Effectiveness of Auditory Distraction and Brief Relaxation Therapy in Reducing Anxiety in Dental Patients Undergoing Extraction: A Randomized Controlled Trial

Objective: This study compared the effectiveness of auditory distraction and brief relaxation therapy for reducing anxiety in patients undergoing tooth extraction. Methods: A non-blind, three-armed, randomized control trial was carried out. The targeted study population were patients who needed extraction of a non-restorable and non-mobile molar tooth. Eighty-six patients were recruited; the brief relaxation therapy and auditory distraction groups had 32 participants each, while 10 of the 22 participants in the control group were excluded due to missing data. The Hierarchical Anxiety Questionnaire was used to assess the anxiety level. The Mann–Whitney U or Kruskal–Wallis test was performed to compare means between the groups. The before and after comparisons in each group were carried out using the Wilcoxon Signed-Rank test. The alpha value was set at 0.05, and data were analyzed using SPSS version 24. Results: The mean anxiety score after brief relaxation therapy and auditory distraction had significantly decreased (p < 0.001). Although not significant (p = 0.13), there was a slight increase in the anxiety score of the study participants in the control group just before the extraction procedure. Brief relaxation therapy was significantly effective in reducing anxiety scores in comparison to the control group (MD = 5.87, 95% CI = 2.58, 9.17; p = 0.001), but auditory distraction was not (p = 0.14). Conclusion: Both auditory distraction and brief relaxation therapy were effective in reducing patient anxiety before a dental procedure. Furthermore, it would be interesting to learn if these findings remain consistent for more complex dental procedures, such as surgical removal of an impacted third molar.

Positive and negative mood states do not influence cross-modal auditory distraction in the serial-recall paradigm

The aim of this study was to examine whether positive and negative mood states affect auditory distraction in a serial-recall task. The duplex-mechanism account differentiates two types of auditory distraction. The changing-state effect is postulated to be rooted in interference-by-process and to be automatic. The auditory-deviant effect is attributed to attentional capture by the deviant distractors. Only the auditory-deviant effect, but not the changing-state effect, should be influenced by emotional mood states according to the duplex-mechanism account. Four experiments were conducted to test how auditory distraction is affected by emotional mood states. Mood was induced by autobiographical recall (Experiments 1 and 2) or the presentation of emotional pictures (Experiments 3 and 4). Even though the manipulations were successful in inducing changes in mood, neither positive mood (Experiments 1 and 3) nor negative mood (Experiments 2 and 4) had any effect on distraction despite large samples sizes (N = 851 in total). The results thus are not in line with the hypothesis that auditory distraction is affected by changes in mood state. The results support an automatic-capture account according to which the auditory-deviant effect and the changing-state effect are mainly stimulus-driven effects that are rooted in the automatic processing of the to-be-ignored auditory stream.

Dissociation Between Speech and Emotion Effects in Short-Term Memory: A Data Reanalysis.

Performance in visual serial recall tasks is often impaired by irrelevant auditory distracters. The duplex-mechanism account of auditory distraction states that if the distracters provide order cues, these interfere with the processing of the order cues in the serial recall task (interference by process). In contrast, the unitary account states that distracters capture only attention on a general level (attentional distraction) without interfering specifically withorder processing. Marsh et al. (2018, Journal of Experimental Psychology-Learning Memory and Cognition, 44, 882-897) reported finding a dissociation between the effects of serial recall tasks and those of a missing-item task on the disruptive effects of speech and of emotional words, as predicted by the duplex-mechanism account. Critically, the reported analyses did not test specifically for the claimed dissociation. Therefore, I reanalyzed the Marsh et al. data and conducted the appropriate analyses. I also tested the dissociation more directly and added a Bayesian hypothesis test to measure the strength of the evidence for a dissociation. Results provided strong evidence for a dissociation (i.e., crossover interaction) between effects of speech and of emotion. Because the duplex-mechanism account predicts this dissociation between speech effects (interference by process) and emotion effects (attentionaldiversion) whereas the unitary account does not, Marsh et al.’s data support the duplex-mechanism account. However, to show that this dissociation is robust, researchers are advised to replicate this dissociation in an adversarial registered report.

EEG-Microstates Reflect Auditory Distraction After Attentive Audiovisual Perception Recruitment of Cognitive Control Networks

Processing of sensory information is embedded into ongoing neural processes which contribute to brain states. Electroencephalographic microstates are semi-stable short-lived power distributions which have been associated with subsystem activity such as auditory, visual and attention networks. Here we explore changes in electrical brain states in response to an audiovisual perception and memorization task under conditions of auditory distraction. We discovered changes in brain microstates reflecting a weakening of states representing activity of the auditory system and strengthening of salience networks, supporting the idea that salience networks are active after audiovisual encoding and during memorization to protect memories and concentrate on upcoming behavioural response.

The Effects of Working Memory Load on Auditory Distraction in Adults With Attention Deficit Hyperactivity Disorder

Cognitive control provides us with the ability to inter alia, regulate the locus of attention and ignore environmental distractions in accordance with our goals. Auditory distraction is a frequently cited symptom in adults with attention deficit hyperactivity disorder (aADHD)–yet few task-based fMRI studies have explored whether deficits in cognitive control (associated with the disorder) impedes on the ability to suppress/compensate for exogenously evoked cortical responses to noise in this population. In the current study, we explored the effects of auditory distraction as function of working memory (WM) load. Participants completed two tasks: an auditory target detection (ATD) task in which the goal was to actively detect salient oddball tones amidst a stream of standard tones in noise, and a visual n-back task consisting of 0-, 1-, and 2-back WM conditions whilst concurrently ignoring the same tonal signal from the ATD task. Results indicated that our sample of young aADHD (n = 17), compared to typically developed controls (n = 17), had difficulty attenuating auditory cortical responses to the task-irrelevant sound when WM demands were high (2-back). Heightened auditory activity to task-irrelevant sound was associated with both poorer WM performance and symptomatic inattentiveness. In the ATD task, we observed a significant increase in functional communications between auditory and salience networks in aADHD. Because performance outcomes were on par with controls for this task, we suggest that this increased functional connectivity in aADHD was likely an adaptive mechanism for suboptimal listening conditions. Taken together, our results indicate that aADHD are more susceptible to noise interference when they are engaged in a primary task. The ability to cope with auditory distraction appears to be related to the WM demands of the task and thus the capacity to deploy cognitive control.

The metacognition of auditory distraction: Judgments about the effects of deviating and changing auditory distractors on cognitive performance

The duplex-mechanism account of auditory distraction has been extended to predict that people should have metacognitive awareness of the disruptive effect of auditory deviants on cognitive performance but little to no such awareness of the disruptive effect of changing-state relative to steady-state auditory distractors. To test this prediction, we assessed different types of metacognitive judgments about the disruptive effects of auditory-deviant, changing-state, and steady-state distractor sequences on serial recall. In a questionnaire, participants read about an irrelevant-speech experiment and were asked to provide metacognitive beliefs about how serial-recall performance would be affected by the different types of distractors. Another sample of participants heard the auditory distractors before predicting how their own serial-recall performance would suffer or benefit from the distractors. After participants had experienced the disruptive effects of the distractor sequences first hand, they were asked to make episodic retrospective judgments about how they thought the distractor sequences had affected their performance. The results consistently show that people are, on average, well aware of the greater disruptive effect of deviant and changing-state relative to steady-state distractors. Irrespective of condition, prospective and retrospective judgments of distraction were poor predictors of the individual susceptibility to distraction. These findings suggest that phenomena of auditory distraction cannot be categorized in two separate classes based on metacognitive awareness.

Auditory Attention

The modern world is noisy. Streets are cacophonies of traffic noise; homes and workplaces are replete with bleeping timers, announcements, and alarms. Everywhere there is the sound of human speech—from the casual chatter of strangers and the unwanted intrusion from electronic devices through to the conversations with friends and loved ones one may actually wish to hear. Unlike vision, it is not possible simply to “close our ears” and shut out the auditory world and nor, in many cases, is it desirable. On the one hand, soft background music or environmental sounds, such as birdsong or the noise of waves against the beach, is often comfortingly pleasurable or reassuring. On the other, alarms are usually auditory for a reason. Nevertheless, people somehow have to identify, from among the babble that surrounds them, the sounds and speech of interest and importance and to follow the thread of a chosen speaker in a crowded auditory environment. Additionally, irrelevant or unwanted chatter or other background noise should not hinder concentration on matters of greater interest or importance—students should ideally be able to study effectively despite noisy classrooms or university halls while still being open to the possibility of important interruptions from elsewhere. The scientific study of auditory attention has been driven by such practical problems: how people somehow manage to select the most interesting or most relevant speaker from the competing auditory demands made by the speech of others or isolate the music of the band from the chatter of the nightclub. In parallel, the causes of auditory distraction—and how to try to avoid it where necessary—have also been subject to scrutiny. A complete theory of auditory attention must account for the mechanisms by which selective attention is achieved, the causes of auditory distraction, and the reasons why individuals might differ in their ability in both cases.