Don’t touch that drink! Making serious cognitive testing more engaging for use in substance consumer contexts


Background: Cognition is increasingly recognised as an important contributor to substance treatment outcomes. In particular, the ability to inhibit primed responses is associated with a reduced risk of relapse. Workforce surveys have indicated strong interest in assessment of cognition during substance use treatment but these are poorly utilised due to cost, licencing restrictions, and test factors such as duration and poor appeal to participants. In recent years a ‘serious games’ movement has emerged that aims to develop engaging tools for the assessment of cognition. Here, we aimed to develop an engaging open access, brief, valid assessment of inhibitory control for adoption with substance consuming populations.

Methods: A traditional assessment of inhibitory control, the go-nogo task, was adapted from a whack-a-mole task. Instead of moles, go-stimuli are bottles of healthy drinks (water, juice) and no-go stimuli are bottles of alcohol (beer, wine). As per traditional cognitive assessment tasks, numbers of trials, stimuli presentation time, and proportion of no-go stimuli are all variable. Participant response data (correct responses, reaction time, inhibitory control errors) are stored for analysis. The task was validated against existing measures of inhibitory control and other aligned measures (flankers with no-go, consistent with the NIH-Toolbox; stop-signal task).

Results: The task demonstrated large magnitude correlations with existing measures of inhibitory control and minimal learning effects on repeat assessments. Participants reported greater acceptability of the task than comparative traditional cognitive assessments.

Conclusions: The new task provides a valid assessment of inhibitory control that is also useful for repeat assessments. The software is available free of charge for those working in academic and treatment arenas and is compatible with most Android devices. Norms and interpretation guides for standard assessment are also in development.



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