Objective This study examines how psychological aspects of vestibular disorders are currently addressed highlighting any national variation. Method An online survey was completed by 101 UK healthcare professionals treating vestibular disorders. The survey covered service configurations, attitudes towards psychological aspects and current clinical practice. Results Ninety-six per cent of respondents thought there was a psychological component to vestibular disorders. There was a discrepancy between perceived importance of addressing psychological aspects and low confidence to undertake this. Those with more experience felt more confident addressing psychological aspects. History taking and questionnaires containing one or two psychological items were the most common assessment approaches. Discussing symptoms and signposting were the most frequent management approaches. Qualitative responses highlighted the interdependence of psychological and vestibular disorders which require timely intervention. Barriers included limited referral pathways, resources and interdisciplinary expertise. Conclusion Although psychological distress is frequently identified, suitable psychological treatment is not routinely offered in the UK.

There is evidence to suggest that variations in difficulty during learning can moderate long-term retention. However, the direction of this effect is under contention throughout the literature. According to both the Desirable Difficulties Framework (DDF) and the Retrieval Effort Hypothesis (REH), increasing difficulty (thus relative effort) during retrieval-based learning can help achieve superior long-term retention. One reason for this is due to improved schema formation following a deeper encoding strategy, allowing for more efficient retrieval techniques. A conflicting theory discussed in this review is the Cognitive Load Theory (CLT). The CLT states that conditions for learning are best when extraneous load is reduced, and intrinsic load is optimised. By doing this, germane resources can focus on schema formation. While both theories consider schema formation key to successful retention, the way in which it is best achieved is conflicting. To date, both theories have yet to be compared despite their commonalities. This review evaluates the aforementioned theories, before proposing a new model of difficulty in learning. The proposed model integrates principles from the DDF, REH, and CLT, incorporating insights from Perceptual Load Theory (PLT). It suggests that task difficulty should be adjusted based on the material's complexity and the learner's expertise. Increasing difficulty benefits low-element-interactivity tasks by enhancing focus and retention, while reducing difficulty in high-element-interactivity tasks prevents cognitive overload.

Abstract Introduction People with vestibular disorders frequently experience reduced quality of life and challenges with activities of daily living. Anxiety, depression and cognitive problems often co‐present with vestibular disorders and can aggravate symptoms and prolong clinical recovery. We aimed to gain in‐depth insights into the impact of vestibular disorders and the contribution of psychological factors by exploring multistakeholder perspectives. Methods Semistructured interviews were conducted between October 2021 and March 2022 with 47 participants in the United Kingdom including: 20 patients (age M = 50.45 ± 13.75; 15 females), nine family members (age M = 61.0 ± 14.10; four females), and 18 healthcare professionals. Data were analysed using framework analysis. Results Vestibular disorders impact diverse aspects of patients' lives including work, household chores, socialising, and relationships with family and friends. Being unable to engage in valued activities or fulfil social roles contributes to feelings of grief and frustration, affecting identity, confidence, and autonomy. Anxiety and low mood contribute to negative thought processes, avoidance, and social withdrawal, which can impede clinical recovery through reduced activity levels, and end engagement with treatment. Coping strategies were thought to help empower patients to self‐manage their symptoms and regain a sense of control, but these require oversight from healthcare providers. Conclusions Daily activity limitations, social participation restrictions, and psychological distress can interact to impact quality of life, sense of self, and clinical recovery amongst people with vestibular disorders. Information and resources could aid societal awareness of the impact of vestibular disorders and help patients and families feel understood. An individualised and comprehensive approach that concurrently addresses mental, physical, social, and occupational needs is likely to be beneficial. Patient or Public Contribution Two group meetings were held at the beginning and end of the study with a patient and public involvement network formed of people with vestibular disorders and family members. These individuals commented on the study aims, interview schedule, participant recruitment practices, and interpretation of the themes identified. Two core patient members were involved at all stages of the research. These individuals contributed to the formulation of the interview schedule, development and application of the coding scheme, development and interpretation of themes, and preparation of the final manuscript.

The current study aimed to provide normative paired-associate data for an unexplored logographic language system (Japanese). 240 participants with a mean age of 21.8 (SD = 3.6) were randomly allocated to one of three conditions in an independent groups design: logographic (Japanese symbol - English word), lexical (Japanese word - English word), or abstract paired associates (Japanese symbol - Japanese word). Participants underwent three study-test trials in each condition. Recall accuracy was found to increase across trials whilst relative item difficulty (correlations between trials in each condition) remained similar. A simultaneous multiple regression revealed that Japanese symbol stroke count was the only reliable and significant predictor of recall accuracy. Metacognitive measures, when correlated with recall accuracy, showed that participants were generally aware of how well they had learned the paired associates. Based on prior research into memory for pictures and words, we hypothesized that the recall accuracy of participants in the logographic condition would exceed that of those in the lexical condition. This hypothesis was rejected following a post hoc independent t-test comparing the two groups. This study provides a thorough normative data set that can be customized by researchers for diverse purposes in addition to novel insights, such as revealing participants’ recall accuracy for abstract paired associates for which they had no previous semantic representations.

Anodal transcranial direct current stimulation (tDCS) to the left dorsolateral prefrontal cortex (DLPFC) has been shown to improve performance on a multitude of cognitive tasks. These are, however, often simple tasks, testing only one cognitive domain at a time. Therefore, the efficacy of brain stimulation for complex tasks has yet to be understood. Using a task designed to increase learning efficiency, this study investigates whether anodal tDCS over the left DLPFC can modulate both learning ability and subsequent long-term memory retention. Using a within-subject design, participants ( N = 25) took part in 6 training sessions over consecutive days in which active or sham stimulation was administered randomly (3 of each). A computer-based task was used, containing flags from countries unknown to the participants. Each training session consisted of the repetition of 8 pairs of flag/country names. Subsequently, in three testing sessions, free, cued, and timed cued recall, participants were assessed on all 48 flags they had learnt. No difference in learning speed between active and sham tDCS was found. Furthermore, in the timed cued recall phase, flags learnt in the sham tDCS sessions were recalled significantly better than flags learnt in the active tDCS sessions. This effect was stronger in the second testing session. It was also found that for the flags answered incorrectly; thus, meaning they were presented more frequently, subsequent long-term retention was improved. These results suggest that for a complex task, anodal tDCS is ineffective at improving learning speed and potentially detrimental to long-term retention when employed during encoding. This serves to highlight the complex nature of brain stimulation, providing a greater understanding of its limitations and drawbacks.

The present study used event-related potentials (ERPs) to examine differences in the temporal dynamics of emotion processing in young and older adults, with a specific focus on the positivity effect, that is, the preferential processing of positive over negative information. To this aim, we used a language paradigm that allowed us to investigate early ERP components as well as later components, namely the N400 and the late positive complex (LPC). Young and older adults were presented with neutral sentence stems with positive, negative or neutral/semantically-incongruent critical word endings while their electrical brain activity was recorded. There were no effects of emotional valence on early ERP components. Instead, a positivity effect was evident in young adults indexed by reduced N400s for positive sentence endings. Perhaps due to reduced semantic processing abilities, older adults did not show any N400 effect. ERP effects in this group were evident at a later processing stage and took the form of larger LPCs for neutral/incongruent information. Overall, there was no effect of emotional valence on either the N400 or the LPC in older adults. Our data suggest that with age, more effortful semantic processing may deplete resources for emotional processing.

1 School of Sports and Exercise Sciences, Urmia University, Urmia, Iran; 2 School of Psychology, University of Kent, Canterbury, UK; wp77@kent.ac.uk 3 School of Sports and Exercise Sciences, Urmia University, Urmia, Iran; ha.moha64@gmail.com 4 Department of Neuroscience, Iran University of Medical Sciences, Tehran, Iran; nazaripsycho@yahoo.com 5 School of Psychology, University of Kent, Canterbury, UK; Institute of Behavioral Neuroscience, University College London, London, UK; School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran; a.h.javadi@gmail.com

Objectives Many studies have looked at the effects of physical exercise on long-term memory. However, to date, no study has compared the effect of different intensities and protocols of physical exercise and different rest conditions on long-term memory. Methods In three studies (N=59) we measured the extent that physical exercise (in its varying intensities) and wakeful rest (active-rest; in which participants were cognitively engaged while seated and passive-rest; no cognitive engagement while seated) could influence long-term memory. Across all three studies, nearly identical procedures were employed, using the same old/new recognition memory test in order to establish the most effective protocol for cognitive enhancement. In Study 1, the effects of continuous moderate intensity exercise, uninterrupted wakeful rest (passive) and rest with an engagement task (active) were explored. In Study 2, continuous moderate intensity exercise was compared to high-intensity interval training (HIIT) and passive rest. Study 3 observed the effects of low-, moderate- and high-intensity continuous exercise. Results Across the three studies moderate intensity exercise had the greatest positive impact on memory performance. Passive rest was more effective than active rest, however, less than high-intensity interval-training (HIIT). Conclusion Our findings suggest that it is not necessary to physically overexert oneself in order to achieve observable improvements to long-term memory. By also investigating uninterrupted wakeful rest, it reaffirmed the importance of the consolidation period for the formation of long-term memories.

Objectives This experiment assessed the effectiveness of three interventions; neurofeedback, motor imagery and physical training, on their ability to improve visuomotor accuracy, measured by scores achieved on a dart throwing task. Methods Thirty-two female participants, all with no experience in dart throwing, took part and were assigned to either one of the three experimental conditions, or a control group (eight per condition). Training sessions for neurofeedback (NFB) involved participants encouraging both Theta rhythms and Sensorimotor rhythms (SMR). For Motor Imagery (MI), internal (1st person) imagery was used, where participants had to imagine throwing a dart and for physical training (PT) participants physically practised dart throwing. Measurements were recorded pre-intervention, after two weeks (6 sessions) of training (mid-intervention), after 5 weeks (15 sessions) of training (in total; Outcome Measure 1) and again two weeks after training had finished (Outcome Measure 2). Results from Mid-intervention, Outcome Measure 1 and Outcome Measure 2 were compared to baseline scores achieved pre-intervention and showed all three interventions to significantly increase performance on dart throwing compared to the Control group. Conclusion Our findings show that, as well as traditional physical practise, both motor imagery and neurofeedback can effectively improve performance on a fine visuomotor task.