Elizabeth J. Edwards

Effects of trait anxiety and situational stress on attentional shifting are buffered by working memory capacity

Background and Objectives: Attentional Control Theory (ACT) predicts that trait anxiety and situation stress combine to reduce performance efficiency on tasks requiring rapid shifts in attention. Recent evidence has also suggested that working memory capacity (WMC) might moderate this relationship. We controlled for methodological difficulties in the existing literature to investigate the relationships between trait anxiety, situational stress, and WMC on attentional shifting. Design and Method: Seventy undergraduate students participated in the study. Trait anxiety was operationalized using questionnaire scores, situational stress was manipulated through a pressured counting task, and WMC was based on performance on the Automated Operation Span Task (AOSPAN). The shifting task involved a modified version of the Sternberg paradigm as the primary task and an oddball tone-discrimination task as the secondary task. Dependent variables were performance effectiveness (accuracy) and processing efficiency (accuracy divided by response time) on the secondary task. Results: There was no effect of anxiety, stress, or WMC in predicting performance effectiveness; however, a significant three-way interaction on processing efficiency was observed. At higher WMC, anxiety and situational stress were not associated with processing efficiency. Conversely, at lower WMC, higher trait anxiety was associated with poorer efficiency but only for those who reported higher situational stress; for those who reported lower situational stress higher trait anxiety predicted facilitated efficiency. Conclusions: Results are interpreted with respect to ACT and directions for future research are discussed.

Cognitive trait anxiety, situational stress, and mental effort predict shifting efficiency: Implications for attentional control theory

Attentional control theory (ACT) predicts that trait anxiety and situational stress interact to impair performance on tasks that involve attentional shifting. The theory suggests that anxious individuals recruit additional effort to prevent shortfalls in performance effectiveness (accuracy), with deficits becoming evident in processing efficiency (the relationship between accuracy and time taken to perform the task). These assumptions, however, have not been systematically tested. The relationship between cognitive trait anxiety, situational stress, and mental effort in a shifting task (Wisconsin Card Sorting Task) was investigated in 90 participants. Cognitive trait anxiety was operationalized using questionnaire scores, situational stress was manipulated through ego threat instructions, and mental effort was measured using a visual analogue scale. Dependent variables were performance effectiveness (an inverse proportion of perseverative errors) and processing efficiency (an inverse proportion of perseverative errors divided by response time on perseverative error trials). The predictors were not associated with performance effectiveness; however, we observed a significant 3-way interaction on processing efficiency. At higher mental effort (+1 SD), higher cognitive trait anxiety was associated with poorer efficiency independently of situational stress, whereas at lower effort (-1 SD), this relationship was highly significant and most pronounced for those in the high-stress condition. These results are important because they provide the first systematic test of the relationship between trait anxiety, situational stress, and mental effort on shifting performance. The data are also consistent with the notion that effort moderates the relationship between anxiety and shifting efficiency, but not effectiveness.

Building skills, knowledge and confidence in eating and exercise behavior change: brief motivational interviewing training for healthcare providers.

OBJECTIVE Obesity related health problems affect individuals, families, communities and the broader health care system, however few healthcare providers (e.g., doctors, nurses, social workers, psychologists, counselors) receive formal training in obesity prevention interventions. We examined the effectiveness of training healthcare providers in brief motivational interviewing (brief MI) targeting eating and exercise behavior change. METHODS 163 healthcare providers participated. 128 participants completed a one-day experiential brief MI training workshop followed by electronic peer-support and a further 35 matched controls did not receive the training. RESULTS Participants knowledge of brief MI and confidence in their ability to counsel patients using brief MI significantly improved following training (p<0.05) and remained at 3 and 6-month follow-up (p<0.05). Brief MI skills assessed during the simulated patient interactions indicated a significant improvement across two practical training blocks (p<0.05). CONCLUSION Healthcare providers can learn brief MI skills and knowledge quickly and confidence in their counseling abilities improves and is sustained. PRACTICE IMPLICATIONS Healthcare providers may consider brief MI as an obesity prevention intervention.

Cognitive trait anxiety, stress and effort interact to predict inhibitory control

ABSTRACT Few studies have focussed on the link between anxiety and inhibitory control in the absence of stimulus-driven external threat. This two-part experiment examined the interactions between (1) somatic trait anxiety, somatic situational stress (i.e. threat of electric shock), and effort, and (2) cognitive trait anxiety, cognitive situational stress (i.e. ego-threat instructions), and effort, on inhibitory processes using a Go-No-Go paradigm. Trait anxiety was operationalised using questionnaire scores and effort was operationalised using a visual analogue scale. Performance effectiveness was measured using the d′ parameter from signal detection theory and processing efficiency was indexed by the ratio of d′ to response time on correct trials. Results indicated that somatic trait anxiety and stress did not predict effectiveness or efficiency. Cognitive trait anxiety and stress were associated with both inhibitory effectiveness and efficiency deficits; however, contrary to expectations these deficits were evident at higher rather than lower mental effort. Results suggest a distinction between how somatic and cognitive anxiety manifest on tasks involving inhibitory control.

Interrelationships between trait anxiety, situational stress and mental effort predict phonological processing efficiency, but not effectiveness

Attentional control theory (ACT) describes the mechanisms associated with the relationship between anxiety and cognitive performance. We investigated the relationship between cognitive trait anxiety, situational stress and mental effort on phonological performance using a simple (forward-) and complex (backward-) word span task. Ninety undergraduate students participated in the study. Predictor variables were cognitive trait anxiety, indexed using questionnaire scores; situational stress, manipulated using ego threat instructions; and perceived level of mental effort, measured using a visual analogue scale. Criterion variables (a) performance effectiveness (accuracy) and (b) processing efficiency (accuracy divided by response time) were analyzed in separate multiple moderated-regression analyses. The results revealed (a) no relationship between the predictors and performance effectiveness, and (b) a significant 3-way interaction on processing efficiency for both the simple and complex tasks, such that at higher effort, trait anxiety and situational stress did not predict processing efficiency, whereas at lower effort, higher trait anxiety was associated with lower efficiency at high situational stress, but not at low situational stress. Our results were in full support of the assumptions of ACT and implications for future research are discussed. (PsycINFO Database Record

Twelve tips for teaching brief motivational interviewing to medical students

Abstract Background: Shifting from paternalistic to patient-centred doctor-patient relationships has seen a growing number of medical programs incorporate brief motivational interviewing training in their curriculum. Some medical educators, however, are unsure of precisely what, when, and how to incorporate such training. Aims: This article provides educators with 12 tips for teaching brief motivational interviewing to medical students, premised on evidence-based pedagogy. Methods: Tips were drawn from the literature and authors’ own experiences. Results: The 12 tips are: (1) Set clear learning objectives, (2) Select experienced educators, (3) Provide theoretical perspectives, (4) Share the evidence base, (5) Outline the “spirit”, principles, and sequence, (6) Show students what it looks like, (7) Give students a scaffold to follow, (8) Provide opportunities for skill practice, (9) Involve clinical students in teaching, (10) Use varied formative and summative assessments, (11) Integrate and maintain, and (12) Reflect and evaluate. Conclusions: We describe what to include and why, and outline when and how to teach the essential components of brief motivational interviewing knowledge and skills in a medical curriculum.