Attention Training

● Attending and exercising cognitive control are vital aspects of human

adaptability.
● Attention training is based on the premise that attentional abilities can
be improved by activating particular aspects of attention through a
stimulus drill approach.
● Attention can be improved by repetition of a specific task that involves
an attention network (network training), or by exercise or meditation
that changes the brain state (state training).
● We consider two brain training strategies to improve attention and
other cognitive functions. Network training involves the practice of a
cognitive task thought to exercise specific brain networks related to
attention. State training, on the other hand, uses practice designed to
develop a brain state that may influence attention and other networks.
State training also involves networks, but it does not include cognitive
tasks explicitly designed to train a network. Both aerobic exercise and
meditation training can establish a state that appears to improve
cognition, attention and mood.

Training attention networks

Since attention involves a number of neural networks with different
functions, there are many ways to improve one or more of these functions
and thereby improve the efficiency of the network.

● ANT is an attentional assay that uses the Ericksen flanker task as a

target.
● The Ericksen flanker task is a paradigm in which participants are
asked to respond to a centred and directed item surrounded or
flanked by distracting symbols like arrows or letters. Congruent
flanking arrows all point in the same direction; incongruent flanking
arrows point in different directions. Congruency affects the speed and
accuracy with which the task is performed.
● The ANT requires participants to determine whether central arrow
points are left or right. Participants press the left key if the central
arrows point left and the right key if they point right. Prior to a target,
cues are used to provide information about when and where the
target will be presented.
● Three subtractions provide scores for alerting, orienting and time to
resolve conflict (executive attention). The measure of the efficiency of
conflict resolution (executive attention) is given by subtracting the
congruent RTs from the incongruent RTs. The alerting measure is
given by subtracting the double cue (asterisks above and below
fixation) from the no cue condition; the orienting measure is by
subtracting the RTs when the cue is at the target location from those
where it is presented at fixation.
● There may be ways to enhance the success of network training. For
example, there is evidence that training parents can greatly enhance
the effectiveness of child training, presumably by getting the parent to
support home activity [22]. It is also possible that brain stimulation
through scalp electrodes or trans-cortical magnetic stimulation (TMS)
may improve plasticity and enhance training [23].
Training brain states
A number of methods have been proposed for training a brain state that will
foster attention and self-regulation.

AST refers to changes in state that accompany certain forms of experience

such as meditation or exposure to nature. These methods have in common
an altered state of mind and body but they use different sensory inputs to
achieve their effects on mind and body and improve performance. They
also include measures of self-regulation such as mood and response to
stress.

Exposure to nature

When people are required to focus their attention and put forth a sustained
cognitive effort, there is a possibility of mental fatigue. Attention restoration
theory was proposed by Kaplan [16,17] to highlight the benefits of exposure
to nature to restore directed attention. Mental restoration seems to work by
encouraging a period of higher levels of involuntary attention while
decreasing directed, voluntary attention to restore efficient mental effort.
Recent psychological studies comparing an experimental group exposed to
pictorial scenes of nature with a control group exposed to urban scenes
indicated that interacting with nature improves executive attention.

The mechanism for improved attention after nature exposure was thought
to be because of a state change restoring attentional efficiency. Recent
studies have shown that performing mental tasks involving cognitive control
can lead to a reduction in systemic glucose. Replenishment of glucose
leads to a return to high levels of performance. These data indicate that
sustained mental effort can produce a state of fatigue that influences
performance.

Mindfulness

Mindfulness is awareness of one’s present thoughts, emotions or actions.

Mindfulness training involves bringing one’s awareness back from the past
or the future into the present moment. Many studies have shown the
training effects of mindfulness, including reduced pain and stress,
improvement of cognitive functioning and positive emotion. Mindfulness
requires awareness of the present moment and focuses mainly on changes
in the state of the mind.
One study observed changes in performance on the second of two
repeated target stimuli during the rapid visual presentation. Failure of
people to detect a second target soon after the first has been called ‘the
attentional blink’. Three months of intensive mental training resulted in
improved second target detection (reduced attentional blink) and also
reduced brain-resource allocation to the first target, indicating that mental
training can result in increased control over the distribution of limited brain
resources, resulting in an improvement in the executive attention network.

IBMT

Integrative Body-Mind Training (IBMT) originates from ancient Eastern

tradition. IBMT does not stress efforts to control thoughts, but instead
induces a state of restful alertness, enabling a high degree of awareness of
body, mind and external instructions. It seeks a balanced state of relaxation
while focusing attention. Control of thought is achieved gradually through
posture and relaxation. The coach works to achieve a balanced and
harmonious state rather than having the trainee attempt an internal struggle to
control thoughts in accordance with the instruction.

In short, IBMT improves attention and self-regulation through state changes

involving both body and mind. Training leads to better performance in
cognition, emotion and social behaviours [15]. The combined use of body
and mind training is also supported by studies of embodied cognition, in
which changes in the body, particularly in facial expression, influence
emotional processing and facilitate retrieval of autobiographical memories.
Attention Training Technique(ATT)
ATT is a component of metacognitive therapy based on a transdiagnostic
model of emotional disorders by Wells (2009). The self-regulatory executive
function (S-REF) model provides the theoretical basis for the metacognitive
model and therapy more broadly (Wells and Matthews, 1996; Wells, 2009).
The S-REF model proposes that sustained inflexible styles of thinking in
response to negative thoughts, feelings and beliefs lead to long-term
emotional distress. An individual may for example experience the thought “I
will get a new heart attack soon” and experience negative emotions (e.g.,
anxiety) because of the thought. If the individual easily dismisses this
thought, the negative emotion associated with it is likely to dissipate.
However, if the person responds with perseverative thinking (worry,
rumination), the person is likely to experience persistent negative emotions.
Furthermore, if the person has the belief that the sustained processing style
is helpful (“If I worry about having a heart attack it is less likely to happen”)
it may lead to the persistence of the processing in terms of worry and
rumination.
The Attention Training Technique (ATT; Wells, 1990) is a 12-minute audio
recording that was developed to train attention control so that individuals
could learn to shift their attention away from maladaptive cognitive
processes such as worry. The technique has shown to be promising at
reducing symptoms across a variety of mental disorders (Knowles, Foden,
El-Deredy, & Wells, 2016) and is recommended for use in people who
suffer from chronic worry.
ATT aims to disrupt prolonged inflexible self-focused worry and
rumination-based thinking styles that develop and maintain psychological
distress. ATT seeks to weaken the internal focus of attention and
strengthen the external focus of attention and thereby reducing
preservative thinking in terms of worry and rumination.