Sleep deprivation selectively disrupts top-down adaptation to cognitive conflict in the Stroop test.

Sleep deprivation is known to exert detrimental effects on various cognitive domains, including attention, vigilance and working memory. Seemingly at odds with these findings, prior studies repeatedly failed to evidence an impact of prior sleep deprivation on cognitive interference in the Stroop test, a hallmark paradigm in the study of cognitive control abilities. The present study investigated further the effect of sleep deprivation on cognitive control using an adapted version of the Stroop test that allows to segregate top-down (attentional reconfiguration on incongruent items) and bottom-up (facilitated processing after repetitions in responses and/or features of stimuli) components of performance. Participants underwent a regular night of sleep or a night of total sleep deprivation before cognitive testing. Results disclosed that sleep deprivation selectively impairs top-down adaptation mechanisms: cognitive control no longer increased upon detection of response conflict at the preceding trial. In parallel, bottom-up abilities were found unaffected by sleep deprivation: beneficial effects of stimulus and response repetitions persisted. Changes in vigilance states due to sleep deprivation selectively impact on cognitive control in the Stroop test by affecting top-down, but not bottom-up, mechanisms that guide adaptive behaviours.

Electroencephalography microstate alterations reflect potential double-edged cognitive adaptation in Ménière's disease.

PURPOSE: To explore the microstate characteristics and underlying brain network activity of Ménière's disease (MD) patients based on high-density electroencephalography (EEG), elucidate the association between microstate dynamics and clinical manifestation, and explore the potential of EEG microstate features as future neurobiomarkers for MD. METHODS: Thirty-two patients diagnosed with MD and 29 healthy controls (HC) matched for demographic characteristics were included in the study. Dysfunction and subjective symptom severity were assessed by neuropsychological questionnaires, pure tone audiometry, and vestibular function tests. Resting-state EEG recordings were obtained using a 256-channel EEG system, and the electric field topographies were clustered into four dominant microstate classes (A, B, C, and D). The dynamic parameters of each microstate were analyzed and utilized as input for a support vector machine (SVM) classifier to identify significant microstate signatures associated with MD. The clinical significance was further explored through Spearman correlation analysis. RESULTS: MD patients exhibited an increased presence of microstate class C and a decreased frequency of transitions between microstate class A and B, as well as between class A and D. The transitions from microstate class A to C were also elevated. Further analysis revealed a positive correlation between equilibrium scores and the transitions from microstate class A to C under somatosensory challenging conditions. Conversely, transitions between class A and B were negatively correlated with vertigo symptoms. No significant correlations were detected between these characteristics and auditory test results or emotional scores. Utilizing the microstate features identified via sequential backward selection, the linear SVM classifier achieved a sensitivity of 86.21% and a specificity of 90.61% in distinguishing MD patients from HC. CONCLUSIONS: We identified several EEG microstate characteristics in MD patients that facilitate postural control yet exacerbate subjective symptoms, and effectively discriminate MD from HC. The microstate features may offer a new approach for optimizing cognitive compensation strategies and exploring potential neurobiological markers in MD.

A Pilot Study Examining Feasibility and Initial Efficacy of Remotely Delivered Cognitive Adaptation Training.

Cognitive Adaptation Training (CAT) is an evidence-based treatment that uses environmental supports including signs, text messages, checklists, smart pill containers, and the organization of belongings to bypass cognitive and motivational impairments and to cue adaptive behavior in the home or work environment. We developed and tested a remote version of CAT to make the treatment available more broadly. Because CAT is focused on working with the individual in their home environment to establish supports, CAT may not be as easy to translate into an effective virtual treatment as talk-therapies. Fifty-six members of managed care were assigned to or given their treatment preference for CAT or Remote CAT (R-CAT) for 6 months. In-person or virtual pill counts were conducted monthly and assessments of habit-formation, symptoms, functioning, and satisfaction were administered every 2 months by independent raters. Analyses using mixed models with repeated measures focused on pre-planned evaluations of within-group change. Adherence improved significantly in R-CAT, functioning improved significantly in CAT and both groups improved significantly on measures of habit-formation and symptoms across 6 months. Higher functioning individuals appeared to choose R-CAT. Satisfaction with treatment was very high in both groups. R-CAT appears to be a potentially effective treatment, particularly for medication follow-though. However, in contrast to decades of previous research, fewer than 20% of eligible Medicaid recipients agreed to participate in the study. This may have been due to recruitment during and immediately post-pandemic.

The McGurk effect in the time of pandemic: Age-dependent adaptation to an environmental loss of visual speech cues.

Seeing a person's mouth move for [ga] while hearing [ba] often results in the perception of "da." Such audiovisual integration of speech cues, known as the McGurk effect, is stable within but variable across individuals. When the visual or auditory cues are degraded, due to signal distortion or the perceiver's sensory impairment, reliance on cues via the impoverished modality decreases. This study tested whether cue-reliance adjustments due to exposure to reduced cue availability are persistent and transfer to subsequent perception of speech with all cues fully available. A McGurk experiment was administered at the beginning and after a month of mandatory face-mask wearing (enforced in Czechia during the 2020 pandemic). Responses to audio-visually incongruent stimuli were analyzed from 292 persons (ages 16-55), representing a cross-sectional sample, and 41 students (ages 19-27), representing a longitudinal sample. The extent to which the participants relied exclusively on visual cues was affected by testing time in interaction with age. After a month of reduced access to lipreading, reliance on visual cues (present at test) somewhat lowered for younger and increased for older persons. This implies that adults adapt their speech perception faculty to an altered environmental availability of multimodal cues, and that younger adults do so more efficiently. This finding demonstrates that besides sensory impairment or signal noise, which reduce cue availability and thus affect audio-visual cue reliance, having experienced a change in environmental conditions can modulate the perceiver's (otherwise relatively stable) general bias towards different modalities during speech communication.

Cognitive Gain or Handicap: Magical Ideation and Self-Absorption in Clinical and Non-clinical Participants.

Background: This study aimed to examine magical ideation and absorption traits across non-clinical and clinical groups to determine their potential adaptive and maladaptive functions. Method: We enrolled 760 healthy participants from neighboring communities (female = 53.2%). Moreover, we recruited 318 patients (female = 66.5%), which included 25, 183, and 110 patients with schizophrenia spectrum disorders, anxiety disorders, and mood disorders, respectively. Potentially adaptive and maladaptive sociocognitive functions were measured to determine the role of magical ideation and self-absorption in patients with psychiatric disorders. Results: The degree of magical ideation and absorption gradually increased in the following order: anxiety disorders, mood disorders, and schizophrenia spectrum disorders. Furthermore, enhanced self-absorption-related enhanced consciousness traits were essential indicators of the presence of self-integration weakness in patients with schizophrenia spectrum disorders. Conclusion: Magical ideation and psychological absorption may be considered as mental model construction functions, which result in both gains and handicaps in social adaptation.

Executive function is inversely correlated with physical function: the cognitive profile of adult Spinal Muscular Atrophy (SMA).

BACKGROUND: Spinal muscular atrophy (SMA) issues from mutations in the survival of motor neuron (SMN) 1 gene. Loss or reduction of the SMN protein results in progressive muscle weakness. Whether this protein deficiency also affects cortical function remains unclear. While no data on adult patients exists so far, prior studies in children with SMA indicate cognitive abilities equal or even superior to healthy controls. This may suggest a possible compensatory-neuropsychological and interactional-process. The goal of this study was to assess the cognitive profile of adult patients with SMA, with a special focus on social cognition as a potential candidate for enhanced cognitive function through compensatory processes. METHODS: In a cross-sectional design, N = 31 adult SMA patients (types II and III) were assessed for language, verbal fluency, memory, visuospatial abilities and executive function with the Edinburgh Cognitive and Behavioural ALS Screen and for social cognition with the Reading the Mind in the Eyes Test. Physical function was evaluated using the Hammersmith Functional Motor Scale Expanded. N = 19 neurologically healthy controls were matched with patients for age, sex and years of education. RESULTS: In none of the abovementioned cognitive domains significant differences between SMA patients and controls were found. Among patients, no differences between type II SMA and type III SMA were detected for any domain. However, a trend towards better social cognition in patients with type II SMA, compared to those with type III SMA was observed. Furthermore, a significant inverse correlation of physical function and executive function was detected: lower motor function was associated with a better executive function. CONCLUSIONS: This study shows cognitive abilities in adult SMA in the normal range for all assessed domains. Thus, reduction of SMN protein has no obvious negative impact on cognitive function. Executive functions are identified as the only cognitive domain correlated with disease severity. Therefore, executive functions may play a role in the adaptation to physical restrictions in SMA, making them a promising target for future research.

A comparison of compensatory and restorative cognitive interventions in early psychosis.

This randomized trial examined the relative effectiveness of primarily compensatory and primarily restorative cognitive interventions in an early psychosis population. A total of 56 patients were randomized to one of two treatments which were applied for four months with a five month follow up assessment. Comparisons were between (1) Cognitive Adaptation Training (CAT) - a treatment that uses environmental supports and weekly home visits to compensate for cognitive challenges and improve community functioning and (2) Action Based Cognitive Remediation (ABCR) - a treatment involving computerized cognitive drill and practice exercises, simulations, goal setting, and behavioral activation. Linear mixed effects models demonstrated significant effects on community functioning for both CAT and ABCR without a difference between conditions (n = 39), with an indication of greater gains at follow up in the ABCR group (n = 31). Improvements in symptomatology were less robust with mixed findings across neurocognition metrics. This study concluded that both CAT and ABCR hold promise as interventions for early intervention psychosis populations but more work is needed to identify illness severity, subtype and contextual considerations that might indicate an emphasis on more compensatory versus more restorative cognitive interventions.

ERP evidence for rapid within-trial adaptation of cognitive control during conflict resolution.

People often have to resolve many conflicts at the same time in their everyday lives. So far, the mechanisms of conflict resolution when multiple conflicts co-occur are not clear. This study examined the neurocognitive mechanisms of cognitive-control adaptation when two sources of conflict co-occur. To this aim, we measured event-related potentials in a task combining the Stroop conflict (the meaning and the color of a word differ) and the word-word conflict (two different words are presented). The word-word conflict was expected to tap the same stage of stimuli processing (i.e., semantics) and to modulate the magnitude of the Stroop conflict. Behavioral data showed that the word-word conflict facilitated the resolution of the Stroop conflict, which indicates the within-trial adaptation of cognitive control. ERP data showed two additive effects (the Stroop conflict and the word-word conflict) in the N450 time window, which suggests that at the neural level these two conflicts were processed in parallel (simultaneously and independently of each other). The N450 finding demonstrates that the control system flexibly and rapidly adapts to different types of conflict by modulating information processing in ways that individually address each source of conflict. Crucially, processing the conflicts in parallel substantially improved the efficiency of the control system. Overall, the study shows that the cognitive-control system can act as a collection of parallel but independent mechanisms; it thereby advances our understanding of goal-directed behavior.

Family-Directed Cognitive Adaptation Pilot: Teaching Cognitive Adaptation to Families of Individuals with Schizophrenia.

Cognitive deficits are a major determinant of functional outcome in schizophrenia. A promising treatment involves teaching individuals to use cognitive adaptation strategies to minimize the functional impact of cognitive difficulties. We developed Family Directed Cognitive Adaptation (FCA) to train caregivers to help their relatives with schizophrenia use cognitive adaptations to improve living skills. The goal of this open pilot trial was to examine the feasibility of FCA. Ten adults with schizophrenia, each with at least one relative, participated in FCA and were evaluated at baseline, post-treatment, and 6-month follow-up. Domains assessed included adaptive functioning, psychiatric symptoms, school/work involvement, hospitalizations, family burden, and treatment satisfaction. Participants reported high levels of satisfaction with FCA, and all families completed the 16-session intervention. Relatives reported reduced burden at termination and follow-up. No participants were hospitalized during the treatment or follow-up period, and rates of work/school involvement increased from 30% at baseline to 50% at the end of treatment and follow-up. Individuals improved in negative symptoms and adaptive functioning over the course of treatment, but these gains were not maintained. This pilot provides preliminary support for the acceptability and feasibility of FCA, and points to the need to address the maintenance of treatment gains after termination.

Feasibility and acceptability of cognitive adaptation training for first-episode psychosis.

AIM: Cognitive and functioning impairments are present early in the course of psychotic disorder and remain one of the greatest treatment challenges. Cognitive adaptation training (CAT) is a compensatory approach to psychosocial intervention that is underpinned by a model that incorporates the role of cognition in daily functioning. CAT has established effectiveness in chronic schizophrenia but has received limited investigation in first-episode psychosis (FEP). The aim of this study was to examine the feasibility and acceptability of CAT in young people with FEP. METHODS: This was a single-arm feasibility study of CAT conducted at the Early Psychosis Prevention and Intervention Centre, Melbourne, Australia. Five FEP participants received manually guided CAT from a fully trained CAT therapist. A range of feasibility and acceptability measures were recorded throughout the study, including participant and case manager satisfaction ratings. RESULTS: All participants completed the CAT intervention and session attendance rates were very high (95.3%). Participants and their case managers indicated strong satisfaction with CAT as indicated by positive mean ratings on all satisfaction items, although there was a greater range in the participant ratings. Importantly, CAT did not have a negative effect on existing case management, with case managers reporting that CAT enhanced their treatment. CONCLUSIONS: This study provides evidence that CAT is a highly feasible and acceptable intervention in FEP, which may be easily integrated within existing services. The effectiveness of CAT in improving functional outcomes in FEP is worthy of investigation in a larger trial.

Is cognitive adaptation training (CAT) compensatory, restorative, or both?

Cognitive adaptation training (CAT) is a psychosocial treatment incorporating environmental supports including signs, checklists to bypass the cognitive deficits of schizophrenia. Our objective was to examine the association between CAT, functional outcomes, and cognitive test performance (cognition). The two research questions were as follows: 1) Does cognition mediate the effect of CAT intervention on functional outcome? 2) Does CAT impact cognitive test performance? A total of 120 participants with schizophrenia were randomized to one of three treatments: 1) CAT (weekly for 9months; monthly thereafter), 2) generic environmental supports (given to participants on clinic visits to promote adaptive behavior), or 3) treatment as usual (TAU). Assessments of cognition and functional outcome were conducted at baseline, 9 and 24months. Mediation analyses and mixed effects regression were conducted. Mediation analyses revealed that during the initial 9months, the direct path from treatment group to functional outcome on the primary measure was positive and highly significant. CAT significantly improved functional outcome compared to the other treatments. However, paths involving cognition were negligible. There was no evidence that cognition mediated improvement in functional outcomes. At 24months, cognition improved more in CAT compared to other treatment groups. The test for cognition mediating improvement in functional outcomes was not significant at this time point. However, improvement in functional outcome led to better performance on cognitive testing. We concluded that improvement in cognition is not a necessary condition for improvement in functional outcome and that greater engagement in functional behavior has a positive impact on cognition.

Testing a modification of cognitive adaptation training: streamlining the model for broader implementation.

Cognitive adaptation training (CAT) is a home-based, manualized treatment that utilizes environmental supports to improve target behaviors and functional outcomes in persons with schizophrenia. Although clinical trials have shown CAT to be effective across functional, clinical, and treatment adherence domains, when the intervention is withdrawn clients experience significant declines. The aim of the current study was to test a modified version of CAT, which decreases the duration of intensive CAT intervention while utilizing ongoing case management-supported CAT to maintain the fundamental components of the treatment. Twenty-three people participated in an outcome study of the modified version of CAT, evaluating improvements after 4months of CAT specialist intervention and after an additional 5months of case manager support. Analysis revealed significant improvements in adaptive functioning, psychiatric symptomatology, and goal attainment, which were maintained throughout case management follow-up. This suggests that an intervention that has previously demonstrated good functional outcomes in randomized trials might sustain its impacts in an abbreviated format with support from existing case managers.

Cognitive adaptation theory as a predictor of adjustment to emerging adulthood for youth with and without type 1 diabetes.

OBJECTIVE: The purpose of the study was to determine whether resilience, defined by cognitive adaptation theory, predicted emerging adulthood outcomes among youth with and without type 1 diabetes. METHODS: Youth with (n=118) and without type 1 diabetes (n=122), who were part of a previous longitudinal study during adolescence, completed on-line questionnaires during their senior year of high school and one and two years later. They were average age 18, 53% female, and 93% white. Questionnaires assessed cognitive adaptation theory (CAT) indicators (self-esteem, mastery, optimism) and psychological, relationship, behavioral, vocational, and, for those with diabetes, diabetes outcomes. RESULTS: The CAT index at baseline predicted reduced psychological distress, enhanced psychological well-being, increased friend support, reduced friend conflict, the presence of romantic relationships, reduced likelihood of romantic breakups, higher GPA, higher work satisfaction, and lower work stress during the transition to emerging adulthood. Among those with diabetes, the CAT index predicted better self-care behavior and revealed a marginal relation to better glycemic control. Analyses controlled for baseline levels when appropriate. Findings were stronger one year than two years post high school graduation, and findings were stronger for those with than without diabetes. Youth with diabetes also scored lower on the CAT index than youth without diabetes. CONCLUSIONS: These findings suggest that the implications of CAT include not only psychological health but also relationship, vocational, and diabetes outcomes. Those who score lower on CAT indicators should be identified as children so that interventions designed to enhance resilience can be implemented.

A randomized trial comparing in person and electronic interventions for improving adherence to oral medications in schizophrenia.

Poor adherence to medication leads to symptom exacerbation and interferes with the recovery process for patients with schizophrenia. Following baseline assessment, 142 patients in medication maintenance at a community mental health center were randomized to one of 3 treatments for 9 months: (1) PharmCAT, supports including pill containers, signs, alarms, checklists and the organization of belongings established in weekly home visits from a PharmCAT therapist; (2) Med-eMonitor (MM), an electronic medication monitor that prompts use of medication, cues the taking of medication, warns patients when they are taking the wrong medication or taking it at the wrong time, record complaints, and, through modem hookup, alerts treatment staff of failures to take medication as prescribed; (3) Treatment as Usual (TAU). All patients received the Med-eMonitor device to record medication adherence. The device was programmed for intervention only in the MM group. Data on symptoms, global functioning, and contact with emergency services and police were obtained every 3 months. Repeated measures analyses of variance for mixed models indicated that adherence to medication was significantly better in both active conditions than in TAU (both p<0.0001). Adherence in active treatments ranged from 90-92% compared to 73% in TAU based on electronic monitoring. In-person and electronic interventions significantly improved adherence to medication, but that did not translate to improved clinical outcomes. Implications for treatment and health care costs are discussed.

Zero-sum bias: perceived competition despite unlimited resources.

Zero-sum bias describes intuitively judging a situation to be zero-sum (i.e., resources gained by one party are matched by corresponding losses to another party) when it is actually non-zero-sum. The experimental participants were students at a university where students' grades are determined by how the quality of their work compares to a predetermined standard of quality rather than to the quality of the work produced by other students. This creates a non-zero-sum situation in which high grades are an unlimited resource. In three experiments, participants were shown the grade distribution after a majority of the students in a course had completed an assigned presentation, and asked to predict the grade of the next presenter. When many high grades had already been given, there was a corresponding increase in low grade predictions. This suggests a zero-sum bias, in which people perceive a competition for a limited resource despite unlimited resource availability. Interestingly, when many low grades had already been given, there was not a corresponding increase in high grade predictions. This suggests that a zero-sum heuristic is only applied in response to the allocation of desirable resources. A plausible explanation for the findings is that a zero-sum heuristic evolved as a cognitive adaptation to enable successful intra-group competition for limited resources. Implications for understanding inter-group interaction are also discussed.

"Still the same and better off than others?": social and temporal comparisons in old age.

Cognitive adaptation in the elderly and the motivated use of temporal and social comparisons set the conceptual frame for the present study. Three research questions were investigated in a sample of 2.129 persons aged between 50 and 90 years. First, the direction of social and temporal comparisons for three domains (physical fitness, mental fitness, psychological resilience) was studied, and findings did show that especially lateral followed by upward comparisons were most frequent under both perspectives; downward comparisons clearly showed the least frequency. Second, the distribution of comparison directions was investigated across four age groups. These analyses showed that upward comparisons increased and lateral comparisons decreased across age groups; differential results were observed for the domains under consideration. Third, the relation between social and temporal comparisons and self-esteem was studied. Results obtained here indicated a motivated use of specific comparison directions since downward social comparisons and upward temporal comparisons were most frequent in persons with low self-esteem. Taken together, the study underlines the different functions of social and temporal comparisons in adulthood and old age; it indicates a predominant need for consensus and consistency, and it highlights the importance of self-esteem in cognitive adaptation.