WO2010100208A1

WO2010100208A1 - A training tool

Info

Publication number: WO2010100208A1
Application number: PCT/EP2010/052720
Authority: WO
Inventors: David Ian Delany
Original assignee: David Ian Delany
Priority date: 2009-03-03
Filing date: 2010-03-03
Publication date: 2010-09-10
Also published as: IES20100126A2; IE20100125A1

Abstract

This invention relates to a training tool and a computer implemented method of training an individual. The training tool and method comprise an IQ training module having a plurality of independently adjustable neurocognitive variables, each of which is used to exercise a specific sub-component of executive function (EF). Furthermore, the invention comprises an EQ training module to allow conditioning/deconditioning and an IQ-EQ training module to provide a combined IQ-EQ approach. The IQ training module uses a modified N-back test using an array of images including a target image and a plurality of distracter images. The manner in which the target and the distracter images are displayed to a user may be varied and in this way, multiple aspects of EF can be trained simultaneously and to different levels of complexity. The tool and method may be used to treat a range of conditions by targeting specific areas of EF as well as simultaneously or sequentially targeting attentional biases.

Description

"A training tool"

introduction

This invention relates to a training tool and more specifically a computer implemented method of training an individual.

It has been proven that it is possible to improve certain aspects of ones mental ability by performing dedicated adaptive training tasks. For example, various dedicated tasks have been devised to improve ones short term memory, ones ability to concentrate and ones ability to process information quickly. These dedicated tasks are often collectively referred to as "brain training" tools and there are a number of these brain training tools available on the market today.

One subcategory of brain training tools operate by targeting a particular aspect of a person's executive function and developing that aspect of executive function. Executive function (EF) is a neurocognitive umbrella term for high-order functions such as planning, working memory, impulse control, inhibition, mental flexibility, and the initiation and monitoring of behavior. Significantly, it has been found that deficits in executive functioning are a vulnerability factor for a wide range of clinical and non-clinical problems. Clinically, executive system dysfunction is central to a wide range of mental disorders including schizophrenia, depression, ADHD, anxiety, and OCD. In healthy individuals who are otherwise matched for age, education level and the like, differences in general intelligence (IQ) are primarily due to differences in the efficiency of the EF system. Diffuse degradation of the brain's EF system also underlies young-old performance differences on intelligence tests. Non-clinically, executive function has been linked to self-control; the ability to regulate our thoughts, emotions, impulses, and performance. Higher levels of self-control are correlated with a wide range of positive outcomes including higher academic performance, lower incidence of emotional psychopathology, higher self-esteem, lower levels of substance abuse, along with better relationships and interpersonal skills.

Executive function can be analysed using statistical techniques, such as latent variable statistical analysis, into more fundamental cognitive abilities or subcomponents. Examples of these subcomponents include updating, inhibition, and set-shifting. Updating is the ability to refresh the contents of working memory. Inhibition refers to the ability to inhibit task-irrelevant thoughts, emotions, and behaviors. Set-shifting is the capacity to switch attentional focus from one task, or object, to another. Mental disorders, such as schizophrenia, autism and ADHD, and both normal and gifted intellectual ability are characterized by fairly typical profiles of strengths and weaknesses in the range of EF subcomponents. Significantly, the functional impact of a condition is strongly correlated with the magnitude of the corresponding profile of executive function subcomponents.

Recent research has demonstrated that executive function subcomponents such as updating (Jaeggi et al., 2008. "Improving fluid intelligence with training on working memory" Proceedings of the National Academy of Sciences of the United States of America, 105(19), 6829-33), and set-shifting (Minear et al. 2008, 'Training and transfer effects in task switching." Memory & Cognition, 36(8), 1470-83) are amenable to improvement through training using targeted adaptive computer-based interventions.

One related training technique that principally targets the updating component of executive function is that described in the aforementioned paper by Jaeggi et al., hereinafter referred to as Jaeggi. Jaeggi discloses a dual N-back task. In an N-back task, a subject is serially presented with single images and has to respond when the current image matches the image that occurred N images ago. N-back tasks measure the ability of the subject to continuously update the contents of working memory and are strongly predictive of IQ. Jaeggi trained subjects on an adaptive dual N-back task comprising simultaneous auditory and visuo-spatial N-back tasks, and showed that training on such a task results in large gains in IQ.

At a fundamental level, regardless of the specific disease manifestations, emotional psychopathologies such as phobias (from specific phobias such as arachnophobia and agoraphobia to more general forms such as generalized anxiety disorder), depression, OCD, addiction (drug, alcohol, eating, gambling, and the like), and violent behavior, share a similar neuropsychological feature, namely a selective pre-conscious attentional bias or vigilance. In other words, on an automatic and pre-conscious level, sufferers find it hard to disengage their attention from, and exhibit a selective heightened awareness of, the objects of their particular concern. For example, those suffering from depression exhibit a selective heightened awareness of indicators of personal failure, those suffering from compulsive cleaning variants of OCD exhibit an attentional bias towards contamination cues, and those suffering from nicotine addiction display a selective heightened awareness towards smoking cues. The magnitude of these selective attentional biases is generally predictive of the severity of the disorder and of emotional intelligence (EQ) more generally.

Attentional bias retraining is a form of deconditioning whereby previously learned behavioural contingencies are unlearned. Several approaches to retraining attention have been developed in recent years and successfully applied to the treatment of conditions such as alcoholism (Field et al, 2007, "Experimental manipulation of attentional biases in heavy drinkers: do the effects generalise?" Psychopharmacology, 192(4), 593-608), low explicit self-esteem (Dandeneau & Baldwin, 2004 'The Inhibition of Socially Rejecting Information Among People with High Versus Low Self-Esteem: The Role of Attentional Bias and the Effects of Bias Reduction Training" Journal of Social and Clinical Psychology, 23(4), 584-603) and low implicit self-esteem (Dijksterhuis, 2004, "I like myself but I don't know why: enhancing implicit self-esteem by subliminal evaluative conditioning" Journal of Personality and Social Psychology, 86(2), 345-55).

A specific variant of attentional bias deconditioning is described in Canadian patent application number CA2,506,379 entitled "Interpersonal Cognition Method and System" in the name of McGiII University, hereinafter referred to as McGiII. McGiII describes a training tool that uses deconditioning techniques to improve an individual's self-esteem. This system involves deconditioning attentional biases towards negative social cues, in this case frowning faces, by forcing the user to repeatedly override their bias towards the negative social cues by seeking out a smiling face from an array consisting of a single smiling face and a plurality of frowning faces. By forcing users to repeatedly override their attentional bias the individual's bias towards the negative social cues is significantly reduced or extinguished, and concomitantly, low self-esteem significantly improved.

Although the specific cues that preoccupy sufferers of emotional psychopathologies emerge through experiential learning, the susceptibility to forming such pathological associations in the first place is largely determined by level of executive functioning. In other words, low levels of executive functioning constitute a vulnerability factor for developing an emotional psychopathology, such as low self-esteem or addiction. Consequently, attentional retraining approaches, such as those employed by McGiII treat the symptoms of low self-esteem but do not attempt to treat the underlying predisposing factor, namely, dysregulated executive function. Conversely, specific executive function training approaches, such as Jaeggi, permit neither independent adaptive training of multiple subcomponents of executive functioning, nor remediation of the attentional biases that drive emotional psychopathologies.

It is an object of the present invention to provide a training tool and a computer implemented method of training an individual that overcomes at least some of the problems with the known training tools and methods of training individuals.

Statements of Invention

According to the invention there is provided a training tool comprising an IQ training module having a plurality of neurocognitive variables, each of which exercises a specific sub-component of executive function (EF); and in which a complexity level of at least two of the neurocognitive variables are parametrically adjustable independently of the other neurocognitive variables.

In this way, the tool operates by targeting multiple aspects of a subject's executive function and simultaneously developing those aspects of executive function. The different aspects of EF may be trained to differing degrees so that deficient aspects of EF may receive more or less training as required. By using IQ training module to normalize the executive function profile of individuals with mental conditions it is expected that significant gains in function will be obtained.

In one embodiment of the invention the neurocognitive variables exercise two or more of an updating sub-component, an inhibition sub-component, a set-shifting sub-component, a memory interference resolution sub-component and a divided attention sub- component.

In one embodiment of the invention the IQ training module comprises a variant of the N- back task, varied through the incorporation of a neurocognitive variable that exercises at least one of an inhibition sub-component of EF and a set-shifting sub-component of EF. In one embodiment of the invention the IQ training module comprises an array having a target and a plurality of distracters, and in which the target is periodically updated.

In one embodiment of the invention the position of the target in the array is changed periodically.

In one embodiment of the invention the size of the target relative to the array is changed periodically.

In one embodiment of the invention the prominence of the target relative to the distracters is modified periodically.

In one embodiment of the invention the distracters are emotionally salient distracters.

In one embodiment of the invention the distracters are updated periodically.

In one embodiment of the invention the target and the distracters are images in an image array.

In one embodiment of the invention there is further provided an EQ training module, the EQ training module comprising an EQ array having an emotionally salient or neutral target and a plurality of emotionally salient distracters. In this way, the invention relates to an integrated brain training tool and more specifically to a unique computer- implemented combined method of training both the cognitive and emotional capacities of an individual. The tool adaptively trains two core neuropsychological factors underpinning both cognitive and emotional capabilities and disabilities, namely Executive Function (EF) and pre-conscious attentional biases. Since both mental disease and mental high capability emerge largely through the interaction of these core cognitive (IQ) and emotional (EQ) factors this tool is intended to constitute a comprehensive methodology for effectively and positively modifying the mental condition of a user.

In one embodiment of the invention the EQ training module further comprises an emotionally salient primer. By having such a feature, the EQ trainer module of the current invention extends existing attentional retraining approaches in two ways. Firstly, it incorporates a conditioning component that facilitates active formation of pre-conscious unconscious biases of the user's choosing and secondly it provides a customisable tool for deconditioning.

In one embodiment of the invention the EQ training tool comprises a sub-array consisting of the primer and the target.

In one embodiment of the invention there is provided an emotional stimuli calibration test module.

In one embodiment of the invention the EQ training module comprises a plurality of arrays each with an emotionally salient target and a plurality of emotionally salient distracters, and means to select one of the plurality of arrays based on a result from the emotional stimuli calibration test.

In one embodiment of the invention there is provided means to select an initial complexity level of one or more of the neurocognitive variables.

In one embodiment of the invention there is provided means to upload one of a target, a distracter and a stimuli for use in the training tool.

In one embodiment of the invention computer implemented method for training the executive functioning of a subject, the method comprising the steps of:

providing an IQ training module having a plurality of neurocognitive variables, each of which exercises a specific sub-component of executive function (EF) and in which a complexity level of at least two of the neurocognitive variables are parametrically adjustable independently of the other neurocognitive variables; and

adjusting the complexity level of at least one of the neurocognitive variables in response to a subjects input. In one embodiment of the invention the step of providing an IQ training module comprises providing a variant of the N-back test, varied through the incorporation of a neurocognitive variable that exercises at least one of an inhibition sub-component of EF and a set-shifting sub-component of EF.

In one embodiment of the invention the step of providing an IQ training module comprises providing an array having a target and a plurality of distracters, and in which the target is periodically updated.

In one embodiment of the invention the method comprises the steps of providing a plurality of arrays each with an emotionally salient or neutral target and a plurality of emotionally salient distracters, and selecting one of the plurality of arrays based on a result from the emotional stimuli calibration test.

In one embodiment of the invention the method comprises the step of a user selecting an initial complexity level of one or more of the neurocognitive variables.

In one embodiment of the invention the step of a user supplying one of a target, a distracter and a stimuli for use in the training tool.

In one embodiment of the invention there is provided a computer program product having program instructions for causing a computer to implement the method.

Detailed Description of the Invention

The invention will be more clearly understood from the following description of some embodiments thereof, given by way of example only with reference to the accompanying drawings, in which:

Figures 1(a) to 1(e) are graphs illustrating profiles of typical executive function subcomponent levels for a range of different conditions;

Figures 2(a) and 2(b) are graphs demonstrating the effect on execution function subcomponents caused by implementation of the present invention; Figures 3(a) to 3(d) are graphs illustrating representative profiles of attentional biases of individuals with a range of different conditions;

Figures 4(a) to 4(d) are graphs illustrating the cognitive (IQ) and emotional (EQ) characteristics of an individual suffering from alcoholism before and after being subjected to the training tool of the present invention;

Figure 5 is a diagrammatic representation of an IQ task of the training tool according to the invention;

Figure 6 is a diagrammatic representation similar to that shown in Figure 5 of an alternative embodiment of IQ task of the training tool according to the invention;

Figure 7 is a diagrammatic representation similar to that shown in Figures 5 and 6 of an a further still embodiment of IQ task of the training tool according to the invention;

Figure 8 is a diagrammatic representation of an EQ deconditioning task of the training tool according to the present invention; and

Figure 9 is a diagrammatic representation of an EQ conditioning task of the training tool according to the present invention.

Referring to Figure 1 (a) of the drawings, there is shown a graph, indicated generally by the reference numeral 1 , of the executive function profile including the executive function subcomponents of an average individual. The subcomponents include an updating subcomponent 3, an inhibition subcomponent 5 and a set-shifting subcomponent 7. The subcomponents 3, 5, 7 are measured on a scale 9 indicative of the relative level of function or performance of the subcomponent. The scale is provided with an average mark 11 , a below average mark 13 and an above average mark 15. It can be seen that the updating, inhibition and set shifting subcomponents are all in or around the average mark 11 of the scale 9.

Referring to Figures 1(b) to 1(e) inclusive, there is shown a number of diagrammatic idealized representations of the executive function profiles, or levels of selected subcomponents of executive function, of individuals suffering from various mental disorders (Figures 1 (b)-1 (d)), or displaying heightened levels of intelligence (Figure 1 (e)). Referring specifically to Figure 1(b), there is shown a diagrammatic representation of the executive function subcomponents of an individual suffering from attention deficit hyperactivity disorder (ADHD). Typically, individuals suffering from ADHD exhibit a very low or below average inhibition subcomponent 5, and to a lesser extent below average updating subcomponent 3, and to an even lesser extent a below average set-shifting subcomponent 7. These are traits typical of an individual suffering from ADHD and may vary slightly depending on the individual's particular condition.

Referring specifically to Figure 1 (c), there is shown a diagrammatic representation of the executive function subcomponents of an individual suffering from schizophrenia. It can be seen that the individual suffering from schizophrenia demonstrates below average performance in updating, inhibition and set-shifting subcomponents. In this case, the updating subcomponent 3 is the worst performing subcomponent, the inhibition subcomponent 5 is the next worst performing subcomponent and finally the set-shifting subcomponent 7 is the least adversely affected subcomponent. The updating subcomponent 3 is around the below average mark 13 on the scale 9.

Referring now to Figure 1(d), there is shown a diagrammatic representation of the executive function subcomponents of an individual suffering from autism. It can be seen from the diagram that all three subcomponents, namely the updating subcomponent 3, the inhibition subcomponent 5 and the set-shifting subcomponent 7 are all below average performance, however, the most poorly performing subcomponent is set-shifting, followed by the inhibition subcomponent 5 and finally the updating subcomponent 3 is the least adversely affected subcomponent.

Referring to Figure 1(e), there is shown a diagrammatic representation of the executive function subcomponents of a gifted individual. It can be seen that the updating subcomponent 3, the inhibition subcomponent 5 and the set shifting subcomponent 7 are all in or around the above average mark 15 on the scale 9. What can be seen therefore is that depending on the particular illness or condition, certain traits and patterns appear which are directly related to the subcomponents of executive function. Furthermore, individuals with gifted ability have an above-average performance in many or all of the various subcomponents 3, 5, 7 of executive function.

The aforementioned profiles of executive functioning across a range of conditions are illustrative of the general principal that, broadly speaking, different mental conditions have characteristic profiles of strengths and weaknesses in executive functioning. This is significant because the functional impact of a disorder can typically be predicted from executive function performance. Clinical improvements in mental disorders, such as schizophrenia, autism, obsessive compulsive disorder and the like are also characterized by concomitant improvements in executive function performance.

Referring to Figures 2(a) and 2(b), there is shown a diagrammatic representation of the effects of one aspect of the present invention, namely the improvement and normalization of the subcomponents of executive function thereby improving the individual's performance. Referring specifically to Figure 2(a), there is shown the diagrammatic representation of the subcomponents of executive function for an individual suffering from autism, indicated generally by the reference numeral 21, which, over time, through appropriate training can be brought in line with the executive function subcomponent characteristics as illustrated generally by the reference numeral 23. Similarly, referring to Figure 2(b), there is shown the diagrammatic representation of the subcomponents of executive function for a normal individual, indicated generally by the reference numeral 25, which can be improved over time to more closely represent those of a gifted individual, indicated generally by the reference numeral 27. Again, this is achieved through appropriate integrated training of the subcomponents of executive function.

Referring to Figures 3(a) to 3(d) of the drawings, there is shown a diagrammatic representation of the attentional bias of individuals suffering from a number of different addictions or other emotional psychopathologies characterized by specific dysfunctional attentional biases, indicated generally by the reference numeral 31. The reaction times on a reaction time task in the presence of selected cues, in this case smoking cues 33, rejection cues 35 and alcohol cues 37 are demonstrated. These representations of attentional bias may be obtained by carrying out an emotional stimuli calibration test such as a Stroop Test or an Implicit Association Test. These tests allow for the emotional psychopathology of an individual to be measured and graphically represented. Alternatively, the training tool may operate in an emotional stimuli calibration test mode in which the training tool will perform a series of tests and monitor the responses of the user to the tests. From those tests, it will be possible to compare the results of the user against a sample of other users and determine an emotional stimuli profile for the user. In such a way, the training tool will function as a diagnostic tool. It has been shown that due to the fact that individuals display a selective attentional bias towards particular cues, their reaction times to those cues tend to be slower than other cues. Therefore, in the embodiment shown three different cues are represented, smoking cues 33, rejection cues 35 and alcohol cues 37. The magnitude of the slow-down in reaction time is correlated with the severity of the condition.

For an individual suffering from nicotine addiction, as shown by the chart 38 in Figure 3(a), the smoking cues are the slowest reaction times, whereas their reaction times for rejection cues and alcohol cues are around average. For an individual who suffers from social anxiety as shown in Graph 39 of Figure 3(b), the reaction times of the rejection cues are far slower than those for smoking cues and alcohol cues. For an individual suffering from alcoholism as demonstrated by the Graph 40 in Figure 3(c), the alcohol cues display a reaction time far slower than either the rejection cues or smoking cues which are approximately average. Finally, there is shown a graph 41 of a normal individual's reaction times in Figure 3(d), the smoking cues, rejection cues and alcohol cues are all around average reaction times. It is an aspect of the present invention to normalise the reaction times in the presence of emotionally salient cues of the individuals in question, and thereby remediate their attentional biases, by providing tasks that can be customised to decondition the selective attentional biases and regularise the reaction times to the different types of cues.

The principle of the combined IQ-EQ approach is illustrated in Figures 4(a) and 4(b). Referring to Figures 4(a) to 4(d), there is shown a characteristic executive function performance profile and the selective attentional bias reactivity profile to various cues of an individual suffering from alcoholism, illustrated by graphs 43 (Figure 4(a)) and 44 (Figure 4(c)), respectively. Prior to use of the training tool according to the present invention, the individual suffering with alcoholism displays below average updating, inhibition and set shifting subcomponents performance and slower than average reaction times for alcohol cues in particular. Once these patterns are identified a particular programme of IQ and EQ training may be adopted to normalise the updating, inhibition and set shifting subcomponents of executive function as shown in Graph 45 (Figure 4(b)) and also regularise the reaction times (in this instance) to alcohol cues as shown by Graph 46 (Figure 4(d)). In this way, both the underlying neurocognitive causes (executive function deficits) and symptoms (attentional biases towards alcohol-related cues) of alcoholism can be tackled by regularising the executive function subcomponents, thereby treating a significant predisposing factor for alcoholism, and also then treating the emotional aspect by overcoming the attentional bias towards the emotional cues towards alcohol, thereby treating a significant factor in the maintenance and severity of alcoholism.

Referring to Figure 5 of the drawings, there is shown a diagrammatic representation of one embodiment of an IQ task according to the present invention. The task comprises an array, indicated generally by the reference numeral 50, having a plurality of images 51 - 59 therein. One of the images 55 is a target image and the remaining images 51-54 and 56-59 are distracter images. The IQ task comprises a variant of the classic N-back task, whereby the target image 55 may be changed periodically and the subject must indicate when the target image 55 is the same image that was displayed N times/iterations ago.

For example, when N = 2 the individual must indicate when the target image is the same as the target image displayed two target images previously. As the individual becomes more proficient at identifying when the image is identical to that shown N times ago, the value of N may be increased. If the individual subject can master the IQ task when N = 2, the value of N can be increased to 3 so that they must match the target image with the target image that appeared three iterations ago. In this way, the individual must constantly update their working memory and remember a sequence of images. If the individual cannot master the advanced level, they can regress to a lower level until such time as they become proficient at the level. In addition to the classic N-back Test, a number of distracter images are presented. The distracter images are used to test the inhibition of the individual, or in other words, their ability to be able to block out the distracter images and focus their attention on the target image. Therefore, the updating subcomponent and the inhibition subcomponent of executive function may be tested at the same time. The prominence of the distracter images relative to the target image may be varied thereby further testing the ability of an individual to inhibit the distracter images and focus their attention on the target images. This allows the difficulty of both the updating and inhibition subcomponents to be varied in a single task. Referring to Figure 6, there is shown another variant on the IQ task of the training tool as illustrated in Figure 5. In this instance, the position of the target image 55 is changed in the array. The target is still used in the classic N-back test, however in this case the position of the target image in the array 50 is changed periodically thereby requiring the subject to utilise their set-shifting subcomponent of executive function. The speed and the frequency with which the target image 55 shifts position in the array 50 can be modified to further test the subject and tax the ability of the subject to set shift. For example, the better the individual becomes at the task, the more likely it will be that the target image 55 will shift to another position in the array, thereby increasing the difficulty with which the set-shifting component is tested. In this way, the updating, inhibition and set-shifting sub-components may be tested and improved at the same time.

Referring to Figure 7, there is shown another implementation in which the set-shifting subcomponent of the executive function of the subject can be tested. In this case, there is provided an array 60 with a number of distracter images 61-65 inclusive and a target image 55. The target image 55 can take up a number of positions in the array with greater or lesser prominence and may indeed take up the whole array or part thereof and shift around in positions if desired. Again, this will test the set-shifting ability of the subject as they will have to be able to switch their focus from a small image to a larger image and back again.

In the embodiment shown in Figures 5 to 7 inclusive, the target image 55 may be delineated from distracter images by providing a border 66 surrounding the image 55. Similarly, the background of the target image could be a different colour to that of the distracter images, or some other indicator could be provided to indicate which image of the array 50 is the target image 55. Similarly in the embodiment shown in Figure 7 a distracter image may be given more prominence and take up a number of different spaces in the array, rather than the target image, in order to test the inhibition and set shifting and updating subcomponents of the individual's executive function. It can be seen from the above that the training tool can be parametrically modified to test the individual subcomponents of executive function including the updating subcomponent, the inhibition subcomponent and the set shifting subcomponent all in one process.

In the N-back test, the task for the subject is to indicate if the current image matches the image presented N images ago. For example, in the 2-back version of the task the player must respond if the current image is the same as that seen 2 images ago. A key difficulty for the player is the requirement to continually update the sequence of images held in memory as each new image is presented e.g. in the 2-back case, a continually changing sequence of two prior images must be remembered. The task difficulty is increased as N gets larger. Recent research has shown that training on an adaptive variant of the N-back task leads to large increases in IQ. Importantly, prior to results such as these, IQ has until recently been assumed to be fixed and predominantly genetically determined.

The IQ training task of the present invention is an adaptive extension of the basic form of N-back test and is designed to simultaneously train multiple subcomponents of executive function, in addition to updating, within a single task. This approach is referred to as Integrated Executive Function training. The additional EF subcomponents include, but are not limited to, inhibition and set shifting and their variants. By variant, what is meant is that there are numerous ways in which the inhibition and set shifting subcomponents could be tested. For example, with inhibition it is possible to modify the prominence of the distracters and/or the similarity of the distracter images to the target image. Similarly, with set shifting, it is possible to have simply spatial set shifting whereby the target image moves position in the array or local/global set shifting whereby the target image shifts between a single image or a composite image composed of a plurality of single images.

Other EF subcomponents that could be tested include memory interference resolution and divided attention. In order to test memory interference resolution, a test similar to the N-back test would be used however in this instance "lures" would be used. The "lures" are identical to the target but instead of being in the N-back position, are in a different position, for example, the N-1 position. In other words, in an N-back test using target and distracter images where N=3 and the object is to match a target image with a target image that appeared 3 iterations of the target image ago, the "lure" may be an image identical to the target image but instead of being 3 iterations of images after the target image, is only two iterations of images after the target image. The divided attention subcomponent may be tested using a multi N-back test whereby there are two or more sequences of target images that must be followed in the array. A different colour border or other identifier may be used to identify the images from a particular sequence. The user must follow all sequences simultaneously and indicate when an N-back match occurs in any sequence.

Depending on the particular condition of the individual, the level of complexity of the various different tasks within the IQ task (those aspects relating to updating, inhibition and set shifting subcomponents) can be automatically individually altered and modified to target those areas requiring work. It is envisaged that a control panel will be provided that will allow a user or a clinician to initially set the level of difficulty of the various different tasks that target the sub-components. The control panel will have a scale of difficulty for each of the IQ and EQ trainer neurocognitive variables and the user or clinician may set the level of difficulty on the scale appropriately. For example, if it is desirable to test the updating subcomponent the starting level of N may be selected, if it desirable to test the inhibition subcomponent the starting level of contrast of the distracter images may be selected and if it is desirable to test the set shifting subcomponent, the starting level of frequency with which the target image will shift may be selected. As the individual performs the tasks, the level of complexity of each of the tasks can be automatically adjusted depending on their performance.

The basic task design entails a screen consisting of an array of image placeholders displaying discrete images, for example in the embodiments shown, nine in number. One of these images will be indicated as a target for the purposes of the N-Back task, by having, for example, a highlighted border. The placeholders are then successively updated with new images at fixed or variable time intervals. The user's task is to successfully indicate, using, for example, a computer mouse click over the target image, whenever a current target image matches a target image that appeared N images ago. The difficulty level is varied as a function of the user's performance. The task is adaptive in that it becomes incrementally easier if the user makes an error, and incrementally harder if the user successfully indicates an N-Back match.

Unlike conventional N-Back tasks, which simply vary updating difficulty by increasing or decreasing the N variable (or, in the case of the dual N-Back task the N variable for both N-back tasks), the difficulty of the IQ task is determined by a number of neurocognitive variables (neurocognitive task variables) that can be parametrically varied to load and train different executive function subcomponents, such as inhibition and set shifting, in different ways. For example, inhibition may be trained by altering the visibility of non- target ('distracter') images, or by altering the motion or size of the distracter images. In another example, EF local-global set shifting capacity may be trained by altering the probability with which the target image jumps to a different placeholder at each image updating thereby implementing spatial set-shifting training, or by altering the number of placeholders required to display a single unitary image (i.e. local/global set shifts in spatial scale) thereby implementing local-global set shifting training.

The neurocognitive variables or module parameters that may be manually or automatically altered dynamically as a function of the user's performance in order to progressively load, and thereby train, different executive function subcomponents include, but are not limited to, the N value (updating subcomponent), the number of target sequences (updating and divided attention subcomponent), the location of the target sequence(s) (set-shifting subcomponent), the predictability of the location of target sequence or sequences (set-shifting subcomponent), the sensory modality of the target sequence(s) or distracters (for example, visual and auditory), the total number of images onscreen (inhibition subcomponent), the relative visibility of the images (inhibition subcomponent), the motion of the images (set-shifting subcomponent), the topic matter of the images (inhibition subcomponent), the emotional salience of the images (inhibition subcomponent), the similarity or relatedness of the prior images (memory interference resolution subcomponent), the relative size of the images (set-shifting subcomponent), the number of placeholders required to display a single unitary image (local-global set- shifting subcomponent), and the sequence in which, and the magnitude by which, variables such as these are modified automatically as the game progresses. By varying the sequence and magnitude by which the neurocognitive variables are altered the nature of the neurocognitive capacities targeted for training and the rate at which the difficultly of the task changes can be controlled. In this way, multiple components of the executive function system can be trained within the same progressive adaptive task with complete control.

The integrated executive function, or IQ trainer, component of the present invention is unique in that it parametrically and independently adaptively loads and trains multiple components of the executive function system simultaneously. As a result, the IQ trainer can be used, without disorder-specific modification, in the treatment of a wide range of mental conditions with widely varying executive function profiles such as schizophrenia, autism, and ADHD.

If the emotional salience of, for example, the distracter images, is significant then the IQ task effectively functions in an IQ-EQ training mode. In this case, the additional attentional bias imposed by the distracter images allows the user to train his ability to perform at a high cognitive level whilst under acute psychological distraction or stress.

The IQ-EQ task thus allows users to simultaneously enhance their intellectual ability and their emotional resilience. It is envisaged that customized variants of this form of training would be of use in training individuals in high-stress occupations to perform optimally.

Examples include air traffic controllers, call centre operatives, stock traders, and aircraft pilots.

Referring to Figure 8 of the drawings, there is shown a diagrammatic schematic representation of an emotional task (EQ task) used for deconditioning, or breaking, a selected attentional bias of an individual. The user is initially presented with a randomized array 80 with a plurality of images in the array 81-89, one of which, 86, is a neutral or positive image whereas the remaining images 81-85 and 87-89 are negative images, and particular to the individuals condition. The neutral or positive image is the target image and the negative images are the distracter images. The object is to repetitively train the individual to focus on the neutral or positive image and repeatedly override the attentional bias towards the negative images. The term images, in this context, may refer to pictorial images, words, video clips, or audio clips indicated by a visual placeholder.

For example, for an individual with a nicotine addiction, the images 81-85 and 87-89 inclusive may all represent smoking cues such as images of a lit cigarette, a cigarette packet, a box of matches, or the like, while the image 86 is a neutral or a positive image such as a smiling face or other object, such as a flower, that is not a nicotine cue. The task for the subject is to select the correct non-smoking cue image 86 as shown and then the correct answer is highlighted.

In the deconditioning variant of the EQ task, the user is trained to break, or decondition, their automatic implicit tendency to engage their attention with images that represent their area of concern. For example, indicators of personal failure in depression, contamination cues in compulsive cleaning variants of OCD, or smoking cues in nicotine addiction.

The user is presented with a random array (for example 4 x 4) of placeholders displaying images. All but one of these images are attention-capturing 'distracter⁴ images. The remaining image is the target image. This image may be relevantly emotionally positive (assumed in this context) or neutral. The user's task is to visually or otherwise search the array, and find and indicate, using, for example, a computer mouse click on the target image, as quickly as possible. This procedure is repeated multiple times with different random arrays. The goal is to increase the speed at which the user can find the target positive image in the array. In order to increase their targeting speed, the user must repeatedly override their automatic learned tendency to orient their attention towards the images that represent their area of concern. In doing so repeatedly the user gradually learns to break, or decondition, the automatic associations of concern.

In one variant the speed at which the arrays are presented to the user increases as the user's targeting speed decreases. Similarly, the speed at which the arrays are presented to the user decreases as the user's targeting speed increases. In another variant the presentation of a new image array is dependent upon the user successfully identifying the target image.

Referring now to Figure 9, there is shown an emotional intelligence (EQ) conditioning task. The EQ conditioning task is a variant of the basic deconditioning task. However, the intention is that the subject can positively associate certain attributes with an item. For example, in order to overcome their fear of spiders, an arachnaphobe may wish to associate positive phrases such as "safety", "fearless", "friendly", "furry" with spiders and disassociate words such as "fear", "biting", "poisonous", "harmful" with spiders. Therefore, the array 90 first of all presents a stimulus image 91 which may be an image of a spider and thereafter presents a number of words 92-99 in the array, one of which 97 is a target word and the remaining words 92-96 and 98-99 are distracter words. In this instance, the target word might be "friendly" and the distracter words might be "poisonous", "harmful", and the like. The user must select the target word 97 from the distracter words 92-96 & 98, 99. If the user successfully selects the target word 97, both the target word and the stimulus image 97, 91 are displayed on the screen together. In the conditioning variant of the EQ tasks, the user is conditioned to automatically associate two areas of interest. In other words, unconscious biases are customisably formed as opposed to broken, as in the case of the deconditioning variant. For example, an arachnaphobe might decide to condition herself to associate spiders with ideas of safety (for example, "safe", "unthreatening", "relaxing"). The conditioning task is similar to the deconditioning task but adds a priming stage where the 'to be conditioned' stimulus (stimi in the diagram), e.g. a spider, is briefly presented alone in order to activate the automatic associations with the stimulus in the user's mind. The "right" -"wrong" stimuli then appear and the user proceeds as in the deconditioning task. The goal is to learn to associate e.g. spiders with some positive, rather than negative, concepts.

In one version, the user is presented with an array of image placeholders on screen. All but one of these placeholders are blank. The non-blank placeholder contains a target image that represents an area of interest that the user would like to automatically associate with another area of interest. Following a brief interval (or in another variant, following the user indicating the image) images appear in the blank placeholders. As in the EQ deconditioning task, all but one of these randomly displayed new images are distracter images. The non-distracter image is a target image representing the second area of interest. The user's task is to quickly indicate the location of the second target image. Upon the user indicating the second target image, the distracter images disappear and, in one variant, the pair of target images expand in size. This process is repeated with new randomly located images until the user has formed an automatic conditioned association between the two areas of interest and simultaneously attenuated an existing automatic association.

If the distracter images are emotionally salient the task serves to condition one set of associations whilst simultaneously de-conditioning another. For example, an arachnaphobe might decide to condition herself to associate spiders with ideas of safety ("safe", "unthreatening", "relaxing", etc) whilst simultaneously deconditioning prior associations with danger ("biting", "poisonous", "dangerous", etc). In this example, the target images are, respectively, spiders and ideas of safety, whilst the distracter images convey ideas of danger. The emotional (EQ) tasks are designed to constitute a flexibly customizable approach to treating the specific dysfunctional attentional biases (i.e. automatic stimulus-response thoughts, emotions, and behaviors) that characterize emotional psychopathologies such as phobias, depression, OCD, addiction, and violent behavior. The EQ tasks comprise an EQ deconditioning training task that allows users to break (decondition) selected undesirable, or unhealthy, automatic attentional biases, and an EQ conditioning training task that allows users to form selected desirable, or healthy, automatic associations or attentional biases. The EQ conditioning task is effectively a variant of the EQ deconditioning task.

Task variables that may be altered as a function of the user's performance in the deconditioning and conditioning EQ task variants in order to optimally modulate a user's attentional biases include, but are not limited to, the number of distracter images, the number of target and distracter images, the location of the target and distracter images, the sensory modality of the target or distracters images (for example, visual and auditory), the total number of images onscreen, the relative visibility of the images, the motion of the images, the emotional salience of the images, the similarity between the images, the relative size of the images, and the sequence in which, and the magnitude by which, variables such as these are modified.

It is envisaged that the present invention may also be used as a diagnostic tool. The configuration of neurocognitive variables settings at any given point in the task constitutes a level. It will be noted that the performance of a user at a level or combination of levels, on the IQ and/or EQ tasks, may readily be benchmarked against the performance of other comparable users at that level or combination of levels, thereby allowing the IQ-EQ method to be usefully utilized as a comparative diagnostic tool for any of the dimensions of cognitive and emotional functioning the method is designed to improve.

The key neuroscientific insight behind the present invention is the recognition that executive function is the fundamental link between emotional and cognitive performance. The invention consists of a number of possible variants of the basic IQ training task (for example, the IQ-EQ training task) and the two categories of EQ training tasks i.e. the conditioning and deconditioning tasks. The invention consists of a brain training method (¹IQ-EQ training') for improving intellectual (IQ) and emotional (EQ) performance. The IQ-EQ training approach consists of three interrelated tasks. The IQ task which is designed to enhance core intellectual ability by simultaneously and adaptively training multiple aspects of executive function. The EQ tasks which are designed to treat emotional psychopathologies such as anxiety, depression, OCD, by using associative conditioning or deconditioning to induce rapid modulation of implicit automatic associations such as attitudes, and beliefs. The IQ-EQ task which is a variant of the IQ task designed to enhance intellectual performance under emotional stress by using emotionally salient stimuli within the task. The combined IQ-EQ method is designed to benefit an unprecedented range of normal, sub-clinical and clinical populations of children, young adults and senior adults.

The invention constitutes a method (IQ-EQ training) for improving intellectual (IQ) and emotional (EQ) performance in normal, sub-clinical and clinical populations of children, young adults and senior adults. The IQ-EQ brain training approach can not only be used to enhance the mental abilities of healthy individuals, but can also be used to treat an unprecedented range of mental problems including learning, mood, anxiety, psychotic, and impulse-control disorders. As such, this approach constitutes a substantial theoretical and practical advance over existing brain training approaches. The IQ-EQ approach consists of three interrelated tasks, the IQ task, the EQ task and the IQ-EQ task.

The IQ task is designed to enhance core intellectual ability by simultaneously and adaptively training multiple aspects of executive function. The EQ task is designed to treat emotional psychopathologies such as anxiety, depression, OCD, by using associative conditioning (the EQ conditioning task) or deconditioning (the EQ deconditioning task) to induce rapid modulation of implicit associations such as attitudes, and beliefs. And finally the IQ-EQ task is a variant of the IQ task that uses emotionally salient stimuli and is designed to enhance intellectual performance under emotional stress by using emotionally salient stimuli within the IQ task.

Whilst the EQ task works by treating the specific symptoms of an emotional psychopathology (i.e. a specific dysfunctional attentional bias) it is the level of executive function ability that determines our initial susceptibility to forming pathological emotional, cognitive, and behavioral patterns. Therefore, by virtue of its targeted training of executive function the IQ task treats the underlying, or causal, neurocognitive deficits in executive function that constitute a vulnerability factor for mental illness in the first place. In other words, unlike conventional psychiatric approaches, the (sequential or simultaneous) combined IQ-EQ approach acts to treat both the fundamental causes and superficial manifestations of clinical and sub-clinical mental problems. Moreover, the training tasks can also be used by healthy individuals to augment their intellectual and emotional performance.

By fundamentally unifying cognitive and affective training in a single task the IQ-EQ training approach described here constitutes a substantial theoretical and practical advance over existing brain training approaches. Implemented using a computer, the IQ- EQ is designed to individuals an unprecedented ability to maximize their intellectual capacities, fine-tune their emotional health, rationally modulate their attitudes and beliefs on any topic, and deliberately enhance their capacity for self-control.

In summary, by using innovative brain training task designs that combine adaptive executive control cognitive training with conditioning/deconditioning affective training, the IQ-EQ approach uniquely allows users to simultaneously, or serially, enhance their intellectual ability (IQ) and their emotional resilience and stability (EQ). The novel class of IQ-EQ tasks can potentially benefit an unprecedented range of normal, sub-clinical and clinical populations of children, young adults and senior adults.

The utility of the IQ-EQ brain training method may be increased by allowing the user to fully customize both the images stimuli presented within the tasks, and aforementioned task variables in order to optimize the efficacy of the intervention. For example, the user may provide the target, stimulus and distracter images and/or words to use in the conditioning and deconditioning tasks. For example, if a user has a nicotine addiction, they may obtain images or words that are emotionally salient to them and supply those images in electronic format or words for use in the tasks. If a certain time of day is a cue for nicotine for the individual, the individual may upload an image of a clock face showing that time of day, or if a coffee break is a cue for nicotine for them, the person may upload a picture of a cup of coffee onto their device for use in the application. The user may designate that these are distracter images and these will be selected and displayed to them as distracter images when they are performing the tasks. Similarly, the user may select the specific subtask or subcomponent s/he would like to train on and may select the level of difficulty of the particular task.

In one embodiment, the EQ task comes preloaded with a range of stimulus image sets designed for several emotional psychopathologies, for example OCD, depression, alcohol addiction. However, the capacity will exist to allow users to fully customize the stimulus sets to address their specific areas of concern (for example nicotine addiction, arachnophobia and the like). Similarly, it is envisaged that third parties may develop tasks and provide their own target, distracter and stimuli images (if relevant) and make them available to others (for example through a so-called "App-store"). In this way, third party developers can create their own applications so that different phobias and conditions may be treated.

User performance feedback in the form of scores, performance variance, reaction times, accuracy and other measures may be provided. Feedback may be extended to comparison with the performance of other users playing on the same computer or on different computers over a network. Although a variety of scoring and measuring schemes are readily conceivable, no specific implementations are necessarily preferred.

A further elaboration, that may be implemented with the intention of maximizing the efficacy of the IQ-EQ brain training task, is a customizable training regime scheduler that allows the user to select a set of customized training tasks for training on periodically over an extended span of time (e.g. months). This scheduler may optionally incorporate an automatic reminder service that prompts the user when a scheduled IQ-EQ brain training session is due. Although a variety of scheduling and reminder schemes are readily conceivable, no specific implementations are necessarily preferred.

Another feature that may usefully be implemented is a multiplayer mode wherein a user may play the training tasks in competition with one, or more, other users, either on a shared computer, or on two or more computers connected across a network. For example, in one potential embodiment of a multiplayer variant of the IQ training task two users (player 1 and player 2) sequentially attempt to play the same task across a network. In this variant only one user may play at any one time. Player 1 starts the game whilst player 2 watches player 1's progress on their screen. Play switches between players under three conditions: 1) player 1 makes an error; 2) player 1 deliberately forces player 2's turn; 3) The program randomly switches play to player 2. Points may only be gained by correctly indicating N-Back matches. The user with the highest score at the end of the game wins. Although a variety of such multiplayer implementations are readily conceivable, no specific implementations are necessarily preferred.

The unique aspect of the invention is that it is possible to simultaneously train several aspects of executive function, including working memory updating, inhibition, and set- shifting, within a single task. Other executive function subcomponents, such as memory interference resolution, can also be independently and parametrically varied within the same task in order to provide comprehensive executive function training. Since practically every mental condition can be fundamentally or endophenotypically characterized by a particular profile of strengths and weaknesses in executive functions in combination with a particular profile of pre-conscious attentional biases this single IQ-EQ method can potentially be used to treat practically any mental condition.

In this specification, for convenience the examples have all related to images including words and pictorial representations of targets of interest. However, the invention includes the delivery of targets, stimuli and distracters in a range of different formats and therefore the terms image and images are intended encompasses a variety of formats including static images, video clips and auditory clips. Furthermore, the terms "neurocognitive module parameters" and "neurocognitive variables" have been used interchangeably throughout the specification and will be understood to be equivalent.

The preferred implementation of the invention is as software running on a computer, therefore the present invention extends also to computer programs, on or in a carrier, comprising program instructions for causing a computer to carry out the method and implement the training tool. The computer program may be in source code format, object code format or a format intermediate source code and object code. The computer program may be stored on or in a carrier including any computer readable medium, including but not limited to a floppy disc, a CD, a DVD, a memory stick, a tape, a RAM, a ROM, a PROM, an EPROM, a hardware circuit or a transmissible carrier such as a carrier signal when transmitted either wirelessly and/or through wire and/or cable. The term computer will be understood to encompass a broad range of computing devices used by individuals including but not limited exclusively to a personal computer (PC), a laptop, a netbook, a personal digital assistant, a handheld device such as a mobile phone, Blackberry ® or other mobile computing device. In addition to software implementations, hardware implementations can readily be envisaged.

In this specification the terms "comprise, comprises, comprised and comprising" and the terms "include, includes, included and including" are all deemed totally interchangeable and should be afforded the widest possible interpretation.

The invention is in no way limited to the embodiment hereinbefore described but may be varied in both construction and detail within the scope of the specification.

Claims

Claims:

(1) A training tool comprising an IQ training module having a plurality of neurocognitive variables, each of which exercises a specific sub-component of executive function (EF); and in which a complexity level of at least two of the neurocognitive variables are parametrically adjustable independently of the other neurocognitive variables.

(2) A training tool as claimed in claim 1 in which the neurocognitive variables exercise two or more of an updating sub-component, an inhibition subcomponent, a set-shifting sub-component, a memory interference resolution subcomponent and a divided attention sub-component.

(3) A training tool as claimed in claim 1 or 2 in which the IQ training module comprises a variant of the N-back task, varied through the incorporation of a neurocognitive variable that exercises at least one of an inhibition subcomponent of EF and a set-shifting sub-component of EF.

(4) A training tool as claimed in claim 3 in which the IQ training module comprises an array having a target and a plurality of distracters, and in which the target is periodically updated.

(5) A training tool as claimed in claim 4 in which the position of the target in the array is changed periodically.

(6) A training tool as claimed in claim 4 or 5 in which the size of the target relative to the array is changed periodically.

(7) A training tool as claimed in 4 to 6 in which the prominence of the target relative to the distracters is modified periodically.

(8) A training tool as claimed in claims 4 to 7 in which the distracters are emotionally salient distracters.

(9) A training tool as claimed in claims 4 to 8 in which the distracters are updated periodically.

(10) A training tool as claimed in claims 4 to 9 in which the target and the distracters are images in an image array.

(11) A training tool as claimed in any preceding claim in which there is further provided an EQ training module, the EQ training module comprising an array having an emotionally salient or neutral target and a plurality of emotionally salient distracters.

(12) A training tool as claimed in claim 11 in which the EQ training module further comprises an emotionally salient primer.

(13) A training tool as claimed in claim 12 in which the EQ training tool comprises a sub-array consisting of the primer and the target.

(14) A training tool as claimed in claims 11 to 13 in which there is provided an emotional stimuli calibration test module.

(15) A training tool as claimed in claim 14 in which the EQ training module comprises a plurality of arrays each with an emotionally salient target and a plurality of emotionally salient distracters, and means to select one of the plurality of arrays based on a result from the emotional stimuli calibration test.

(16) A training tool as claimed in any preceding claim in which there is provided means to select an initial complexity level of one or more of the neurocognitive variables.

(17) A training tool as claimed in any preceding claim in which there is provided means to supply one of a target, a distracter and a stimuli for use in the training tool.

(18) A computer implemented method for training the executive functioning of a subject, the method comprising the steps of:

adjusting the complexity level of at least one of the neurocognitive variables in response to a subjects input.

(19) A computer implemented method as claimed in claim 18 in which the neurocognitive variables exercise two or more of an updating sub-component, an inhibition sub-component, a set-shifting sub-component, a memory interference resolution sub-component and a divided attention sub-component.

(20) A computer implemented method as claimed in claim 18 or 19 in which the step of providing an IQ training module comprises providing a variant of the N-back test, varied through the incorporation of a neurocognitive variable that exercises at least one of an inhibition sub-component of EF and a set-shifting subcomponent of EF.

(21) A computer implemented method as claimed in claim 20 in which the step of providing an IQ training module comprises providing an array having a target and a plurality of distracters, and in which the target is periodically updated.

(22) A computer implemented method as claimed in claim 21 in which the position of the target in the array is changed periodically.

(23) A computer implemented method as claimed in claims 21 or 22 in which the size of the target relative to the array is changed periodically.

(24) A computer implemented method as claimed in claims 21 to 23 in which the prominence of the target relative to the distracters is modified periodically.

(25) A computer implemented method as claimed in claims 21 to 24 in which the distracters are emotionally salient distracters.

(26) A computer implemented method as claimed in claims 21 to 25 in which the target and the distracters are images in an image array.

(27) A computer implemented method as claimed in claims 21 to 26 in which the distracters are periodically updated.

(28) A computer implemented method as claimed in claims 18 to 27 in which there is further provided an EQ training module, the EQ training module comprising an EQ array having an emotionally salient or emotionally neutral target and a plurality of emotionally salient distracters.

(29) A computer implemented method as claimed in claim 28 in which the EQ training module further comprises an emotionally salient primer.

(30) A computer implemented method as claimed in claim 29 in which the EQ training tool comprises a sub-array consisting of the primer and the target.

(31) A computer implemented method as claimed in claims 28 to 30 in which there is provided an emotional stimuli calibration test module.

(32) A computer implemented method as claimed in claims 30 to 32 comprising providing a plurality of arrays each with an emotionally salient or neutral target and a plurality of emotionally salient distracters, and selecting one of the plurality of arrays based on a result from the emotional stimuli calibration test.

(33) A computer implemented method as claimed in any of claims 18 to 32 in which the method comprises the step of a user selecting an initial complexity level of one or more of the neurocognitive variables.

(34) A computer implemented method as claimed in claims 18 to 33 comprising the step of a user supplying one of a target, a distracter and a stimuli for use in the training tool.

(35) A computer program product having program instructions for causing a computer to implement the method of any of claims 18 to 34.