Valentin Benzing

Classroom-Based Physical Activity Breaks and Children's Attention: Cognitive Engagement Works!

Classroom-based physical activity breaks are postulated to positively impact childrens attention during their school day. However, empirical evidence for this claim is scarce and the role of cognitive engagement in enhancing childrens attentional performance is unexplored in studies on physical activity breaks. The aim of the present study was therefore to disentangle the separate and/or combined effects of physical exertion and cognitive engagement induced by physical activity breaks on primary school childrens attention. In addition, the role of childrens affective reactions to acute interventions at school was investigated. Using a 2 × 2 between-subjects experimental design, 92 children between the ages of 11 and 12 years (M = 11.77, SD = 0.41) were randomly assigned to one of four experimental conditions: (1) combo group (physical activity with high cognitive demands), (2) cognition group (sedentary with high cognitive demands), (3) physical group (physical activity with low cognitive demands), and (4) control group (sedentary with low cognitive demands). Attention and affect were measured before and immediately after a 10-min intervention. ANCOVAs revealed that whereas physical exertion had no effect on any measure of childrens attentional performance, cognitive engagement was the crucial factor leading to increased focused attention and enhanced processing speed. Mediational analyses showed that changes in positive affect during the interventions mediated the effect between cognitive engagement and focused attention as well as between cognitive engagement and processing speed. These surprising results are discussed in the light of theories predicting both facilitating and deteriorative effects of positive affect on attention.

Acute cognitively engaging exergame-based physical activity enhances executive functions in adolescents

The study aimed to elucidate the influence of cognitive engagement comprised in an acute bout of exergame-based physical activity on executive functions (inhibition, cognitive flexibility) in adolescents. Therefore, the level of cognitive engagement and the intensity of physical activity were systematically varied across three experimental conditions. Sixty-five healthy male adolescents (13–16 years) were randomly assigned to one of three conditions: (a) physical activity with high levels of cognitive engagement during active video gaming, (b) physical activity with low levels of cognitive engagement during active video gaming, (c) sedentary with low levels of cognitive engagement during passive video watching. Manipulation checks, including subjective and objective operationalizations of cognitive engagement, were applied. Executive functions were assessed before and after each condition using the D-KEFS design fluency test. Results showed that cognitive engagement, operationalized by subjects’ ratings and heart rate variability, differed between conditions. The physical activity condition with a high level of cognitive engagement resulted in significantly better performance in cognitive flexibility compared to conditions with low levels of cognitive engagement. Regarding benefits for executive functions in male adolescents, the results indicate that acute physical activity with high cognitive engagement could be more efficient than physical activity of the same intensity with low cognitive engagement. Even though further evidence is needed, these results extend previous research and suggest a methodological approach for measuring cognitive engagement.

Disentangling the relationship between children’s motor ability, executive function and academic achievement

Even though positive relations between children’s motor ability and their academic achievement are frequently reported, the underlying mechanisms are still unclear. Executive function has indeed been proposed, but hardly tested as a potential mediator. The aim of the present study was therefore to examine the mediating role of executive function in the relationship between motor ability and academic achievement, also investigating the individual contribution of specific motor abilities to the hypothesized mediated linkage to academic achievement. At intervals of ten weeks, 236 children aged between 10 and 12 years were tested in terms of their motor ability (t1: cardiovascular endurance, muscular strength, motor coordination), core executive functions (t2: updating, inhibition, shifting), and academic achievement (t3: mathematics, reading, spelling). Structural equation modelling revealed executive function to be a mediator in the relation between motor ability and academic achievement, represented by a significant indirect effect. In separate analyses, each of the three motor abilities were positively related to children’s academic achievement. However, only in the case of children’s motor coordination, the mediation by executive function accounted for a significance percentage of variance of academic achievement data. The results provide evidence in support of models that conceive executive function as a mechanism explaining the relationship that links children’s physical activity-related outcomes to academic achievement and strengthen the advocacy for quality physical activity not merely focused on health-related physical fitness outcomes, but also on motor skill development and learning.

Does Integrated Neurocognitive Therapy (INT) reduce severe negative symptoms in schizophrenia outpatients

Negative symptoms often inhibit the social integration of people suffering from schizophrenia. Reducing severe negative symptoms (SNS) in a clinically relevant way is a major unmet need. The aim of this study was to investigate whether Integrated Neurocognitive Therapy (INT), a group cognitive remediation therapy (CRT), reduces SNS in schizophrenia outpatients. INT was compared with Treatment As Usual (TAU) in a randomized-controlled trial (RCT). A total of 61 SNS outpatients participated in the study, 28 were allocated to the INT group and 33 to the TAU group. A test-battery was used at baseline, post-treatment at 15weeks, and 1-year-follow-up. Remission rates of SNS after therapy were significantly higher for INT compared to TAU. A trend favoring INT was obtained at follow-up. Furthermore, INT showed significantly higher functional outcome during follow-up compared to TAU. Regarding cognition, the strongest significant effect was found in attention post-treatment. No effects between groups on more complex neurocognition and social cognition were evident. SNS outpatients seem to accept INT group intervention as suggested by the high attendance rate.

Acute Physical Activity Enhances Executive Functions in Children with ADHD

Acute physical activity of moderate to vigorous intensity has been shown to improve cognitive functions in children. However, the empirical evidence associated with Attention Deficit Hyperactivity Disorder (ADHD) in children is still limited, in particular regarding which specific cognitive functions benefit. This study investigated the effects of an acute bout of physical activity on multiple aspects of executive functions (inhibition, switching, and visual working memory) in children with ADHD. Forty-six children (8–12 years old; 82.6% boys) were randomly assigned to either 15 minutes of acute exergaming (physical activity of moderate intensity) or to a control condition (sedentary). Executive function performance in inhibition, switching and visual working memory were assessed before and after each condition, using a modified version of both the Flanker and the Color Span Backwards Task. The results revealed that participants in the exergaming group performed significantly faster than those in the control group in terms of both inhibition and switching, but there was no significant difference in the accuracy of the two tasks nor in visual working memory performance. These findings suggest that acute physical activity utilizing exergaming has the potential to improve specific aspects of executive functions (reaction times in inhibition and switching) in children with ADHD.

Poster #S79 EFFECTIVENESS OF INTEGRATED COGNITIVE REMEDIATION THERAPY FOR SCHIZOPHRENIA OUTPATIENTS: EARLY VERSUS LONG-TERM COURSE OF ILLNESS – RESULTS FROM AN INTERNATIONAL RCT

Background Nowadays there is extensive evidence available showing the efficacy of cognitive remediation therapies. Integrative approaches seem superior regarding the maintenance of proximal outcome at follow-up as well as generalization to other areas of functioning. To date, only limited evidence about the efficacy of CRT is available concerning elder schizophrenia patients. The Integrated Neurocognitive Therapy (INT) represents a new developed cognitive remediation approach. It is a manualized group therapy approach targeting all 11 NIMH-MATRICS dimensions within one therapy concept. In this study we compared the effects of INT on an early course group (duration of disease 15 years). Methods An international multicenter study carried out in Germany, Switzerland and Austria with a total of 90 outpatients diagnosed with Schizophrenia (DSM-IV-TR) were randomly assigned either to an INT-Therapy or to Treatment-As-Usual (TAU). 50 of the 90 Patients were an Early-Course (EC) group, suffering from schizophrenia for less than 5 years (Mean age=29 years, Mean duration of illness=3.3 years). The other 40 were a Long-term Course (LC) group, suffering from schizophrenia longer than 15 years (Mean age= 45 years, Mean duration of illness=22 years). Treatment comprised of 15 biweekly sessions. An extensive assessment battery was conducted before and after treatment and at follow up (1 year). Multivariate General Linear Models (GLM) (duration of illness x treatment x time) examined our hypothesis, if an EC group of schizophrenia outpatients differ in proximal and distal outcome from a LC group. Results Irrespective of the duration of illness, both groups (EC & LC) were able to benefit from the INT. INT was superior compared to TAU in most of the assessed domains. Dropout rate of EC group was much higher (21.4%) than LC group (8%) during therapy phase. However, interaction effects show that the LC group revealed significantly higher effects in the neurocognitive domains of speed of processing (F>3.6) and vigilance (F>2.4). In social cognition the EC group showed significantly higher effects in social schema (F>2.5) and social attribution (blame; F>6.0) compared to the LC group. Regarding more distal outcome, patients treated with INT obtained reduced general symptoms unaffected by the duration of illness during therapy phase and at follow-up (F>4.3). Discussion Results suggest that INT is a valid goal-oriented treatment to improve cognitive functions in schizophrenia outpatients. Irrespective of the duration of illness significant treatment, effects were evident. Against common expectations, long-term, more chronic patients showed higher effects in basal cognitive functions compared to younger patients and patients without any active therapy (TAU). Consequently, more integrated therapy offers are also recommended for long-term course schizophrenia patients.