Cognitive and neuropsychological correlates of the attention training technique: a systematic review and evidence synthesis

IntroductionThe Attention Training Technique (ATT) is a brief metacognitive intervention recognised as a possibly efficacious standalone transdiagnostic treatment for emotional disorders. The cognitive and neuropsychological mechanisms underlying its clinical effects are of particular interest in understanding and developing the technique. The aim of the systematic review was to synthesise and evaluate the cognitive-attentional task performance and neurocognitive correlates of ATT in the context of theoretical mechanisms from which ATT is derived.MethodsFive electronic databases (PsycINFO, MEDLINE, PubMed, Web of Science and EMBASE) were searched from January 1990 to November 2025. Studies that used ATT as part of a metacognitive multi-component treatment package or combined with other therapy/technique(s) were excluded. Sample inclusion was diverse to capture effects on non-clinical and clinical individuals and across age groups for potential sub-group analyses.ResultsIn total, 20 studies with 1, 230 participants met the inclusion criteria. Four studies included clinical samples, four studies included non-clinical participants, two studies used experimental induction of pain or mind wandering, and 10 used healthy samples of which two used school children. Study quality varied from strong to weak with the majority receiving ‘moderate’ ratings. Across 14 cognitive-attentional tasks and three neural methodologies (EEG, fNIRS, fMRI), the review found small to large cognitive and neural effects associated with ATT. Nine cognitive tasks showed significant ATT-dependent effects in at least one study, with the most consistency shown on the emotional dot-probe. Neural findings across all methodologies converged, suggesting that ATT modulates cognitive control, frontoparietal, dorsal attention networks and reduces default mode network connectivity.DiscussionInterpretation and synthesis of findings based on the S-REF model are consistent with cognitive and neural effects involving reduced threat monitoring, improved executive control, and enhanced disengagement from self-referential processing; central theoretical mechanisms and design parameters of ATT. Where inconsistencies across study effects emerged, they may be due to heterogeneity in cognitive task and measurement factors and ATT protocol deviations. Future research on individual differences in neurocognitive effects associated with ATT across clinical and sub-clinical populations is needed. Studies must safeguard fidelity and adherence to the ATT protocol and improve reporting of these important factors.Systematic review registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024483053.

Gaming-based program for internet gaming disorder: feasibility and preliminary outcomes of a structured camp program

BackgroundAlthough controlled trials support several psychosocial interventions for adolescent internet gaming disorder (IGD), short, highly structured residential camp formats remain underreported, particularly regarding feasibility, safety, and process data from routine service settings.ObjectiveTo evaluate the feasibility, safety, and short-term entry-to-exit signals of a structured gaming-based camp program using retrospective, de-identified routinely collected service data, with a focus on implementation evidence for a brief, highly structured residential format.MethodsWe conducted a single-group entry-to-exit evaluation of a 7-day structured camp in 12 adolescents aged 11–16 years clinically diagnosed with IGD by psychiatrists using DSM-5 criteria. Entry and exit assessments were organized hierarchically, with the Gaming Disorder Screening Scale (GDSS), the Game Addiction Scale–7 (GAS-7), and the Visual Analog Scale (VAS) craving score as primary outcomes; the Barratt Impulsiveness Scale–11 (BIS-11), Zung Self-Rating Depression Scale (SDS), Zung Self-Rating Anxiety Scale (SAS), Social Avoidance and Distress Scale (SADS), and Chinese version of the Interpersonal Reactivity Index (IRI-C) as supportive secondary outcomes; and camp residential counselor–rated Conners scores and the Stroop task as exploratory external-rating and objective complementary indicators, respectively. Wilcoxon signed-rank tests reported effect size r and Hodges–Lehmann (HL) median difference with 95% CI. Exploratory Spearman correlations examined baseline characteristics and change.ResultsCompletion was 100% (12/12) and attendance 98.6% (142/144), with no serious adverse events; two participants had a brief single-session interruption (coded as non-attendance for that session-person) but completed subsequent sessions and exit assessment. Primary outcomes decreased at exit: GDSS 50.00 (SD 8.32) to 28.67 (SD 8.98), p<0.001, r=0.88, HL −20.5 (95% CI −27.0 to −16.5); GAS-7 21.50 (SD 6.57) to 13.33 (SD 4.44), p=0.003, r=0.89, HL −8.5 (95% CI −12.5 to −6.0); VAS 4.25 (SD 2.63) to 2.75 (SD 2.05), p=0.012, r=0.85, HL −2.0 (95% CI −3.0 to −1.0). High-risk GDSS decreased from 66.7% to 0%, GAS-7 positivity from 58.3% to 8.3%, and moderate-to-severe craving from 58.3% to 25.0%. BIS-11, SDS, and IRI-C showed supportive short-term changes, and counselor-rated Conners scores showed exploratory external-rating changes, whereas SAS and SADS did not. Stroop reaction time decreased and accuracy increased in both conditions, while interference effects did not change significantly. Baseline PSQI correlated with change in VAS craving (ρ=0.767, p=0.004).ConclusionsThis pilot program evaluation suggests that a short, highly structured gaming-based residential camp can be delivered feasibly and safely and may be associated with short-term reductions in IGD symptom severity and craving. Its main value is to provide early implementation and short-term signal data for a service-based camp format that should be tested in subsequent controlled studies with follow-up.

Optimizing Digital Cardiac Rehabilitation Using the Multiphase Optimization Strategy: Mixed Methods Feasibility Study

<strong>Background:</strong> Cardiac rehabilitation (CR) is an evidence-based, multicomponent intervention. However, participation in and reach of CR remain suboptimal globally. Digital CR is a promising alternative to traditional center-based CR, with the potential to increase intervention reach and efficiency. However, efforts to increase the efficiency of digital CR require an understanding of the relative effectiveness of the components of CR, which is currently lacking. The Multiphase Optimization Strategy provides a framework to evaluate the effects of individual components within complex interventions. <strong>Objective:</strong> This mixed methods study explored the feasibility and acceptability of implementing the procedures of a factorial design and delivering multiple intervention components in preparation for an optimization randomized controlled trial of a digital CR intervention. <strong>Methods:</strong> Patients attending CR in a community setting were randomized to 1 of 8 experimental conditions in a 2 × 2 × 2 (2<sup>3</sup>) factorial trial design. Each condition received a different combination of three intervention components over a 6-week study period (1) goal setting and self-monitoring, (2) education, and (3) feedback messages. Feasibility was assessed through intervention fidelity (eg, usage statistics) and outcome measure data completeness. Acceptability was measured using the System Usability Scale, a questionnaire, and semistructured interviews based on the Theoretical Framework of Acceptability. <strong>Results:</strong> A total of 8 participants were recruited and retained in the study. The mean age was 75 (SD 5.6) years, and the majority were female (5/8, 62.5%). The digital CR intervention demonstrated good usability (System Usability Scale score 72.1, SD 19.1), and 83.3% (5/6) of participants found the digital technology acceptable. However, only half (2/4, 50%) found the feedback messages acceptable. Fidelity was high for goal setting/self-monitoring and feedback but lower for education. Qualitative findings indicated that participants held positive attitudes toward the intervention and reported improvements in physical activity, although many expressed a preference for more tailored feedback and 2-way communication. Of the 3 prespecified progression criteria, usability met the “Go” criterion, whereas intervention fidelity, acceptability, and outcome measure data completeness met the “Amend” threshold. <strong>Conclusions:</strong> This study demonstrated the feasibility of implementing a factorial design and delivering multiple intervention components within a digital CR intervention. While the intervention was generally acceptable, modifications to the education and feedback components are necessary prior to conducting a pilot optimization randomized controlled trial.

Learning to lead in a hybrid human-AI enterprise

As adoption of AI agents looks set to surge by as much as 300% in the next two years, leadership teams are carefully considering the implications of a hybrid human-AI workforce. 

Unlike existing enterprise-level automation that relies on manual input, AI agents are capable of autonomously coordinating complex tasks, interacting with multiple tools and environments across an organization. In early applications that center on customer service, HR, and sales, adoption of agentic AI has led to productivity gains of 30-50%

Their autonomy positions agents more as collaborators than tools, working side-by-side with human employees in blended teams that look poised to upend traditional workplace dynamics. 

More than three-quarters of HR leaders believe that the deployment of AI agents will transform existing workplace norms, driving a complete reappraisal of how roles and responsibilities are distributed, how skills are prioritized, and how workplace culture is shaped.

Though many admit they’re in the early or preparatory phase of this shift, 86% of chief HR officers predict that navigating digital labor shaped by agentic AI will be a central component of their role in the years ahead.

Fluency in the change management aspect of agentic AI adoption will be a crucial differentiator when it comes to unlocking the full potential of the technology going forward, believes Ateet Jayaswal, chief culture and employee experience officer at Wipro, a leading technology services and consulting company. This moment is one that he says, “calls for a mindset shift in how HR leaders would enable their organizations.”

Redeploying roles to enable higher-value work

As AI agents assume ownership of more complex and integral tasks, the distribution of roles and responsibilities within an organization will undergo significant change. It’s estimated that three-quarters of current roles will require redesign, reskilling, or redeployment by 2030 as a result of agentic AI. 

For leadership, this shift should be about reskilling employees toward higher-value work in order to optimize the potential of an agent-human hybrid workforce, says Jayaswal. 

For example, Wipro is a complex organization of 240,000 employees across 65 countries. It previously had multiple policies, documents, and knowledge fragmented across different systems, which delayed response to employee queries. 

But the company has recently integrated a custom agentic AI assistant—an agent co-created in partnership with enterprise agentic AI platform Ema Unlimited—that can swiftly navigate this complex system, assuming responsibility for 50 HR tasks that had previously fallen to human employees. With the help of an AI agent, average response time to queries has lowered from 48 hours to five seconds. 

Human employees have more time to focus on work “that requires a creative and imaginative mind and cross-functional collaboration, leveraging diverse ideas and thoughts to problem-solve,” says Jayaswal. The AI agent, meanwhile, handles rote administrative tasks like sorting timesheets or helping employees navigate policies and take actions in the flow of work. 

When reallocating employee responsibilities, though, it is imperative that humans remain in the loop, Jayaswal caveats. When agentic AI is incorporated into enterprise technology, it must work with sensitive and personal data and therefore needs even more stringent guardrails and constraints than consumer applications. “When you expose an AI agent to organizational data, when you integrate it into multiple enterprise systems, then pathways around the AI agent become extremely important,” he says. “It’s an evolving space that leadership needs to have front-of-mind.” Governance should include robust data privacy rules and the establishment of governance layers, such as an AI council, he suggests.  

At a fundamental level, the adoption of AI agents will force a re-evaluation of human roles, believes Jayaswal. Rather than employees primarily performing repetitive tasks or troubleshooting, a significant proportion of their time will shift to designing, teaching, and optimizing an AI agent that can do this work for them with far greater speed and predictability and without the agent getting bored. 

“The nature of your job changes from being the hero who comes in to solve the problem to designing the hero who can solve the problem,” he summarizes. “The individuals who I have seen thrive in this environment are the ones who make this shift.”

An evolving employee skillset

Just as roles and responsibilities will be reconfigured to reflect the input of AI agents, the core skills of human employees will be reprioritized. More than four in five HR leaders say they’re planning to reskill workers to become more competitive in a market shaped by AI agents. 

Technical skills will be increasingly important. Leading employers such as Salesforce, Danone, and Walmart are already rolling out dedicated AI and digital skills programs that aim to equip everyone from frontline workers to C-suite executives with a baseline level of AI literacy in response to the pervasiveness of the technology. 

But desirable soft skills will also evolve, Jayaswal points out. Employees who assign tasks to an AI agent need to plainly articulate what modular steps may be needed to accomplish a task, what the desired outcome should be, and what parameters or guardrails need to be in place to ensure the agent doesn’t access or share confidential data. 

As HR executives adapt to a blended workforce, three skills are emerging as top priorities during recruitment, according to a recent survey: relationship building, like forging constructive partnerships and account management; collaboration; and adaptability. 

Maintaining a healthy workplace culture

In freeing up human employees to focus on higher-value tasks, the hope is that AI agents can elevate the employee experience, deepening fulfilment and satisfaction in the workplace. 

“At Wipro, our vision is to improve the life of Wiproites,” says Jayaswal. “We are taking away non-value added work by embracing modern ways of collaborating, engaging, and transacting, leaving associates with higher order work content.” 

But leadership teams embracing agentic AI will also need to plan for the new pressures and stressors that the technology can place on a workforce. 

There is already confusion and knowledge gaps, with 73% of HR leaders reporting their employees don’t yet understand how digital labor will impact their work. Many organizations have opted to define AI agents as teammates or colleagues on org charts, but new research says this could erode trust and a sense of professional identity. It also raises new questions around accountability and ownership. 

The role of management in addressing these concerns is critical, says Jayaswal. To maintain healthy dynamics, managers need to become skilled at orchestrating blended systems, splitting their focus between supervising AI agents and motivating human employees as they also build and supervise AI agents.

Upgrading employee well-being programs will be a core part of maintaining a robust workplace culture. “As there are more interactions with AI agents, you are losing some of the human touch that was provided by service delivery partners or leaders, or often even by colleagues and peers,” Jayaswal says. Employee services that encourage social connection and empathetic communication may help teams navigate this. 

A breakneck transformation

Agentic AI looks set to scale at breakneck speed across many enterprises, and it will significantly transform how these organizations operate. 

Carefully considering and deciding how to adapt to this newly blended workforce is now a top priority for leadership teams. Reviewing and refining organizational strategies is essential for optimizing both technological gains and the employee experience.

This content was produced by Insights, the custom content arm of MIT Technology Review. It was not written by MIT Technology Review’s editorial staff. It was researched, designed, and written by human writers, editors, analysts, and illustrators. This includes the writing of surveys and collection of data for surveys. AI tools that may have been used were limited to secondary production processes that passed thorough human review.

Genome Wide Analysis Broadens Genetic Knowledge of Anxiety

A large European meta-analysis led by King’s College London has revealed 39 new areas of the genome linked to symptoms of anxiety and provided new estimates of heritability of this common condition.

Writing in Nature Human Behaviour, the researchers explain they found 80 variants linked to anxiety in 74 specific areas of the genome, but 35 were already known to be linked to the disorder from previous research.

“These correlations highlight the interconnection between mental and physical health,” said Brittany Mitchell, PhD, a senior researcher at the QIMR Berghofer medical research institute and co-first author on the study in a press statement.

“Importantly, while some shared genetic variants may increase risk for both a physical health condition and more severe anxiety symptoms, it’s also true that living with chronic pain or illness can contribute to anxiety symptoms. Our findings don’t reveal causation or the direction of effect, but they do open up important questions for future research.”

Anxiety disorders are very common mental health conditions across the globe with large variations in severity from mild to debilitating. Previous research has attempted to assess the genetic heritability of anxiety but estimates of how heritable this condition is vary widely.

In this study, genetic data from 14 cohorts of people with generalized anxiety symptoms assessed via self-report questionnaires between 2007 and 2023 was combined to carry out a large meta-analysis of 693,869 people. Most of the cohorts were largely made up of people of European ancestry, for example, the UK Biobank, and mostly came from Europe or North America.

In addition to finding the new variants, the team also created a polygenic risk score for anxiety aggregating genome-wide SNP effects. Overall, the estimated SNP-based heritability was around 6% and the team estimated that about 1-3% of variance in anxiety symptom severity could be attributed to genetics according to the polygenic risk score.

Notably the research also highlighted some links between the genetics of anxiety and other conditions like irritable bowel syndrome, coronary artery disease, and migraine.

“Given the high and rising rates of anxiety, especially in young adults, it is more important than ever to improve our ability to identify and understand sources of risk,” write the authors.

“Despite its public health impact, progress in anxiety genetics lags behind other major mental health conditions. We hope our findings encourage genome-wide investigations leveraging existing but potentially underutilized anxiety severity data in genotyped cohorts, accelerating our progress in understanding the genetic architecture of anxiety.”

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