motivation, control and hearing loss-related fatigue...vanderbilt bill wilkerson center motivation,...
TRANSCRIPT
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Vanderbilt Bill Wilkerson Center
Motivation, Control and Hearing Loss-Related Fatigue
Benjamin W. Y. Hornsby, PhD Fred H. Bess, PhD
Aging and Speech Communication Research Conference
Bloomington, IN October 11-14, 2015
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Faculty collaborators
Acknowledgements
Lab Group(s) members Beth Boedeker Hilary Davis Tonia Davis
Funding for portions of the works reported here was provided by NIH R21 DC012865-01A1 IES #R324A110266 IES #R324A150029
the ASHFoundation and the Dan Maddox Foundation
Sam Gustafson Amanda Headley Katie Makowiec
Travis Moore Virginia Rich Bridget Stone
Dan Ashmead Fred Bess Stephen
Camarata
Aaron Kipp Sasha Key
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Hearing Loss, Listening Effort and Fatigue
• Listening IS exhausting!!! – Post on hearingaidforums.com
• “…since I lost most of my hearing…, I've had periodic bouts of tiredness that are deeper and of a different quality than I ever experienced before.” – Copithorne, 2006
• “I go to bed most nights with nothing left. It takes so much energy to participate in conversations all day, that I’m often asleep within minutes.” – Blog post http://hearingelmo.wordpress.com
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Fatigue- More than effort and task difficulty High effort/difficulty ≠ always lead to fatigue
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Fatigue- More than effort and task difficulty • Risk for fatigue increases in:
– Mentally/physically challenging conditions • Requires effortful control to attain/maintain performance • Maintaining “acceptable” performance is difficult or not
possible – Low control conditions
• Timed or scheduled tasks with limited flexibility • Limited ability to modify the task characteristics
– Important conditions • High motivation • Negative consequences for poor performance
Hockey & Earle (2006); Boksem & Tops (2008); Ackerman (2011); Hockey (2013); Earle & Hockey (2015).
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A motivational control theory of cognitive fatigue (Hockey, 2013) • Fatigue is an emotional response serving an
adaptive, goal-directed, function – forces us to evaluate current goal-directed behaviors
in terms of an effort/reward balance
Hockey, R. (2013). The Psychology of Fatigue: Work, Effort and Control: Cambridge
• Fatigue is a “protective” mechanism to help us decide if the effort applied towards a goal is worth the reward.
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Goal: Successful Communication
Successful communication with
minimal effort
Unsuccessful communication with
allocated effort
Evaluate effort/reward
ratio
Low reward/benefit
Maintain effort: No change in performance
Reduce effort: Disengage
Variable effort: Change goal
High reward/benefit
Increase effort: Successful
communication with allocated effort
Increase effort: Unsuccessful
communication with allocated effort
A motivational control theory of cognitive fatigue (Hockey, 2013)
A simple block diagram interpretation of Hockey’s (2013) model
A continuum
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Goal: Successful Communication
Successful communication with
minimal effort
Unsuccessful communication with
allocated effort
Evaluate effort/reward
ratio
Low reward/benefit
Maintain effort: No change in performance
Reduce effort: Disengage
Variable effort: Change goal
High reward/benefit
Increase effort: Successful
communication with allocated effort
Increase effort: Unsuccessful
communication with allocated effort
A motivational control theory of cognitive fatigue (Hockey, 2013)
A simple block diagram interpretation of Hockey’s (2013) model
Fatigue develops/increases
Fatigue development is minimal
A continuum
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Model Predictions-
• Speech processing-related fatigue should be associated with task difficulty and hearing loss – Conditions where speech understanding is more difficult &
effortful should be more fatiguing
• Degree of hearing loss would be associated with perceived effort and speech processing-related fatigue – More hearing loss -> more
difficulties-> more effort -> more fatigue
Task difficulty & HL may have effects here
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Vanderbilt Bill Wilkerson Center
Assessing speech-processing related fatigue in the laboratory
1. Does task difficulty or hearing loss modulate effort and speech-processing related fatigue?
2. Does degree of hearing loss modulate effort and speech-processing related fatigue?
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Vanderbilt Bill Wilkerson Center
PARTICIPANTS AND PROCEDURES
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Participants • Young normal hearing adults (N = 50)
– Mean age = 24 years • range 18-32 years
• Older adults with hearing loss (N=31) – Mean age =71 years
• range 63-79 years – Mean PTA = 35.6 dB
• range 25-53 dB – All hearing aid users – All tested unaided
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“Listening IS exhausting!!”
What Color was Charlie?
Ready Charlie go to Blue 1 now Ready Eagle go to Green 4 now
Speech Fatigue Task (SFT)
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“Listening IS exhausting!!”
What CallSign was One?
Ready Charlie go to Blue 1 now Ready Eagle go to Green 4 now
Speech Fatigue Task (SFT)
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“Listening IS exhausting!!”
What Number was Green?
Ready Charlie go to Blue 1 now Ready Eagle go to Green 4 now
Speech Fatigue Task (SFT)
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“Listening IS exhausting!!”
Alert Alert
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Task Parameters and Test Conditions • Speech Task:
• Duration: 50-60 minutes (340 stimuli) • Speech presented free field (60 dBA)
– Mixed with a cafeteria babble • 4 SNRs- Participants did an “easy” and “hard” SNR. Specific
SNR’s varied b/w groups (G1, G2) – Young NH: G1: Quiet & -4; G2: -2 & -6 dB SNRs – Older HI: G1: +2 & -2; G2: 0 & -4 dB SNRs
– Visual “Alerts” occur on 30% of trials
• Random occurrence but distributed evenly – half during the first 170 trials and half during the 2nd 170 trials
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Subjective Measures of Effort and Fatigue • Rating Scale of Mental Effort (RSME; Zijlstra,
1993) – Visual analogue scale, rate effort from “absolutely
no effort” to > “Extreme effort” • Numeric range of 0-150
– S’s rate “…effort it took you to finish the task.”
• Fatigue and vigor subscales of the Profile of Mood States (POMS; McNair, et al., 1971) – 15 items, describes “how you feel RIGHT NOW.”
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252
Behavioral Measure of Fatigue
• Psychomotor Vigilance Task (PVT; Dinges &
Powell, 1985) to assess sustained attention
– Simple 10 minute visual vigilance task sensitive to fatigue related changes in attention
– Completed before 1st POMS and after 2nd POMS • Fatigue quantified as a “decrement” in response
times to visual marker (ability to maintain attention)
251 250 249
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Study Procedures
Speech Fatigue Task
POMS POMS
RSME
Time
PVT PVT
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Vanderbilt Bill Wilkerson Center
Results
Does task difficulty or HL modulate fatigue?
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Does task difficulty or HL modulate fatigue? Performance effects
• Monotonic changes in performance with SNR for NH and HI groups
SNR (in dB)-6 -4 -2 0 2 Quiet
SFT
Acc
urac
y (in
%)
40
50
60
70
80
90
100
NHHI
Error bars = 1 St. Error
e.g., What color was Charlie?
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TimePre Post
PO
MS
Fat
igue
Sco
re
0
2
4
6
8
10
12
14-6 dB SNR-4 dB SNR-2 dB SNRQuiet
NH Data
TimePre Post
0
2
4
6
8
10
12
14
-4 dB SNR-2 dB SNR0 dB SNR+2 dB SNR
HI Data
Does task difficulty or HL modulate fatigue? Subjective fatigue
• Task is fatiguing for both groups – More so for older HI group (p<0.05)
• But unaffected by task difficulty (SNR) – And no SNR x time/group interactions (all p>0.05)
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Does task difficulty or HL modulate fatigue? Behavioral fatigue
TimePre Post
PVT
Med
ian
RT
(in m
s)
260
270
280
290
300
310
320
330-6 dB SNR-4 dB SNR-2 dB SNRQuiet
NH Data
TimePre Post
260
270
280
290
300
310
320
330
-4 dB SNR-2 dB SNR0 dB SNR+2 dB SNR
HI Data
• Significant effect of time and group (older HI are slower) – But no effect of SNR (p>0.05) – And no interactions bw SNR, time or group (all p>0.05)
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Vanderbilt Bill Wilkerson Center
Results
Does task difficulty or HL modulate effort?
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SNR (in dB)-6 -4 -2 0 2 Quiet
SFT
Acc
urac
y (in
%)
40
50
60
70
80
90
100
NHHI
Error bars = 1 St. Error
Associations Between Performance (SNR) and Mental Effort
• Performance changes with SNR for NH and HI groups
Mean data
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SNR (in dB)-6 -4 -2 0 2 Quiet
RS
ME
Rat
ing
40
50
60
70
80
90
100
NHHI
Very GreatEffort
Great Effort
ConsiderableEffort
RatherMuch Effort
Some Effort
Error bars = 1 St. Error
Associations Between Performance (SNR) and Mental Effort
• But effort changes with SNR only for NH
Mean data
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RSME Rating40 60 80 100 120 140
SFT
Acc
urac
y (in
%)
40
50
60
70
80
90
100
-6 dB SNR-4 dB SNR-2 dB SNRQuiet
40 60 80 100 120 140
40
50
60
70
80
90
100
-4 dB SBR -2 dB SNR0 dB SNR+2 dB SNR
r= -0.27p = 0.006
r= -0.06p > 0.05
Associations Between Performance (SNR) and Mental Effort
• Weak (NH) or no (HI) association between task difficulty (SNR) and perceived effort on the task
Individual NH data Individual HI data
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Vanderbilt Bill Wilkerson Center
Results
Associations between Degree of Hearing Loss, Effort and Fatigue
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Better Ear PTA (in dB HL)20 25 30 35 40 45 50 55
Cha
nge
in P
OM
S F
atig
ue
-10
-5
0
5
10
15
20
25
r= -0.26p = 0.054
Better Ear PTA (in dB HL)25 30 35 40 45 50 55
RS
ME
Rat
ing
20
40
60
80
100
120
140
160
-4 dB SNR-2 dB SNR0 dB SNR+2 dB SNR
r= -0.29p = 0.039
Association Between 1) PTA & effort and 2) PTA & fatigability
• Weak association bw PTA and mental effort on task (RSME) • No association bw PTA and change in POMS fatigue scores • As PTA increases fatigability and effort decrease
PTA vs. Change in POMs PTA vs. RSME
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• In contrast, strong association between fatigability and perceived effort on the task – Esp. in HI
RSME Rating40 60 80 100 120 140
Cha
nge
in P
OM
S F
atig
ue
-10
-5
0
5
10
15
20
25-6 dB SNR-4 dB SNR-2 dB SNRQuiet
40 60 80 100 120 140-10
-5
0
5
10
15
20
25-4 dB SNR-2 dB SNR0 dB SNR+2 dB SNR
r= 0.38p < 0.001
r= 0.55p < 0.001
Associations Between Fatigability and Mental Effort
Individual NH data Individual HI data
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Vanderbilt Bill Wilkerson Center
Summary/Conclusions
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Sustained speech processing can lead to subjective and behavioral fatigue 1. Does task difficulty or HL modulate speech-
processing related fatigue? – Task difficulty: No! – No relationship between
SNR or individual performance on fatigability
– Hearing Loss: Partly- – Subjective fatigue (POMS)
was larger for older HI • No bw group difference
in behavioral (PVT) fatigue
Task difficulty & HL may have effects here
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Sustained speech processing can lead to subjective and behavioral fatigue- Why?
2. Does degree of HL modulate speech-processing related fatigue? – No: PTA was not
associated with variations in effort or fatigue
Task difficulty & HL may have effects here
• Neither speech understanding ability OR degree of HL were strongly related to speech processing-related fatigue
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Task difficulty & HL may have effects here
Sustained speech processing can lead to subjective and behavioral fatigue- Why?
• Perceived effort (RSME rating) was the strongest predictor of speech processing-related fatigue – Esp. for our participants with
hearing loss – But perceived effort was
NOT strongly related to SNR, performance, or degree of hearing loss
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Task difficulty & HL may have effects here
Sustained speech processing can lead to subjective and behavioral fatigue- Why?
• Perceived effort (RSME rating) was the strongest predictor of speech processing-related fatigue
• Other individual factors must
play a dominant role – E.g., motivation,
expectations, personality…
– Esp. for our participants with hearing loss
– But perceived effort was NOT strongly related to SNR, performance, or degree of hearing loss
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Goal: Successful Communication
Successful communication with
minimal effort
Unsuccessful communication with
allocated effort
Evaluate effort/reward
ratio
Low reward/benefit
Maintain effort: No change in performance
Reduce effort: Disengage
Variable effort: Change goal
High reward/benefit
Increase effort: Successful
communication with allocated effort
Increase effort: Unsuccessful
communication with allocated effort
A motivational control theory of cognitive fatigue (Hockey, 2013)
A block diagram interpretation of Hockey’s (2013) model
A continuum
Task difficulty & HL may have effects here
Other individual factors may have effects here
– motivation, expectations, personality…
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Vanderbilt Bill Wilkerson Center
Future Research
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There is a lot we don’t know! • Better understand the “fatigue experience” of persons
with HL – Do our lab studies or generic questionnaires adequately capture the
experiences of persons with HL?
• Develop/refine methods to quantify hearing loss- related stress, effort and fatigue – In laboratory and real world
• Characterize individual factors and physiologic mechanisms responsible for hearing loss- related fatigue
• More directly test and refine a model of hearing loss- related fatigue – Important for developing effective intervention strategies
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Questions?
Interested in this area? Potential Post-doc position available. See me for details!