Internal attention modulates the functional state of novel stimulus-response associations in working memory

Information in working memory (WM) is crucial for guiding behavior. However, not all WM representations are equally relevant simultaneously. Current theoretical frameworks propose a functional dissociation between 'latent' and 'active' states, in which relevant representations are prioritized into an optimal (active) state to face current demands, while relevant information that is not immediately needed is maintained in a dormant (latent) state. In this context, task demands can induce rapid and flexible prioritization of information from latent to active state. Critically, these functional states have been primarily studied using simple visual memories, with attention selecting and prioritizing relevant representations to serve as templates to guide subsequent behavior. It remains unclear whether more complex WM representations, such as novel stimulus-response associations, can also be prioritized into different functional states depending on their task relevance, and if so how these different formats relate to each other. In the present study, we investigated whether novel WM-guided actions can be brought into different functional states depending on current task demands. Our results reveal that planned actions can be flexibly prioritized when needed and show how their functional state modulates their influence on ongoing behavior. Moreover, they suggest the representations of novel actions of different functional states are maintained in WM via a non-orthogonal coding scheme, thus are prone to interference.

Author instructions in biomedical journals infrequently address systematic review reporting and methodology: a cross-sectional study

OBJECTIVES

We aimed to analyze how instructions for authors in journals indexed in MEDLINE address systematic review (SR) reporting and methodology.

STUDY DESIGN AND SETTING

We analyzed instructions for authors in 20% of MEDLINE-indexed journals listed in the online catalog of the National Library of Medicine on July 27, 2021. We extracted data only from the instructions published in English. We extracted data on the existence of instructions for reporting and methodology of SRs.

RESULTS

Instructions from 1,237 journals mentioned SRs in 45% (n = 560) of the cases. Systematic review (SR) registration was mentioned in 104/1,237 (8%) of instructions. Guidelines for reporting SR protocols were found in 155/1,237 (13%) of instructions. Guidelines for reporting SRs were explicitly mentioned in 461/1,237 (37%), whereas the EQUATOR (Enhancing the Quality and Transparency of Health Research) network was referred to in 474/1,237 (38%) of instructions. Less than 2% (n = 20) of instructions mentioned risk of bias and meta-analyses; less than 1% mentioned certainty of evidence assessment, methodological expectations, updating of SRs, overviews of SRs, or scoping reviews.

CONCLUSION

Journals indexed in MEDLINE rarely provide instructions for authors regarding SR reporting and methodology. Such instructions could potentially raise authors' awareness and improve how SRs are prepared and reported.

Conscious knowledge of CS-UCS contingency information affects extinction retrieval of conditioned disgust responses: Findings from an online de novo disgust conditioning task

Objective

The present study aimed to establish and develop an online de novo conditioning paradigm for the measurement of conditioned disgust responses. We further explored the effects of explicit instructions about the CS-UCS contingency on extinction learning and retrieval of conditioned disgust responses.

Method

The study included a sample of 115 healthy participants. Geometric figures served as conditioned stimuli (CS) and disgust-evoking pictures as unconditioned stimuli (UCS). During disgust conditioning, the CS+ was paired with the UCS (66% reinforcement) and the CS- remained unpaired; during extinction and retrieval, no UCS was presented. Half of the participants (n = 54) received instructions prior to the disgust extinction stating that the UCS will not be presented anymore. 1-2 days or 7-8 days later participants performed a retrieval test. CS-UCS contingency, disgust and valence ratings were used as dependent measures.

Results

Successful acquisition of conditioned disgust response was observed on the level of CS-UCS contingency, disgust and valence ratings. While some decline in valence and disgust ratings during the extinction stage was observed, contingency instructions did not significantly affect extinction performance. Retrieval one week later revealed that contingency instructions increased the discrimination of the CSs.

Conclusions

Extinction of conditioned disgust responses is not affected by explicit knowledge of the CS-UCS contingencies. However, contingency instructions prior to extinction seem to have a detrimental effect on long-term extinction retrieval.

Shifting students toward testing: impact of instruction and context on self-regulated learning

Much of the learning that college students engage in today occurs in unsupervised settings, making effective self-regulated learning techniques of particular importance. We examined the impact of task difficulty and supervision on whether participants would follow written instructions to use repeated testing over restudying. In Study 1, we found that when supervised, instructions to test resulted in changes in the self-regulated learning behaviors such that participants tested more often than they studied, relative to participants who were unsupervised during learning. This was true regardless of the task difficulty. In Study 2, we showed that failure to shift study strategies in unsupervised learning was likely due to participants avoidance of testing rather than failure to read the instructions at all. Participants who tested more frequently remembered more words later regardless of supervision or whether or not they received instructions to test, replicating the well-established testing effect (e.g., Dunlosky et al. in Psychol Sci Public Interest 14:4-58, 2013. http://doi.org/10.1177/1529100612453266 ). In sum, there was a benefit to testing, but instructing participants to test only increased their choice to test when they were supervised. We conclude that supervision has an impact on whether participants follow instructions to test.

Directing Attention Externally Produces Consistent Vertical Jump Assessment Results

Recent research has demonstrated that consistent external attentional focus instructions produce more reliable jumping measurements compared to non-consistent focus of attention instructions. While previous research has examined the effects of different external attentional focus instructions, less is known about different external focus of attention instruction effects during a vertical jump. Given that previous work has demonstrated that consistent external focus of attention instructions produced reliable jumping estimations, we hypothesized that using multiple methods to direct attention externally would produce consistent vertical jump results. Using a within-participant design, college aged students (n = 35) completed two vertical jumps on a Vertec^TM within five conditions. Each condition was provided different external directing instructions conditions (control; external-lower near, -upper near, -upper far, -unreachable far). Data were analyzed using a repeated measures analysis of variance (ANOVA). Results showed that jump heights in the control and external focus of attention conditions were not significantly different from one another, p = .119. The findings of this study suggest there are numerous external focus of attention instructions that can be provided during a vertical jump producing consistent results.

The effect of feedback and recollection rejection instructions on the development of memory monitoring and accuracy

Recollection rejection (a form of memory monitoring) involves rejecting false details on the basis of remembering true details (recall to reject), thereby increasing memory accuracy. This study examined how recollection rejection instructions and feedback affect memory accuracy and false recognition in 5-year-olds, 6- and 7-year-olds, 8- and 9-year-olds, and adults. Participants (N = 336) completed three study-test phases. Instructions and item-level feedback were manipulated during the first two phases, with the third phase including a test containing no instructions or feedback to evaluate learning effects. As predicted, in the younger children, as compared with the older children and adults, we found reduced accuracy scores (hits to studied items minus false alarms to related lures), reduced recollection rejection to related lures, and increased false recognition scores. We also found that, in the third phase, prior feedback reduced false recognition scores, potentially by improving monitoring, and typical developmental differences in false recognition were eliminated. However, there were mixed findings of instructions and feedback, and in some conditions these interventions harmed memory. These findings provide initial evidence that combining instructions and feedback with repeated task practice may improve monitoring effectiveness, but additional work is needed on how these factors improve and sometimes harm performance in young children.

Performance differences between instructions on paper vs digital glasses for a simple assembly task

OBJECTIVE

Providing instruction for assembly tasks is essential in modern manufacturing industry, as well as in households for customers that buy products to be assembled at home. Recent technological developments might be able to assist in completing an assembly task faster and more accurately. The aim of this study was to evaluate whether performance and usability differs when instructions for an assembly task are presented on digital glasses versus paper.

METHODS

Participants (n = 63) completed one of three versions of an assembly task (between-subject-design) with LEGO® bricks: (1) with paper instruction (P), (2) with text instructions presented stepwise via digital glasses (GT), (3) with stepwise text and auditory instruction (in parallel) on digital glasses (GA). Outcome measures on performance were completion time and errors. Furthermore, usability was measured by the User Experience Questionnaire, the Standardized Usability Questionnaire, the Post-Study Usability Questionnaire, and cognitive processing skills were assessed by the Trail Making Test and different versions of the Eriksen Flanker Task. Analyses were adjusted for the confounding factors age, gender, experience with glasses and LEGO, and problems with instruction.

RESULTS

Findings indicate that task completion was faster with the paper instructions compared to both versions of instruction via digital glasses (GT, GA). We observed no difference in accuracy and usability between the instructions. "Novelty" was rated higher for instructions for both GT and GA, compared to P.

DISCUSSION

Results show that instructions on digital glasses may not always be more effective for assembly than the traditional paper-based instructions. Further studies are necessary to investigate whether effectiveness may depend on task complexity, target group, experience of the user with task and device, and how the information is presented.

Role of verbal working memory in rapid procedural acquisition of a choice response task

How quickly are instructions for a task translated into an effective task-set? If declarative working memory (dWM) is used to maintain a task's S-R rules until practice compiles them adequately into procedural memory, variables that affect retrieval from dWM should influence task performance while it is still dependent on dWM. Participants were trained on a series of 6-choice RT tasks, with a 1:1 mapping from object pictures to keys. In Experiments 1 and 2, an instruction phase - presentation of the S-R rules one by one -was followed by test trials. The phonological similarity of the objects' names significantly affected performance only during the first few encounters with the stimuli. Serial position effects were also consistent with retrieval from verbal dWM during those early trials. In Experiment 3, instruction onon the S-R rules was omitted, so participants had to learn the S-R mappings by trial and error alone; the effect of phonological similarity lasted longer, but still disappeared after a dozen encounters with each stimulus. Experiment 4 showed that instructions and just four trials of practice per S-R rule were sufficient to form a persisting representation of the S-R rules robust enough to interfere with later acquisition of a competing S-R rule after several minutes spent acquiring other task-sets. An effective and lasting task-set is rapidly compiled into procedural memory through instruction and early feedback; verbal dWM plays little role thereafter.

Great expectations: minor differences in initial instructions have a major impact on visual search in the absence of feedback

Professions such as radiology and aviation security screening that rely on visual search-the act of looking for targets among distractors-often cannot provide operators immediate feedback, which can create situations where performance may be largely driven by the searchers' own expectations. For example, if searchers do not expect relatively hard-to-spot targets to be present in a given search, they may find easy-to-spot targets but systematically quit searching before finding more difficult ones. Without feedback, searchers can create self-fulfilling prophecies where they incorrectly reinforce initial biases (e.g., first assuming and then, perhaps wrongly, concluding hard-to-spot targets are rare). In the current study, two groups of searchers completed an identical visual search task but with just a single difference in their initial task instructions before the experiment started; those in the "high-expectation" condition were told that each trial could have one or two targets present (i.e., correctly implying no target-absent trials) and those in the "low-expectation" condition were told that each trial would have up to two targets (i.e., incorrectly implying there could be target-absent trials). Compared to the high-expectation group, the low-expectation group had a lower hit rate, lower false alarm rate and quit trials more quickly, consistent with a lower quitting threshold (i.e., performing less exhaustive searches) and a potentially higher target-present decision criterion. The expectation effect was present from the start and remained across the experiment-despite exposure to the same true distribution of targets, the groups' performances remained divergent, primarily driven by the different subjective experiences caused by each groups' self-fulfilling prophecies. The effects were limited to the single-targets trials, which provides insights into the mechanisms affected by the initial expectations set by the instructions. In sum, initial expectations can have dramatic influences-searchers who do not expect to find a target, are less likely to find a target as they are more likely to quit searching earlier.

I told you it was safe: Associations between intolerance of uncertainty and different parameters of uncertainty during instructed threat of shock

BACKGROUND AND OBJECTIVES

Self-reported Intolerance of Uncertainty (IU) is the tendency to find uncertainty aversive. There is a lack of empirical research on how IU modulates anticipatory responding during threatening contexts with different parameters of uncertainty.

METHODS

Exploratory secondary analyses were conducted on an existing data set (n = 45) to examine whether IU is related to a particular parameter of uncertainty during instructed threat of shock (i.e. certain shock, certain safety from shock, outcome uncertainty of shock, temporal uncertainty of shock).

RESULTS

Analyses revealed that IU was associated with larger auditory startle blink during the anticipatory period for the certain safety from shock condition relative to the certain shock condition.

LIMITATIONS

The sample was relatively small.

CONCLUSIONS

Individuals with higher self-reported IU may be more inclined to generalize threat to safety cues in the context of instructed threat of shock.

Impact of the format of user instructions on the handling of a wrist blood pressure monitor

Few studies have focused on procedural documents in the field of home medical devices, although incorrect use and usability problems can have important consequences for the patient's health. In this study, we focused on the procedural learning of a home medical device, a blood pressure monitor. Five formats (unimodal: text, audio, pictures; and multimodal: text/audio with pictures) were tested on 124 novice participants randomly assigned to 5 groups. We judged the quality of the formats on the basis of three metrics: efficiency (i.e., handling errors), effectiveness (i.e., consultation time of the procedure, execution time of the devices) and memorability (i.e., recall task). Results suggest that the audio format was more effective than the other groups but also the least efficient. We consider the audio format to be beneficial for patient safety because this format would oblige participants to use a strategy suited to the situation, namely an atomization of the action corresponding to a segmentation of information less likely to saturate working memory. Results in relation to the other formats did not show a more effective, efficient and memorable format. This lack of difference in user performance is nevertheless important, illustrating the need to adapt each instruction to the context of learning, i.e., according to the users, the environment, the resources and the complexity of the task to be executed.

Applying different emotion regulation strategies while providing negative feedback: Introduction of a new laboratory protocol

One aim of creating a new laboratory protocol was to investigate stress responses while being confronted with a work-related task, that is, having to provide negative feedback. It was central to the development of the scenario to make potential testosterone and cortisol responses measurable. The first part of the protocol comprises the introduction to the cover story, that is, being a member of the assessors' team as part of a larger assessment center program aiming to estimate the proficiency of students prior to their entry into professional life. Watching a video of one of the assessment center's candidates and having to assess his performance in a self-presentation task was introduced to personally involve participants in the feedback conversation they had to conduct with the same candidate later on. A second aim was to introduce an experimental manipulation in the form of instructions and brief tutorials regarding different emotion regulation strategies to apply. Participants were randomly assigned to one out of four conditions: expressive suppression (keeping a neutral expression); cognitive reappraisal (staying task-oriented and emotionally distanced); affect utilization (moving towards and using emotions); or control condition. Distinguishing these ways to regulate one's emotions enabled us to reveal differential hormonal stress responses: Applying either cognitive reappraisal or affect utilization strategies alleviated temporary testosterone declines compared with the other two conditions. This method article contains details regarding the procedure as well as the following documents in their original wording: • Introduction to the cover story (being a member of the assessors' team, observation of the attendant's self-presentation, assessment dimensions) • Slides and audio instructions regarding experimental conditions (how to regulate emotions) • Documents handed out to assist participants in conducting the feedback conversation.

Frontoparietal action-oriented codes support novel instruction implementation

A key aspect of human cognitive flexibility concerns the ability to convert complex symbolic instructions into novel behaviors. Previous research proposes that this transformation is supported by two neurocognitive states: an initial declarative maintenance of task knowledge, and an implementation state necessary for optimal task execution. Furthermore, current models predict a crucial role of frontal and parietal brain regions in this process. However, whether declarative and procedural signals independently contribute to implementation remains unknown. We report the results of an fMRI experiment in which participants executed novel instructed stimulus-response associations. We then used a pattern-tracking procedure to quantify the contribution of format-unique signals during instruction implementation. This revealed independent procedural and declarative representations of novel S-Rs in frontoparietal areas, prior to execution. Critically, the degree of procedural activation predicted subsequent behavioral performance. Altogether, our results suggest an important contribution of frontoparietal regions to the neural architecture that regulates cognitive flexibility.

Human fear conditioning is moderated by stimulus contingency instructions

Recent research findings indicate that human fear conditioning is affected by instructions, particularly those concerning the contingency between the conditioned stimulus (CS) and the unconditioned stimulus (US). However, whether or not such instructions were provided to participants often remains unsaid in fear conditioning studies. In the current study (N = 102), we investigated whether conditioned fear acquisition depends on CS-US contingency instructions. Participants were randomly assigned to one of three groups. The first group was instructed about the precise CS-US contingency before conditioning. The second group was instructed to discover the CS-US contingency. The third group did not receive any contingency instructions. We found facilitated fear acquisition (using skin conductance and startle) and increased contingency awareness in the first and second group compared to the third group. Furthermore, contingency reversal instructions immediately reversed conditioned responses. Based on these results, we advise to systematically report the contingency instructions used in fear conditioning research.

A review of user training methods in brain computer interfaces based on mental tasks

Mental-Tasks based Brain-Computer Interfaces (MT-BCIs) allow their users to interact with an external device solely by using brain signals produced through mental tasks. While MT-BCIs are promising for many applications, they are still barely used outside laboratories due to their lack of reliability. MT-BCIs require their users to develop the ability to self-regulate specific brain signals. However, the human learning process to control a BCI is still relatively poorly understood and how to optimally train this ability is currently under investigation. Despite their promises and achievements, traditional training programs have been shown to be sub-optimal and could be further improved. In order to optimize user training and improve BCI performance, human factors should be taken into account. An interdisciplinary approach should be adopted to provide learners with appropriate and/or adaptive training. In this article, we provide an overview of existing methods for MT-BCI user training - notably in terms of environment, instructions, feedback and exercises. We present a categorization and taxonomy of these training approaches, provide guidelines on how to choose the best methods and identify open challenges and perspectives to further improve MT-BCI user training.

Visual and kinesthetic alleys formed with rods

Geometries of visual and kinesthetic spaces were estimated by alley experiments. For the visual alley, 24 observers set rods that extended in depth so that they appeared 1) to neither diverge nor converge, 2) to be separated by the same lateral distance, or 3) to be perpendicular to the frontal plane. The separation of rods and the height of the observer's eyes were varied. Under each instruction, another group of 20 observers set the rods visually at eye level or kinesthetically without seeing the rods. We obtained these findings. First, the rods seen obliquely from above were set more accurately than the rods seen at eye level. Second, the visual settings were parallel to one another for small separation and were convergent to the observer for large separation, whereas the kinesthetic settings were divergent to the observer for the small separation and were convergent to the observer for the large separation. These differences between sense modalities were explained by the location of the egocenter(s) and the sensitivity to direction. Third, the visual or kinesthetic settings did not differ with instructions, suggesting that visual and kinesthetic spaces were Euclidean. Fourth, the visual angle of the near ends of the rods, plotted against that of the far ends, was described by Euclidean geometry, provided that the visual angle is exaggerated. Last, the kinesthetic angle of the near ends of the rods, plotted against that of the far ends, was not described by any simple geometry even when we assumed that the kinesthetic angle is exaggerated.

Investigating the effect of trustworthiness on instruction-based reflexivity

Unlike other species, humans are capable of rapidly learning new behavior from a single instruction. While previous research focused on the cognitive processes underlying the rapid, automatic implementation of instructions, the fundamentally social nature of instruction following has remained largely unexplored. Here, we investigated whether instructor trustworthiness modulates instruction implementation using both explicit and reflexive measures. In a first preregistered study, we validated a new paradigm to manipulate the perceived trustworthiness of two different virtual characters and showed that such a manipulation reliably induced implicit associations between the virtual characters and trustworthiness attributes. Moreover, we show that trustworthy instructors are followed more frequently and faster. In two additional preregistered experiments, we tested if trustworthiness towards the instructor influenced the cognitive processes underlying instruction implementation. While we show that verbally conveyed instructions led to automatic instruction implementation, this effect was not modulated by the trustworthiness of the instructor. Thus, we succeeded to design and validate a novel trustworthiness manipulation (Experiment 1) and to create a social variant of the instruction-based reflexivity paradigm (Experiments 2 and 3). However, this instruction-based reflexivity effect was not modulated by the instructors' trustworthiness.

The effects of declaratively maintaining and proactively proceduralizing novel stimulus-response mappings

Working memory (WM) allows for the maintenance and manipulation of information when carrying out ongoing tasks. Recent models propose that representations in WM can be either in a declarative format (as content of thought) or in a procedural format (in an action-oriented state that drives the cognitive operation to be performed). Current views on the implementation of novel instructions also acknowledge this distinction, assuming these are first encoded as declarative content, and then reformatted into an action-oriented procedural representation upon task demands. Although it is widely accepted that WM has a limited capacity, little is known about the reciprocal costs of maintaining instructions in a declarative format and transforming them in an action code. In a series of three experiments, we asked participants to memorize two or four S-R mappings (i.e., declarative load), and then selected a subset of them by means of a retro-cue to trigger their reformatting into an action-oriented format (i.e., procedural load). We measured the performance in the implementation of the proceduralized mapping and in the declarative recall of the entire set of memorized mappings, to test how the increased load on one component affected the functioning of the other. Our results showed a strong influence of declarative load on the processing of the procedural component, but no effects in the opposite direction. This pattern of results suggests an asymmetry in the costs of maintenance and manipulation in WM, at least when procedural representations cannot be retrieved from long term memory and need to be reformatted online. The available resources seem to be first deployed for the maintenance of all the task-relevant declarative content, and proceduralization takes place to the extent the system can direct attention to the relevant instruction.

Preprocessing pupil size data: Guidelines and code

Pupillometry has been one of the most widely used response systems in psychophysiology. Changes in pupil size can reflect diverse cognitive and emotional states, ranging from arousal, interest and effort to social decisions, but they are also widely used in clinical practice to assess patients’ brain functioning. As a result, research involving pupil size measurements has been reported in practically all psychology, psychiatry, and psychophysiological research journals, and now it has found its way into the primatology literature as well as into more practical applications, such as using pupil size as a measure of fatigue or a safety index during driving. The different systems used for recording pupil size are almost as variable as its applications, and all yield, as with many measurement techniques, a substantial amount of noise in addition to the real pupillometry data. Before analyzing pupil size, it is therefore of crucial importance first to detect this noise and deal with it appropriately, even prior to (if need be) resampling and baseline-correcting the data. In this article we first provide a short review of the literature on pupil size measurements, then we highlight the most important sources of noise and show how these can be detected. Finally, we provide step-by-step guidelines that will help those interested in pupil size to preprocess their data correctly. These guidelines are accompanied by an open source MATLAB script (available at https://github.com/ElioS-S/pupil-size). Given that pupil diameter is easily measured by standard eyetracking technologies and can provide fundamental insights into cognitive and emotional processes, it is hoped that this article will further motivate scholars from different disciplines to study pupil size.

A centralized system for providing dispatcher assisted CPR instructions to 9-1-1 callers at multiple municipal public safety answering points

BACKGROUND

Dispatcher CPR instruction increases the odds of survival. However, many communities do not provide this lifesaving intervention, often citing the barriers of limited personnel, funding, and liability.

OBJECTIVE

Describe the implementation of a novel centralized dispatcher CPR instruction program that serves seven public safety answering points (PSAPs).

METHODS

Seven municipal PSAPs that did not previously provide dispatcher instructions implemented our program. Using a 30-min self-directed video, 84 PSAP dispatchers were trained to utilize a two-question protocol to identify and transfer suspected out-of-hospital cardiac arrest (OHCA) cases to a central communication center. At this central communication center, a trained communicator delivered CPR instructions to the caller. The 26 central communicators were trained with a 2-h in-person didactic session followed by a 2-h practice session. We collected and analyzed data from recordings of communicator-to-caller interactions.

RESULTS

169 calls were transferred to the central communication center. Of those, 106 needed CPR instructions and 56 of those callers performed chest compressions (53%). The county-wide EMS documented bystander CPR rate was 20% the prior year. The 63 remaining transferred calls were non-OHCA calls. Of the calls where CPR was needed and performed, 11 victims survived to hospital discharge (20%); the countywide survival rate was 12%.

CONCLUSIONS

Using a central communication center for instructions allowed us to train and maintain a smaller group of communicators, leading to less cost and more experience for those communicators, while limiting the burden on PSAP dispatchers.

Evaluating the impact of translated written discharge instructions for patients with limited English language proficiency

INTRODUCTION

Patients with limited English language proficiency have indicated that they believe post-operative instructions written in their native language will improve comprehension over verbal translation alone, but the effect of this has not been previously studied. We hypothesize that providing written discharge instructions in Spanish for native Spanish speakers will improve comprehension regarding post-operative care after routine otolaryngologic procedures when compared to instructions written in English.

METHODS

This prospective randomized controlled trial enrolled subjects who met criteria from June 2016 to November 2016. Subjects were Spanish-speaking parents and legal guardians of children undergoing tympanostomy tube insertion, adenoidectomy, and/or tonsillectomy. Subjects were given written discharge instructions in either English or Spanish. Both cohorts received standard verbal counseling in Spanish as well. Primary outcome was score on a standardized quiz assessing comprehension of discharge instructions. Patient satisfaction and preferences were secondary outcomes assessed through a survey. Participants underwent follow up one month after initial enrollment.

RESULTS

Twenty subjects were enrolled, with ten receiving written discharge instructions in Spanish and ten receiving instructions written in English. There was no significant difference in comprehension scores between the two groups. Eleven participants completed the survey on patient satisfaction and preferences. Most subjects (91%, 10/11, p<0.01) preferred written instructions in their native language and subjectively felt this would improve their comprehension. However, there was no significant effect on patient satisfaction.

CONCLUSIONS

Spanish-speaking patients indicate a strong preference for written discharge instructions in their native language, although there was no significant difference in short-term comprehension of instructions written in English vs. Spanish on objective evaluation. Accommodating these preferences may improve long-term comprehension and patient satisfaction, and ultimately build invaluable rapport between providers and patients.

A gaze interactive assembly instruction with pupillometric recording

This paper presents a study of a gaze interactive digital assembly instruction that provides concurrent logging of pupil data in a realistic task setting. The instruction allows hands-free gaze dwells as a substitute for finger clicks, and supports image rotation as well as image zooming by head movements. A user study in two LEGO toy stores with 72 children showed it to be immediately usable by 64 of them. Data logging of view-times and pupil dilations was possible for 59 participants. On average, the children spent half of the time attending to the instruction (S.D. 10.9%). The recorded pupil size showed a decrease throughout the building process, except when the child had to back-step: a regression was found to be followed by a pupil dilation. The main contribution of this study is to demonstrate gaze-tracking technology capable of supporting both robust interaction and concurrent, non-intrusive recording of gaze- and pupil data in-the-wild. Previous research has found pupil dilation to be associated with changes in task effort. However, other factors like fatigue, head motion, or ambient light may also have an impact. The final section summarizes our approach to this complexity of real-task pupil data collection and makes suggestions for how future applications may utilize pupil information.

Relational information moderates approach-avoidance instruction effects on implicit evaluation

Previous research demonstrated that instructions to approach one stimulus and avoid another stimulus can result in a spontaneous or implicit preference for the former stimulus. In the current study, we tested whether the effect of approach-avoidance instructions on implicit evaluation depends on the relational information embedded in these instructions. Participants received instructions that they would move towards a certain non-existing word and move away from another non-existing word (self-agent instructions) or that one non-existing word would move towards them and the other non-existing word would move away from them (stimulus-agent instructions). Results showed that self-agent instructions produced stronger effects than stimulus-agent instructions on implicit evaluations of the non-existing words. These findings support the idea that propositional processes play an important role in effects of approach-avoidance instructions on implicit evaluation and in implicit evaluation in general.

Different mechanisms can account for the instruction induced proportion congruency effect

When performing a conflict task, performance is typically worse on trials with conflict between two responses (i.e., incongruent trials) compared to when there is no conflict (i.e., congruent trials), a finding known as the congruency effect. The congruency effect is reduced when the proportion of incongruent trials is high, relative to when most of the trials are congruent (i.e., the proportion congruency effect). In the current work, it was tested whether different kinds of instructions can be used to induce a proportion congruency effect, while holding the actual proportion of congruent trials constant. Participants were instructed to strategically use the (invalid) information that most of the trials would be congruent versus incongruent, or they were told to adopt a liberal versus a conservative response threshold. All strategies effectively altered the size of the congruency effect relative to baseline, although in terms of statistical significance the effect was mostly limited to the error rates. A diffusion-model analysis of the data was partially consistent with the hypothesis that both types of instructions induced a proportion congruency effect by means of different underlying mechanisms.

Toward a unified framework for research on instructions and other messages: An introduction to the special issue on the power of instructions

Instructions are known to have a profound impact on human behavior. Nevertheless, research on the effects of instructions is relatively scarce and scattered across different areas of research in psychology and neuroscience. The current issue of this journal contains six papers that review research on instructions in different research areas. In this introduction to the special issue, we provide the outline of a framework that focuses on five components that can be varied in research on this topic (sender, message, receiver, context, and outcome). The framework brings order to the boundless potential variability in research on the effects of messages (i.e., it has heuristic value) and highlights that past research explored only a tiny fraction of what is possible (i.e., it has predictive value). Moreover, it reveals that research in different areas tends to examine different instantiations of the five components. The latter observation implies that much can be gained from closer interactions between researchers from different areas.

Treating Food Approval-Seeking Behavior: One Bite at a Time

The prevalence of feeding problems in children with autism is high. The current investigation was a treatment of a unique presentation of food-related prompt dependence with a 6-year-old boy with autism who was reliant upon approval from adults for consumption of every bite of food. Instructions were used to establish independent eating, in which the number of bites specified in the instruction was systematically increased. Independent bites increased from a baseline level of 0.67% to a final phase level of almost 100%, and the instruction was faded to "eat your lunch".

The time course of pattern discrimination in the human brain

In electrophysiological experiments on visual pattern discrimination, decision difficulty was manipulated either via the physical characteristics of the test stimuli, or by changing the instruction given to the observer. Visual stimuli were rectangular matrices each composed of 100 Gabor patches having different orientations. Matrices differed in the number of Gabor patches with vertical, or horizontal, orientation. The observers' task was either to discriminate the dominant orientation or to detect collinear elements in the matrix. Relating task difficulty to performance, in the first experimental paradigm (detection of orientation) we obtained the conventional S-like psychometric function but in the second (detection of collinearity) the psychometric function showed a complicated U-curve. Matching between electrophysiological and psychophysical data and image statistical functions allowed us to establish the relative timing of the cortical processes underlying perception and decision making in relation to textural features. In the first 170ms after stimulus onset coding of the low-level properties of the image takes place. In the time interval 170-400ms, ERP amplitude correlated only with complex image properties, but not with task difficulty. The first effects arising from decision difficulty were observable at 400ms after stimulus onset, and therefore this is probably the earliest electrophysiological signature of the decision making processes, in the given experimental paradigm.

The impact of a context switch and context instructions on the return of verbally conditioned fear

BACKGROUND AND OBJECTIVES

Repeated exposure to a conditioned stimulus can lead to a reduction of conditioned fear responses towards this stimulus (i.e., extinction). However, this reduction is often fragile and sensitive to contextual changes. In the current study, we investigated whether extinction of fear responses established through verbal threat instructions is also sensitive to contextual changes. We additionally examined whether verbal instructions can strengthen the effects of a context change.

METHODS

Fifty-two participants were informed that one colored rectangle would be predictive of an electrocutaneous stimulus, while another colored rectangle was instructed to be safe. Half of these participants were additionally informed that this contingency would only hold when the background of the computer screen had a particular color but not when it had another color. After these instructions, the participants went through an unannounced extinction phase that was followed by a context switch.

RESULTS

Results indicate that extinguished verbally conditioned fear responses can return after a context switch, although only as indexed by self-reported expectancy ratings. This effect was stronger when participants were told that CS-US contingency would depend on the background color, in which case a return of fear was also observed on physiological measures of fear.

LIMITATIONS

Extinction was not very pronounced in this study, possibly limiting the extent to which return of fear could be observed on physiological measures.

CONCLUSIONS

Contextual cues can impact the return of fear established via verbal instructions. Verbal instructions can further strengthen the contextual control of fear.

Learned, instructed and observed pathways to fear and avoidance

BACKGROUND AND OBJECTIVES

Conditioned fear may emerge in the absence of directly experienced conditioned stimulus (CS)--unconditioned stimulus (US) pairings. Here, we compared three pathways by which avoidance of the US may be acquired both directly (i.e., through trial-and-error instrumental learning) and indirectly (i.e., via verbal instructions and social observation).

METHODS

Following fear conditioning in which CS+ was paired with shock and CS- was unpaired, three separate groups of participants learned by direct experience (Instrumental-learning), were instructed about (Instructed-learning), or observed (Observational-learning) a demonstrator performing an avoidance response that canceled upcoming US (shock) presentations. Groups were then tested in extinction with presentations of the directly experienced CS+ and CS-, and either a novel CS (Instrumental and observational groups) or an instructed CS (instructed-group).

RESULTS

Similar to instrumental learning, results demonstrate that avoidance may be acquired via instructions and social observation in the absence of directly learning that an avoidance response prevents the US. Retrospective US expectancy ratings were modulated by the assumed presence or absence of avoidance. Overall, these findings suggest that instrumental-, instructed-, and observational-learning pathways to avoidance in humans are similar.

LIMITATIONS

Alternative experimental designs would permit direct comparison between the pathways for stimuli with no prior experience of fear conditioning, and trial-by-trial US expectancy ratings would help track the modulation of fear by avoidance pathway.

CONCLUSIONS

Instrumental-, instructed-, and observational-learning pathways of avoidance are similar. Findings may have implications for understanding the etiology of clinical avoidance in anxiety.

The mind-muscle connection in resistance training: friend or foe?

The results of Calatayud et al. (Eur J Appl Physiol, 2015. doi: 10.1007/s00421-015-3305-7 ) indicate that focusing on the pectoralis major and triceps brachii muscles during bench press exercise selectively enhanced their activation, and thus suggest a training strategy. However, the authors did not discuss the well-established negative effects that focusing on specific muscle groups has on exercise performance. For proper perspective of the results and their practical utility, it is helpful to note the interplay between negative and positive effects of different focus conditions.

Congruency effects on the basis of instructed response-effect contingencies

Previous research indicated that stimulus-response congruency effects can be obtained in one task (the diagnostic task) on the basis of the instructed stimulus-response mappings of another task (the inducer task) and this without having executed the instructions of the inducer task once. A common interpretation of such finding is that instructed stimulus-response mappings are implemented into functional associations, which automatically trigger responses when being irrelevant and this without any practice. The present study investigated whether instruction-based congruency effects are also observed for a different type of instructions than instructed S-R mappings, namely instructed response-effect contingencies. In three experiments, instruction-based congruency effects were observed in the diagnostic task when the instructions of the inducer task specified response-effect contingencies. On the one hand, our results indicate that instruction-based congruency effects are not restricted to instructed S-R mappings. On the other hand, our results suggest that the representations that mediate these effects do not specify the nature of the relation between response and effect even though this relation was explicitly specified by the instructions.

The effect of instructions on postural-suprapostural interactions in three working memory tasks

Examining postural control while simultaneously performing a cognitive, or suprapostural task, has shown a fairly consistent trend of improving postural control in young healthy adults and provides insight into postural control mechanisms used in everyday life. However, the role of attention driven by explicit verbal instructions while dual-tasking is less understood. Therefore, the purpose of this investigation is to determine the effects of explicit verbal instructions on the postural-suprapostural interactions among various domains of working memory. A total of 22 healthy young adults with a heterogeneous history of ankle sprains volunteered to participate (age: 22.2±5.1 years; n=10 history of ankle sprains, n=12 no history). Participants were asked to perform single-limb balance trials while performing three suprapostural tasks: backwards counting, random number generation, and the manikin test. In addition, each suprapostural task was completed under three conditions of instruction: no instructions, focus on the postural control task, focus on the suprapostural task. The results indicate a significant effect of instructions on postural control outcomes, with postural performance improving in the presence of instructions across all three cognitive tasks which each stress different aspects of working memory. Further, postural-suprapostural interactions appear to be related to the direction or focus of an individual's attention as instructions to focus on the suprapostural task resulted in the greatest postural control improvements.Thus, attention driven by explicit verbal instructions influence postural-suprapostural interactions as measured by a temporal-spatial postural control outcome, time-to-boundary, regardless of the suprapostural task performed.

Comparing the Effectiveness of Behavioral Recognition and Group Stress Surmounting Techniques Instructions on Changing University Students' Positive Attitudes towards Opiate Abuse

BACKGROUND

One of the most important strategies in preventing addiction is changing positive attitudes and stabilizing negative attitudes towards opiate abuse. Current research has been comparing the effectiveness of behavioral recognition and stress surmounting techniques instructions on changing students' positive attitudes towards opiate abuse.

METHODS

To determine the effectiveness of behavioral-recognition and group stress surmounting instructions on changing student's positive attitudes towards opiate abuse, 90 students (45 boys and 45 girls) who had got good grades in attitude measuring questionnaire were chosen and were randomly assigned in 3 groups (two test groups and the control group) and then, were randomly replaced in 15 person groups with sex distinction. The research data were analyzed using multivariate statistical analysis method.

FINDINGS

The results of pot-test analyses showed significant improvement compared with pretest analysis in both training methods and in both genders (P < 0.05). Then, the surmounting methods group training and recognition-behavioral group training both significantly improved positive attitudes towards opiate abuse in male and female students.

CONCLUSION

Behavioral-recognition and stress surmounting techniques instructions brought about changes in students attitudes towards opiate abuse and these changes were more prominent in female students than in males.