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Nemati S, Arjmandi M, Busby N, Bonilha L, Fridriksson J. The impact of age-related hearing loss on cognitive decline: The mediating role of brain age gap. Neuroscience 2024; 551:185-195. [PMID: 38838977 DOI: 10.1016/j.neuroscience.2024.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2024] [Revised: 05/01/2024] [Accepted: 05/03/2024] [Indexed: 06/07/2024]
Abstract
In recent years, the relationship between age-related hearing loss, cognitive decline, and the risk of dementia has garnered significant attention. The significant variability in brain health and aging among individuals of the same chronological age suggests that a measure assessing how one's brain ages may better explain hearing-cognition links. The main aim of this study was to investigate the mediating role of Brain Age Gap (BAG) in the association between hearing impairment and cognitive function. This research included 185 participants aged 20-79 years. BAG was estimated based on the difference between participant's brain age (estimated based on their structural T1-weighted MRI scans) and chronological age. Cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA) test while hearing ability was measured using pure-tone thresholds (PTT) and words-in-noise (WIN) perception. Mediation analyses were used to examine the mediating role of BAG in the relationship between age-related hearing loss as well as difficulties in WIN perception and cognition. Participants with poorer hearing sensitivity and WIN perception showed lower MoCA scores, but this was an indirect effect. Participants with poorer performance on PTT and WIN tests had larger BAG (accelerated brain aging), and this was associated with poorer performance on the MoCA test. Mediation analyses showed that BAG partially mediated the relationship between age-related hearing loss and cognitive decline. This study enhances our understanding of the interplay among hearing loss, cognition, and BAG, emphasizing the potential value of incorporating brain age assessments in clinical evaluations to gain insights beyond chronological age, thus advancing strategies for preserving cognitive health in aging populations.
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Affiliation(s)
- Samaneh Nemati
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA.
| | - Meisam Arjmandi
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Natalie Busby
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
| | - Leonardo Bonilha
- Department of Neurology, University of South Carolina, Columbia, SC, USA
| | - Julius Fridriksson
- Department of Communication Sciences and Disorders, University of South Carolina, Columbia, SC, USA
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林 欢, 刘 潘, 孙 钰, 俞 欣, 钱 君, 池 霞, 洪 琴. [Association between auditory processing and problem behaviors in preschool children: the mediating role of executive function]. ZHONGGUO DANG DAI ER KE ZA ZHI = CHINESE JOURNAL OF CONTEMPORARY PEDIATRICS 2024; 26:174-180. [PMID: 38436316 PMCID: PMC10921876 DOI: 10.7499/j.issn.1008-8830.2309067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 12/25/2023] [Indexed: 03/05/2024]
Abstract
OBJECTIVES To investigate the association between auditory processing and problem behaviors in preschool children, as well as the mediating role of executive function. METHODS A total of 2 342 preschool children were selected from 7 kindergartens in Nanjing, China from June to August 2021. They were evaluated using Preschool Auditory Processing Assessment Scale, Conners Parent Symptom Questionnaire, and Behavior Rating Inventory of Executive Functioning-Preschool version. Children with different demographic features were compared in the scores and the abnormality rates of auditory processing, problem behaviors, and executive function. The influencing factors of the total scores of auditory processing, problem behaviors, and executive function were evaluated using multiple linear regression analysis. Whether executive function was a mediating factor between auditory processing and executive function was examined. RESULTS Sex and grade were the main influencing factors for the total score of auditory processing (P<0.05), and sex, grade, parental education level, and family economic status were the main influencing factors for the total scores of problem behaviors and executive function (P<0.05). The auditory processing score (rs=0.458, P<0.05) and problem behavior score (rs=0.185, P<0.05) were significantly positively correlated with the executive function score, and the auditory processing score was significantly positively correlated with the problem behavior score (rs=0.423, P<0.05). Executive function played a partial mediating role between auditory processing and problem behaviors, and the mediating effect accounted for 33.44% of the total effect. CONCLUSIONS Auditory processing can directly affect the problem behaviors of preschool children and indirectly affect problem behaviors through executive function.
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Visentin C, Pellegatti M, Garraffa M, Di Domenico A, Prodi N. Individual characteristics moderate listening effort in noisy classrooms. Sci Rep 2023; 13:14285. [PMID: 37652970 PMCID: PMC10471719 DOI: 10.1038/s41598-023-40660-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 08/16/2023] [Indexed: 09/02/2023] Open
Abstract
Comprehending the teacher's message when other students are chatting is challenging. Even though the sound environment is the same for a whole class, differences in individual performance can be observed, which might depend on a variety of personal factors and their specific interaction with the listening condition. This study was designed to explore the role of individual characteristics (reading comprehension, inhibitory control, noise sensitivity) when primary school children perform a listening comprehension task in the presence of a two-talker masker. The results indicated that this type of noise impairs children's accuracy, effort, and motivation during the task. Its specific impact depended on the level and was modulated by the child's characteristics. In particular, reading comprehension was found to support task accuracy, whereas inhibitory control moderated the effect of listening condition on the two measures of listening effort included in the study (response time and self-ratings), even though with a different pattern of association. A moderation effect of noise sensitivity on perceived listening effort was also observed. Understanding the relationship between individual characteristics and classroom sound environment has practical implications for the acoustic design of spaces promoting students' well-being, and supporting their learning performance.
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Affiliation(s)
- Chiara Visentin
- Department of Engineering, University of Ferrara, Via Saragat 1, 44122, Ferrara, Italy.
- Institute for Renewable Energy, Eurac Research, Via A. Volta/A. Volta Straße 13/A, 39100, Bolzano-Bozen, Italy.
| | - Matteo Pellegatti
- Department of Engineering, University of Ferrara, Via Saragat 1, 44122, Ferrara, Italy
| | - Maria Garraffa
- School of Health Sciences, University of East Anglia, Norwich Research Park, Norwich, Norfolk, NR4 7TJ, UK
| | - Alberto Di Domenico
- Department of Psychological, Health and Territorial Sciences, University of Chieti-Pescara, Via dei Vestini 31, 66100, Chieti, Italy
| | - Nicola Prodi
- Department of Engineering, University of Ferrara, Via Saragat 1, 44122, Ferrara, Italy
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Xu S, Fan J, Zhang H, Zhang M, Zhao H, Jiang X, Ding H, Zhang Y. Hearing Assistive Technology Facilitates Sentence-in-Noise Recognition in Chinese Children With Autism Spectrum Disorder. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2023:1-21. [PMID: 37418749 DOI: 10.1044/2023_jslhr-22-00589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/09/2023]
Abstract
PURPOSE Hearing assistive technology (HAT) has been shown to be a viable solution to the speech-in-noise perception (SPIN) issue in children with autism spectrum disorder (ASD); however, little is known about its efficacy in tonal language speakers. This study compared sentence-level SPIN performance between Chinese children with ASD and neurotypical (NT) children and evaluated HAT use in improving SPIN performance and easing SPIN difficulty. METHOD Children with ASD (n = 26) and NT children (n = 19) aged 6-12 years performed two adaptive tests in steady-state noise and three fixed-level tests in quiet and steady-state noise with and without using HAT. Speech recognition thresholds (SRTs) and accuracy rates were assessed using adaptive and fixed-level tests, respectively. Parents or teachers of the ASD group completed a questionnaire regarding children's listening difficulty under six circumstances before and after a 10-day trial period of HAT use. RESULTS Although the two groups of children had comparable SRTs, the ASD group showed a significantly lower SPIN accuracy rate than the NT group. Also, a significant impact of noise was found in the ASD group's accuracy rate but not in that of the NT group. There was a general improvement in the ASD group's SPIN performance with HAT and a decrease in their listening difficulty ratings across all conditions after the device trial. CONCLUSIONS The findings indicated inadequate SPIN in the ASD group using a relatively sensitive measure to gauge SPIN performance among children. The markedly increased accuracy rate in noise during HAT-on sessions for the ASD group confirmed the feasibility of HAT for improving SPIN performance in controlled laboratory settings, and the reduced post-use ratings of listening difficulty further confirmed the benefits of HAT use in daily scenarios.
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Affiliation(s)
- Suyun Xu
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, China
| | - Juan Fan
- Department of Child and Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, China
| | - Hua Zhang
- Department of Child and Adolescent Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, China
| | - Minyue Zhang
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, China
| | - Hang Zhao
- Faculty of Education, East China Normal University, Shanghai
| | - Xiaoming Jiang
- Institute of Linguistics, Shanghai International Studies University, China
| | - Hongwei Ding
- Speech-Language-Hearing Center, School of Foreign Languages, Shanghai Jiao Tong University, China
| | - Yang Zhang
- Department of Speech-Language-Hearing Sciences and Masonic Institute for the Developing Brain, University of Minnesota, Minneapolis
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van Wieringen A, Van Wilderode M, Van Humbeeck N, Krampe R. Coupling of sensorimotor and cognitive functions in middle- and late adulthood. Front Neurosci 2022; 16:1049639. [PMID: 36532286 PMCID: PMC9752872 DOI: 10.3389/fnins.2022.1049639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Accepted: 11/08/2022] [Indexed: 11/03/2023] Open
Abstract
Introduction The present study explored age effects and the coupling of sensorimotor and cognitive functions in a stratified sample of 96 middle-aged and older adults (age 45-86 years) with no indication of mild cognitive decline. In our sensorimotor tasks, we had an emphasis on listening in noise and postural control, but we also assessed functional mobility and tactile sensitivity. Methods Our cognitive measures comprised processing speed and assessments of core cognitive control processes (executive functions), notably inhibition, task switching, and working memory updating. We explored whether our measures of sensorimotor functioning mediated age differences in cognitive variables and compared their effect to processing speed. Subsequently, we examined whether individuals who had poorer (or better) than median cognitive performance for their age group also performed relatively poorer (or better) on sensorimotor tasks. Moreover, we examined whether the link between cognitive and sensorimotor functions becomes more pronounced in older age groups. Results Except for tactile sensitivity, we observed substantial age-related differences in all sensorimotor and cognitive variables from middle age onward. Processing speed and functional mobility were reliable mediators of age in task switching and inhibitory control. Regarding coupling between sensorimotor and cognition, we observed that individuals with poor cognitive control do not necessarily have poor listening in noise skills or poor postural control. Discussion As most conditions do not show an interdependency between sensorimotor and cognitive performance, other domain-specific factors that were not accounted for must also play a role. These need to be researched in order to gain a better understanding of how rehabilitation may impact cognitive functioning in aging persons.
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Affiliation(s)
- Astrid van Wieringen
- Research Group Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Mira Van Wilderode
- Research Group Experimental Oto-Rhino-Laryngology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Nathan Van Humbeeck
- Research Group Brain and Cognition, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
| | - Ralf Krampe
- Research Group Brain and Cognition, Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Belgium
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Bsharat-Maalouf D, Karawani H. Bilinguals' speech perception in noise: Perceptual and neural associations. PLoS One 2022; 17:e0264282. [PMID: 35196339 PMCID: PMC8865662 DOI: 10.1371/journal.pone.0264282] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 02/07/2022] [Indexed: 01/26/2023] Open
Abstract
The current study characterized subcortical speech sound processing among monolinguals and bilinguals in quiet and challenging listening conditions and examined the relation between subcortical neural processing and perceptual performance. A total of 59 normal-hearing adults, ages 19–35 years, participated in the study: 29 native Hebrew-speaking monolinguals and 30 Arabic-Hebrew-speaking bilinguals. Auditory brainstem responses to speech sounds were collected in a quiet condition and with background noise. The perception of words and sentences in quiet and background noise conditions was also examined to assess perceptual performance and to evaluate the perceptual-physiological relationship. Perceptual performance was tested among bilinguals in both languages (first language (L1-Arabic) and second language (L2-Hebrew)). The outcomes were similar between monolingual and bilingual groups in quiet. Noise, as expected, resulted in deterioration in perceptual and neural responses, which was reflected in lower accuracy in perceptual tasks compared to quiet, and in more prolonged latencies and diminished neural responses. However, a mixed picture was observed among bilinguals in perceptual and physiological outcomes in noise. In the perceptual measures, bilinguals were significantly less accurate than their monolingual counterparts. However, in neural responses, bilinguals demonstrated earlier peak latencies compared to monolinguals. Our results also showed that perceptual performance in noise was related to subcortical resilience to the disruption caused by background noise. Specifically, in noise, increased brainstem resistance (i.e., fewer changes in the fundamental frequency (F0) representations or fewer shifts in the neural timing) was related to better speech perception among bilinguals. Better perception in L1 in noise was correlated with fewer changes in F0 representations, and more accurate perception in L2 was related to minor shifts in auditory neural timing. This study delves into the importance of using neural brainstem responses to speech sounds to differentiate individuals with different language histories and to explain inter-subject variability in bilinguals’ perceptual abilities in daily life situations.
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Affiliation(s)
- Dana Bsharat-Maalouf
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
| | - Hanin Karawani
- Department of Communication Sciences and Disorders, University of Haifa, Haifa, Israel
- * E-mail:
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El Bouzaïdi Tiali S, Spinelli E, Meunier F, Palluel-Germain R, Perrone-Bertolotti M. Influence of homophone processing during auditory language comprehension on executive control processes: A dual-task paradigm. PLoS One 2021; 16:e0254237. [PMID: 34264980 PMCID: PMC8282032 DOI: 10.1371/journal.pone.0254237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2020] [Accepted: 06/22/2021] [Indexed: 11/19/2022] Open
Abstract
In the present preregistered study, we evaluated the possibility of a shared cognitive mechanism during verbal and non-verbal tasks and therefore the implication of domain-general cognitive control during language comprehension. We hypothesized that a behavioral cost will be observed during a dual-task including both verbal and non-verbal difficult processing. Specifically, to test this claim, we designed a dual-task paradigm involving: an auditory language comprehension task (sentence comprehension) and a non-verbal Flanker task (including congruent and incongruent trials). We manipulated sentence ambiguity and evaluated if the ambiguity effect modified behavioral performances in the non-verbal Flanker task. Under the assumption that ambiguous sentences induce a more difficult process than unambiguous sentences, we expected non-verbal flanker task performances to be impaired only when a simultaneous difficult language processing is performed. This would be specifically reflected by a performance cost during incongruent Flanker items only during ambiguous sentence presentation. Conversely, we observed a facilitatory effect for the incongruent Flanker items during ambiguous sentence suggesting better non-verbal inhibitory performances when an ambiguous sentence was simultaneously processed. Exploratory data analysis suggests that this effect is not only related to a more difficult language processing but also to the previous (n-1) Flanker item. Indeed, results showed that incongruent n-1 Flanker items led to a facilitation of the incongruent synchronized Flanker items only when ambiguous sentences were conjointly presented. This result, even if it needs to be corroborated in future studies, suggests that the recruitment of executive control mechanisms facilitates subsequent executive control implication during difficult language processing. The present study suggests a common executive control mechanism during difficult verbal and non-verbal tasks.
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Affiliation(s)
| | - Elsa Spinelli
- Université Grenoble Alpes, CNRS, LPNC UMR 5105, Grenoble, France
| | | | | | - Marcela Perrone-Bertolotti
- Université Grenoble Alpes, CNRS, LPNC UMR 5105, Grenoble, France
- Institut Universitaire de France (IUF), Paris, France
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Francis AL, Bent T, Schumaker J, Love J, Silbert N. Listener characteristics differentially affect self-reported and physiological measures of effort associated with two challenging listening conditions. Atten Percept Psychophys 2021; 83:1818-1841. [PMID: 33438149 PMCID: PMC8084824 DOI: 10.3758/s13414-020-02195-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 12/14/2022]
Abstract
Listeners vary in their ability to understand speech in adverse conditions. Differences in both cognitive and linguistic capacities play a role, but increasing evidence suggests that such factors may contribute differentially depending on the listening challenge. Here, we used multilevel modeling to evaluate contributions of individual differences in age, hearing thresholds, vocabulary, selective attention, working memory capacity, personality traits, and noise sensitivity to variability in measures of comprehension and listening effort in two listening conditions. A total of 35 participants completed a battery of cognitive and linguistic tests as well as a spoken story comprehension task using (1) native-accented English speech masked by speech-shaped noise and (2) nonnative accented English speech without masking. Masker levels were adjusted individually to ensure each participant would show (close to) equivalent word recognition performance across the two conditions. Dependent measures included comprehension tests results, self-rated effort, and electrodermal, cardiovascular, and facial electromyographic measures associated with listening effort. Results showed varied patterns of responsivity across different dependent measures as well as across listening conditions. In particular, results suggested that working memory capacity may play a greater role in the comprehension of nonnative accented speech than noise-masked speech, while hearing acuity and personality may have a stronger influence on physiological responses affected by demands of understanding speech in noise. Furthermore, electrodermal measures may be more strongly affected by affective response to noise-related interference while cardiovascular responses may be more strongly affected by demands on working memory and lexical access.
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Affiliation(s)
- Alexander L Francis
- Department of Speech, Language and Hearing Sciences, Purdue University, Lyles-Porter Hall, 715 Clinic Dr., West Lafayette, IN, 47907, USA.
| | - Tessa Bent
- Department of Speech, Language and Hearing Sciences, Indiana University, Bloomington, IN, USA
| | - Jennifer Schumaker
- Department of Speech, Language and Hearing Sciences, Purdue University, Lyles-Porter Hall, 715 Clinic Dr., West Lafayette, IN, 47907, USA
| | - Jordan Love
- Department of Speech, Language and Hearing Sciences, Purdue University, Lyles-Porter Hall, 715 Clinic Dr., West Lafayette, IN, 47907, USA
| | - Noah Silbert
- Applied Research Laboratory for Intelligence and Security, University of Maryland, College Park, MD, USA
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Sprachverstehen und kognitive Leistungen in akustisch schwierigen Situationen. HNO 2020; 68:171-176. [DOI: 10.1007/s00106-019-0727-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Francis AL, Love J. Listening effort: Are we measuring cognition or affect, or both? WILEY INTERDISCIPLINARY REVIEWS. COGNITIVE SCIENCE 2019; 11:e1514. [PMID: 31381275 DOI: 10.1002/wcs.1514] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 07/07/2019] [Accepted: 07/10/2019] [Indexed: 12/14/2022]
Abstract
Listening effort is increasingly recognized as a factor in communication, particularly for and with nonnative speakers, for the elderly, for individuals with hearing impairment and/or for those working in noise. However, as highlighted by McGarrigle et al., International Journal of Audiology, 2014, 53, 433-445, the term "listening effort" encompasses a wide variety of concepts, including the engagement and control of multiple possibly distinct neural systems for information processing, and the affective response to the expenditure of those resources in a given context. Thus, experimental or clinical methods intended to objectively quantify listening effort may ultimately reflect a complex interaction between the operations of one or more of those information processing systems, and/or the affective and motivational response to the demand on those systems. Here we examine theoretical, behavioral, and psychophysiological factors related to resolving the question of what we are measuring, and why, when we measure "listening effort." This article is categorized under: Linguistics > Language in Mind and Brain Psychology > Theory and Methods Psychology > Attention Psychology > Emotion and Motivation.
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Affiliation(s)
- Alexander L Francis
- Department of Speech, Language and Hearing Sciences, Purdue University, West Lafayette, Indiana
| | - Jordan Love
- Department of Speech, Language and Hearing Sciences, Purdue University, West Lafayette, Indiana
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Hedge C, Powell G, Bompas A, Vivian-Griffiths S, Sumner P. Low and variable correlation between reaction time costs and accuracy costs explained by accumulation models: Meta-analysis and simulations. Psychol Bull 2018; 144:1200-1227. [PMID: 30265012 PMCID: PMC6195302 DOI: 10.1037/bul0000164] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2017] [Revised: 05/15/2018] [Accepted: 06/01/2018] [Indexed: 12/15/2022]
Abstract
The underpinning assumption of much research on cognitive individual differences (or group differences) is that task performance indexes cognitive ability in that domain. In many tasks performance is measured by differences (costs) between conditions, which are widely assumed to index a psychological process of interest rather than extraneous factors such as speed-accuracy trade-offs (e.g., Stroop, implicit association task, lexical decision, antisaccade, Simon, Navon, flanker, and task switching). Relatedly, reaction time (RT) costs or error costs are interpreted similarly and used interchangeably in the literature. All of this assumes a strong correlation between RT-costs and error-costs from the same psychological effect. We conducted a meta-analysis to test this, with 114 effects across a range of well-known tasks. Counterintuitively, we found a general pattern of weak, and often no, association between RT and error costs (mean r = .17, range -.45 to .78). This general problem is accounted for by the theoretical framework of evidence accumulation models, which capture individual differences in (at least) 2 distinct ways. Differences affecting accumulation rate produce positive correlation. But this is cancelled out if individuals also differ in response threshold, which produces negative correlations. In the models, subtractions between conditions do not isolate processing costs from caution. To demonstrate the explanatory power of synthesizing the traditional subtraction method within a broader decision model framework, we confirm 2 predictions with new data. Thus, using error costs or RT costs is more than a pragmatic choice; the decision carries theoretical consequence that can be understood through the accumulation model framework. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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