Investigating Cognitive Flexibility Training

ConditionHealthy
Trial statusNot yet recruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age18-29
SponsorNanyang Technological University

About this trial

The investigators' previous research identified two distinct subtypes of Cognitive Flexibility (CF), termed CF1 (shifting flexibility) and CF2 (strategy flexibility). The present study aims to determine whether these forms of CF can be trained, how they differ, and the extent to which improvements transfer to broader learning and cognitive skills. In addition, social functioning outcomes and the extent to which social factors moderate the effects of cognitive flexibility training are assessed. The investigators will employ a multi-modal approach combining cognitive-behavioural and neuroimaging methods to examine how brain mechanisms and cognitive performance change following CF-targeted training intervention (Structure learning) compared with active control and a no-training paradigm (passive control).

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

Healthy volunteer (male of female) between 18 and 29 years who gave written informed consent to participate

Disqualifiers

Current and/or prior history of learning disabilities

Current and/or prior history of neurological disorder

Current and/or prior history of psychiatric disorder

Current and/or prior history of cardiovascular disorder

Trial design

Design model

Parallel

Treatments tested in this trial

  • Experimental (Implicit Training): Structure Learning Training

    Behavioral

    Participants will undergo 6-12 sessions of Structure Learning or set-shifting training in the active control training group lasting up to 30 minutes each. Each session will be conducted in a remote-guided manner with an approximate 1-day gap in between sessions. The entire training will span a maximum of 12 days. Across the task, difficulty will progressively increase through changes in probabilistic contingencies. For example, following each symbol, one subsequent symbol may occur with 75% probability and an alternative symbol with 25% probability. Participants will first learn symbol-based contingencies (e.g., 75/25), followed by contingency reversals (25/75) requiring updating of learned associations. An additional stimulus dimension (frames surrounding symbols) will then be introduced with similar probabilistic contingencies and subsequent reversals, requiring flexible adaptation to shifting rules.

  • Active Control (Explicit Training): 'All You Can E.T.'

    Behavioral

    The protocol for the active control condition will mirror that of the experimental arm. Participants will complete an equivalent number of training sessions, and total task time will be matched between the experimental and control groups.

Treatment groups

225 Participants
are divided into 3 treatment groups
Group A: Implicit Training: Structure Learning TrainingExperimental treatment 1 intervention
Group B: Active Control (Explicit Training): 'All You Can E.T.'Active comparator 1 intervention
Group C: Passive ControlNo intervention 0 interventions

Trial outcomes

Primary outcomes

1

Structure Learning Outcome 1 - Performance Index (PI) Relative

Performance index (PI) is the minimum overlap between the distribution of participant responses and the distribution of presented targets per context. The overall PI is then the average of the performance indices across contexts. The PI relative is a normalised PI measure that quantifies participant's performance relative to random guessing.

Time frame
Through training completion (adaptive, up to 12 days)
2

Structure Learning Outcome 2 - Strategy choice

Strategy choice is the difference between the Kullback-Leibler (KL) divergence from model matching to the response-based model and the KL divergence from model maximization to the response-based model. Positive strategy choice values indicate a strategy closer to matching, whereas negative values indicate a strategy closer to maximization.

Time frame
Through training completion (adaptive, up to 12 days)
3

Structure Learning Outcome 3 - Strategy ICD index (measured by the integral curve difference)

Derived by calculating the integral of each participant's strategy curve and subtracting it from the integral of the exact matching curve, as defined by model matching across training.

Time frame
Through training completion (adaptive, up to 12 days)
4

Structure Learning Outcome 4 - Learning rate

Rate of learning across the training sessions or days.

Time frame
Through training completion (adaptive, up to 12 days)

Secondary outcomes

1

Stress Outcome 1 - Perceived Stress Scale (PSS): Perceived Stress Scale Score

The PSS measures the degree to which situations in one's life are appraised as stressful. It contains 10 items, which ask about respondents' feelings and thoughts during the last month. Possible scores for each item range from 0 (never) to 4 (very often). Individual scores on the PSS can range from 0 to 40 with higher scores indicating higher perceived stress.

Time frame
Baseline (pre-intervention and within two weeks prior to pre-MRI scan) and Post-intervention (within two weeks after post-MRI scan)
2

Sleep Quality Outcome 1 - Pittsburgh Sleep Quality Index (PSQI): Global PSQI Score

The PSQI measures several different aspects of sleep. The component scores comprise subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleeping medication, and daytime dysfunction. Each item is weighted on a 0-3 interval scale. The global PSQI score is then calculated by totalling the seven component scores and can range from 0 to 21, where lower scores denote a healthier sleep quality.

Time frame
Post-intervention (within two weeks after post-MRI scan)
3

Literacy and Numeracy Outcome 1 - Wide Range Achievement Test-5

The Wide Range Achievement Test-5 (WRAT-5) is a standardized assessment of core academic skills. Scores will be obtained from the Word Reading, Spelling, Sentence Comprehension, and Math Computation subtests to index literacy and numeracy performance. Performance will be quantified using age-normed standard scores from each subtest. Pre- to post-intervention improvement will be calculated as the change in standard scores between baseline and post-test assessment, with higher scores indicating stronger literacy and numeracy skill proficiency.

Time frame
Pre-intervention (within one week before pre-MRI) and Post-intervention (within one week after post-MRI scan)
4

Decision Making Outcome 1 - Social Value Orientation: Social Preference Score

The social value orientation task is intended to measure an individual's preferred allocation of resources between themselves and an anonymous partner (Player B). There are six rounds, each consisting of nine options. Each option is presented in the form of points allocated to the participant and Player B. Participants are instructed to choose the option they prefer the most. A participant's social preference score can be derived by calculating the inverse tangent of the ratio between the mean allocation for Player B minus 50 and the mean allocation for themselves minus 50. A higher score indicates greater baseline nonstrategic cooperativeness.

Time frame
Baseline (pre-intervention and within two weeks prior to pre-MRI scan) and Post-intervention (within two weeks after post-MRI scan)

Other outcomes

1

Mood and State Outcome 1 - Self-Assessment Manikin (SAM)

Used as a control variable. This is a non-verbal pictorial assessment that measures an individual's emotional response. The original scale consists of three items rated on a nine-point scale.

Time frame
Through training completion (adaptive, up to 12 days)
2

Mood and State Outcome 2 - Self-Assessment Manikin (SAM)

Used as a control variable. This is a non-verbal pictorial assessment that measures an individual's emotional response. The original scale consists of three items rated on a nine-point scale.

Time frame
Pre-intervention (at pre-MRI scan) and Post-intervention (at post-MRI scan) with maximum 6-12 days scan interval
3

Mood and State Outcome 3 - Training Feedback: Task enjoyment level

Used as a control variable. Participants are asked to report how enjoyable they find the training task at the end of each training session. Possible scores range from 0 (Not at all enjoyable) to 10 (Very much enjoyable). Higher scores indicate higher enjoyment level in intervention training.

Time frame
Through training completion (adaptive, up to 12 days)
4

Mood and State Outcome 4 - Training Feedback: Task difficulty level

Used as a control variable. Participants are asked to report how difficult they find the training task at the end of each training session. Possible scores range from 0 (Not at all difficult) to 10 (Extremely difficult). Higher scores indicate higher difficulty level of intervention training.

Time frame
Through training completion (adaptive, up to 12 days)

Sponsors and contacts

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Nanyang Technological University

Lead sponsor

University of Cambridge

Collaborator

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