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BackgroundAttention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with a worldwide prevalence rate of 5%. Individuals with ADHD often tend to have difficulties with emotional regulation. The advances in experimental psychology have led to the discovery of emotional biases. Targeting emotional biases could potentially help improve the core symptoms of irritability and short-temperedness among these individuals. Emotional biases refer to the preferential allocation of attention toward emotional stimuli. A recent study reported the presence of emotional biases among individuals with ADHD when they compared individuals with ADHD with those without. Gamification technologies have been explored to help diminish the repetitiveness of the task and increase the intrinsic motivation to train. These inconsistent findings of the impact of gaming on the effectiveness of mobile interventions call for further work to better understand the needs of patients (users) and health care professionals. ObjectiveThe aim of this research study is to collate health care professionals’ perspectives on the limitations of the existing task, and to determine if gamification elements could be incorporated, to refine the conventional intervention. MethodsA qualitative research approach, that of a focus group, will be used. Health care professionals from the Department of Development Psychiatry, Institute of Mental Health, Singapore will be invited to participate in this qualitative research. During the focus group, participants are to comment on the limitations of the existing emotional bias intervention; recommend strategies to improve the intervention; and provide their perspectives pertaining to the use of gamification to improve the intervention. ResultsWe expect that the study will be completed in 12 months from the publication of this protocol. ConclusionsTo our best knowledge, this is perhaps one of the only few studies that have attempted to explore emotional biases among adolescents with ADHD. International Registered Report Identifier (IRRID)PRR1-10.2196/24078

BackgroundAdvances in experimental psychology have led to a better understanding of unconscious, automatic processes that result in individuals relapsing into their substance-using habits. While some reviews have demonstrated the effectiveness of bias retraining of these unconscious biases, there have been other reviews that have highlighted that bias retraining is not always effective. Other studies have revealed there was no baseline biases among some participants. An examination of mobile bias retraining interventions has also revealed mixed results, with some reporting effectiveness and others null findings. A recent feasibility and acceptability study, done by the authors, revealed that 53% of participants have had no baseline biases and 21% of those with positive baseline biases did not have a positive change in magnitude following intervention. ObjectiveThe aim of this paper was to explore potential variables (demographic and clinical) that could account for the negative baseline biases in the prior feasibility and acceptability study, and to discuss some of the factors that could account for the absence of baseline biases. We also explored potential reasons for why there was no reduction in the magnitude of attentional biases among individuals with baseline biases. MethodsParticipants who were in the rehabilitation phase of their treatment were invited to participate. During the study they had to complete a set of baseline questionnaires, and on each day that they were on the ward they had to complete an attention bias assessment and modification task and rate their cravings using a visual analogue scale. Attention bias was deemed to be present if individuals had a positive score. ResultsIn our study, 53% (16/30) of individuals did not present with baseline attentional biases, and among those with positive baseline biases a total of 21% (3/14) of participants did not have a reduction in the overall magnitude of attentional biases. Chi-square analyses undertaken to compare the demographic characteristics of participants with and without baseline biases did not reveal any significant findings. However, with respect to clinical characteristics, those who had positive baseline biases had experimented with more substances. ConclusionsOur study is one of the first to have explored negative findings in attention bias modification interventions for individuals with addictive disorders. We postulate that several factors could account for the absence of baseline biases and there being no changes following bias retraining. Future research ought to take into consideration these factors.

BackgroundAdvances in experimental psychology have highlighted the need to modify underlying automatic cognitive biases, such as attentional biases. The effectiveness of bias modification has been well studied for substance use disorders. With recent advances in technology, it is now possible to work outside the laboratory with Web-based and mobile-based attention bias interventions. Gamification technologies might also help diminish the repetitiveness of the task and increase the intrinsic motivation to train. The inconsistent findings of the impact of gaming on the effectiveness of mobile interventions call for further work to better understand the needs of patients (users) and health care professionals. ObjectiveThe aim of this study was to involve patients, together with health care professionals, in the design of a gamified mobile attention bias modification intervention for substance use disorders. MethodsThe participatory design research method adopted is that of a user-oriented design approach in the form of a future workshop. In the first phase of the workshop, participants shared their critique of an attention bias modification intervention. In the second phase of the workshop, participants were asked to brainstorm features. Participants were also shown gamification approaches and asked to consider if gaming elements could enhance the existing app. In the last phase, participants were asked to sketch a new prototype. ResultsThree co-design workshops were conducted with health care professionals, inpatients, and outpatients. There were 20 participants, consisting of 10 health care professionals and 10 patients. When asked to identify the limitations in the existing app, common issues identified were those of the design, visual probe task, and the included images. Outpatients were also concerned with the safety of administration of the intervention. In the brainstorming sessions, health care professionals made recommendations as to how the stimulus, the mechanism of responding, and the presentation of the scores could be enhanced. Inpatient participants recommended the addition of functionalities, such as information on the harms associated with the substance use, and for there to be enhancements in the design, images, and task. Outpatient participants perceived a need to improve the images and presentation of the results and recommended the inclusion of gaming features. There were differences in opinion on the inclusion of gaming features, as only health care professionals endorsed their inclusion. In the last phase of the workshop, participants were tasked with the conceptualization of prototypes, and the commonality in the design was for a gradual shortening of the interval for stimulus/image presentation. ConclusionsThe results from this research will guide the development of an app that meets the specific needs of patients and is still based on a pre-existing validated task paradigm.

BackgroundConventional psychology therapies are unable to address automatic biases that result in individuals relapsing into their substance use disorder. Advances in experimental psychology have led to a better understanding of attention and approach biases and methods to modify these biases. Several studies have demonstrated the effectiveness of bias modification among clinical cohorts. The advances in mobile health technologies have allowed remote delivery of these interventions. To date, there is a lack of studies examining bias modification in a substance-using non-Western sample. ObjectiveThis study was designed to determine the feasibility of an attention bias modification intervention and an attention bias modification smartphone app for the reduction of attention biases among treatment-seeking individuals. The secondary aim is to determine the acceptability of the intervention. MethodsA feasibility study was conducted among inpatients who were in their rehabilitation phase at the National Addictions Management Service. Participants were to complete a set of baseline questionnaires, and on each day that they are in the study, undertake an attention bias assessment and modification task while completing a visual analogue scale to assess their craving. Feasibility was determined by the acceptance rate of participation and participants’ adherence to the interventions. Acceptability was assessed by a perception questionnaire. Descriptive statistical analyses were performed using SPSS version 22. A thematic analysis approach was used in the qualitative synthesis of users’ perceptions. ResultsOf the 40 participants invited to participate in the feasibility study, 10 declined, yielding an acceptance rate of 75%. Of the recruited participants, 6 participants were diagnosed with alcohol dependence; 17, with opioid dependence; 2, with cannabis dependence; and 5, with stimulant dependence. In addition, of the final 30 participants, 11 (37%) failed to complete all the planned interventions and 22 (73%) completed the perspective questionnaires; of these 22 participants, 100% rated the app as extremely and very easy, 77% rated it as extremely or very interactive, 54% rated it as extremely or very motivating, and 33% reported a change in their confidence levels. ConclusionsOur results highlight the feasibility of recruiting participants to undertake attention bias modification interventions. Participants generally accept use of a mobile version of such an intervention. Nevertheless, our acceptability data indicate that there could be improvements in the existing app, and a participatory design approach might be helpful in its future conceptualization. International Registered Report Identifier (IRRID)RR2-10.2196/11822

BackgroundAutomatic processes, such as attentional biases or interpretative biases, have been purported to be responsible for several psychiatric disorders. Recent reviews have highlighted that cognitive biases may be modifiable. Advances in eHealth and mHealth have been harnessed for the delivery of cognitive bias modification. While several studies have evaluated mHealth-based bias modification intervention, no review, to our knowledge, has synthesized the evidence for it. In addition, no review has looked at commercial apps and their functionalities and methods of bias modification. A review is essential in determining whether scientifically validated apps are available commercially and the proportion of commercial apps that have been evaluated scientifically. ObjectiveThe objective of this review was primarily to determine the proportion of attention or cognitive bias modification apps that have been evaluated scientifically and secondarily to determine whether the scientifically evaluated apps were commercially available. We also sought to identify commercially available bias modification apps and determine the functionalities of these apps, the methods used for attention or cognitive bias modification, and whether these apps had been evaluated scientifically. MethodsTo identify apps in the published literature, we searched PubMed, MEDLINE, PsycINFO, and Scopus for studies published from 2000 to April 17, 2018. The search terms used were “attention bias” OR “cognitive bias” AND “smartphone” OR “smartphone application” OR “smartphone app” OR “mobile phones” OR “mobile application” OR mobile app” OR “personal digital assistant.” To identify commercial apps, we conducted a manual cross-sectional search between September 15 and 25, 2017 in the Apple iTunes and Google Play app stores. The search terms used to identify the apps were “attention bias” and “cognitive bias.” We also conducted a manual search on the apps with published evaluations. ResultsThe effectiveness of bias modification was reported in 7 of 8 trials that we identified in the published literature. Only 1 of the 8 previously evaluated apps was commercially available. The 17 commercial apps we identified tended to use either an attention visual search or gamified task. Only 1 commercial app had been evaluated in the published literature. ConclusionsThis is perhaps the first review to synthesize the evidence for published mHealth attention bias apps. Our review demonstrated that evidence for mHealth attention bias apps is inconclusive, and quite a few commercial apps have not been validated scientifically.

Given the significant role vocabulary plays in second language acquisition, how to help learners acquire vocabulary has always been a concern for educators. Despite the general consensus that beliefs influence learners' behaviour, limited research effort has been devoted to the exploration of English as a second language (ESL) learners' beliefs about vocabulary knowledge and learning in the secondary education context and how their beliefs are affected by such factors as grades and proficiency levels. This paper reports on a convergent mixed-methods study that addresses the research gap with the use of a questionnaire administered to 556 ESL students in a Hong Kong secondary school. Results revealed that while students in general perceived vocabulary learning as important, their beliefs about vocabulary knowledge and learning were found to be related to their grade and proficiency levels. Open-ended responses provided further insights into learners' beliefs qualitatively about the difficulties faced by learners and their perceptions of the effective ways to tackle these difficulties. Overall, this paper broadens the understanding of L2 learners' beliefs about vocabulary knowledge and learning. It complements existing literature on L2 vocabulary learning and sheds light on issues related to vocabulary learning and teaching.

The language learner strategies research field has often tried to identify the good language learner (GLL) by distinguishing more proficient from less proficient learners. However the notion of 'good' may be problematic without taking into account an individual's linguistic knowledge (LK). This article foregrounds LK in relation to strategy use in the context of 'listening to the teacher': a language use task relatively under-researched. Secondary school students in Hong Kong (n = 646) completed a questionnaire and tests of LK including vocabulary and grammar. Lower LK learners reported using more translation strategies, whereas those with higher LK reported using a range of additional strategies. A further cluster analysis, however, indicated that a sub-group of lower LK learners were comparably strategic with the higher LK group perhaps compensating for low LK via strategy deployment. This article provides evidence that strategy deployment when listening to the teacher is not wholly constrained by levels of LK. Pedagogical implications are suggested.

Traditional bullying typically occurs in schools and has been associated with a myriad of mental health problems. Recent evidence has indicated that cyberbullying may just be traditional bullying that is extended to the online world, but this possibility has received only limited study in Asian countries. This study explored the co-occurrence of traditional and cybervictimization and its association with mental health among 3319 adolescents aged 12 to 17 years in Singapore. Victims of bullying were categorized into mutually exclusive groups: traditional-only victims, cyber-only victims, or combined traditional and cybervictims. Results indicated that there were substantial overlaps between victimization in traditional bullying and cyberbullying and that traditional victimization was more prevalent than cybervictimization. Being a victim of either form of bullying (i.e., traditional-only or cyber-only victims) was associated with higher reports of internalizing and externalizing problems, and combined traditional and cybervictims reported the most internalizing problems. However, there were no significant differences in problem scores between traditional-only victims and cyber-only victims. The findings highlight the need to consider the extensive overlap between traditional and cybervictimization when investigating their differential association with adolescents' mental health. Prevention and intervention efforts by school staff and mental health practitioners need to target both traditional bullying and cyberbullying in an integrated manner, and extra attention should be provided to adolescents who are victims of both forms of bullying.

In Content and Language Integrated Learning (CLIL) programmes, students learn content knowledge and a second/foreign language (L2) simultaneously. It follows that both content and language are assessed, although research on how to do so remains scarce. This study explores the interplay between cognitive and linguistic demands of CLIL assessments. Having analysed over 4900 questions in Science/Biology textbooks, workbooks and examination papers in Hong Kong, we observed that junior secondary assessments were dominated by low-level cognitive (i.e. recall of knowledge) and linguistic (i.e. no production or word-level production) demands, whereas senior secondary assessments required higher-order thinking skills (i.e. application and analysis of knowledge) expressed in sentences or even texts. Also, based on the analysis of 70 junior secondary students' performance in school examination papers, we noticed a potential hindrance of linguistic demands to students' performance in CLIL assessments. These findings together underscore the integral role of language in CLIL assessments and raise questions about the adequacy of existing pedagogical practices in preparing students to tackle both cognitive and linguistic demands in CLIL assessments, particularly when they proceed to higher grade levels where the demands in both dimensions leap. These have significant implications for CLIL assessment design, pedagogy and teacher education.

Reading is a core element in language education. Despite extensive research in second/foreign language (L2/FL) reading, relatively little is known about the differences between two common practices: Compulsory reading (i.e. reading assigned by teachers) and voluntary reading (i.e. self‐initiated reading). This article reports two related quantitative studies (n = 124; n = 498) investigating learners' out‐of‐class compulsory and voluntary English‐as‐a‐foreign‐language (EFL) story reading frequencies in Hong Kong. Learners' perceptions, EFL proficiency and school banding were analysed in relation to reading frequencies. It was found that the frequencies of engaging in both kinds of reading were very low. Reading frequencies and favourability towards story reading were found to be mildly to moderately correlated with proficiency. Among these variables, however, only voluntary reading significantly predicted proficiency. Students who were academically more competent showed greater favourability while those in the middle school banding reported a higher frequency of reading. The findings are discussed and implications are drawn. [ABSTRACT FROM AUTHOR]

Despite the rapid growth of English Medium Instruction (EMI) programmes around the globe, the language goals in such programmes have not been clearly defined, making it difficult to evaluate their success. Accordingly, our paper reports on a study that attempted to identify the language goals, operationalised as the vocabulary expected of learners, by investigating the under-explored area of EMI assessment. We sampled a corpus of 16 sets of examination papers in two subject areas, namely, Biology and Geography, spanning eight years in Hong Kong. The examination papers, analysed for their vocabulary profiles, indicated that students were expected to learn beyond the K3 level (the most frequent 3,000 words in English) and master mid-frequency words (K4−K8) as well as academic words. Our findings suggest that the less frequent words were not often shared by the two subjects. Analysing academic words also enabled us to showcase how some words were common across the two subjects while others were more subject-specific. Pedagogical implications are discussed, highlighting the need for teachers and students to attend to target language goals in EMI, and to consider the subject-specific nature of vocabulary items in EMI. [ABSTRACT FROM AUTHOR]