Aversive conditioning is impaired in impulsive individuals: A study on learning asymmetries.

BACKGROUND AND OBJECTIVES: Appetitive and aversive conditioning are thought to be involved in the development and maintenance of mental disorders including anxiety, mood, eating, and substance use disorders. However, few studies measure the relative strength of appetitive and aversive associations, and their relevance to the risk of mental disorders. This study aims to address this gap. METHODS: We tested how readily healthy volunteers acquire appetitive vs. aversive associations. 150 participants associated complex 3D objects with either gain or loss and made decisions to gain or avoid losing points. We investigated the relationship of a learning asymmetry with neuroticism, impulsivity, and anhedonia, to test the hypothesis that a stronger learning asymmetry corresponds to more extreme scores on these traits. RESULTS: Impulsivity was positively associated with the learning asymmetry (R2 = .10). This resulted from an inverse relation with the strength of aversive associations, indicating that impulsive individuals are worse at aversive learning. However, appetitive associations did not differ significantly. No correlations with neuroticism or anhedonia were found. LIMITATIONS: Conditioning studies typically use primary reinforcers and a CS-. Lacking these may make these results less comparable to other studies. CONCLUSIONS: We demonstrate that the learning asymmetry can measure individual differences linked to personality traits, and that impulsivity, normally linked with appetitive learning, also influences aversive learning. These results enable additional studies of learning asymmetry in relation to mental disorders, which could include measurements of mental health symptoms to provide further insight into how appetitive and aversive learning interacts with mental disorders.

Food rejection and the relation with category-based induction and memory in young children.

BACKGROUND: Childhood rejection of fruits and vegetables (F/V) has been associated with an immature food categorization system, characterized by difficulties in accurately categorizing and making inductions about foods. This may result in variations in the kind of category-based induction children use, such as relying on the color of a fruit/vegetable. Research indicates that children who reject food frequently tend to prioritize perceptual features like color and shape over abstract features, such as the type of food (e.g., tomato) when making food-related inductions. The way children categorize food can also impact what they remember about foods. Food rejection may therefore be related to better memory for perceptual features and diminished memory for abstract features. To explore this further, a pre-registered study was conducted to examine how category-based induction and memory relate to each other, and to children's food rejection. METHODS: 107 children aged 4-6 years old performed a category-based induction and memory task related to F/V, based on color and shape (perceptual features), and type of food (abstract feature). A vegetable photo task measured vegetable acceptance, and parents completed the Child Food Rejection Scale (CFRS). RESULTS: Children generally used color-based induction and displayed better memory for F/V color. Performance on the two tasks was related: higher type-based induction for F/V was linked to better memory for the type of F/V. However, there were no associations found with food rejection. CONCLUSION: Which category young children use for inductive reasoning about food, is related to what they remember best about food. Nevertheless, our study did not establish a relationship between an immature food categorization system and food rejection. Other factors, such as food familiarity, might play a stronger role in children's food acceptance.

Choice-induced tasting. Evaluating the effect of choice on children's acceptance of an unfamiliar vegetable.

Children's vegetable intake is in general below recommendations. It is known that self-selection of vegetables out of multiple options can increase intake in children. However, it is not clear if this effect is driven by a pre-existing preference for the selected food, or purely by having a choice. Allowing children to choose could create a positive bias and endorse feelings of autonomy, which could increase acceptance of the food and promote intake. The aim of the present pre-registered study was to investigate the effect of choice in promoting the acceptance of an unfamiliar vegetable during a blind-choice task. Children aged 4-5 years old (n = 161) were randomly assigned to the choice or no-choice condition. Each child was presented with three closed cups, containing a vegetable. The children were unaware that the cups contained the same vegetable, a piece of raw celeriac. In the choice condition, the children were able to choose a cup themselves whereas in the no-choice condition, the experimenter made the decision. We hypothesized that children in the choice condition would show more acceptance of the vegetable compared to children in the no-choice condition and that higher levels of picky eating would lead to less vegetable acceptance. The results demonstrated that choice indeed significantly increased vegetable acceptance (4.7 ± 1.7 versus 4.0 ± 1.9 on a 6-point scale), irrespective of pickiness in eating. In addition, picky children showed less acceptance of the vegetable compared to non-picky children. The results of this study imply that choice is an important factor in promoting unfamiliar vegetable intake in young children. Including children in the decision process may be a practical strategy for educators and caregivers to increase children's vegetable intake.

Eating disorders in weight-related therapy (EDIT): Protocol for a systematic review with individual participant data meta-analysis of eating disorder risk in behavioural weight management.

The Eating Disorders In weight-related Therapy (EDIT) Collaboration brings together data from randomised controlled trials of behavioural weight management interventions to identify individual participant risk factors and intervention strategies that contribute to eating disorder risk. We present a protocol for a systematic review and individual participant data (IPD) meta-analysis which aims to identify participants at risk of developing eating disorders, or related symptoms, during or after weight management interventions conducted in adolescents or adults with overweight or obesity. We systematically searched four databases up to March 2022 and clinical trials registries to May 2022 to identify randomised controlled trials of weight management interventions conducted in adolescents or adults with overweight or obesity that measured eating disorder risk at pre- and post-intervention or follow-up. Authors from eligible trials have been invited to share their deidentified IPD. Two IPD meta-analyses will be conducted. The first IPD meta-analysis aims to examine participant level factors associated with a change in eating disorder scores during and following a weight management intervention. To do this we will examine baseline variables that predict change in eating disorder risk within intervention arms. The second IPD meta-analysis aims to assess whether there are participant level factors that predict whether participation in an intervention is more or less likely than no intervention to lead to a change in eating disorder risk. To do this, we will examine if there are differences in predictors of eating disorder risk between intervention and no-treatment control arms. The primary outcome will be a standardised mean difference in global eating disorder score from baseline to immediately post-intervention and at 6- and 12- months follow-up. Identifying participant level risk factors predicting eating disorder risk will inform screening and monitoring protocols to allow early identification and intervention for those at risk.

How does Go/No-Go training lead to food devaluation? Separating the effects of motor inhibition and response valence.

Palatable, unhealthy food stimuli can be devalued via Go/No-Go (GNG) training that consistently pairs such stimuli with motor inhibition. However, it remains unclear whether this devaluation is caused via learned associations with motor inhibition or via inferential learning based on the valence of emitted motor responses. The present research disentangles the effects of motor assignment and response valence in GNG training through task instructions. In two studies, chocolate stimuli were consistently paired with motor inhibition ("no-go") or with motor excitation ("go"). Task instructions indicated that no-go responses were negatively valenced ("do not take") and that go responses were positively valenced ("take"), or identified no-go responses as positively valenced ("keep") and go as negatively valenced ("throw away"). The results show an effect of response valence on chocolate evaluations, but no effect of motor assignment: Chocolate stimuli were consistently devalued following pairings with a negatively valenced response, regardless of whether this response entailed motor inhibition or excitation. These findings align best with an inferential account of GNG training, suggesting that devaluation effects critically depend on inferential processes regarding motor response valence. GNG training procedures may, therefore, be optimised by disambiguating the valence of go and no-go motor responses prior to training.

Cognitive training and remediation interventions for substance use disorders: a Delphi consensus study.

AIMS: Substance use disorders (SUD) are associated with cognitive deficits that are not always addressed in current treatments, and this hampers recovery. Cognitive training and remediation interventions are well suited to fill the gap for managing cognitive deficits in SUD. We aimed to reach consensus on recommendations for developing and applying these interventions. DESIGN, SETTING AND PARTICIPANTS: We used a Delphi approach with two sequential phases: survey development and iterative surveying of experts. This was an on-line study. During survey development, we engaged a group of 15 experts from a working group of the International Society of Addiction Medicine (Steering Committee). During the surveying process, we engaged a larger pool of experts (n = 54) identified via recommendations from the Steering Committee and a systematic review. MEASUREMENTS: Survey with 67 items covering four key areas of intervention development: targets, intervention approaches, active ingredients and modes of delivery. FINDINGS: Across two iterative rounds (98% retention rate), the experts reached a consensus on 50 items including: (i) implicit biases, positive affect, arousal, executive functions and social processing as key targets of interventions; (ii) cognitive bias modification, contingency management, emotion regulation training and cognitive remediation as preferred approaches; (iii) practice, feedback, difficulty-titration, bias modification, goal-setting, strategy learning and meta-awareness as active ingredients; and (iv) both addiction treatment work-force and specialized neuropsychologists facilitating delivery, together with novel digital-based delivery modalities. CONCLUSIONS: Expert recommendations on cognitive training and remediation for substance use disorders highlight the relevance of targeting implicit biases, reward, emotion regulation and higher-order cognitive skills via well-validated intervention approaches qualified with mechanistic techniques and flexible delivery options.

Combined Working Memory Training and Transcranial Magnetic Stimulation Demonstrates Low Feasibility and Potentially Worse Outcomes on Delay to Smoking and Cognitive Tasks: A Randomized 2 × 2 Factorial Design Pilot and Feasibility Study.

INTRODUCTION: Repetitive Transcranial Magnetic Stimulation (rTMS) has shown promising results in treating several Substance Use Disorders including Tobacco Use Disorder. However, questions remain regarding how to optimize treatment outcomes. Enhancement of working memory by rTMS is a potential therapeutic mechanism. The current pilot study examined whether rTMS plus a cognitive training program could enhance the effects of rTMS on smoking behaviors using a controlled, factorial design. AIMS AND METHODS: We hypothesized that cognitive training plus stimulation would improve control over smoking behaviors, resulting in enhanced cognitive performance and increased latency to smoke on a delay to smoking analog task. Using a 2 × 2 factorial design, nicotine dependent smokers (n = 43) were randomized to receive 10 sessions of active (10 Hz) or sham rTMS delivered to the left dorsolateral prefrontal cortex, plus active or sham working memory training (WMT) prior to and following stimulation. RESULTS: Contrary to hypotheses, we observed a significant interaction effect, indicating that combining the two active interventions (rTMS+WMT) resulted in worse performance on the smoking analog task (B = -33.0, 95% CI = -64.39, -1.61, p < .05), compared to delivering either intervention alone. Additionally, although active rTMS (compared to sham rTMS) improved letter-sequencing performance (B = 1.23, 95% CI = 0.08-2.38, p < .05), and active WMT (compared to sham WMT) improved back-digit task performance (B = 1.53, 95% CI = 0.02-3.05, p < .05), combining interventions worsened the effect of each on a back-digit task (B = -3.01, 95% CI = -5.96, -0.052, p < .05). CONCLUSIONS: These preliminary findings indicate potential iatrogenic effects of combining rTMS and this working memory training intervention and underscore the need for rigorous evaluation of substance specific conceptual frameworks when selecting future combination interventions. IMPLICATIONS: Counter to hypothesis, this study found no additional benefit of adding a working memory training program to a rTMS protocol in a sample of daily smokers. The combination condition (active rTMS + active training) resulted in worse performance on a delay to smoking analog task and a measure of working memory performance compared to delivering either intervention alone. These preliminary findings inform strategies for optimizing rTMS in smokers and highlight the need for future studies to consider several key components of candidate combination interventions, including effects on regulation of substance use. CLINICAL TRIAL REGISTRATION (IF ANY): The trial was registered at ClinicalTrials.gov (NCT03337113).

Childhood Disorder: Dysregulated Self-Conscious Emotions? Psychopathological Correlates of Implicit and Explicit Shame and Guilt in Clinical and Non-clinical Children and Adolescents.

This study examined psychopathological correlates of implicit and explicit shame and guilt in 30 clinical and 129 non-clinical youths aged 8-17 years. Shame and guilt were measured explicitly via two self-reports and a parent report, and implicitly by means of an Implicit Association Test (IAT), while a wide range of psychopathological symptoms were assessed with questionnaires completed by children, parents, and teachers. The results showed no differences of implicit and explicit shame and guilt between the clinical and non-clinical group, implying that dysregulation of these self-conscious emotions is not per definition associated with psychopathology. Correlational analyses indicated that self-reported explicit shame was positively associated with a broad range of internalizing psychopathology, while self-reported explicit guilt was associated with higher levels of anxiety and to some extent lower levels of externalizing psychopathology. Correlations with parent-rated shame and guilt revealed the same pattern of results but were in general weaker. Furthermore, implicit shame and guilt did not show significant correlations with the various measures of psychopathology. It can be concluded that the link between shame and guilt and psychopathology is complex, and partly dependent on the disorder under study and context-related factors defining the maladaptive nature of these self-conscious emotions.

Working memory training efficacy in COPD: the randomised, double-blind, placebo-controlled Cogtrain trial.

BACKGROUND: Cognitive impairment is highly prevalent in COPD and is associated with a sedentary lifestyle, unhealthy diet and increased cognitive stress susceptibility. Enhancement of cognitive performance by working memory training (WMT) may reverse these effects. Therefore, this study aimed to investigate the efficacy of WMT in COPD on cognitive performance, healthy lifestyle behaviours and cognitive stress susceptibility. METHODS: The double-blind randomised, placebo-controlled Cogtrain trial consisted of a 12-week training phase comprising 30 active or sham WMT sessions, followed by a second 12-week maintenance phase with 12 sessions. Measurements took place at baseline and after the first and second phases. The primary outcome was cognitive performance. Secondary outcomes were the recall of prespecified healthy lifestyle goals, physical capacity and activity, dietary quality and cognitive stress susceptibility. Motivation towards exercising and healthy eating and psychological wellbeing were exploratory outcomes. RESULTS: Sixty-four patients with moderate COPD (45% male, aged 66.2±7.2 years, median forced expiratory volume in 1 s 60.6% predicted) were randomised. WMT significantly increased patients' performance on the trained tasks in the first phase, which remained stable in the second phase. Of the 17 cognitive outcome measures, only one measure of memory improved after the first phase and one measure of reaction time after the second phase. This intervention did not influence physical capacity and activity, recall of prespecified healthy lifestyle goals, psychological wellbeing or cognitive stress susceptibility. CONCLUSION: WMT improved performance on the trained tasks but not overall cognitive performance, healthy lifestyle behaviours or cognitive stress susceptibility in patients with COPD.

Exposure therapy vs lifestyle intervention to reduce food cue reactivity and binge eating in obesity: A pilot study.

BACKGROUND AND OBJECTIVES: Learning models of overeating predict that exposure therapy is effective in reducing food cue reactivity and overeating. This pilot study tested an eight-session exposure therapy aimed at inhibitory learning vs. an active control condition aimed at lifestyle improvement for obesity (treatment-as-usual). Main outcomes are snacking behavior, eating psychopathology, food cue reactivity, and weight loss. Change in overeating expectancies was assessed as mediator for outcomes, and the associations between habituation of eating desires and outcomes were investigated in the exposure condition. Sleep quality was investigated as moderator for outcomes. METHODS: 45 overweight women were randomly assigned to the exposure intervention or control condition. The main outcomes, overeating expectancies and sleep quality were re-assessed at post-treatment and three-month follow-up. Habituation of eating desires was measured during exposure sessions. RESULTS: Compared to the control intervention, exposure led to a significantly stronger reduction in snacking behavior of exposed foods, though this effect did not generalize to non-exposed foods, and stronger binge eating frequency. The exposure condition lost significantly more weight at post-treatment and follow-up than the lifestyle condition. Changes of expectancies mediated the effect of condition on kcal consumption of exposed foods, while habituation during exposure was not related to better treatment outcome. Sleep quality did not moderate the effect of condition on treatment outcome. LIMITATIONS: Small sample size and limited follow-up period. CONCLUSIONS: This short exposure therapy reduced snacking behavior, binge eating and weight more than a lifestyle intervention and is therefore a recommendable intervention for obesity and overeating disorders.

Computerized neurocognitive training for improving dietary health and facilitating weight loss.

Nearly 70% of Americans are overweight, in large part because of overconsumption of high-calorie foods such as sweets. Reducing sweets is difficult because powerful drives toward reward overwhelm inhibitory control (i.e., the ability to withhold a prepotent response) capacities. Computerized inhibitory control trainings (ICTs) have shown positive outcomes, but impact on real-world health behavior has been variable, potentially because of limitations inherent in existing paradigms, e.g., low in frequency, intrinsic enjoyment, personalization, and ability to adapt to increasing ability. The present study aimed to assess the feasibility, acceptability, and efficacy of a gamified and non-gamified, daily, personalized, and adaptive ICT designed to facilitate weight loss by targeting consumption of sweets. Participants (N = 106) were randomized to one of four conditions in a 2 (gamified vs. non-gamified) by 2 (ICT vs. sham) factorial design. Participants were prescribed a no-added-sugar diet and completed 42 daily, at-home trainings, followed by two weekly booster trainings. Results indicated that the ICTs were feasible and acceptable. Surprisingly, compliance to the 44 trainings was excellent (88.8%) and equivalent across both gamified and non-gamified conditions. As hypothesized, the impact of ICT on weight loss was moderated by implicit preference for sweet foods [F(1,95) = 6.17, p = .02] such that only those with higher-than-average implicit preference benefited (8-week weight losses for ICT were 3.1% vs. 2.2% for sham). A marginally significant effect was observed for gamification to reduce the impact of ICT. Implications of findings for continued development of ICTs to impact health behavior are discussed.

Taste the texture. The relation between subjective tactile sensitivity, mouthfeel and picky eating in young adults.

Selective or picky eating can be an obstacle for a varied diet. One reason why people reject certain foods is because they do not like the texture. Several studies show that in children tactile sensitivity is related to pickiness in eating. Children who do not like the feel of sand or of slimy substances with their hands also reject more kinds of food, presumably because the children are more sensitive to the mouthfeel of several food textures. There is however hardly any research on the role of tactile sensitivity in adult food acceptance. Two important questions therefore are: Is tactile sensitivity related to picky eating in adults and if so, does mouthfeel mediate the relation between tactile sensitivity and pickiness? In the current study, picky eating, subjective tactile sensitivity, and evaluation of mouthfeel were measured in 87 undergraduate students. It appeared that the three measures are moderately related, with mouthfeel mediating the relation between subjective tactile sensitivity and pickiness in eating. These results show that in adults too, tactile sensitivity plays a role in the acceptance of a larger variety of foods. This means that when aiming to change or improve dietary quality of adults, acceptance of food texture should be taken into account.

Food healthiness versus tastiness: Contrasting their impact on more and less successful healthy shoppers within a virtual food shopping task.

A virtual shopping task was employed to illuminate why women who intend to shop healthily are differentially successful in doing so. Female undergraduates (N = 68) performed a modified approach and avoidance task that employed food items differing in healthiness and tastiness, and yielded relative speed to select and reject food items in a stylised supermarket. Participants categorised a food item either in terms of healthiness or tastiness, then pulled (selected) or pushed (rejected) the item using a joystick. Participants showed faster selection of tasty food after categorisation in terms of tastiness, irrespective of the food's healthiness. However, after categorisation in terms of healthiness, only more successful healthy food shoppers showed faster selection of healthy items regardless of tastiness. Less successful healthy food shoppers showed this effect only for tasty food, and displayed faster rejection of food items not considered tasty, regardless of their assessed healthiness. Thus, when participants who reported the greatest gap between their shopping intention and shopping behaviour were judging the healthiness of food items, their speed to select and reject items continued to be influenced by tastiness. This suggests that reducing incidental processing of food tastiness may reduce the intention-behaviour gap in healthy food shopping.

When food becomes an obsession: Overweight is related to food-related obsessive-compulsive behavior.

In this study, it was examined whether overweight is associated with food-related obsessions and compulsions. Participants with a healthy weight (n = 27) and participants who were overweight (n = 33) filled out the Yale-Brown-Cornell Eating Disorder Scale, the Eating Obsessive-Compulsive Scale, and the Emotional and Behavioral Reactions to Intrusions Questionnaire to assess frequency, distress, control, and reactance associated with food-related preoccupations and compulsions. Overweight participants showed increased food-related preoccupations, compulsive eating, and heightened emotional and behavioral reactance compared to participants with a healthy weight. Increased food-related obsessive-compulsiveness was also associated with unhealthy eating patterns.

A randomized controlled trial of inhibitory control training for the reduction of alcohol consumption in problem drinkers.

OBJECTIVE: We conducted a randomized controlled trial to compare the effects of three types of Internet-delivered Inhibitory Control Training (ICT) with each other and with an active control intervention on alcohol consumption in a community sample of problem drinkers. METHOD: Two hundred and 46 heavy drinkers, who were motivated to reduce their alcohol consumption (mean age 41.32, 130 female) self-monitored their alcohol consumption for 1 week before being randomized to receive 1 of 3 variants of ICT (Associative No-Go, Associative Stop Signal, General Inhibition) or an active control. Participants then completed up to 14 ICT/control sessions on the Internet over a 4-week period, while regularly recording their alcohol consumption. RESULTS: There were significant reductions in alcohol consumption across all groups over the 4-week training period (main effect of time, F(2, 402) = 77.12, p < .01, ηp2 = .28, BF10 > 99), however there were no differences between ICT groups, or between ICT groups and the active control group (Group × Time interaction, F(6, 402) = 1.10, p = .36, ηp2 = .02, BF10 = 0.03). Contrary to hypotheses, there were no changes in general inhibitory control, the disinhibiting effects of alcohol cues, or alcohol affective associations after ICT. CONCLUSIONS: In this study, which attempted to translate findings from proof-of-concept laboratory studies into a viable behavior change intervention, we found that multiple sessions of ICT delivered over the Internet did not help heavy drinkers to reduce their alcohol consumption beyond nonspecific effects associated with taking part in a trial. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Will work less for food: Go/No-Go training decreases the reinforcing value of high-caloric food.

Consistently inhibiting responses to palatable food stimuli increases motor suppression for those stimuli and reduces their hedonic value, suggesting a close link between motor inhibition and food reward. The current study aimed to investigate whether GNG training also reduces the motivational, reinforcing value of palatable, high-calorie food. Participants completed either GNG training for high-calorie food or a control task. This was followed by a Concurrent Schedules Task (CST) to measure the reinforcing value of high-calorie food. As hypothesized, participants in the GNG condition showed reduced high-caloric food reinforcement, as indexed by the number of key presses participants were willing to execute to obtain the food, compared to the control condition. This difference between GNG and control, however, was only significant when the response requirement to obtain high-calorie food was high. These results suggest that GNG training not only reduces hedonic food value but also the motivational, reinforcing value of food.

Does working memory training improve dietary self-care in type 2 diabetes mellitus? Results of a double blind randomised controlled trial.

AIMS: Controlling food intake despite adequate knowledge remains a struggle for many people with type 2 diabetes. The present study investigated whether working memory training can reduce food intake and improve glycaemic control. It also examined training effects on cognition, food cravings, and dietary self-efficacy and self-care. METHODS: In a double-blind multicentre parallel-group randomised controlled trial, adults with type 2 diabetes mellitus were randomly allocated to receive 25 sessions of either active (n = 45) or control (n = 36) working memory training. Assessments at baseline, post-training and 3-month follow-up measured cognition, food intake (primary outcomes), glycaemic control (HbA1c) and cholesterol (secondary outcomes). Semi-structured interviews assessed participants' experiences of the training. RESULTS: Intention-to-treat ANOVAs (N = 81) showed improved non-trained updating ability in active compared to control training from pre-test (active M = 34.37, control M = 32.79) to post-test (active M = 31.35, control M = 33.53) and follow-up (active M = 31.81, control M = 32.65; η2 = 0.05). There were no overall effects of training on other measures of cognition, food intake, HbA1c, cholesterol, food cravings and dietary self-efficacy and self-care. In post-hoc analyses, those high in dietary restraint in the active training group showed a greater reduction in fat intake pre to post-test compared to controls. Interviews revealed issues around acceptability and performance of the training. CONCLUSIONS: Transfer of working memory training effects to non-trained behaviour were limited, but do suggest that training may reduce fat intake in those who are already motivated to do so. TRIAL REGISTRATION: Current Controlled Trials ISRCTN22806944.

Self-regulation and obesity: the role of executive function and delay discounting in the prediction of weight loss.

Obesity rates are rising worldwide. Executive function and delay discounting have been hypothesized to play important roles in the self-regulation of behavior, and may explain variance in weight loss treatment success. First, we compared individuals with obesity (n = 82) to healthy weight controls (n = 71) on behavioral and self-report measures of executive function (working memory, inhibition and shifting) and delay discounting. Secondly, the individuals with obesity took part in a multidisciplinary weight loss program and we examined whether executive function and delay discounting predicted weight change. Individuals with obesity displayed weaker general and food-specific inhibition, and weaker self-reported executive function. Better behavioral working memory and better self-reported inhibition skills in daily life were predictive of greater weight loss. As findings are correlational, future studies should investigate the causal relationship between executive function and weight loss, and test whether intervening on executive function will lead to better prevention and treatment of obesity.

Do daily fluctuations in inhibitory control predict alcohol consumption? An ecological momentary assessment study.

RATIONALE: Deficient inhibitory control is predictive of increased alcohol consumption in the laboratory; however, little is known about this relationship in naturalistic, real-world settings. OBJECTIVES: In the present study, we implemented ecological momentary assessment methods to investigate the relationship between inhibitory control and alcohol consumption in the real world. METHODS: Heavy drinkers who were motivated to reduce their alcohol consumption (N = 100) were loaned a smartphone which administered a stop signal task twice per day at random intervals between 10 a.m. and 6 p.m. for 2 weeks. Each day, participants also recorded their planned and actual alcohol consumption and their subjective craving and mood. We hypothesised that day-to-day fluctuations in inhibitory control (stop signal reaction time) would predict alcohol consumption, over and above planned consumption and craving. RESULTS: Multilevel modelling demonstrated that daily alcohol consumption was predicted by planned consumption (ß = .816; 95% CI .762-.870) and craving (ß = .022; 95% CI .013-.031), but inhibitory control did not predict any additional variance in alcohol consumption. However, secondary analyses demonstrated that the magnitude of deterioration in inhibitory control across the day was a significant predictor of increased alcohol consumption on that day (ß = .007; 95% CI .004-.011), after controlling for planned consumption and craving. CONCLUSIONS: These findings demonstrate that short-term fluctuations in inhibitory control predict alcohol consumption, which suggests that transient fluctuations in inhibition may be a risk factor for heavy drinking episodes.

Computer training of attention and inhibition for youngsters with obesity: A pilot study.

Obesity is a widespread problem that starts from an early age. Previous studies suggest that obese youngsters have an attentional bias and an automatic approach tendency towards high-calorie food and display difficulties inhibiting impulses, which may result in a higher intake of (high-calorie) food. An interesting idea for improvement of the current obesity treatment is adding a program that enables to train their difficulties. Subjects were 36 youngsters aged 9-15 years old from an inpatient treatment program for obesity, randomized over a training group and an active control group. The training consisted of six training sessions with cognitive tasks aimed at enhancing inhibition towards unhealthy food items (with a go/no-go task), as well as decreasing a food approach bias (using an approach/avoidance task) and a food attentional bias (using a dot-probe task). The current study evaluated the feasibility, acceptability and initial effectiveness of the training and explores if these characteristics helps obese youngsters to maintain weight-loss once they return home at the end of their inpatient treatment program. Results on the cognitive performances were investigated during two measurement sessions, spread over 5 weeks while weight evolution was followed over 13 weeks. Results showed that the training program was feasible and acceptable to the majority of participants and clinicians. Furthermore, the preliminary findings suggest that the training tasks used were ineffective in this group of obese children. Lessons learned and suggestions for future research are discussed.