Stop signals decrease choices for palatable foods through decreased food evaluation

What Is Trained During Food Go/No-Go Training? A Review Focusing on Mechanisms and a Research Agenda

Purpose of Review

During food go/no-go training, people consistently withhold responses toward no-go food items. We discuss how food go/no-go training may change people’s behavior toward no-go food items by comparing three accounts: (a) the training strengthens ‘top-down’ inhibitory control over food-related responses, (b) the training creates automatic ‘bottom-up’ associations between no-go food items and stopping responses, and (c) the training leads to devaluation of no-go food items.

Recent Findings

Go/no-go training can reduce intake of food and choices for food and facilitate short-term weight loss. It appears unlikely that food go/no-go training strengthens top-down inhibitory control. There is some evidence suggesting the training could create automatic stop associations. There is strong evidence suggesting go/no-go training reduces evaluations of no-go food items.

Summary

Food go/no-go training can change behavior toward food and evaluation of food items. To advance knowledge, more research is needed on the underlying mechanisms of the training, the role of attention during go/no-go training, and on when effects generalize to untrained food items.

Training response inhibition to reduce food consumption: Mechanisms, stimulus specificity and appropriate training protocols

Training individuals to inhibit their responses towards unhealthy foods has been shown to reduce food intake relative to a control group. Here we aimed to further explore these effects by investigating the role of stimulus devaluation, training protocol, and choice of control group. Restrained eaters received either inhibition or control training using a modified version of either the stop-signal or go/no-go task. Following training we measured implicit attitudes towards food (Study 1) and food consumption (Studies 1 and 2). In Study 1 we used a modified stop-signal training task with increased demands on top-down control (using a tracking procedure and feedback to maintain competition between the stop and go processes). With this task, we found no evidence for an effect of training on implicit attitudes or food consumption, with Bayesian inferential analyses revealing substantial evidence for the null hypothesis. In Study 2 we removed the feedback in the stop-signal training to increase the rate of successful inhibition and revealed a significant effect of both stop-signal and go/no-go training on food intake (compared to double-response and go training, respectively) with a greater difference in consumption in the go/no-go task, compared with the stop-signal task. However, results from an additional passive control group suggest that training effects could be partly caused by increased consumption in the go control group whereas evidence for reduced consumption in the inhibition groups was inconclusive. Our findings therefore support evidence that inhibition training tasks with higher rates of inhibition accuracy are more effective, but prompt caution for interpreting the efficacy of laboratory-based inhibition training as an intervention for behaviour change.

Cue avoidance training and inhibitory control training for the reduction of alcohol consumption: a comparison of effectiveness and investigation of their mechanisms of action

RATIONALE

Both cue avoidance training (CAT) and inhibitory control training (ICT) reduce alcohol consumption in the laboratory. However, these interventions have never been directly compared and their mechanisms of action are poorly understood.

OBJECTIVES

We compared the effects of both types of training on alcohol consumption and investigated if they led to theoretically predicted changes in alcohol avoidance (CAT) or alcohol inhibition (ICT) associations and changes in evaluation of alcohol cues.

METHODS

Heavy drinking young adults (N = 120) were randomly assigned to one of four groups: (1) CAT (repeatedly pushing alcohol cues away with a joystick), (2) sham (control) CAT; (3) ICT (repeatedly inhibiting behaviour in response to alcohol cues); or (4) sham (control) ICT. Changes in reaction times and automatic evaluations of alcohol cues were assessed before and after training using assessment versions of tasks used in training and the implicit association test (IAT), respectively. Finally, participants completed a bogus taste test as a measure of ad libitum alcohol consumption.

RESULTS

Compared to sham conditions, CAT and ICT both led to reduced alcohol consumption although there was no difference between the two. Neither intervention affected performance on the IAT, and changes in reaction time did not suggest the formation of robust alcohol avoidance (CAT) or alcohol inhibition (ICT) associations after training.

CONCLUSIONS

CAT and ICT yielded equivalent reductions in alcohol consumption in the laboratory. However, these behavioural effects were not accompanied by devaluation of stimuli or the formation of alcohol avoidance or alcohol inhibition associations.

Neural mechanisms of cue-approach training

Biasing choices may prove a useful way to implement behavior change. Previous work has shown that a simple training task (the cue-approach task), which does not rely on external reinforcement, can robustly influence choice behavior by biasing choice toward items that were targeted during training. In the current study, we replicate previous behavioral findings and explore the neural mechanisms underlying the shift in preferences following cue-approach training. Given recent successes in the development and application of machine learning techniques to task-based fMRI data, which have advanced understanding of the neural substrates of cognition, we sought to leverage the power of these techniques to better understand neural changes during cue-approach training that subsequently led to a shift in choice behavior. Contrary to our expectations, we found that machine learning techniques applied to fMRI data during non-reinforced training were unsuccessful in elucidating the neural mechanism underlying the behavioral effect. However, univariate analyses during training revealed that the relationship between BOLD and choices for Go items increases as training progresses compared to choices of NoGo items primarily in lateral prefrontal cortical areas. This new imaging finding suggests that preferences are shifted via differential engagement of task control networks that interact with value networks during cue-approach training.

Executive functions and consumption of fruits/ vegetables and high saturated fat foods in young adults

Executive functions play a critical role in regulating eating behaviors and have been shown to be associated with overeating which over time can result in overweight and obesity. There has been a paucity of research examining the associations among healthy dietary behaviors and executive functions utilizing behavioral rating scales of executive functioning. The objective of the present cross-sectional study was to evaluate the associations among fruit and vegetable consumption, intake of foods high in saturated fat, and executive functions using the Behavioral Rating Inventory of Executive Functioning-Adult Version. A total of 240 university students completed the Behavioral Rating Inventory of Executive Functioning-Adult Version, the 26-Item Eating Attitudes Test, and the Diet subscale of the Summary of Diabetes Self-Care Activities Questionnaire. Multiple linear regression analysis was conducted with two separate models in which fruit and vegetable consumption and saturated fat intake were the outcomes. Demographic variables, body mass index, and eating styles were controlled for in the analysis. Better initiation skills were associated with greater intake of fruits and vegetables in the last 7 days (standardized beta = -0.17; p < 0.05). Stronger inhibitory control was associated with less consumption of high fat foods in the last 7 days (standardized beta = 0.20; p < 0.05) in the multiple linear regression analysis. Executive functions that predict fruit and vegetable consumption are distinct from those that predict avoidance of foods high in saturated fat. Future research should investigate whether continued skill enhancement in initiation and inhibition following standard behavioral interventions improves long-term maintenance of weight loss.

Mechanisms of Choice Behavior Shift Using Cue-approach Training

Cue-approach training has been shown to effectively shift choices for snack food items by associating a cued button-press motor response to particular food items. Furthermore, attention was biased toward previously cued items, even when the cued item is not chosen for real consumption during a choice phase. However, the exact mechanism by which preferences shift during cue-approach training is not entirely clear. In three experiments, we shed light on the possible underlying mechanisms at play during this novel paradigm: (1) Uncued, wholly predictable motor responses paired with particular food items were not sufficient to elicit a preference shift; (2) Cueing motor responses early – concurrently with food item onset – and thus eliminating the need for heightened top–down attention to the food stimulus in preparation for a motor response also eliminated the shift in food preferences. This finding reinforces our hypothesis that heightened attention at behaviorally relevant points in time is key to changing choice behavior in the cue-approach task; (3) Crucially, indicating choice using eye movements rather than manual button presses preserves the effect, thus demonstrating that the shift in preferences is not governed by a learned motor response but more likely via modulation of subjective value in higher associative regions, consistent with previous neuroimaging results. Cue-approach training drives attention at behaviorally relevant points in time to modulate the subjective value of individual items, providing a mechanism for behavior change that does not rely on external reinforcement and that holds great promise for developing real world behavioral interventions.

Dissonance-Based Eating Disorder Prevention Program Reduces Reward Region Response to Thin Models; How Actions Shape Valuation

Research supports the effectiveness of a dissonance-based eating disorder prevention program wherein high-risk young women with body dissatisfaction critique the thin ideal, which reduces pursuit of this ideal, and the theory that dissonance induction contributes to these effects. Based on evidence that dissonance produces attitudinal change by altering neural representation of valuation, we tested whether completing the Body Project would reduce response of brain regions implicated in reward valuation to thin models. Young women with body dissatisfaction were randomized to this intervention or an educational control condition, completing assessments and fMRI scans while viewing images of thin versus average-weight female models at pre and post. Whole brain analyses indicated that, compared to controls, Body Project participants showed greater reductions in caudate response to images of thin versus average-weight models, though participants in the two conditions showed pretest differences in responsivity of other brain regions that might have contributed to this effect. Greater pre-post reductions in caudate and putamen response to thin models correlated with greater reductions in body dissatisfaction. The finding that the Body Project reduces caudate response to thin models provides novel preliminary evidence that this intervention reduces valuation of media images thought to contribute to body dissatisfaction and eating disorders, providing support for the intervention theory by documenting that this intervention alters an objective biological outcome.

Stimulus devaluation induced by action stopping is greater for explicit value representations

We recently showed that rapidly stopping an action in the face of a reward-related stimulus reduces the subjective value of that stimulus (Wessel et al., 2014). In that study, there were three phases. In an initial learning phase, geometric shapes were associated with monetary value via implicit learning. In a subsequent treatment phase, half the shapes were paired with action stopping, and half were not. In a final auction phase, shapes that had been paired with stopping in the treatment phase were subjectively perceived as less valuable compared to those that were not. Exploratory post hoc analyses showed that the stopping-induced devaluation effect was larger for participants with greater explicit knowledge of stimulus values. Here, we repeated the study in 65 participants to systematically test whether the level of explicit knowledge influences the degree of devaluation. The results replicated the core result that action stopping reduces stimulus value. Furthermore, they showed that this effect was indeed significantly larger in participants with more explicit knowledge of the relative stimulus values in the learning phase. These results speak to the robustness of the stopping-induced devaluation effect, and furthermore imply that behavioral therapies using stopping could be successful in devaluing real-world stimuli, insofar as stimulus values are explicitly represented. Finally, to facilitate future investigations into the applicability of these findings, as well as the mechanisms underlying stopping-induced stimulus devaluation, we herein provide open source code for the behavioral paradigm.

Does inhibitory control training improve health behaviour? A meta-analysis

OBJECTIVES

Inhibitory control training has been hypothesised as a technique that will improve an individual's ability to overrule impulsive reactions in order to regulate behaviour consistent with long-term goals.

METHODS

A meta-analysis of 19 studies of inhibitory control training and health behaviours was conducted to determine the effect of inhibitory control training on reducing harmful behaviours. Theoretically driven moderation analyses were also conducted to determine whether extraneous variables account for heterogeneity in the effect; in order to facilitate the development of effective intervention strategies. Moderators included type of training task, behaviour targeted, measurement of behaviour and training duration.

RESULTS

A small but homogeneous effect of training on behaviour was found, d(+)  = 0.378, CI95 = [0.258, 0.498]. Moderation analyses revealed that the training paradigm adopted, and measurement type influenced the size of the effect such that larger effects were found for studies that employed go/no-go (GNG) training paradigms rather than stop-signal task paradigms, and objective outcome measures that were administered immediately yielded the largest and most consistent effects on behaviour.

CONCLUSIONS

Results suggest that GNG inhibitory control training paradigms can influence health behaviour, but perhaps only in the short-term. Future research is required to systematically examine the influence of training duration, and the longevity of the training effect. Determining these factors could provide the basis for cost-effective and efficacious health-promoting interventions.

Training response inhibition to food is associated with weight loss and reduced energy intake

The majority of adults in the UK and US are overweight or obese due to multiple factors including excess energy intake. Training people to inhibit simple motor responses (key presses) to high-energy density food pictures reduces intake in laboratory studies. We examined whether online response inhibition training reduced real-world food consumption and weight in a community sample of adults who were predominantly overweight or obese (N = 83). Participants were allocated in a randomised, double-blind design to receive four 10-min sessions of either active or control go/no-go training in which either high-energy density snack foods (active) or non-food stimuli (control) were associated with no-go signals. Participants' weight, energy intake (calculated from 24-h food diaries), daily snacking frequency and subjective food evaluations were measured for one week pre- and post-intervention. Participants also provided self-reported weight and monthly snacking frequency at pre-intervention screening, and one month and six months after completing the study. Participants in the active relative to control condition showed significant weight loss, reductions in daily energy intake and a reduction in rated liking of high-energy density (no-go) foods from the pre-to post-intervention week. There were no changes in self-reported daily snacking frequency. At longer-term follow-up, the active group showed significant reductions in self-reported weight at six months, whilst both groups reported significantly less snacking at one- and six-months. Excellent rates of adherence (97%) and positive feedback about the training suggest that this intervention is acceptable and has the potential to improve public health by reducing energy intake and overweight.

The impact of transcranial direct current stimulation on inhibitory control in young adults

BACKGROUND

There is increasing evidence that the dorso-lateral prefrontal cortex (DLPFC), a brain region related to reward and motivational processes, is involved in effective response inhibition and that decreased activity in this region coincides with reduced inhibitory capacity. Using transcranial direct current stimulation (tDCS) to manipulate cortical activation, this study examined whether cross-hemispheric tDCS over the DLPFC affected performance on an inhibitory control task.

METHODS

Neurologically intact participants performed a modified Stroop color-word matching task before and after completing one of two tDCS conditions; (1) anodal stimulation over the left DLPFC or (2) sham tDCS.

RESULTS

There was a statistically significant effect of tDCS condition on Stroop reaction time (RT) pre-post tDCS change scores. Participants who received anodal stimulation over the left DLPFC demonstrated statistically significant faster RT change scores on the Stroop items compared to participants in the sham condition. Although errors on Stroop incongruent items decreased before and after receiving the tDCS treatment, there were no significant differences in errors on Stroop items between the anodal stimulation over left DLPFC and sham tDCS conditions. Anodal tDCS, which is known to elevate neural excitation, may have enhanced activation levels in the left DLPFC and minimized impairment of inhibitory control, resulting in better task performance.

CONCLUSIONS

Current findings provide preliminary evidence that increased excitation of the left DLPFC improves inhibitory control and are a step toward understanding the potential of tDCS for moderating deficits in inhibitory control.

How does response inhibition influence decision making when gambling?

Recent research suggests that response inhibition training can alter impulsive and compulsive behavior. When stop signals are introduced in a gambling task, people not only become more cautious when executing their choice responses, they also prefer lower bets when gambling. Here, we examined how stopping motor responses influences gambling. Experiment 1 showed that the reduced betting in stop-signal blocks was not caused by changes in information sampling styles or changes in arousal. In Experiments 2a and 2b, people preferred lower bets when they occasionally had to stop their response in a secondary decision-making task but not when they were instructed to respond as accurately as possible. Experiment 3 showed that merely introducing trials on which subjects could not gamble did not influence gambling preferences. Experiment 4 demonstrated that the effect of stopping on gambling generalized to different populations. Further, 2 combined analyses suggested that the effect of stopping on gambling preferences was reliable but small. Finally, Experiment 5 showed that the effect of stopping on gambling generalized to a different task. On the basis of our findings and earlier research, we propose that the presence of stop signals influences gambling by reducing approach behavior and altering the motivational value of the gambling outcome.

Stimulus devaluation induced by stopping action

Impulsive behavior in humans partly relates to inappropriate overvaluation of reward-associated stimuli. Hence, it is desirable to develop methods of behavioral modification that can reduce stimulus value. Here, we tested whether one kind of behavioral modification--the rapid stopping of actions in the face of reward-associated stimuli--could lead to subsequent devaluation of those stimuli. We developed a novel paradigm with three consecutive phases: implicit reward learning, a stop-signal task, and an auction procedure. In the learning phase, we associated abstract shapes with different levels of reward. In the stop-signal phase, we paired half those shapes with occasional stop-signals, requiring the rapid stopping of an initiated motor response, while the other half of shapes was not paired with stop signals. In the auction phase, we assessed the subjective value of each shape via willingness-to-pay. In 2 experiments, we found that participants bid less for shapes that were paired with stop-signals compared to shapes that were not. This suggests that the requirement to try to rapidly stop a response decrements stimulus value. Two follow-on control experiments suggested that the result was specifically due to stopping action rather than aversiveness, effort, conflict, or salience associated with stop signals. This study makes a theoretical link between research on inhibitory control and value. It also provides a novel behavioral paradigm with carefully operationalized learning, treatment, and valuation phases. This framework lends itself to both behavioral modification procedures in clinical disorders and research on the neural underpinnings of stimulus devaluation.

Stopping to food can reduce intake. Effects of stimulus-specificity and individual differences in dietary restraint

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We examine whether cognitive training (response inhibition) modifies food intake.

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Food stimulus-specific training can influence food intake.

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These effects are more pronounced in restrained eaters.

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General training to non-food stimuli did not influence food intake.

Overeating in our food-rich environment is a key contributor to obesity. Computerised response-inhibition training could improve self-control in individuals who overeat. Evidence suggests that training people to inhibit motor responses to specific food pictures can reduce the subsequent choice and consumption of those foods. Here we undertook three experiments using the stop-signal task to examine the effects of food and non-food related stop-training on immediate snack food consumption. The experiments examined whether training effects were stimulus-specific, whether they were influenced by the comparator (control) group, and whether they were moderated by individual differences in dietary restraint. Experiment 1 revealed lower intake of one food following stop- vs. double- (two key-presses) response training to food pictures. Experiment 2 offered two foods, one of which was not associated with stopping, to enable within- and between-subjects comparisons of intake. A second control condition required participants to ignore signals and respond with one key-press to all pictures. There was no overall effect of training on intake in Experiment 2, but there was a marginally significant moderation by dietary restraint: Restrained eaters ate significantly less signal-food following stop- relative to double-response training. Experiment 3 revealed that stop- vs. double-response training to non-food pictures had no effect on food intake. Taken together with previous findings, these results suggest some stimulus-specific effects of stop-training on food intake that may be moderated by individual differences in dietary restraint.

Food-cue affected motor response inhibition and self-reported dieting success: a pictorial affective shifting task

Behavioral inhibition is one of the basic facets of executive functioning and is closely related to self-regulation. Impulsive reactions, that is, low inhibitory control, have been associated with higher body mass index (BMI), binge eating, and other problem behaviors (e.g., substance abuse, pathological gambling, etc.). Nevertheless, studies which investigated the direct influence of food-cues on behavioral inhibition have been fairly inconsistent. In the current studies, we investigated food-cue affected behavioral inhibition in young women. For this purpose, we used a go/no-go task with pictorial food and neutral stimuli in which stimulus-response mapping is reversed after every other block (affective shifting task). In study 1, hungry participants showed faster reaction times to and omitted fewer food than neutral targets. Low dieting success and higher BMI were associated with behavioral disinhibition in food relative to neutral blocks. In study 2, both hungry and satiated individuals were investigated. Satiation did not influence overall task performance, but modulated associations of task performance with dieting success and self-reported impulsivity. When satiated, increased food craving during the task was associated with low dieting success, possibly indicating a preload-disinhibition effect following food intake. Food-cues elicited automatic action and approach tendencies regardless of dieting success, self-reported impulsivity, or current hunger levels. Yet, associations between dieting success, impulsivity, and behavioral food-cue responses were modulated by hunger and satiation. Future research investigating clinical samples and including other salient non-food stimuli as control category is warranted.