Can we harness computerised cognitive bias modification to treat anxiety in schizophrenia? A first step highlighting the role of mental imagery

A new wave of computerised therapy is under development which, rather than simulating talking therapies, uses bias modification techniques to target the core psychological process underlying anxiety. Such interventions are aimed at anxiety disorders, and are yet to be adapted for co-morbid anxiety in psychosis. The cognitive bias modification (CBM) paradigm delivers repeated exposure to stimuli in order to train individuals to resolve ambiguous information in a positive, rather than anxiety provoking, manner. The current study is the first to report data from a modified form of CBM which targets co-morbid anxiety within individuals diagnosed with schizophrenia. Our version of CBM involved exposure to one hundred vignettes presented over headphones. Participants were instructed to actively simulate the described scenarios via visual imagery. Twenty-one participants completed both a single session of CBM and a single control condition session in counter-balanced order. Within the whole sample, there was no significant improvement on interpretation bias of CBM or state anxiety, relative to the control condition. However, in line with previous research, those participants who engage in higher levels of visual imagery exhibited larger changes in interpretation bias. We discuss the implications for harnessing computerised CBM therapy developments for co-morbid anxiety in schizophrenia.

Evaluating the intonation of non-native speakers of English using a computerised test battery

This study investigates the intonation of Chinese and Arabic learners of English using the computerized test battery Profiling Elements of Prosody for Speech and Communication (PEPS-C). The aims were to ascertain which aspects of intonation are difficult for these learners, and to determine whether PEPS-C can be used to assess the intonation of adult learners. Although some results were significantly different from native-speaker data, raw scores showed that the learner groups performed well in most tasks, which may indicate that the learners' level is too high for the PEPS-C to be useful. However, the PEPS-C did reveal that Arabic learners performed significantly worse at contrastive stress placement, and Chinese learners performed significantly worse assessing likes and dislikes.

Computerised therapies for anxiety and depression in children and young people: a systematic review and meta-anaylsis

One quarter of children and young people (CYP) experience anxiety and/or depression before adulthood, but treatment is sometimes unavailable or inadequate. Self-help interventions may have a role in augmenting treatment and this work aimed to systematically review the evidence for computerised anxiety and depression interventions in CYP aged 5–25 years old. Databases were searched for randomised controlled trials and 27 studies were identified. For young people (12–25 years) with risk of diagnosed anxiety disorders or depression, computerised CBT (cCBT) had positive effects for symptoms of anxiety (SMD −0.77, 95% CI −1.45 to −0.09, k = 6, N = 220) and depression (SMD −0.62, 95% CI −1.13 to −0.11, k = 7, N = 279). In a general population study of young people, there were small positive effects for anxiety (SMD −0.15, 95% CI −0.26 to −0.03; N = 1273) and depression (SMD −0.15, 95% CI −0.26 to −0.03; N = 1280). There was uncertainty around the effectiveness of cCBT in children (5–11 years). Evidence for other computerised interventions was sparse and inconclusive. Computerised CBT has potential for treating and preventing anxiety and depression in clinical and general populations of young people. Further program development and research is required to extend its use and establish its benefit in children.

Design of a computerised treatment for short-term memory deficits in aphasia

The treatment of auditory-verbal short-term memory (STM) deficits in aphasia is a growing avenue of research (Martin & Reilly, 2012; Murray, 2012). STM treatment requires time precision, which is suited to computerised delivery. We have designed software, which provides STM treatment for aphasia. The treatment is based on matching listening span tasks (Howard & Franklin, 1990), aiming to improve the temporal maintenance of multi-word sequences (Salis, 2012). The person listens to pairs of word-lists that differ in word-order and decides if the pairs are the same or different. This approach does not require speech output and is suitable for persons with aphasia who have limited or no output. We describe the software and how its review from clinicians shaped its design.

Memo test: standardisation of computerised assessment of auditory verbal short-term memory

Short-term memory (STM) impairments are prevalent in adults with acquired brain injuries. While there are several published tests to assess these impairments, the majority require speech production, e.g. digit span (Wechsler, 1987). This feature may make them unsuitable for people with aphasia and motor speech disorders because of word finding difficulties and speech demands respectively. If patients perceive the speech demands of the test to be high, the may not engage with testing. Furthermore, existing STM tests are mainly ‘pen-and-paper’ tests, which can jeopardise accuracy. To address these shortcomings, we designed and standardised a novel computerised test that does not require speech output and because of the computerised delivery it would enable clinicians identify STM impairments with greater precision than current tests. The matching listening span tasks, similar to the non-normed PALPA 13 (Kay, Lesser & Coltheart, 1992) is used to test short-term memory for serial order of spoken items. Sequences of digits are presented in pairs. The person hears the first sequence, followed by the second sequence and s/he decides whether the two sequences are the same or different. In the computerised test, the sequences are presented in live voice recordings on a portable computer through a software application (Molero Martin, Laird, Hwang & Salis 2013). We collected normative data from healthy older adults (N=22-24) using digits, real words (one- and two-syllables) and non-words (one- and two- syllables). Their performance was scored following two systems. The Highest Span system was the highest span length (e.g. 2-8) at which a participant correctly responded to over 7 out of 10 trials at the highest sequence length. Test re-test reliability was also tested in a subgroup of participants. The test will be available as free of charge for clinicians and researchers to use.

Can a computerised training paradigm assist people with intellectual disabilities to learn cognitive mediation skills? A randomised experiment

Aims: The aim was to examine whether specific skills required for cognitive behavioural therapy (CBT) could be taught using a computerised training paradigm with people who have intellectual disabilities (IDs). Training aimed to improve: a) ability to link pairs of situations and mediating beliefs to emotions, and b) ability to link pairs of situations and emotions to mediating beliefs. Method: Using a single-blind mixed experimental design, sixty-five participants with IDs were randomised to receive either computerised training or an attention-control condition. Cognitive mediation skills were assessed before and after training. Results: Participants who received training were significantly better at selecting appropriate emotions within situation beliefs pairs, controlling for baseline scores and IQ. Despite significant improvements in the ability of those who received training to correctly select intermediating beliefs for situation-feelings pairings, no between-group differences were observed at post-test. Conclusions: The findings indicated that computerised training led to a significant improvement in some aspects of cognitive mediation for people with IDs, but whether this has a positive effect upon outcome from therapy is yet to be established. (C) 2015 Elsevier Ltd. All rights reserved.

Enhanced effects of combined cognitive bias modification and computerised cognitive behaviour therapy on social anxiety

This study examines whether combined cognitive bias modification for interpretative biases (CBM-I) and computerised cognitive behaviour therapy (C-CBT) can produce enhanced positive effects on interpretation biases and social anxiety. Forty socially anxious students were randomly assigned into two conditions, an intervention group (positive CBM-I + C-CBT) or an active control (neutral CBM-I + C-CBT). At pre-test, participants completed measures of social anxiety, interpretative bias, cognitive distortions, and social and work adjustment. They were exposed to 6 × 30 min sessions of web-based interventions including three sessions of either positive or neutral CBM-I and three sessions of C-CBT, one session per day. At post-test and two-week follow-up, participants completed the baseline measures. A combined positive CBM-I + C-CBT produced less negative interpretations of ambiguous situations than neutral CBM-I + C-CBT. The results also showed that both positive CBM-I + C-CBT and neutral CBM-I + C-CBT reduced social anxiety and cognitive distortions as well as improving work and social adjustment. However, greater effect sizes were observed in the positive CBM-I + C-CBT condition than the control. This indicates that adding positive CBM-I to C-CBT enhanced the training effects on social anxiety, cognitive distortions, and social and work adjustment compared to the neutral CBM-I + C-CBT condition.

A behavioural analysis of enforced delays in computerised programmed instruction

To evaluate the putative advantages of student self pacing in automated instruction,the studies in this thesis compare the effects of self-paced, and externally-paced, programmed instruction on student accuracy, retention, efficiency, and satisfaction. The results of the experiments show that self-pacing reduced accuracy, retention, and workrates compared to external pacing and indicated that learners often make poor choices about optimum learning conditions. They also show that small changes in the learning environment can result in consistent and substantial changes in learner performance, and that behaviour analysts have an important role to play in the design and implementation of instructional material.

The impact of a computerised consolidation accounting package (CCAP) on student performance

Purpose – The purpose of this paper is to investigate the association between the use of a computerised learning tool (specifically designed to teach consolidation accounting) and student performance in the final examination of an undergraduate accounting unit on Corporate Accounting.

Design/methodology/approach – A regression model was developed to analyse 1,103 observations of assignment and examination scores, collected over three semesters, to test the central proposition that computer assisted learning enhances student learning outcomes and performance in the exam.

Findings – The results show a positive and significant relationship between the computerised accounting assignment on consolidated accounting (linked to usage of the computerised tool) and the consolidation question in the final examination. The findings suggest that the computerised consolidation accounting package (CCAP) assists students to understand the concepts underpinning consolidation accounting.

Research limitations/implications – The data were collected from a single institution, which may not represent the population of accounting students. Due to ethical obligations, the study lacked a control group that would have allowed meaningful comparison and assessment of student performance. Furthermore, whilst the findings in this study were able to demonstrate a positive association between the CCAP and exam performance, it is unable to determine the quality and depth of the learning experience from using the CCAP.

Practical implications – The present study found that a CCAP and its usage has the potential to positively impact student performance on assessment tasks on subject matter similar to concepts contained the computer package. Such findings may encourage instructors to seek ways of incorporating learning technologies in the pedagogical design.

Originality/value – This is believed to be one the few papers that has exclusively studied the impact of a specific CCAP and a specific segment in accounting education (consolidation accounting) using direct measures, CCAP assignment score and the final examination score for a question dedicated to consolidation accounting.