that varied the proportion of congruent trials in emotional vs. non-emotional conflict tasks across blocks. We observed domain-general conflict-related signals in the dorsal anterior cingulate cortex (dACC) and pre-supplementary motor area and, more importantly, task-domain also interacted with global control context effects: specifically, the dorsal striatum and anterior insula tracked control-modulated conflict effects exclusively in the emotional domain. These results suggest that, similar to the neural mechanisms of local control context effects, there are both overlapping as well as distinct neural substrates involved in the modulation of emotional and non-emotional conflict-control by global control context.

Cue and target processing modulate the onset of inhibition of return.

Inhibition of return (IOR) is modulated by task set and appears later in discrimination tasks than in detection tasks. Several hypotheses have been suggested to account for this difference. We tested three of these hypotheses in two experiments by examining the influence of cue and target level of processing on the onset of IOR. In the first experiment, participants were required to respond to both the cue and target. The pattern of results showed that deeper processing of the cue or target advanced the onset of IOR. In the second experiment, participants were not required to respond to the cue and a reverse pattern of results emerged, which replicated the general findings in cuing tasks. We conclude that in more-demanding tasks, an additional process slows down the processing of a nonpredictive cue in order to enhance the processing of the target.

Top-down and bottom-up deficits in conflict adaptation after frontal lobe damage.

The ability to adaptively control our responses to conflicting information is crucial if we are to respond in a flexible manner to the environment. The "conflict monitoring model" proposes that the prefrontal cortex is responsible of reactive adjustments in cognitive control. We present neuropsychological data contrasting the performance of patients with prefrontal lesions with the one exhibited by patients with lesions outside the frontal lobe and nonlesioned participants, on the processes involved in the dynamic adaptation to conflicting stimulus information. Relative to both lesioned and nonlesioned control groups, prefrontal patients were impaired in adapting to conflict when all features of the conflicting stimuli and their associated responses changed on consecutive trials. However, the prefrontal patients also showed an unusually large conflict adaptation effect when the stimuli and/or response features repeated across trials. We conclude that prefrontal cortex is relevant both for genuine "top-down" conflict monitoring and for regulating the influence of "bottom-up" responses based on the integration of stimulus features across trials.

Effects of spatial frequency bands on perceptual decision: it is not the stimuli but the comparison.

Observers performed three between- and two within-category perceptual decisions with hybrid stimuli comprising low and high spatial frequency (SF) images. We manipulated (a) attention to, and (b) congruency of information in the two SF bands. Processing difficulty of the different SF bands varied across different categorization tasks: house-flower, face-house, and valence decisions were easier when based on high SF bands, while flower-face and gender categorizations were easier when based on low SF bands. Larger interference also arose from response relevant distracters that were presented in the "preferred" SF range of the task. Low SF effects were facilitated by short exposure durations. The results demonstrate that decisions are affected by an interaction of task and SF range and that the information from the non-attended SF range interfered at the decision level. A further analysis revealed that overall differences in the statistics of image features, in particular differences of orientation information between two categories, were associated with decision difficulty. We concluded that the advantage of using information from one SF range over another depends on the specific task requirements that built on the differences of the statistical properties between the compared categories.

Pleasant music overcomes the loss of awareness in patients with visual neglect.

During the past 20 years there has been much research into the factors that modulate awareness of contralesional information in neurological patients with visual neglect or extinction. However, the potential role of the individual's emotional state in modulating awareness has been largely overlooked. In the current study, we induced a pleasant and positive affective response in patients with chronic visual neglect by allowing them to listen to their pleasant preferred music. We report that the patients showed enhanced visual awareness when tasks were performed under preferred music conditions relative to when tasks were performed either with unpreferred music or in silence. These results were also replicated when positive affect was induced before neglect was tested. Functional MRI data showed enhanced activity in the orbitofrontal cortex and the cingulate gyrus associated with emotional responses when tasks were performed with preferred music relative to unpreferred music. Improved awareness of contralesional (left) targets with preferred music was also associated with a strong functional coupling between emotional areas and attentional brain regions in spared areas of the parietal cortex and early visual areas of the right hemisphere. These findings suggest that positive affect, generated by preferred music, can decrease visual neglect by increasing attentional resources. We discuss the possible roles of arousal and mood in generating these effects.