What Is Trained During Food Go/No-Go Training? A Review Focusing on Mechanisms and a Research Agenda

Neural activity and connectivity are related to food preference changes induced by food go/no-go training

Simply withholding a response while viewing an appetizing food, over the course of many presentations (i.e., during food go/no-go training) can modify individuals' food preferences-which could, in turn, promote healthier eating behaviors. However, the neural mechanisms underlying this food go/no-go training-induced change in food preferences are still relatively unclear. We addressed this issue in the present functional magnetic resonance imaging (fMRI) study. To this end, we administered a novel passive viewing task before and after food go/no-go training to 91 participants in the scanner. Participants' food preferences were measured with a binary food choice task. At the behavioral level, we found the expected training effect on food preferences: Participants preferred go over no-go foods following training. At the neural level, we found that changes in food preferences were associated with training-related go vs. no-go differences in activity and functional connectivity, such as less activity in the anterior cingulate cortex and superior frontal gyrus but greater functional connectivity between the superior frontal gyrus and middle occipital gyrus. Critically, Dynamic causal modeling showed that this preference change effect was largely driven by top-down influence from the superior frontal gyrus to the middle occipital gyrus. Together, these findings suggest a neural mechanism of the food go/no-go training effect-namely, that the food-viewing-related interplay between prefrontal regions and visual regions might be related to the food preference change following food go/no-go training.

Mechanisms underlying food devaluation after response inhibition to food

Multiple studies reveal that a requirement to stop a response to appetitive food stimuli causes devaluation of these stimuli. However, the mechanism underlying food devaluation after stopping is still under debate. The immediate-affect theory suggests that an increase in negative affect after stopping a response is the driving force for food devaluation. A competing value-updating theory presumes that food devaluation after stopping occurs through the need to align behavior with goals. The current study assessed how food devaluation after response inhibition is influenced by negative emotional reactivity and behavior-goal alignment on a trial-by-trial basis. The study included 60 healthy participants who completed a Food-Stop-Signal-Emotion task. Participants categorized high vs. low-calorie food stimuli and stopped their response upon encountering a stop signal. Subsequently, participants made subjective negativity ratings of negative- or neutral-valenced emotional images, and rated their desire to eat the previously depicted food. In contrast to predictions made by the immediate-affect account, food devaluation after stopping was not mediated nor moderated via changes in negative emotional reactivity after stopping. In support of the value-updating account, food devaluation was modulated by behavior-goal alignment, indicated by larger food devaluation after successful vs. failed stopping. In agreement with this theory, the findings indicate that devaluation occurs more strongly when performance aligns with the task requirement. This study sheds light on the mechanism that likely underlies food devaluation after stopping. Implications regarding applied use of food-inhibition trainings are discussed.

Testing Go/No-Go training effects on implicit evaluations of unhealthy and healthy snack foods

OBJECTIVE

Despite intending to eat healthy foods, people often yield to temptation. In environments rife with unhealthy food options, a positive implicit evaluation of unhealthy foods may inadvertently influence unhealthy choices. This study investigates if and under which conditions implicit evaluations of unhealthy and healthy foods can be influenced by a computer-based Go/No-Go (GNG) training.

DESIGN

Undergraduate student participants (N = 161 participants; 117 females, 44 males; Mage = 19 years, SD = 2 years) completed a GNG training with two healthy (grape and nut) and two unhealthy (potato chip and cookie) stimuli. Participants were either instructed to inhibit their responses to the potato chip (No-Go Chips/Go Grape) or to a grape (No-Go Grape/Go Chips).

MAIN OUTCOME MEASURE

Implicit evaluations of chips and grapes were assessed using the Extrinsic Affective Simon Task.

RESULTS

This GNG training impacted implicit evaluations of chips, but not grapes. GNG training effects were stronger for participants with lower sensitivity for behavioural inhibition measured with the Behavioural Inhibition System scale.

CONCLUSION

GNG training might help people change implicit food evaluations. More research is needed to understand how individual and training characteristics affect outcomes with the goal of tailoring and optimising the GNG training to produce the strongest effect.

Cognitive training interventions for substance use disorders: what they really offer?

Cognitive training (CT) has emerged as a potential therapeutic approach for substance use disorders (SUD), aiming to restore cognitive impairments and potentially improve treatment outcomes. However, despite promising findings, the effectiveness of CT in real-life applications and its impact on SUD symptoms has remained unclear. This perspective article critically examines the existing evidence on CT for SUD and explores the challenges and gaps in implementing CT interventions. It emphasizes the need for clarity in expectations and decision-making from a public health standpoint, advocating for comprehensive studies that consider a broader range of SUD consequences and utilize measures that reflect patients' actual experiences.

Stimulus variability improves generalization following response inhibition training

The present study examined the effect of stimulus variability and practice order on generalization to novel stimuli following a single session of response inhibition training. Ninety-six young adults practiced the Go/No-go task online in three training conditions: (1) constant (N = 32)-inhibition practiced on one stimulus; (2) variable-blocked (N = 32)-inhibition practiced on 6 stimuli, each in a separate block; and (3) variable-random (N = 32)-inhibition practiced on 6 stimuli in random order. Generalization was measured by comparing groups on inhibition of novel stimuli and a trained stimulus immediately and 24 h after training. Consistent with our hypothesis, the variable-random and the variable-blocked groups showed better generalization to the novel items than the constant group, demonstrating the benefit of stimulus variability. The variable-random group also showed better generalization than the variable-blocked group, demonstrating the benefit of presenting stimuli in random order. Participants' capacity for working memory maintenance was found to modulate the effect of practice order. While the benefit of variability was retained 24 h after training, the effect of order was not. Results also show generalization to (1) different type of stimuli using the same task and (2) the same stimuli on a different response inhibition task (the Stop-Signal Task), however, the effect of variable practice and order were not evident in these cases. The study findings illustrate the advantage of using variable stimuli presented in random order for generalization and suggest that these principles of motor learning can be applied to learning of cognitive skills.

Response inhibition training as an intervention to modify liking and wanting for foods based on energy density: a proof of concept study

The ubiquity of energy-dense, processed foods has been implicated as a salient feature of the modern 'obesogenic' environment. Cognitive strategies, such as response inhibition training, have been demonstrated to reduce the hedonic value of such foods in previous studies. However, this effect has generally been inconsistent or heterogenous, depending on the outcome measure, characteristics of the sample, and the specificity of food stimuli. Characterising the extent of generalised effects may help define the application of this type of intervention in natural settings. A repeated-measures, proof-of-concept study, using mobile app-based response inhibition training (RIT) versus a control app-based activity (N = 25), was undertaken to establish the valid application of a food reward measure to assess intervention efficacy. Liking (i.e., affect) and wanting (i.e., motivation) for food stimuli categorised by energy density were taken concurrently pre- and post-training. A statistically significant reduction in explicit liking, but not implicit wanting, for foods irrespective of their energy density was observed during the RIT app-based training session relative to the control (p = .041, ηp2 = .16). However, effect sizes associated with devaluation of energy-dense relative to low calorie food stimuli, although non-significant, were higher when measured as implicitly wanting (p = .098, ηp2 = .11) than explicit liking (p = .756, ηp2 = .00). Trends in explicit stimulus evaluations were empirically discordant from implicit evaluations for low calorie foods in particular. Additional research is needed to investigate whether these trends are reproducible with larger samples, trained and novel food stimuli in outcome measures, and more comprehensive training protocols.

The effectiveness of Go/No-Go and Stop-Signal training in reducing food consumption and choice: A systematic review and meta-analysis

The Go/No-Go and Stop-Signal tasks have been used to reduce excess food intake via repeated pairing of food cues with response inhibition. A meta analysis of 32 studies was conducted to determine whether, and under which conditions, the Go/No-Go and Stop-Signal training tasks are effective in reducing food consumption or choice. Moderators included task parameters (e.g., number of sessions, stop signal), sample differences (e.g., age, weight), and the measure of food consumption or choice. Overall, there was a small effect for Go/No-Go and Stop-Signal training in reducing food consumption or choice, g = -0.21, CI95 = [-0.31, -0.11], p < .001, with this holding individually only for a single session of the Go/No-Go Task, g = -0.31, CI95 = [-0.45, -0.18], p < .001. Comprehensive investigation of the impact of varying moderators indicated that the effect for Go/No-Go training was robust. Nevertheless, there was significant variation in the specific parameters of the task. Overall, the present meta-analysis extends previous findings by providing comprehensive evidence that the Go/No-Go Task is effective in reducing food consumption and choice, as well as providing optimal parameter recommendations for the task.

Fostering positive attitudes toward food in individuals with restrained eating: the impact of flexible food-related inhibition

Individuals exhibiting restrained eating behaviors demonstrate increased inhibitory control when exposed to food-related stimuli, indicating the presence of an automatic food-inhibition association. Existing literature proposes that this association contributes to the devaluation of food within this population. Efforts to disrupt this association by promoting the complete elimination of the inhibition of food responses have resulted in increased food consumption but have also led to heightened food-related anxiety in individuals with restrained eating behaviors. In the current investigation, we investigated whether a novel flexible food response/inhibition computerized task could yield favorable changes in attitudes toward food in individuals with restrained eating. We randomly assigned 78 females who engage in restrained eating to one of three training groups. In the flexible response/inhibition group, participants were instructed to equally inhibit or respond to food stimuli. In the response group, participants consistently responded to food stimuli, while in the inhibition group, participants consistently inhibited their response to food cues. Implicit attitudes toward food were assessed both before and after the manipulation. To examine the stability of the effect of the training, participants also engaged in a seemingly unrelated bogus taste test. Our results revealed that only the flexible response/inhibition group demonstrated a significant improvement in positive attitudes toward high-calorie foods after eating, while there were no observable changes in negative attitudes among the other two groups. These findings suggest that promoting a balance between the responding and inhibiting responses to food stimuli can increase positive attitudes toward food amongst individuals with restrained eating.

Be more mindful: Targeting addictive responses by integrating mindfulness with cognitive bias modification or cue exposure interventions

This review provides an overview of the most prominent neurocognitive effects of cognitive bias modification (CBM), cue-exposure therapy and mindfulness interventions for targeting addictive responses. It highlights the key insights that have stemmed from cognitive neuroscience and brain imaging research and combines these with insights from behavioural science in building a conceptual model integrating mindfulness with response-focused CBM or cue-exposure interventions. This furthers our understanding of whether and how mindfulness strategies may i) facilitate or add to the induced response-focused effects decreasing cue-induced craving, and ii) further weaken the link between craving and addictive responses. Specifically, awareness/monitoring may facilitate, and decentering may add to, response-focused effects. Combined awareness acceptance strategies may also diminish the craving-addiction link. The conceptual model presented in this review provides a specific theoretical framework to deepen our understanding of how mindfulness strategies and CBM or cue-exposure interventions can be combined to greatest effect. This is important in both suggesting a roadmap for future research, and for the further development of clinical interventions.

Self-control training supplementing inpatient multidisciplinary obesity treatment in children and adolescents

Research points to self-control as a possible mechanism for facilitating health behaviour and weight loss. The dual pathway model underpins the role of strong bottom-up reactivity towards food and weak top-down executive functions in obesity. Despite flourishing lab studies on attention bias modification or inhibition trainings, relatively few focused on training both processes to improve self-control in children and adolescents in inpatient multidisciplinary obesity treatment (MOT). Being part of the WELCOME project, this study investigated the effectiveness of Brain Fitness training (using the Dot Probe and Go/No-Go) as an adjunct to inpatient MOT in 131 Belgian children and adolescents. Changes in self-control (performance-based inhibitory control and attention bias as well as self-reported eating behaviour) in the experimental group were compared to sham training. Multiple Imputation was used to handle missing data. Inhibitory control and external eating improved over time (pre/post/follow-up), but we found no evidence for a significant interaction between time and condition. Future research should pay more attention to the role of individual variability in baseline self-control, sham training, and ecological validity of self-control training to improve real-life health behaviour and treatment perspectives for children and adolescents with weight problems.

Attentional bias for high-calorie food cues by the level of hunger and satiety in individuals with binge eating behaviors

Introduction

The abnormal hyperreactivity to food cues in individuals with binge eating behaviors could be regulated by hedonic or reward-based system, overriding the homeostatic system. The aim of the present study was to investigate whether attentional bias for food cues is affected by the level of hunger, maintaining the normal homeostatic system in individuals with binge eating behaviors.

Methods

A total of 116 female participants were recruited and divided into four groups: hungry-binge eating group (BE) (n = 29), satiated BE (n = 29), hungry-control (n = 29), satiated control (n = 29). While participants completed a free-viewing task on high or low-calorie food cues, visual attentional processes were recorded using an eye tracker.

Results

The results revealed that BE group showed longer initial fixation duration toward high-calorie food cues in both hunger and satiety condition in the early stage, whereas the control group showed longer initial fixation duration toward high-calorie food cues only in hunger conditions. Moreover, in the late stage, the BE group stared more at the high-calorie food cue, compared to control group regardless of hunger and satiety.

Discussion

The findings suggest that automatic attentional bias for food cues in individuals with binge eating behaviors occurred without purpose or awareness is not affected by the homeostatic system, while strategic attention is focused on high-calorie food. Therefore, the attentional processing of food cues in binge eating group is regulated by hedonic system rather than homeostatic system, leading to vulnerability to binge eating.

Associations of food reinforcement and food- related inhibitory control with adiposity and weight gain in children and adolescents

Some, but not all studies have reported that, among youth with disordered eating and high weight, the relative reinforcing value of food (RRV-F, i.e., how hard a person will work for a high-energy-dense food when another reward is available) is greater, and food-related inhibitory control (i.e., ability to withhold a response to food-related stimuli) is lower, compared to peers without disordered eating or overweight. In most studies, high RRV-F and low food-related inhibitory control have been studied separately, as independent factors, with each suggested to predict excess weight and adiposity (fat mass) gain. We hypothesized that the interaction of these factors would prospectively exacerbate risk for weight and adiposity (fat mass) gain three years later in a sample of healthy youth. At baseline, RRV-F was measured using a Behavior Choice Task with the rewards being standardized servings of chocolate candies, cheese crackers, or fruit snacks. Food-related inhibitory control was determined by performance in response to food and non-food stimuli during a Food Go/No-Go task. At baseline and 3-year visits, total body adiposity was measured by dual-energy X-ray absorptiometry (DXA) and body mass index (BMI) was obtained using measured weight and height. A linear regression was conducted with 3-year adiposity as the dependent variable. RRV-F, food-related inhibitory control, and the RRV-F x food-related inhibitory control interaction as independent variables. Baseline adiposity, age, height, sex, race/ethnicity, and days between visits were included as covariates for model predicting 3-year adiposity. Baseline BMI, age, sex, race/ethnicity, and days between visits were included as covariates for model predicting 3-year BMI. One-hundred and nine youth (mean 12.4±2.7y, mean 0.50±1.02 BMIz, 30.3% with overweight/obesity, 45.9% female, 51.4% non-Hispanic White), 8-17 years at baseline, were studied. Baseline food-related inhibitory control (βunstandardized = 0.33, p = .037, 95% CI [.02, 0.64]), but not baseline RRV-F (βunstandardized = -0.003, p = .914), 95% CI [-0.05, 0.05]) was significantly associated with 3-year adiposity such that those with the poorest food-related inhibitory control (great number of commision errors) had the greatest adiposity gain. The interaction between RRV-F and food-related inhibitory control did not predict 3-year adiposity (βunstandardized = -0.07, p = .648, 95% CI [-0.39, 0.25]). The pattern of findings was the same for models examining non-food related inhibitory control. Neither baseline food-related inhibitory control (βunstandardized = 2.16, p = .256, 95% CI [-1.59, 5.92]), baseline RRV-F (βunstandardized = 0.14, p = .660, 95% CI [-0.48, 0.75]), nor their interaction (βunstandardized = -1.18, p = .547, 95% CI [-5.04, 2.69]) were significantly associated with 3-year BMI. However, non-food related inhibitory control (βunstandardized = 0.54, p = .038, 95% CI [.22, 7.15]) was significantly associated with 3-year BMI. In summary, food-related inhibitory control but not RRV-F, was associated with changes in adiposity in a sample of children and adolescents. Among generally healthy youth, food-related inhibitory control may be a more relevant risk factor than food reinforcement for adiposity gain. Additional data are needed to determine how inhibitory control and reward systems, as well as other disinhibited eating behaviors/traits, may interact to promote excess weight gain over time in youth.

Reduction in sugar drink valuation and consumption with gamified executive control training

The overvaluation of high-energy, palatable food cues contributes to unhealthy eating and being overweight. Reducing the valuation of unhealthy food may thus constitute a powerful lever to improve eating habits and conditions characterized by unhealthy eating. We conducted a double-blind, placebo-controlled, randomized intervention trial assessing the efficacy of a five to twenty days online cognitive training intervention to reduce sugary drink perceived palatability and consumption. Our intervention involved a recently identified action-to-valuation mechanism of action, in which the repeated inhibition of prepotent motor responses to hedonic food cues in a Go/NoGo (GNG) and an attentional bias modification (ABM) task eventually reduces their valuation and intake. Confirming our hypotheses, the experimental intervention with consistent (100%) mapping between motor inhibition and the targeted unhealthy sugary drinks cues induced a larger decrease in their valuation than the control intervention with inconsistent (50%) mapping (- 27.6% vs. - 19%), and a larger increase of the (water) items associated with response execution (+ 11% vs + 4.2%). Exploratory analyses suggest that the effect of training on unhealthy items valuation may persist for at least one month. Against our hypothesis, we observed equivalent reductions in self-reported consumption of sugary drinks following the two interventions (exp: - 27% vs. ctrl: - 19%, BF01 = 4.7), suggesting a dose-independent effect of motor inhibition on self-reported consumption. Our collective results corroborate the robustness and large size of the devaluation effects induced by response inhibition on palatable items, but challenge the assumption of a linear relationship between such effects and the actual consumption of the target items. PROTOCOL REGISTRATION: The stage 1 protocol for this Registered Report was accepted in principle on 30/03/2021. The protocol, as accepted by the journal, can be found at: https://doi.org/10.17605/OSF.IO/5ESMP .

Cognitive manipulation of emotional and non-emotional information in working memory of patients with depression: a rigid processing style

Introduction

Cognitive psychology is one of the important perspectives to understand depression. Compared with previous studies, recent researchers increasingly focused on the exploration of the comprehensive cognitive process of patients with depression. The cognitive operation ability of working memory is an important comprehensive cognitive process, which reflects how individuals establish representations. This is the basis for the formation of experience and schema. The purpose of this study is to explore whether there are abnormalities in cognitive manipulation in patients with depression, and to analyze its possible role in the pathogenesis and maintenance of depression.

Method

In this cross-sectional study, depressed patients was enrolled in the clinical psychology department of Beijing Chaoyang Hospital as the case group, while healthy individuals were recruited in the hospital and social meetings as the control group. Hamilton Depression Scale (HAMD)-17, Hamilton Anxiety Scale (HAMA) and rumination thinking scale (RRS) were adopted as measurement tools, and working memory operation tasks were adopted to test each subject, so as to measure their cognitive operation ability.

Result

A total of 78 depressed patients and 81 healthy individuals completed the study. The results showed that the rumination level of the case group was higher than that of the control group, and the difference was significant first; Second, in the "inconsistent" condition, the case group under different stimulus conditions when the response was significantly higher than the control group; Thirdly, the "cognitive operation consumption" value of the case group was significantly higher than that of the control group under the three stimulus conditions, among which, the operational cost value of sadness-neutral stimulus was significantly higher than that of the other two stimulus conditions.

Conclusion

Patients with depression had obvious difficulties in cognitive manipulation of information with different values in working memory, which reflected in the fact that it took them longer time to adjust the relationship between information and established new representations. Among them, patients with depression had a higher degree of cognitive manipulation of sad stimuli, indicating that their abnormal cognitive manipulation had certain emotion specificity. Finally, the difficulty of cognitive operation was closely related to the level of rumination.

Approach-Bias Retraining and Other Training Interventions as Add-On in the Treatment of AUD Patients

In the past two decades, a variety of cognitive training interventions have been developed to help people overcome their addictive behaviors. Conceptually, it is important to distinguish between programs in which reactions to addiction-relevant cues are trained (varieties of cognitive bias modification, CBM) and programs in which general abilities are trained such as working memory or mindfulness. CBM was first developed to study the hypothesized causal role in mental disorders: by directly manipulating the bias, it was investigated to what extent this influenced disorder-relevant behavior. In these proof-of-principle studies, the bias was temporarily modified in volunteers, either temporarily increased or decreased, with corresponding effects on behavior (e.g., beer consumption), in case the bias was successfully manipulated. In subsequent clinical randomized controlled trials (RCTs), training (away from the substance vs. sham training) was added to clinical treatment. These studies have demonstrated that CBM, as added to treatment, reduces relapse with a small effect of about 10% (similar effect size as for medication, with the strongest evidence for approach-bias modification). This has not been found for general ability training (e.g., working memory training), although effects on other psychological functions have been found (e.g., impulsivity). Mindfulness also has been found to help people overcome addictions, and different from CBM, also as stand-alone intervention. Research on (neuro-)cognitive mechanisms underlying approach-bias modification has pointed to a new perspective in which automatic inferences rather than associations are influenced by training, which has led to the development of a new variety of training: ABC training.

Neural correlates underlying preference changes induced by food Go/No-Go training

Consistently not responding to appetitive foods during food go/no-go training could change individuals' food choices and sometimes even body weight, however, fewer studies have explored the neural pathways underlying the effects of food go/no-go training. In this study, we scanned eighty-six female participants using functional magnetic resonance imaging and investigated the neural bases of preference changes in a binary food choice task following action (e.g., go) or inaction (e.g., no-go) toward distinct foods within a food go/no-go training paradigm. In line with prior behavioral work, we found that participants' food preferences changed as a function of food go/no-go training, with participants choosing more "go" over "no-go" foods for consumption following training. At a neural level, preference changes were inversely associated with frontoparietal and salience network activity when choosing go (vs. no-go) foods. Additionally, task-related functional connectivities from the inferior parietal lobule to the pre-supplementary motor cortex, dorsolateral prefrontal cortex, and dorsal anterior cingulate cortex were related to these preference changes. Together, current work supports that food go/no-go training reliably changes people's preferences. More importantly, our findings suggest that a neural pathway centered on areas traditionally associated with selective attention may interface with prefrontal regions to guide preference changes induced by food go/no-go training, though future studies using other tasks (e.g., passive viewing tasks) are still needed to test this potential neural mechanism.

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.

Comparing the effects of inhibitory control training and evaluative conditioning for unhealthy food behaviours

Cognitive Bias Modification (CBM) is hypothesised to reduce unhealthy food preference and consumption through the completion of computerised cognitive training tasks. While there is evidence to suggest that two popular CBM paradigms (Inhibitory Control Training (ICT) and Evaluative Conditioning (EC)) can have a positive influence on food-related outcomes, issues (and inconsistencies) related to task standardisation and control group design make it difficult to evaluate their standalone efficacy. In a pre-registered laboratory study using a mixed experimental design, our aim was to directly compare a single session of ICT and EC on implicit preference, explicit choice and ad-libitum food intake, while ensuring appropriate active control groups were utilised for each training type (in addition to a passive control group). The results revealed that there were no significant differences in terms of implicit preferences, ad-libitum food consumption or food choice. These results provide limited evidence to support the use of CBM as a psychological intervention for unhealthy food choice or consumption. Further work is needed to isolate mechanisms of effect for successful training and identify the most effective CBM protocols for implementation in future studies.

Measuring food-related inhibition with go/no-go tasks: Critical considerations for experimental design

The use of go/no-go tasks to assess inhibitory control over food stimuli is becoming increasingly popular. However, the wide variability in the design of these tasks makes it difficult to fully leverage their results. The goal of this commentary was to provide researchers with crucial aspects to consider when designing food-related go/no-go experiments. We examined 76 studies that used food-themed go/no-go tasks and extracted characteristics related to participant population, methodology, and analysis. Based on our observations of common issues that can influence study conclusions, we stress the importance for researchers to design an appropriate control condition and match stimuli between experimental conditions in terms of emotional and physical properties. We also emphasize that stimuli should be tailored to the participants under study, whether at the individual or group level. To ensure that the task truly measures inhibitory abilities, researchers should promote the establishment of a prepotent response pattern by presenting more go than no-go trials and by using short trials. Researchers should also pre-specify the criteria used to identify potentially invalid data. While go/no-go tasks represent valuable tools for studying food cognition, researchers should choose task parameters carefully and justify their methodological and analytical decisions in order to ensure the validity of results and promote best practices in food-related inhibition research.

Pilot study of food-specific go/no-go training for overweight individuals: brain imaging data suggest inhibition shapes food evaluation

Food-specific go/no-go training might reduce overeating and facilitate weight loss. In this pilot study, we examined whether a food-specific go/no-go training over five weeks, as compared to a non-food-specific training, could produce changes in behavioral and neural responses to food images and body weight. Here, we used a sample of 51 overweight participants divided into training and control groups whose brain activity and food evaluation were measured before and after the training. Compared with the control group, in the training group we found significant reductions in high-calorie food evaluation. We also found lower activations in inhibitory control- and reward-related brain regions in response to high-calorie food images. Further, activation change of the mid-insula in response to the high-calorie food images was positively associated with change in the evaluation of those images. However, we found no evidence for a significant effect of food-specific go/no-go training on body weight change. Our findings highlight that food-specific go/no-go training in overweight individuals can reduce high-calorie food evaluation, but also neural activations in inhibitory control- and reward- related brain regions.

Differential Orbitofrontal Cortex Responses to Chocolate Images While Performing an Approach-Avoidance Task in the MRI Environment

Background: Chocolate is one of the most frequently craved foods, and it often challenges self-regulation. These cravings may be underpinned by a neural facilitation of approach behavior toward chocolate. This preregistered study investigated the behavioral and neural correlates of such a bias using functional magnetic resonance imaging (fMRI) and reaction times (RTs). Methods: A total of n = 30 frequent chocolate eaters performed a relevant-feature approach-avoidance task (AAT) in the MRI scanner using buttons to enlarge (approach) or to shrink (avoid) pictures of chocolate and inedible control objects. We tested (a) whether implicit RT-based approach biases could be measured in a supine position in the scanner, (b) whether those biases were associated with activity in reward-related brain regions such as the insula, amygdala, striatum, and orbitofrontal cortex (OFC), and (c) whether individual RT-based bias-scores correlated with measures of chocolate craving. Results: Behaviorally, we found a highly reliable approach bias toward chocolate, defined by faster RTs in the compatible conditions (approach chocolate, avoid objects) compared to the incompatible conditions (avoid chocolate, approach objects). Neurally, this compatibility effect involved activity in the left medial OFC, a neural response that was positively correlated with individual approach bias scores. Conclusions: This study shows that the relevant feature AAT can be implemented in an fMRI setting in a supine position using buttons. An approach bias toward chocolate seems related to medial OFC activation that might serve to devalue chocolate when it has to be avoided. Our demonstration of neural and behavioral approach biases for chocolate underscores the need for stimulus-specific cognitive trainings to support healthy consumption and successful self-regulation.

Gamification and neurotraining to engage men in behavioral weight loss: Protocol for a factorial randomized controlled trial

Over 70% of men are overweight, and most desire weight loss; however, men are profoundly underrepresented in weight loss programs. Gamification represents a novel approach to engaging men and may enhance efficacy through two means: (1) game-based elements (e.g., streaks, badges, team-based competition) to motivate weight control behaviors and (2) arcade-style "neurotraining" to enhance neurocognitive capacities to resist the temptation of unhealthy foods and more automatically select healthy foods. This study will use a 2 × 2 factorial design to examine the independent and combinatory efficacy of gamification and inhibitory control training (ICT). Men with overweight/obesity (N = 228) will receive a 12-month mobile weight loss program that incorporates behavioral weight loss strategies (e.g., self-monitoring, goal setting, stimulus control). Men will be randomly assigned to a non-gamified or gamified version, and an active or sham ICT. A game design company will create the program, with input from a male advisory panel. Aims of the project are to test whether a gamified (versus non-gamified) weight loss program and/or ICT (versus sham) promotes greater improvements in weight, diet, and physical activity; whether these treatment factors have combinatory or synergistic effects; to test whether postulated mechanisms of action (increased engagement, for gamification, and inhibitory control, for ICT) mediate treatment effects; and whether baseline gameplay frequency and implicit preferences for ICT-targeted foods moderate effects. It is hoped this study will contribute to improved mHealth programs for men and enhance our understanding of the impact of gamified elements and neurocognitive training on weight control.

Explicit and Implicit Devaluation Effects of Food-Specific Response Inhibition Training

The overvaluation of reward-associated stimuli such as energy-dense foods can drive compulsive eating behaviours, including overeating. Previous research has shown that training individuals to inhibit their responses towards appetitive stimuli can lead to their devaluation, providing a potential avenue for behaviour change. Over two preregistered experiments, we investigated whether training participants to inhibit their responses to specific foods would be effective in reducing their evaluations when these were assessed using both explicit and implicit measures. Participants completed an online session of go/no-go training with energy-dense foods that were consistently associated with either responding (go) or inhibiting a response (no-go). An 'explicit' devaluation effect was expected as a reduction in self-reported liking from pre-to post-training for no-go items compared to both go items and foods that were not presented during training (untrained items). An 'implicit' devaluation effect was then measured using the affective priming paradigm, by comparing differences in reaction times for congruent and incongruent trials (i.e., priming effects) between food primes. Experiment 1 revealed conclusive evidence for small-to-medium devaluation effects both in terms of explicit ratings and priming effects. We also observed that the priming effect for no-go items was close to zero. Experiment 2 successfully replicated most of the preregistered and exploratory outcomes from Experiment 1 except for the priming effect for untrained items. Potential explanations for this discrepancy are discussed but overall, these findings provide further support for a devaluation effect of response inhibition training. To our knowledge, our study provides the first evidence that training-induced devaluation can potentially be captured by affective priming measures, but more research is needed to further assess their sensitivity before they can be used to elucidate the mechanisms of action underlying devaluation effects.

Effects of environmental impact labels on the sustainability of food purchases: Two randomised controlled trials in an experimental online supermarket

Providing consumers with product-specific environmental impact information for food products (ecolabels) may promote more sustainable purchasing, needed to meet global environmental targets. Two UK studies investigated the effectiveness of different ecolabels using an experimental online supermarket platform. Study 1 (N = 1051 participants) compared three labels against control (no label), while Study 2 (N = 4979) tested four designs against control. Study 1 found significant reductions in the environmental impact score (EIS) for all labels compared to control (labels presented: values for four environmental indicators [-3.9 percentiles, 95%CIs: -5.2,-2.6]; a composite score [taking values from A to E; -3.9, 95%CIs: -5.2,-2.5]; or both together [-3.2, 95%CIs: -4.5,-1.9]). Study 2 showed significant reductions in EIS compared to control for A-E labels [-2.3, 95%CIs: -3.0,-1.5], coloured globes with A-E scores [-3.2, 95%CIs:-3.9,-2.4], and red globes highlighting ’worse’ products [-3.2, 95%CIs:-3.9,-2.5]. There was no evidence that green globes highlighting ’better’ products were effective [-0.5, 95%CIs:-1.3,0.2]. Providing ecolabels is a promising intervention to promote the selection of more sustainable products.

Go or no-go? An assessment of inhibitory control training using the GO/NO-GO task in adolescents

OBJECTIVE

Adolescence is a critical period for the onset of unhealthy eating habits. One important contributing factor is poor inhibitory control (IC), a cognitive skill that enables behavior regulation. IC training appears successful in countering unhealthy eating in adults, but evidence in adolescents is scarce. In addition, the mechanism of change from IC training remains unclear. Therefore, the present study aimed to assess changes in IC during a single session of IC training in adolescents. The effectiveness of the training was assessed by comparing the experimental group to a matched control group.

METHOD

A community sample of 57 adolescents between 10 and 18 years was recruited (M_age = 16.61, SD_age = 2.52, 73.7% girls, M_adj.BMI = 105.17, SD_adj.BMI = 18.81). IC was assessed before, during, and after the training using a GO/NO-GO task. Indices of IC were commission errors (CE; incorrectly responding on a no-go trial) and reaction time (RT) on go trials.

RESULTS

CE rates among adolescents who received the IC training were the highest during the training and decreased significantly after the training. However, there were no differences in CE before compared to after the training. No differences were found in RT before, during or after the training. In addition, compared to the control group, the experimental group showed no significant differences in either CE or RT before, during or after the training.

DISCUSSION

To the best of our knowledge, the present study is the first to assess changes in IC after an IC training in a community sample of adolescents. Results of this study further elucidate the complex role of IC in adolescents' unhealthy eating habits. Future studies should seek to corroborate these findings in a larger sample.

Reduction of symptom after a combined behavioral intervention for reward sensitivity and rash impulsiveness in internet gaming disorder: A comparative study

Impulsivity is both a core symptom and a key psychological mechanism in Internet Gaming Disorder (IGD), and therefore interventions for impulsivity in IGD have both theoretical and practical value. However, previous related interventions only tended to focus on a single factor of impulsivity and achieved inconsistent results. In this study, based on the theory of two-factor model of impulsivity (reward sensitivity and rash impulsiveness), four groups of IGD subjects were recruited to investigate whether there were different effects of single rash impulsiveness or reward sensitivity intervention versus a combined intervention. By comparing the different factors of impulsivity of the four groups before and after a 15-day intervention, the results showed that: (1) compared with the control group, subjects in the Go/No-go training group only had a significantly lower level of rash impulsiveness, subjects in the Stimulus-Response Compatibility (SRC) training group only had a significantly lower level of reward sensitivity, and subjects in the combined training group had significantly lower levels of both impulsivity; (2) among the three intervention groups, only the subjects in the combined training group had significantly lower IGD scores in the follow-up measure. This study indicated that the behavioral training of Go/No-go and SRC were effective in improving rash impulsiveness and reward sensitivity in IGD, respectively, but the intervention effect of the combined training was better than that of the single training.

Exploring acute and non-specific effects of mobile app-based response inhibition training on food evaluation and intake

Previous studies have demonstrated that response inhibition training can modify the appeal of palatable and energy-dense foods, thus serving as a potential intervention for weight management, via changes in food selection and intake. However, empirical findings of efficacy have been inconsistent across studies due to heterogenous approaches to measuring salient appetitive outcomes, training implementation strategies, and sample recruitment. Systematic assessment of both affective and motivational components of food reward may help characterise to what extent devaluation can be generalised to nutritionally similar foods post-training. In this mixed factorial experiment, a non-clinical, adult sample completed time-matched single sessions with mobile app-based response inhibition training and control tasks of short (12 min; n = 27) or long (20 min; n = 25) duration. Participants were assessed on two discrete facets of food reward pre- and post-training: pleasure (i.e., explicit liking) and desire (i.e., implicit wanting) for non-specific (i.e., novel) food stimuli differing in energy-density. Consumption of snacks categorised by energy density was also assessed in a laboratory ad libitum taste test post-training. No significant differences were found between intervention and control sessions on explicit liking or implicit wanting for non-specific energy-dense foods. Moreover, participants ate a similar volume of snack foods during both sessions. Training duration did not significantly moderate differences between intervention and control sessions in primary outcomes. Variance between intervention and control sessions in chocolate intake and frequency of choice for energy-dense foods, but not explicit liking, was associated with a higher BMI. Methodological and theoretical implications for appropriate intervention implementation and underlying mechanisms, respectively, are discussed.

Devaluation of NoGo stimuli is both robust and fragile

Consistently not responding to stimuli during go/no-go training leads to lower evaluations of these NoGo stimuli. How this NoGo-devaluation-effect can be explained has remained unclear. Here, we ran three experiments to test the hypothesis that people form stimulus-stop-associations during the training, which predict the strength of the devaluation-effect. In Experiment 1, we tried to simultaneously measure the stimulus-stop-associations and NoGo-devaluation, but we failed to find these effects. In Experiment 2, we measured NoGo-devaluation with established procedures from previous work, and stimulus-stop-associations with a novel separate task. Results revealed a clear NoGo-devaluation-effect, which remained visible across multiple rating blocks. Interestingly, this devaluation-effect disappeared when stimulus-stop-associations were measured before stimulus evaluations, and there was no evidence supporting the formation of the stimulus-stop-associations. In Experiment 3, we found evidence for the acquisition of stimulus-stop-associations using an established task from previous work, but this time we found no subsequent NoGo-devaluation-effect. The present research suggests that the NoGo-devaluation-effect and stimulus-stop-associations can be found with standard established procedures, but that these effects are very sensitive to alterations of the experimental protocol. Furthermore, we failed to find evidence for both effects within the same experimental protocol, which has important theoretical and applied implications.

Food-Specific Inhibition Training for Food Devaluation: A Meta-Analysis

Theories have suggested that food-specific inhibition training could lead to food devaluation which, in turn, may help people to regulate their eating behavior. In this review, we have synthesized the current literature on this topic by conducting a meta-analysis of studies investigating the effects of food-specific inhibition training on food evaluation. We identified 24 studies-with 36 independent samples, 77 effect sizes, and 3032 participants-that met our inclusion criteria. Effect sizes were analyzed using the robust variance estimation in random effects meta-regression technique. The results indicate that food-specific inhibition training can lead to statistically significant reductions in food evaluation. More specifically, it was observed that the effects of training on participants' food evaluation differed according to the type of evaluation; food-specific inhibition training significantly decreased participants' explicit food evaluation, but not their implicit food evaluation. However, because most of the included studies focused on trained food items and short-term outcomes in normal-weight samples, more research is needed on the continuance of the training effects, as well as on the extent to which effects can be generalized to untrained food items or different populations (e.g., overweight or obese individuals).

Efficacy of approach bias modification as an add-on to smoking cessation treatment: study protocol for a randomized-controlled double-blind trial

Background

Although effective treatments for smoking cessation are available, long-term abstinence is the exception rather than the norm. Accordingly, there is a need for novel interventions that potentially improve clinical outcome. Although implicit information processing biases, for example approach biases for smoking-related stimuli, are ascribed a dominant role in the maintenance of tobacco dependence, these biases are hardly targeted in current treatment. Past research has shown that so-called Approach Bias Modification (AppBM) trainings, aiming to modify this bias, lead to improved long-term abstinence in abstinent alcoholic inpatients when delivered as an add-on to treatment-as-usual. Findings on the efficacy of AppBM in smoking have been inconsistent. The present large-scale clinical trial pursues two goals. First, it aims to investigate the efficacy of AppBM as an add-on to treatment-as-usual in a representative sample of adult smokers. Second, possible mechanisms of change are investigated.

Methods

The study is a randomized-controlled, double-blind, parallel-group superiority trial. We aim at a final sample of at least 336 adult smokers. Participants are allocated with a 1:1:1 allocation ratio to one of the following conditions: (1) treatment-as-usual + AppBM, (2) treatment-as-usual + Sham, (3) treatment-as-usual only. During the add-on training, participants are presented smoking-related and positive pictures and are instructed to respond by either pushing or pulling a joystick, depending on the tilt of the pictures (5^○ to the left/right). During AppBM, all smoking-related pictures are tilted in the direction that is associated with pushing, thereby aiming to train an avoidance bias for smoking. All positive pictures are tilted in the direction associated with pulling. During Sham, the contingency is 50/50. Participants are assessed before and after the intervention and at a 6-month follow-up. The primary outcome is prolonged abstinence, and secondary outcomes include smoking-related variables and psychological distress. Additionally, the motivational significance of smoking-related stimuli (i.e., approach bias, valence) is assessed with different experimental tasks (Approach-Avoidance Task; Single Target Implicit Association Test) and psychophysiological measures.

Discussion

This is the first large-scale clinical trial investigating the efficacy of AppBM as an add-on in smokers including a TAU only condition. Additionally, it is the first study to systematically investigate potential mechanisms mediating the effects of treatment on clinical outcome.

Trial registration

German Clinical Trials Register, DRKS00019221, 11/11/2019

Supplementary Information

The online version contains supplementary material available at 10.1186/s13063-022-06155-6.

Feasibility of an app-based intervention for paediatric weight-management: A Short Report (Preprint)

BACKGROUND

A multidisciplinary approach to weight management is offered at tier 3 pediatric weight management services in the United Kingdom. Encouraging dietary change is a major aim, with patients meeting with dieticians, endocrinologists, psychologists, nurse specialists, and social workers on average every other month.

OBJECTIVE

This research sought to trial an inhibitory control training smartphone app-FoodT-with the clinic population of a pediatric weight management service. FoodT has shown positive impacts on food choice in adult users, with resulting weight loss. It was hoped that when delivered as an adjunctive treatment alongside the extensive social, medical, psychological, and dietetic interventions already offered at the clinic, the introduction of inhibitory control training may offer patients another tool that supports eating choice. In this feasibility trial, recruitment, retention, and app use were the primary outcomes. An extensive battery of measures was included to test the feasibility and acceptability of these measures for future powered trials.

METHODS

FoodT was offered to pediatric patients and their parents during a routine clinic appointment, and patients were asked to use the app at home every day for the first week and once per week for the rest of the month. Feasibility and acceptability were measured in terms of recruitment, engagement with the app, and retention to the trial. A battery of psychometric tests was given before and after app use to assess the acceptability of collecting data on changes to food choices and experiences that would inform future trial work.

RESULTS

A total of 12 children and 10 parents consented (22/62, 35% of those approached). Further, 1 child and no parents achieved the recommended training schedule. No participants completed the posttrial measures. The reasons for not wanting to be recruited to the trial included participants not considering their weight to be connected to eating choices and not feeling that the app suited their needs. No reasons are known for noncompletion.

CONCLUSIONS

It is unclear whether the intervention itself or the research processes, including the battery of measures, prevented completion. It is therefore difficult to make any decisions as to the value that the app has within this setting. Important lessons have been learned from this research that have potential broad relevance, including the importance of co-designing interventions with service users and avoiding deterring people from early-stage participation in extensive data collection.

App-based food-specific inhibitory control training as an adjunct to treatment as usual in binge-type eating disorders: A feasibility trial

Current treatments for binge eating disorder (BED) and bulimia nervosa (BN) only show moderate efficacy, warranting the need for novel interventions. Impairments in food-related inhibitory control contribute to BED/BN and could be targeted by food-specific inhibitory control training (ICT). The aim of this study was to establish the feasibility and acceptability of augmenting treatment for individuals with BN/BED with an ICT app (FoodT), which targets motor inhibition to food stimuli using a go/no-go paradigm. Eighty patients with BED/BN receiving psychological and/or pharmacological treatment were randomly allocated to a treatment-as-usual group (TAU; n = 40) or TAU augmented with the 5-min FoodT app daily (n = 40) for 4 weeks. This mixed-methods study assessed feasibility outcomes, effect sizes of clinical change, and acceptability using self-report measures. Pre-registered cut-offs for recruitment, retention, and adherence were met, with 100% of the targeted sample size (n = 80) recruited within 12 months, 85% of participants retained at 4 weeks, and 80% of the FoodT + TAU group completing ≤8 sessions. The reduction in binge eating did not differ between groups. However, moderate reductions in secondary outcomes (eating disorder psychopathology: SES = -0.57, 95% CI [-1.12, -0.03]; valuation of high energy-dense foods: SES = -0.61, 95% CI [-0.87, -0.05]) were found in the FoodT group compared to TAU. Furthermore, small greater reductions in food addiction (SES = -0.46, 95% CI [-1.14, 0.22]) and lack of premeditation (SES = -0.42, 95% CI [-0.77, -0.07]) were found in the FoodT group when compared to TAU. The focus groups revealed acceptability of FoodT. Participants discussed personal barriers (e.g. distractions) and suggested changes to the app (e.g. adding a meditation exercise). Augmenting treatment for BED/BN with a food-specific ICT app is feasible, acceptable, and may reduce clinical symptomatology with high reach and wide dissemination.

Uncontrolled eating in healthy women has limited influence on food cue reactivity and food-related inhibitory control

Uncontrolled eating-in the general population-is characterized by overeating, hedonic hunger and being drawn towards palatable foods. Theoretically, it is the result of a strong food reward signal in relation to a poor ability to exert inhibitory control. How food consumption influences inhibitory control and food cue sensitivity, and how this relates to the continued urge to eat, remains unclear. We used fMRI in order to investigate the neural mechanism underlying food cue reactivity and food-specific response inhibition (go-nogo task), by comparing women reporting high (n = 21) versus low/average (n = 19) uncontrolled eating across two sessions: during an inter-meal state and after consumption of a high-caloric snack. We found no effects of individual differences in uncontrolled eating, food consumption, nor their interaction on food cue reactivity. Differences in uncontrolled eating and food consumption did interact in modulating activity in an occipital-parietal network, extending from left lateral superior occipital cortex to visual cortex, cuneal cortex, and precuneus during response inhibition of non-food stimuli, areas previously associated with successful nogo-vs. go-trials. Yet, behavioural performance on the go-nogo task was not modulated by uncontrolled eating nor food consumption. Women with a low/average tendency for uncontrolled eating may need more cognitive resources to support successful response inhibition of non-food stimuli during food 'go' blocks in an inter-meal state, whereas women with a high tendency for uncontrolled eating showed this after food consumption. However, considering current and previous findings, it seems that individual differences in uncontrolled eating in healthy women have only limited influence on food cue reactivity and food-related inhibitory control.

Transcranial direct current stimulation combined with alcohol cue inhibitory control training reduces the risk of early alcohol relapse: A randomized placebo-controlled clinical trial

BACKGROUND

Approximately half of all people with alcohol use disorder (AUD) relapse into alcohol reuse in the next few weeks after a withdrawal treatment. Brain stimulation and cognitive training represent recent forms of complementary interventions in the context of AUD.

OBJECTIVE

To evaluate the clinical efficacy of five sessions of 2 mA bilateral transcranial direct current stimulation (tDCS) for 20 min over the dorsolateral prefrontal cortex (DLPFC) (left cathodal/right anodal) combined with alcohol cue inhibitory control training (ICT) as part of rehabilitation. The secondary outcomes were executive functioning (e.g. response inhibition) and craving intensity, two mechanisms strongly related to abstinence.

METHODS

A randomized clinical trial with patients (n = 125) with severe AUD at a withdrawal treatment unit. Each patient was randomly assigned to one of four conditions, in a 2 [verum vs. sham tDCS] x 2 [alcohol cue vs. neutral ICT] factorial design. The main outcome of treatment was the abstinence rate after two weeks or more (up to one year).

RESULTS

Verum tDCS improved the abstinence rate at the 2-week follow-up compared to the sham condition, independently of the training condition (79.7% [95% CI = 69.8-89.6] vs. 60.7% [95% CI = 48.3-73.1]; p = .02). A priori contrasts analyses revealed higher abstinence rates for the verum tDCS associated with alcohol cue ICT (86.1% [31/36; 95% CI = 74.6-97.6]) than for the other three conditions (64% [57/89; 95% CI = 54-74]). These positive clinical effects on abstinence did not persist beyond two weeks after the intervention. Neither the reduction of craving nor the improvement in executive control resulted specifically from prefrontal-tDCS and ICT.

CONCLUSIONS

AUD patients who received tDCS applied to DLPFC showed a significantly higher abstinence rate during the weeks following rehabilitation. When combined with alcohol specific ICT, brain stimulation may provide better clinical outcomes.

TRIAL REGISTRATION

ClinicalTrials.gov number NCT03447054 https://clinicaltrials.gov/ct2/show/NCT03447054.

Can sweet food-specific inhibitory control training via a mobile application improve eating behavior in children with obesity?

OBJECTIVES

Consumption of excess sugar, a common energy-dense nutrient-poor food, is a risk factor for obesity in school-aged children. Food-specific inhibition training, where responses to palatable food stimuli, such as sweet foods, are consistently and repeatedly inhibited, reduces sweet food intake in adults. However, no studies have yet examined the effectiveness of inhibitory control training specifically targeting sweet foods among children with high sugar cravings. We examined whether sweet food-specific inhibitory control training (SF-ICT), administered via a mobile app, reduced choice and consumption of sweet foods, and weight in a sample of children aged 7-11 with overweight or obesity and who had high sugar cravings (N = 46).

DESIGN

This study was designed as a 2 × 3 between-within design.

METHODS

Participants were randomly allocated to a single-blind design with two conditions: they either received 7 sessions of active or control go/no-go training in which either sweet foods or non-food cues were paired with no-go signals. Participants' weight, sweet food choice, and consumption were measured pre and post-training, and at three-month follow-up.

RESULTS

The results revealed that participants in the active group showed a significant reduction in sweet food choice and intake from pre to post-training relative to the control group. The effects of the training on reducing sweet food intake persisted over the 3-month follow-up No significant changes in weight loss were observed.

CONCLUSIONS

These results provide preliminary evidence that sweet food-specific inhibitory control training (SF-ICT) via a mobile app is effective in modifying eating behavior among children with excessive consumption of sugary foods. Further research is required to clarify under what conditions the benefits of training would expand to weight loss.

Gender differences in the effect of gamification on weight loss during a daily, neurocognitive training program

A major contributor to the obesity epidemic is the overconsumption of high-calorie foods, which is partly governed by inhibitory control, that is, the ability to override pre-prepotent impulses and drives. Computerized inhibitory control trainings (ICTs) have demonstrated qualified success at affecting real-world health behaviors, and at improving weight loss, particularly when repeated frequently over an extended duration. It has been proposed that gamification (i.e., incorporating game-like elements such as a storyline, sounds, graphics, and rewards) might enhance participant interest and thus training compliance. Previous findings from a mostly female sample did support this hypothesis; however, it might be expected that the effects of gamification differ by gender such that men, who appear more motivated by gaming elements, stand to benefit more from gamification. The present study evaluated whether gender moderated the effect of a gamified ICT on weight loss. Seventy-six overweight individuals received a no-sugar-added dietary prescription and were randomized to 42 daily and 2 weekly ICTs focused on sweet foods that were either gamified or nongamified. Results supported the hypothesis that gamification elements had a positive effect on weight loss for men and not women (p = .03). However, mechanistic hypotheses for the moderating effect (in terms of enjoyment, compliance, and improvements in inhibitory control) were generally not supported (p's > .20). These results suggest that gamification of ICTs may boost weight loss outcomes for men and not women, but further research is needed to determine the specific mechanisms driving this effect and to arrive at gamification elements that enhance effects for both men and women.

Effects of go/no-go training on food-related action tendencies, liking and choice

Inhibitory control training effects on behaviour (e.g. 'healthier' food choices) can be driven by changes in affective evaluations of trained stimuli, and theoretical models indicate that changes in action tendencies may be a complementary mechanism. In this preregistered study, we investigated the effects of food-specific go/no-go training on action tendencies, liking and impulsive choices in healthy participants. In the training task, energy-dense foods were assigned to one of three conditions: 100% inhibition (no-go), 0% inhibition (go) or 50% inhibition (control). Automatic action tendencies and liking were measured pre- and post-training for each condition. We found that training did not lead to changes in approach bias towards trained foods (go and no-go relative to control), but we warrant caution in interpreting this finding as there are important limitations to consider for the employed approach-avoidance task. There was only anecdotal evidence for an effect on food liking, but there was evidence for contingency learning during training, and participants were on average less likely to choose a no-go food compared to a control food after training. We discuss these findings from both a methodological and theoretical standpoint and propose that the mechanisms of action behind training effects be investigated further.

Targeting executive function for weight loss in adults with overweight or obesity

Obesity is associated with a multitude of negative health sequalae. Behavioral weight loss (BWL) is currently the recommended behavioral treatment for obesity; however, it is not effective for approximately half of the individuals who participate. BWL requires individuals to carry out many tasks requiring executive function (EF; i.e., higher order cognitive functions such as planning and problem solving) in order to be successful. Growing research supports that lower EF may be associated with attenuated weight loss following BWL, and targeting EF in treatment could improve outcomes. This paper aims to describe the rationale for the development of Novel Executive Function Training for Obesity (NEXT), which adapts Compensatory Cognitive Training to be delivered in conjunction with BWL. We summarize evidence relating EF to obesity and reduced weight loss following BWL, as well as the past success of cognitive training on EF. Then we describe the treatment model for NEXT followed by initial data suggesting that NEXT is feasible and acceptable and may impact EF and weight. Obesity treatments incorporating cognitive training, especially those that train compensatory strategies, may improve weight-loss outcomes and provide a more durable treatment than traditional interventions, but larger randomized control trials are necessary.

Food-related inhibitory control training reduces food liking but not snacking frequency or weight in a large healthy adult sample

Inhibitory control training has recently been used as an intervention to aid healthy eating and encourage weight loss. The aim of this pre-registered study was to explore the effects of training on food liking, food consumption and weight loss in a large (n = 366), predominantly healthy-weight sample. Participants received four training sessions within a week, in which they had to inhibit their responses to either energy-dense foods (active group) or non-food images (control group). Subjective food ratings, food consumption frequency and weight were measured pre- and post-training. At two-weeks post-training, the active group reported a greater reduction in liking for energy-dense foods, compared to the control group. Active participants also reported a significantly greater increase in healthy food liking, immediately post-training, relative to the control group. There was no statistically significant difference between groups for the change in consumption of trained foods or for weight loss. These findings are partially consistent with previous research conducted in smaller, more overweight samples. Exploratory analyses suggest that some effects of training may be driven by awareness effects. Methodological differences across findings and avenues for future investigation are discussed.

Social Information Processing in Substance Use Disorders: Insights From an Emotional Go-Nogo Task

Positive social connections are crucial for recovery from Substance Use Disorder (SUD). Of interest is understanding potential social information processing (SIP) mediators of this effect. To explore whether persons with different SUD show idiosyncratic biases toward social signals, we administered an emotional go-nogo task (EGNG) to 31 individuals with Cocaine Use Disorder (CoUD), 31 with Cannabis Use Disorder (CaUD), 79 with Opioid Use Disorder (OUD), and 58 controls. Participants were instructed to respond to emotional faces (Fear/Happy) but withhold responses to expressionless faces in two task blocks, with the reverse instruction in the other two blocks. Emotional faces as non-targets elicited more "false alarm" (FA) commission errors as a main effect. Groups did not differ in overall rates of hits (correct responses to target faces), but participants with CaUD and CoUD showed reduced rates of hits (relative to controls) when expressionless faces were targets. OUD participants had worse hit rates [and slower reaction times (RT)] when fearful faces (but not happy faces) were targets. CaUD participants were most affected by instruction effects (respond/"go" vs withhold response/"no-go" to emotional face) on discriminability statistic A. Participants were faster to respond to happy face targets than to expressionless faces. However, this pattern was reversed in fearful face blocks in OUD and CoUD participants. This experiment replicated previous findings of the greater salience of expressive face images, and extends this finding to SUD, where persons with CaUD may show even greater bias toward emotional faces. Conversely, OUD participants showed idiosyncratic behavior in response to fearful faces suggestive of increased attentional disruption by fear. These data suggest a mechanism by which positive social signals may contribute to recovery.

Modifying food items valuation and weight with gamified executive control training

Recent lines of research suggest that repeated executive control of motor responses to food items modifies their perceived value and in turn their consumption. Cognitive interventions involving the practice of motor control and attentional tasks have thus been advanced as potential approach to improve eating habits. Yet, their efficacy remains debated, notably due to a lack of proper control for the effects of expectations. We examined whether a one-month intervention combining the practice of Go/NoGo and Cue approach training modified the perceived palatability of food items (i.e. decrease in unhealthy and increase in healthy food items' palatability ratings), and in turn participants' weights. We assessed our hypotheses with a parallel, double-blind, randomized controlled trial. Motivation and adherence to the intervention were maximized by a professional-level gamification of the training tasks. The control intervention differed from the experimental intervention only in the biasing of the stimulus-response mapping rules, enabling to balance expectations between the two groups and thus to conclude on the causal influence of motoric control on items valuation. We found a larger decrease of the unhealthy items' palatability ratings in the experimental (20.6%) than control group (13.1%). However, we did not find any increase of the healthy items' ratings or weight loss. Overall, the present registered report confirms that the repeated inhibition of motor responses to food cues, together with the development of attentional biases away from these cues, reduces their perceived value.

Exploring Strategies to Optimise the Impact of Food-Specific Inhibition Training on Children's Food Choices

Food-specific inhibition training (FSIT) is a computerised task requiring response inhibition to energy-dense foods within a reaction-time game. Previous work indicates that FSIT can increase the number of healthy foods (relative to energy-dense foods) children choose, and decrease calories consumed from sweets and chocolate. Across two studies, we explored the impact of FSIT variations (e.g., different response signals, different delivery modes) on children's food choices within a time-limited hypothetical food-choice task. In Study 1, we varied the FSIT Go/No-Go signals to be emotive (happy vs. sad faces) or neutral (green vs. red signs). One-hundred-and-fifty-seven children were randomly allocated to emotive-FSIT, neutral-FSIT, or a non-food control task. Children participated in groups of 4-15. No significant FSIT effects were observed on food choices (all values of p > 0.160). Healthy-food choices decreased over time regardless of condition (p < 0.050). The non-significant effects could be explained by lower accuracy on energy-dense No-Go trials than in previous studies, possibly due to distraction in the group-testing environment. In Study 2, we compared computer-based FSIT (using emotive signals) and app-based FSIT (using neutral signals) against a non-food control with a different sample of 206 children, but this time children worked one-on-one with the experimenter. Children's accuracy on energy-dense No-Go trials was higher in this study. Children in the FSIT-computer group chose significantly more healthy foods at post-training (M = 2.78, SE = 0.16) compared to the control group (M = 2.02, SE = 0.16, p = 0.001). The FSIT-app group did not differ from either of the other two groups (M = 2.42, SE = 0.16, both comparisons p > 0.050). Healthy choices decreased over time in the control group (p = 0.001) but did not change in the two FSIT groups (both p > 0.300) supporting previous evidence that FSIT may have a beneficial effect on children's food choices. Ensuring that children perform FSIT with high accuracy (e.g., by using FSIT in quiet environments and avoiding group-testing) may be important for impacts on food choices though. Future research should continue to explore methods of optimising FSIT as a healthy-eating intervention for children.