Numerosity comparison, cognitive strategies, and general cognitive functioning in older people.

Introduction: Studies have shown age-related differences in numerical cognition, for example, in the level of numerosity comparison ability. Moreover, some studies point out individual differences in the cognitive strategies employed during the performance of numerosity comparison tasks and reveal that they are related to the aging process. One probable cause of these differences is the level of cognitive functioning. The aim of our study was to determine the relationships among numerosity comparison ability, the cognitive strategies utilized in the performance of numerosity comparison tasks and the general cognitive functioning in older people. Methods: Forty-seven elderly people participated in the study. The participants were examined using overall cognitive functioning scales and computerized numerosity comparison task. Results: The results showed many correlations between the participants' level of cognitive functioning and the percent of correct responses (PCR) and response time (RT) during numerosity comparison, as well as with the cognitive strategies applied by the participants. Task correctness was positively related to the level of performance in the attention and executive function tasks. In contrast, the long-term memory resources index and visuospatial skills level were negatively correlated with RT regarding numerosity comparison task performance. The level of long-term memory resources was also positively associated with the frequency of use of more complex cognitive strategies. Series of regression analyses showed that both the level of general cognitive functioning and the cognitive strategies employed by participants in numerosity comparison can explain 9-21 percent of the variance in the obtained results. Discussion: In summary, these results showed significant relationships between the level of cognitive functioning and proficiency in numerosity comparison measured in older people. Moreover, it has been shown that cognitive resources level is related to the strategies utilized by older people, which indicates the potential application for cognitive strategy examinations in the development of new diagnostic tools.

Metacognitive beliefs of efficacy about daily life situations and use of cognitive strategies in amnestic mild cognitive impairment: a cross-sectional study.

Metacognition, the ability to monitor and regulate cognitive processes, is essential for individuals with Mild Cognitive Impairment (MCI) to accurately identify their deficits and effectively manage them. However, previous studies primarily focused on memory awareness in MCI, neglecting other domains affected in daily life. This study aimed to investigate how individuals with MCI perceive their abilities to handle various cognitively challenging situations representing real-life scenarios and their use of compensatory strategies. Thus 100 participants were recruited, including 50 with amnestic MCI with multiple deficits (aMCI) and 50 cognitively healthy controls (HC) matched in age and education. Participants completed three metacognitive scales assessing self-perceived efficacy in everyday life scenarios and one scale evaluating use of cognitive strategies. Results indicated that aMCI participants reported significantly lower self-efficacy in memory and divided-shifted attention scenarios compared to HC. Surprisingly, no significant group differences were found in the self-reports about the use of cognitive strategies. This suggests a potential gap in understanding or applying effective strategies for compensating cognitive deficits. These findings emphasize the importance of cognitive training programs targeting metacognitive knowledge enhancement and practical use of cognitive strategies that could enhance the quality of life for individuals with MCI.

Eye movements reveal that young school children shift attention when solving additions and subtractions.

Adults shift their attention to the right or to the left along a spatial continuum when solving additions and subtractions, respectively. Studies suggest that these shifts not only support the exact computation of the results but also anticipatively narrow down the range of plausible answers when processing the operands. However, little is known on when and how these attentional shifts arise in childhood during the acquisition of arithmetic. Here, an eye-tracker with high spatio-temporal resolution was used to measure spontaneous eye movements, used as a proxy for attentional shifts, while children of 2nd (8 y-o; N = 50) and 4th (10 y-o; N = 48) Grade solved simple additions (e.g., 4+3) and subtractions (e.g., 3-2). Gaze patterns revealed horizontal and vertical attentional shifts in both groups. Critically, horizontal eye movements were observed in 4th Graders as soon as the first operand and the operator were presented and thus before the beginning of the exact computation. In 2nd Graders, attentional shifts were only observed after the presentation of the second operand just before the response was made. This demonstrates that spatial attention is recruited when children solve arithmetic problems, even in the early stages of learning mathematics. The time course of these attentional shifts suggests that with practice in arithmetic children start to use spatial attention to anticipatively guide the search for the answer and facilitate the implementation of solving procedures. RESEARCH HIGHLIGHTS: Additions and subtractions are associated to right and left attentional shifts in adults, but it is unknown when these mechanisms arise in childhood. Children of 8-10 years old solved single-digit additions and subtractions while looking at a blank screen. Eye movements showed that children of 8 years old already show spatial biases possibly to represent the response when knowing both operands. Children of 10 years old shift attention before knowing the second operand to anticipatively guide the search for plausible answers.

Verbal-analytical rather than visuo-spatial Raven's puzzle solving favors Raven's-like puzzle generation.

Raven's advanced progressive matrices (APM) comprise two types of representational codes, namely visuo-spatial and verbal-analytical, that are used to solve APM puzzles. Studies using analytical, behavioral, and imaging methods have supported the multidimensional perspectives of APM puzzles. The visuo-spatial code is expected to recruit operations more responsive to the visual perception tasks. In contrast, the verbal-analytical code is expected to use operations more responsive to the logical reasoning task and may entail different cognitive strategies. Acknowledging different representational codes used in APM puzzle-solving is critical for a better understanding of APM's performance and their relationship with other tasks, especially creative reasoning. We used the eye-tracking method to investigate the role of two representational codes, visuo-spatial and verbal-analytical, in strategies involved in solving APM puzzles and in generating an APM-like puzzle by using a creative-reasoning task (CRT). Participants took longer time to complete the verbal-analytical than visuo-spatial puzzles. In addition, visuo-analytical than visual-spatial puzzles showed higher progressive and regressive saccade counts, suggesting the use of more response elimination than constructive matching strategies employed while solving verbal-analytical than visuo-spatial puzzles. We observed higher CRT scores when it followed verbal-analytical (Mdn = 84) than visuo-spatial (Mdn = 73) APM puzzles, suggesting puzzle-solving specific strategies affect puzzle-creating task performance. The advantage of verbal-analytical over visuo-spatial puzzle-solving has been discussed in light of shared cognitive processing between APM puzzle-solving and APM-like puzzle-creating task performance.

Cognitive Coping Strategies among Inpatient Adolescents with Depression and Psychiatric Comorbidity.

The aim of the present study is to describe and measure the cognitive emotion regulation strategies of inpatient adolescents with clinical depression, aged 13-18, and to analyse these coping strategies in relation to different comorbidities of Major Depressive Disorder (MDD). METHODS: There were 112 adolescents with MDD who were admitted to hospital and 78 healthy adolescents included in the study. The Cognitive Emotion Regulation Questionnaire (CERQ) was used to assess nine specific cognitive coping strategies. A cognitive coping style model for depression in adolescents was described by analysing the differences between the two groups. The CERQ scores in MDD participants, grouped by comorbidity, were also assessed. RESULTS: Adolescents with MDD had significantly higher scores for Self-Blame and Catastrophising strategies, and significantly lower scores for Positive Refocusing, Refocusing on Planning, and Positive Reappraisal. Adolescents with MDD and Borderline Personality Disorder (BPD) traits had significantly higher scores for Rumination, Catastrophising, and Blaming Others than adolescents with MDD and anxiety or with no comorbidity. CONCLUSIONS: Clinical depression in adolescents is associated with a cognitive profile that consists of an increased use of maladaptive coping styles and low employment of adaptive strategies. Early identification can contribute to the development of specific, individualised prevention and intervention programmes, while further longitudinal studies are necessary to adequately measure the outcome of these interventions.

Explorando la relación entre las somatizaciones, la ansiedad y la regulación emocional. El efecto mediador de las estrategias desadaptativas / Exploring the relationship between somatizations, anxiety and emotional regulation. The mediating effect of maladaptive strategies

Los trastornos emocionales como la ansiedad, la depresión o las somatizaciones son los más frecuentes en la población mundial. En el caso concreto de los trastornos de ansiedad y por somatización la incidencia se sitúa en el 11 y 12%, respectivamente. La relación entre sendos trastornos ha sido ampliamente estudiada, mostrando la existencia de una relación bidireccional entre ambos. Sin embargo, los mecanismos que explican dicha interrelación todavía requieren de mayor estudio. El objetivo del presente trabajo es estudiar el rol mediador de las estrategias cognitivas de regulación emocional adaptativas y desadaptativas en la relación entre la ansiedad y los síntomas somáticos. Para ello, se ha utilizado una muestra de 1,730 participantes españoles. La muestra fue recogida mediante encuestas online dentro de un diseño observacional transversal. Para analizar los datos recogidos se plantean análisis correlacionales de las variables implicadas, así como tres modelos de mediación multivariable entre los síntomas de ansiedad (ansiedad generalizada, ansiedad cognitivo-afectiva o ansiedad somática), las estrategias cognitivas de regulación emocional adaptativas y desadaptativas, y los síntomas somáticos. Los resultados muestran que las estrategias de regulación emocional desadaptativas juegan un rol mediador solo entre la ansiedad de tipo somático y los síntomas somáticos, mientras que este efecto no se observó entre los síntomas de ansiedad generalizada y ansiedad cognitiva. Se debaten las implicaciones clínicas a la hora de abordar los trastornos de ansiedad y las somatizaciones.(AU)

Emotional disorders such as anxiety, depression or somatization are the most frequent in the world’s population. In the specific case of anxiety and somatoform disorders, the incidence is 11% and 12%, respectively. The relationship between the two disorders has been extensively studied, showing the existence of a bidirectional relationship between them. However, the mechanisms that explain this interrelationship still require further study. The aim of the present work is to study the mediating role of adaptive and maladaptive cognitive strategies of emotional regulation in the relationship between anxiety and somatic symptoms. For this purpose, a sample of 1,730 Spanish participants was used. The sample was collected through online surveys within a cross-sectional observational design. In order to analyze the data collected, correlational analyses of the variables involved, as well as three multivariate mediation models between anxiety symptoms (generalized anxiety, cognitive-affective anxiety or somatic anxiety), adaptive and maladaptive cognitive strategies of emotional regulation, and somatic symptoms are proposed. Results show that maladaptive emotional regulation strategies play a mediating role only between somatic-type anxiety and somatic symptoms, whereas this effect was not observed between generalized anxiety and cognitive anxiety symptoms. Clinical implications for addressing anxiety disorders and somatization are discussed.(AU)

Cognitive models for mentally visualizing a sharp instrument in a blind procedure.

Purpose: Our objective was to understand the cognitive strategies used by surgeons to mentally visualize navigation of a surgical instrument through blind space. Methods: We conducted semi-structured interviews with 15 expert and novice surgeons following simulated retropubic trocar passage on 3D-printed models of pelvises segmented from preop MRIs. Midurethral sling surgery involves blind passage of a trocar among the urethra, bladder, iliac vessels, and bowel while relying primarily on haptic feedback from the suprapubic bone (SPB) for guidance. Our conceptual foundation was based on Lahav's study on blind people's mental mapping of spaces using haptic cues. Participants detailed how they mentally pictured the trocar's location relative to vital anatomy. We coded all responses and used constant comparative analysis to generate themes, confirmed with member checking. Results: Expert and novice participants utilized multiple cognitive strategies combined with haptic feedback to accomplish safe trocar passage. Some used a step-by-step route strategy, visualizing sequential 2D axial images of anatomy adjacent to the SPB. Others used a map strategy, forming global 3D pictures. Although these mental pictures vanished when they were "lost," a safe zone could be reestablished by touching the SPB. Experts were more likely to relate their body position to the trocar path and rely on minor variations in resistance. Novices were more inclined toward backtracking of the trocar. Conclusions: Our findings may be extended to any blind surgical procedure. Teaching visualization strategies and incorporating tactile feedback can be used intraoperatively to help learners navigate their instrument safely around vital organs.

Strategies, debates, and adversarial collaboration in working memory: The 51st Bartlett Lecture.

Frederic Bartlett championed the importance of individual strategy differences when remembering details of events. I will describe how long-running theoretical debates in the area of working memory may be resolved by considering differences across participants in the strategies that they use when performing cognitive tasks, and through adversarial collaboration between rival laboratories. In common with the established view within experimental cognitive psychology, I assume that adults have a range of cognitive functions, evolved for everyday life. However, I will present evidence showing that these functions can be engaged selectively for laboratory tasks, and that how they are deployed may differ between and within individuals for the same task. Reliance on aggregate data, while treating inter- and intra-participant variability in data patterns as statistical noise, may lead to misleading conclusions about theoretical principles of cognition, and of working memory in particular. Moreover, different theoretical perspectives may be focused on different levels of explanation and different theoretical goals rather than being mutually incompatible. Yet researchers from contrasting theoretical frameworks pursue science as a competition, rarely do researchers from competing labs work in collaboration, and debates self-perpetuate. These approaches to research can stall debate resolution and generate ever-increasing scientific diversity rather than scientific progress. The article concludes by describing a recent extended adversarial collaboration (the WoMAAC project) focused on theoretical contrasts in working memory, and illustrates how this approach to conducting research may help resolve scientific debate and facilitate scientific advance.

Mind Sports: Exploring Motivation and Use of Cognitive Strategies in Bridge.

The game of Bridge is one of the world's most widely played mind-sport games. A growing number of people consider it a meaningful leisure activity and are motivated to play. The aim of this study was to describe a sample of Bridge players in Israel in terms of demographics, player records, motivations, and cognitive strategies used to play Bridge and examine the associations between these variables. A sample of 488 Bridge players' completed an online demographic questionnaire, the Bridge Motivational Factors Checklist, and the Bridge Cognitive Strategies Questionnaire. Most players in the study were men with a mean age of 68.7 years and a Bridge player level between Vice Master and Senior Master. Most players play bridge because "bridge is a fun game". Strategy use that occurred in-game (versus pre- or postgame) obtained the highest mean score. Because Bridge is a strategy game that can be played from childhood to older adulthood, it is important to continue research to further understand the nature and different aspects of the cognitive strategy used among Bridge players and in other mind sports.

Assessing Flexibility of Solution Strategy: Strategy Shifting as a Measure of Cognitive Reserve.

OBJECTIVES: This series of experiments explores whether flexibility in strategy shifting might function as an expression of cognitive reserve (CR). METHODS: A reasoning task was designed using matrix reasoning stimuli that each required 1 of 2 specific solution strategies: logicoanalytic and visuospatial. It was formatted as a task-switching paradigm, assessing the ability to switch between solution strategies as measured by switch costs. Study 1 was done on Amazon Mechanical Turk and included an assessment of CR proxies. Study 2 used participants who had been studied extensively with neuropsychological assessments and structural neuroimaging. RESULTS: Study 1 found that switch costs increased with aging. In addition, a relationship between switch costs and CR proxies was noted, suggesting a relationship between the flexibility of strategy shifting and CR. The results of Study 2 again indicated that age negatively affected strategy-shifting flexibility, but that individuals with higher CR as measured with standard proxies performed better. The flexibility measure accounted for additional variance in cognitive performance over that explained by cortical thickness, suggesting that it may contribute to CR. DISCUSSION: Overall, the results are consistent with the idea that flexibility in strategy shifting might be 1 cognitive process that underlies cognitive reserve.

Pilot Study on the Impact of Gratitude Journaling or Cognitive Strategies on Health Care Workers.

INTRODUCTION: The COVID-19 pandemic has significantly impacted the mental well-being of health care workers (HCWs). This study assessed the feasibility, acceptability, and preliminary efficacy of two psychological interventions, gratitude journaling or cognitive strategies, on pediatric HCWs. METHOD: A pilot randomized parallel repeated measures design was used, with a convenience sample of 59 HCWs. Data were collected before and after the intervention period, 2 weeks after, and again 6 months later. Outcomes included depression, anxiety, meaning and purpose, feasibility, and acceptability. RESULTS: Thirty-seven participants completed the study. The majority were nurses (registered nurses and advanced practice registered nurses) and physicians. In both groups, depression and anxiety scores diminished, but changes were not statistically significant. The study was feasible to conduct, and subjects reported high acceptability. DISCUSSION: Gratitude journaling and cognitive strategies may help mental well-being in HCWs; however, future studies with larger samples are needed.

Strengthening problem-solving skills through occupational therapy to improve older adults' occupational performance - A systematic review.

Background: Evidence supports the role of occupational therapy (OT) for older adults, and therapeutic use of problem solving may provide a way to improve older adult's occupational performance.Aim: To assess the effectiveness and describe the contents of OT interventions aimed at improving older adults' occupational performance by strengthening their problem-solving skills.Material and Methods: This systematic review followed the phases recommended by the Cochrane Collaboration. The following databases were searched for clinical trials on OT for populations 65+ years: CINAHL, EMBASE, MEDLINE and PsycINFO. The Cochrane risk-of-bias tool (RoB-2) and the GRADE approach were used to assess the quality of the evidence. Results were presented in tables and by narrative syntheses.Results: Five studies were included comprising a total of 685 participants. In four studies, OT with a problem-solving approach outperformed control conditions post intervention. The interventions involved problem identification, analysis, strategy development and implementation. Although no serious risk of bias was detected in the individual studies, the quality of evidence was deemed low due to inconsistent and imprecise results.Conclusions: Low-quality evidence suggests that strengthening older adults' problem-solving skills may improve their occupational performance.Significance: Further investigation is required before firm practice recommendations can be prepared.

Cognitive strategies in matrix-reasoning tasks: State of the art.

Cognitive strategies in matrix-reasoning tasks have been investigated for the last decade and a half. Several steps were made since the first paper in the field, but the advances have been sparse and with little connection. Here we present a review of the state of the art in this subject. We introduce how this topic was born and how to measure these strategies, covering the diverse methods and measures that are presented in the literature to progress on this subject and the applications that were developed, as well as the knowledge that resulted from these applications. Furthermore, the future directions are discussed with the intention to engage new researchers in this topic, as well as to bring awareness to limitations that were found given the available scientific literature.

Combined effects of the contraceptive hormones, ethinyl estradiol and levonorgestrel, on the use of place and response memory in gonadally-intact female rats.

During maze navigation rats can rely on hippocampus-mediated place memory or striatum-mediated response memory. Ovarian hormones bias whether females use place or response memory to reach a reward. Here, we investigated the impact of the contraceptive hormones, ethinyl estradiol (EE) and levonorgestrel (LNG), on memory bias. A total of 63 gonadally-intact female rats were treated with either 10 µg/kg of EE alone, 20 µg/kg of LNG alone, both 10 µg/kg of EE and 20 µg/kg of LNG together, or a sesame oil injection with 5% ethanol as a vehicle control. Rats in the control condition were tested during the diestrus phase of the estrous cycle in order to control for the low circulating levels of gonadotropin and ovarian hormones that occur with oral contraceptive administration. Rats treated with LNG alone had a bias towards the use of place memory compared to diestrus phase control rats. This bias was not observed if LNG was administered in combination with EE. Rats treated with EE or EE+LNG did not have a statistically significant difference in memory bias compared to rats in the control group. These data show that synthetic hormones contained in oral contraceptives administered to females influence which cognitive strategy is predominantly used during navigation.

Cognitive Strategies: Moderating the Relationship between Executive Functions and Daily Functioning.

Whereas prior studies have addressed relationships between cognitive strategies and learning and achievement, very few dealt with their connection to daily functioning. This study examines the moderation effect of the frequency of compensatory cognitive strategy use within that relationship among university students. A sample of 336 students (18-36 years; 180 women, 156 men) answered the Dysexecutive Questionnaire (DEX; executive function components), Time Organization and Participation Scale (TOPS; daily functioning), and Compensatory Cognitive Strategies Scale (CCSS; strategy use). The results showed significant correlations between the DEX and TOPS for three CCSS levels (-1.0, -1.0 to 1.0, and 1.0 SD from average); the higher the frequency of cognitive strategy use, the stronger the association between the DEX and TOPS. The findings suggest that more frequently use of cognitive strategies can strengthen efficient daily functioning.

Harnessing cognitive strategy use for functional problems and proposed underlying mechanisms in childhood-onset dystonia.

BACKGROUND: There is a significant gap in knowledge about rehabilitation techniques and strategies that can help children and young people with hyperkinetic movement disorders (HMD) including dystonia to successfully perform daily activities and improve overall participation. A promising approach to support skill acquisition is the Cognitive Orientation to daily Occupational Performance (CO-OP) intervention. CO-OP uses cognitive strategies to help patients generate their own solutions to overcome self-identified problems encountered in everyday living. PURPOSE: 1. To identify and categorize strategies used by children with HMD to support skill acquisition during CO-OP; 2. To review the possible underlying mechanisms that might contribute to the cognitive strategies, in order to facilitate further studies for developing focused rehabilitation approaches. METHODS: A secondary analysis was performed on video-recorded data from a previous study exploring the efficacy of CO-OP for childhood onset HMD, in which CO-OP therapy sessions were delivered by a single occupational therapist. For the purpose of this study, we reviewed a total of 40 randomly selected hours of video footage of CO-OP sessions delivered to six participants (age 6-19 years) over ten intervention sessions. An observational recording sheet was applied to identify systematically the participants' or therapist's verbalizations of cognitive strategies during the therapy. The strategies were classified into six categories in line with published literature. RESULTS: Strategies used by HMD participants included distraction, externally focussed attention, internally focussed attention, emotion self-regulation, motor imagery and mental self-guidance. We postulate different underlying working mechanisms for these strategies, which have implications for the therapeutic management of children and young people with HMD including dystonia. CONCLUSIONS: Cognitive strategy training can fundamentally change and improve motor performance. On-going work will address both the underlying neural mechanisms of therapeutic change and the mediators and moderators that influence how change unfolds.

Identification of Cognitive Strategies Used by Cancer Patients as a Basis for Psychological Self-Support during Oncological Therapy.

Background: Cancer diagnosis is associated not only with health problems but also with psycho-social disability. Both medical and non-medical problems have impacts on cancer patients' quality of life. The aim of the study was the identification of cognitive emotion regulation strategies among cancer patients during radiotherapy. Methods: The study was conducted on 78 radically treated cancer patients (median 63 years). A Cognitive Emotion Regulation Questionnaire (CERQ) was used. Results: Cancer patients mostly used acceptance, positive refocusing, putting into perspective and refocus on planning. Age was inversely correlated with refocus on planning. Patients with higher levels of education tended to use rumination and catastrophizing less frequently (p < 0.05). Adaptive cognitive strategies based on putting into perspective were more frequently used by professionally active patients (p < 0.05). Patients who lived in cities used positive refocusing and putting into perspective significantly often and patients who lived in villages more frequently used catastrophizing (p < 0.05). Among lung cancer patients, catastrophizing and rumination were popular (p < 0.05) and breast cancer patients rarely used non-adaptive cognitive strategies. Conclusion: Cancer patients tended to use adaptive cognitive strategies. Personalized psychological support should be focused on lung cancer patients and older, less educated, unemployed individuals and people who lived in the countryside.

Fostering cognitive strategies for learning with 360° videos in history education contexts.

Learning settings in and out of school are increasingly relying on the use of virtual reality applications, such as 360° videos, to make learning an exciting and vivid experience for students. This applies especially to history-learning contexts. Learning with immersive representations of history-related contents requires a critical examination and reflective processing of the learning content. Cognitive strategies, such as organizing and elaborating information correspond with competencies which are assumed to be important for students' critical examination and reflective processing of history-related content. Research on self-regulated learning (SRL) suggests that the use of cognitive strategies can be promoted through respective SRL trainings. Thus, in the present quasi-experimental study (N = 164), we investigated the effectiveness of a SRL training, which adds to regular instruction on processing history-related learning materials, for students' use of cognitive strategies when examining immersive history-related 360° videos. Our results show that students who practiced analyzing 360° videos within an explicit SRL training used more cognitive strategies than students who received an implicit SRL training on how to analyze these videos. Further findings suggest that the use of these cognitive strategies probably helped students of the training condition (explicit SRL training) to make less imprecise or trivial analyses and to draw more reflective conclusions than students of the control condition (implicit SRL training). By combining research on SRL and history education, our study may provide a new impulse for empirical research on competence-oriented learning with history-related virtual reality media.

Ace Your Self-Study: A Mobile Application to Support Self-Regulated Learning.

Without guidance, students typically overestimate their understanding and memory of learning materials, which can have detrimental effects on the learning process. However, most students do not receive guidance or instruction about how to study. Moreover, students are largely unaware of strategies to self-regulate their learning and study effectively. Research has shown that prompting both cognitive and metacognitive strategies is effective to support self-regulated learning (SRL). Therefore we developed a mobile application, the Ace your self-study app, to prompt both cognitive and metacognitive strategies to support learning processes. In this article a theoretical background, description of the app's features and design choices are presented. Also, data from the application in presented to give provide an idea of how the app has been used.

Video Game Play Does Not Improve Spatial Skills When Controlling for Speed-Accuracy Trade-Off: Evidence From Mental-Rotation and Mental-Folding Tasks.

Researchers have been divided on the efficacy of computerized cognitive training (CCT) for enhancing spatial abilities, transfer of training, and improving malleability of skills. In this study, we assessed the effects of puzzle video game training on subsequent mental rotation (MR) and mental folding (MF) performance among adults with no cognitive impairment. We assessed participants at baseline with the Shepard-Metzler MR test followed by the differential aptitude test: space relations MF test (i.e., far transfer). We ranked participants' skills on these pre-tests and used a matching technique to form two skill groups from which we then randomly assigned members of each skill group either to an experimental group or a wait-list control group. The experimental group played two puzzle video games closely related to two-dimensional and three-dimensional MR tasks during 4-week training sessions (total of 12 hour of video games). Post-training, participants completed the MR and MF tests again. Two months later, we re-assessed only the experimental group's spatial skills to explore the sustainability of the trained performance. In addition to response times (RT) and error scores (ES), reported separately, we combined these variables into rate correct scores (RCS) to form an integrated measure of potential speed-accuracy trade-offs (SAT). As a result, we did not find significant improvements in MR performance from CCT engagement, nor did participants show a transfer of skills obtained by practicing MR-related puzzle games to a MF task. Based on the current findings, we urge caution when proposing a game-based intervention as a training tool to enhance spatial abilities. We argue that separately interpreting individual test measures can be misleading, as they only partially represent performance. In contrast, composite scores illuminate underlying cognitive strategies and best determine whether an observed improvement is attributable to enhanced capacities or individual heuristics and learned cognitive shortcuts.