The Efficacy of Cognitive Intervention in Mild Cognitive Impairment (MCI): a Meta-Analysis of Outcomes on Neuropsychological Measures

Cognitive training in MCI may stimulate pre-existing neural reserves or recruit neural circuitry as “compensatory scaffolding” prompting neuroplastic reorganization to meet task demands (Reuter-Lorenz & Park, 2014). However, existing systematic reviews and meta-analytic studies exploring the benefits of cognitive interventions in MCI have been mixed. An updated examination regarding the efficacy of cognitive intervention in MCI is needed given improvements in adherence to MCI diagnostic criteria in subject selection, better defined interventions and strategies applied, increased use of neuropsychological measures pre- and post-intervention, as well as identification of moderator variables which may influence treatment. As such, this meta-analytic review was conducted to examine the efficacy of cognitive intervention in individuals diagnosed with mild cognitive impairment (MCI) versus MCI controls based on performance of neuropsychological outcome measures in randomized controlled trials (RCT). RCT studies published from January 1995 to June 2017 were obtained through source databases of MEDLINE-R, PubMed, Healthstar, Global Health, PSYCH-INFO, and Health and Psychological Instruments using search parameters for MCI diagnostic category (mild cognitive impairment, MCI, pre-Alzheimer’s disease, early cognitive decline, early onset Alzheimer’s disease, and preclinical Alzheimer’s disease) and the intervention or training conducted (intervention, training, stimulation, rehabilitation, or treatment). Other inclusion and exclusion criteria included subject selection based on established MCI criteria, RCT design in an outpatient setting, MCI controls (active or passive), and outcomes based on objective neuropsychological measures. From the 1199 abstracts identified, 26 articles met inclusion criteria for the meta-analyses completed across eleven (11) countries; 92.31% of which have been published within the past 7 years. A series of meta-analyses were performed to examine the effects of cognitive intervention by cognitive domain, type of training, and intervention content (cognitive domain targeted). We found significant, moderate effects for multicomponent training (Hedges’ g observed?=?0.398; CI [0.164, 0.631]; Z?=?3.337; p?=?0.001; Q?=?55.511; df?=?15; p?=?0.000; I ² ?=?72.978%; τ ² ?=?0.146) as well as multidomain-focused strategies (Hedges’ g?=?0.230; 95% CI [0.108, 0.352]; Z?=?3.692; p??< 0.001; Q?=?12.713; df?=?12; p?=?0.390; I ² ?=?5.612; τ ² ?=?0.003). The effects for other interventions explored by cognitive domain, training type, or intervention content were indeterminate due to concerns for heterogeneity, bias, and small cell sizes. In addition, subgroup and meta-regression analyses were conducted with the moderators of MCI category, mode of intervention, training type, intervention content, program duration (total hours), type of control group (active or passive), post-intervention follow-up assessment period, and control for repeat administration. We found significant overall effects for intervention content with memory focused interventions appearing to be more effective than multidomain approaches. There was no evidence of an influence on outcomes for the other covariates examined. Overall, these findings suggest individuals with MCI who received multicomponent training or interventions targeting multiple domains (including lifestyle changes) were apt to display an improvement on outcome measures of cognition post-intervention. As such, multicomponent and multidomain forms of intervention may prompt recruitment of alternate neural processes as well as support primary networks to meet task demands simultaneously. In addition, interventions with memory and multidomain forms of content appear to be particularly helpful, with memory-based approaches possibly being more effective than multidomain methods. Other factors, such as program duration, appear to have less of an influence on intervention outcomes. Given this, although the creation of new primary network paths appears strained in MCI, interventions with memory-based or multidomain forms of content may facilitate partial activation of compensatory scaffolding and neuroplastic reorganization. The positive benefit of memory-based strategies may also reflect transfer effects indicative of compensatory network activation and the multiple-pathways involved in memory processes. Limitations of this review are similar to other meta-analysis in MCI, including a modest number studies, small sample sizes, multiple forms of interventions and types of training applied (some overlapping), and, while greatly improved in our view, a large diversity of instruments used to measure outcome. This is apt to have contributed to the presence of heterogeneity and publication bias precluding a more definitive determination of the outcomes observed.     

The Effectiveness of the MMPI-2-RF in Detecting Feigned Mental Disorders and Cognitive Deficits: a Meta-Analysis

A cornerstone of forensic assessments involves the assessment of response styles, including feigning and malingering. As a forensic relevant instrument (FRI), the Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) contains embedded overreporting scales that cover the three major domains: feigned mental disorders (i.e., F-r and Fp-r), feigned cognitive impairment (RBS and FBS-r), and feigned medical complaints (Fs). This meta-analytic review of 30 studies examined the effectiveness of various detection strategies and cut scores for the MMPI-2-RF. As an important clinical concern, several feigning scales (F-r, FBS-r, and RBS) exhibited marked elevations (Ms > 80 T) for genuine responders diagnosed with major depressive or somatoform disorders. However, the Fp-r—a true rare-symptoms detection strategy—proved highly effective for discriminating feigned from genuine psychopathology (ds > .90). For feigned cognitive impairment, the FBS-r produced very large effect sizes with feigned TBI (M d = 1.41); however, its cut scores were more indicative of general feigning than feigned cognitive impairment. Finally, Fs yielded a large effect size (d = 1.23) for feigned medical complaints, but its cut scores were more likely to identify examinees feigning mental disorders (M sensitivity = .74) than medical complaints (M sensitivity = .43). These findings are discussed within the context of clinical forensic evaluations.     

General and Domain-Specific Effectiveness of Cognitive Remediation after Stroke: Systematic Literature Review and Meta-Analysis

Cognitive remediation (CR) has been shown to improve cognitive abilities following a stroke. However, an updated quantitative literature review is needed to synthesize recent research and build understanding of factors that may optimize training parameters and treatment effects. Randomized controlled trials of CR were retrieved from seven electronic databases. Studies specific to adult stroke populations were included. Treatment effects were estimated using a random effects model, with immediate and longer-term follow-up outcomes, and moderator effects, examined for both overall and domain-specific functioning. Twenty-two studies were identified yielding 1098 patients (583 in CR groups). CR produced a small overall effect (g?=?0.48, 95% CI 0.35–0.60, p?<?0.01) compared with control conditions. This effect was moderated by recovery stage (p?<?0.01), study quality (p?=?0.04), and dose (p?=?0.04), but not CR approach (p?=?0.63). Significant small to medium (g?=?0.25–0.75) post-intervention gains were evident within each individual outcome domain examined. A small overall effect (g?=?0.27, 95% CI 0.04–0.51, p?=?0.02) of CR persisted at follow-up (range 2–52 weeks). CR is effective and efficient at improving cognitive performance after stroke. The degree of efficacy varies across cognitive domains, and further high-quality research is required to enhance and sustain the immediate effects. Increased emphasis on early intervention approaches, brain-behavior relationships, and evaluation of activity and participation outcomes is also recommended.     

Trait Socio-Cognitive Mindfulness is Related to Affective and Cognitive Empathy

Research regarding the relationship between empathy and mindfulness is sparse. Within the social scientific literature, there are two major branches of mindfulness research: meditative mindfulness (Kabat-Zinn in Gen Hosp Psychiatry 4(1):33–47, 1982) and non-meditative, socio-cognitive mindfulness (Langer and Moldoveanu in J Soc Issues 56(1):1–9, 2000). Meditative mindfulness is the awareness that arises through paying attention non-judgmentally to the present moment whereas socio-cognitive mindfulness is the process of drawing novel distinctions leading to greater attention to the present moment and sensitivity to context. We hypothesized that the two types of mindfulness would correlate with each other and with empathy broadly defined but that there would be divergence in these relationships given their conceptual distinctions. Four hundred and eighty-four participants from Mechanical Turk completed tasks of socio-cognitive mindfulness, meditative mindfulness, affective empathy, cognitive empathy, and social desirability. Socio-cognitive mindfulness correlated with both affective and cognitive empathy as well as with meditative mindfulness. Meditative mindfulness correlated with only affective empathy but not with cognitive empathy. These findings suggested that, in contrast to meditative mindfulness, socio-cognitive mindfulness involves cognitive processes (e.g., perspective-taking, flexibility) potentially amenable to experimental manipulation aimed at increasing empathy more generally.     

Functional Disability in Mild Cognitive Impairment: A Systematic Review and Meta-Analysis

Accumulating evidence suggests that the pre-dementia syndrome mild cognitive impairment (MCI) is characterized by decrements in instrumental activities of daily living (IADL). The current review was a quantitative synthesis of the available literature to objectively characterize IADL disability in MCI while clarifying inconsistencies in findings across studies. It was hypothesized that individuals with MCI would display significantly greater functional impairment relative to cognitively intact controls. Candidate moderators specified a priori included functional assessment approach, MCI subtype, depressive symptoms, and language conducted. Online databases (PubMed/MEDLINE and PsycINFO) and reference lists were searched to identify peer-reviewed publications assessing IADL in MCI compared to normal aging. A total of 151 effect sizes derived from 106 studies met inclusionary criteria (N?=?62,260). Random effects models yielded a large overall summary effect size (Hedges’ g?=?0.76, 95 % confidence interval: 0.68???0.83, p?<?.001) confirmed in multi-level analyses adjusted for nesting of effect sizes within studies (g?=?0.78, 95 % confidence interval: 0.69???0.87). Functional assessment strategy and MCI subtype were significant moderators of effect size, whereas depressive symptoms and language were not. Results convincingly demonstrate that MCI is associated with significant difficulties in the performance of complex everyday tasks. It appears that functional decline, like cognitive decline, exists on a continuum from healthy aging to dementia onset. Implications for clinical practice and research priorities are discussed.     

Emotional Competence and Anxiety in Childhood and Adolescence: A Meta-Analytic Review

Anxiety is conceptualized as a state of negative emotional arousal that is accompanied by concern about future threat. The purpose of this meta-analytic review was to evaluate the evidence of associations between emotional competence and anxiety by examining how specific emotional competence domains (emotion recognition, emotion expression, emotion awareness, emotion understanding, acceptance of emotion, emotional self-efficacy, sympathetic/empathic responses to others’ emotions, recognition of how emotion communication and self-presentation affect relationships, and emotion regulatory processes) relate to anxiety in childhood and adolescence. A total of 185 studies were included in a series of meta-analyses (N’s ranged from 573 to 25,711). Results showed that anxious youth are less effective at expressing (r = ?0.15) and understanding emotions (r = ?0.20), less aware of (r = ?0.28) and less accepting of their own emotions (r = ?0.49), and report less emotional self-efficacy (r = ?0.36). More anxious children use more support-seeking coping strategies (r = 0.07) and are more likely to use less adaptive coping strategies including avoidant coping (r = 0.18), externalizing (r = 0.18), and maladaptive cognitive coping (r = 0.34). Emotion acceptance and awareness, emotional self-efficacy, and maladaptive cognitive coping yielded the largest effect sizes. Some effects varied with children’s age. The findings inform intervention and treatment programs of anxiety in youth and identify several areas for future research.     

Subjective Cognitive Complaints and Objective Cognitive Function in Aging: A Systematic Review and Meta-Analysis of Recent Cross-Sectional Findings

Research investigating how subjective cognitive complaints (SCCs) might reliably indicate impairments in objective cognitive functioning has produced highly varied findings, and despite attempts to synthesise this literature (e.g., Jonker et al. International Journal of Geriatric Psychiatry, 15, 983–991, 2000; Reid and MacLullich Dementia and Geriatric Cognitive Disorders, 22(5–6), 471–485, 2006; Crumley et al. Psychology and Aging, 29(2), 250–263, 2014), recent work continues to offer little resolution. This review provides both quantitative and qualitative synthesis of research conducted since the last comprehensive review in 2006, with the aim of identifying reasons for these discrepancies that might provide fruitful avenues for future exploration. Meta-analysis found a small but significant association between SCCs and objective cognitive function, although it was limited by large heterogeneity between studies and evidence of potential publication bias. Often, assessments of SCCs and objective cognitive function were brief or not formally validated. However, studies that employed more comprehensive SCC measures tended to find that SCCs were associated independently with both objective cognitive function and depressive symptoms. Further explicit investigation of how assessment measures relate to reports of SCCs, and the validity of the proposed ‘compensation theory’ of SCC aetiology, is recommended.     

Sex-Specific Effect of Recalled Parenting on Affective and Cognitive Empathy in Adulthood

Previous research has demonstrated the influence of parenting on the development of children’s empathy. However, few studies have considered the impact of parents on empathy in adulthood, specific components of empathy, or the importance of parent and child biological sex. In the present study, 226 participants (71 men) completed online versions of the Parental Bonding Instrument (Parker et al. British Journal of Medical Psychology, 52, 1–10 1979), Empathy Quotient (Baron-Cohen and Wheelwright Journal of Autism and Developmental Disorders, 34, 163–175 2004), and Interpersonal Reactivity Index (Davis JSAS Catalog of Selected Documents in Psychology, 10, 85 1980). Paternal care and overprotection influenced affective empathy in men, whilst maternal overprotection predicted affective empathy in women. Further, maternal care related to cognitive empathy in men, whilst none of the parental care variables related to cognitive empathy in women. Findings are discussed in relation to sex differences in childhood parenting experiences on adult cognitive and affective empathy.     

Executive Functioning Correlates of <Emphasis Type="Italic">DSM-5</Emphasis> Maladaptive Personality Traits: Initial Evidence from an Italian Sample of Consecutively Admitted Adult Outpatients

In order to evaluate the associations between computer-administered tasks of executive functioning (EF), and maladaptive personality domains and traits listed in DSM-5 Alternative Model of Personality Disorders, 53 consecutively admitted psychotherapy outpatients (female participants: n?=?27, 50.9%; male participants: n?=?26, 49.1%; participants’ mean age?=?37.28 years, SD?=?11.50 years) were administered the Psychology Experiment Building Language (PEBL) EF tasks and the Personality Inventory for DSM-5 (PID-5). According to rank-order correlation analyses, a number of non-negligible and specific associations were observed between selected PID-5 scales and indices of participants’ performance on EF tasks. MM robust regression models showed that participants’ performance on computer-administered EF tasks explained a non-negligible amount of variance in selected PID-5 scale scores (median R² value?=?.17). As a whole, our trait-level analyses of PID-5 dimensions suggest the clinical usefulness of integrating self-reports and EF laboratory tasks in routine clinical assessment.     

Everyday Impact of Cognitive Interventions in Mild Cognitive Impairment: a Systematic Review and Meta-Analysis

Cognitive interventions in Mild Cognitive Impairment (MCI) seek to ameliorate cognitive symptoms in the condition. Cognitive interventions may or may not generalize beyond cognitive outcomes to everyday life. This systematic review and meta-analysis sought to assess the effect of cognitive interventions compared to a control group in MCI on generalizability outcome measures [activities of daily living (ADLs), mood, quality of life (QOL), and metacognition] rather than cognitive outcomes alone. PRISMA guidelines were followed. MEDLINE and PsychInfo were utilized as data sources to locate references related to cognitive interventions in individuals with MCI. The cognitive intervention study was required to have a control or alternative treatment comparison group to be included. Thirty articles met criteria, including six computerized cognitive interventions, 14 therapist-based interventions, and 10 multimodal (i.e., cognitive intervention plus an additional intervention) studies. Small, but significant overall median effects were seen for ADLs (d = 0.23), mood (d = 0.16), and metacognitive outcomes (d = 0.30), but not for QOL (d = 0.10). Computerized studies appeared to benefit mood (depression, anxiety, and apathy) compared to controls, while therapist-based interventions and multimodal interventions had more impact on ADLs and metacognitive outcomes than control conditions. The results are encouraging that cognitive interventions in MCI may impact everyday life, but considerably more research is needed. The current review and meta-analysis is limited by our use of only PsychInfo and MEDLINE databases, our inability to read full text non-English articles, and our reliance on only published data to complete effect sizes.     

Cognitive Interventions for Cognitively Healthy,Mildly Impaired,and Mixed Samples of Older Adults: A Systematic Review and Meta-Analysis of Randomized-Controlled Trials

Cognitive interventions may improve cognition, delay age-related cognitive declines, and improve quality of life for older adults. The current meta-analysis was conducted to update and expand previous work on the efficacy of cognitive interventions for older adults and to examine the impact of key demographic and methodological variables. EBSCOhost and Embase online databases and reference lists were searched to identify relevant randomized-controlled trials (RCTs) of cognitive interventions for cognitively healthy or mildly impaired (MCI) older adults (60+ years). Interventions trained a single cognitive domain (e.g., memory) or were multi-domain training, and outcomes were assessed immediately post-intervention using standard neuropsychological tests. In total, 279 effects from 97 studies were pooled based on a random-effects model and expressed as Hedges’ g (unbiased). Overall, results indicated that cognitive interventions produce a small, but significant, improvement in the cognitive functioning of older adults, relative to active and passive control groups (g = 0.298, p < .001, 95% CI = 0.248–0.347). These results were confirmed using multi-level analyses adjusting for nesting of effect sizes within studies (g = 0.362, p < .001, 95% CI = 0.275, 0.449). Age, education, and cognitive status (healthy vs. MCI) were not significant moderators. Working memory interventions proved most effective (g = 0.479), though memory, processing speed, and multi-domain interventions also significantly improved cognition. Effects were larger for directly trained outcomes but were also significant for non-trained outcomes (i.e., “transfer effects”). Implications for future research and clinical practice are discussed. This project was pre-registered with PROSPERO (#42016038386).     

Cognitive propositions

Soames's new theory of "cognitive propositions" is presented and several prima facie objections are presented to it.     

Interference Control in Children with Attention Deficit/Hyperactivity Disorder

The view that Attention Deficit/Hyperactivity Disorder (ADHD) is associated with a diminished ability to control interfference is controversial and based exclusively on results of (verbal)-visual interference tasks, primarily the Stroop Color Word task. The present study compares medication-naïve children with ADHD (n?=?35 and n?=?51 in Experiments 1 and 2, respectively) with normal controls (n?=?26 and n?=?32, respectively) on two interference tasks to assess interference control in both the auditory and the visual modality: an Auditory Stroop task and a Simon task. Both groups showed reliable but equal degrees of interference on both tasks, suggesting that children with ADHD do not differ from normal controls in their ability to control interference in either modality.     

Measuring discriminability when there are multiple sources of bias

Performance measures such as log d and d′?aim to measure stimulus discriminability independently of response bias in conditional discrimination tasks, including the yes/no signal-detection procedure. However, they assume only one dimension of bias (e.g., response color) and do not account for bias on additional dimensions (e.g., response side). Such bias reduces log d, thus violating the statistical independence of discriminability and bias measurements. We modified log d to account for side bias and reanalyzed previous side-biased data. With strong side bias, the modified log d differed enough from the standard log d to potentially alter the conclusions of an experiment. Simulations showed that the modified log d produces discriminability estimates that are more accurate and bias-independent than the standard log d calculation.     

Alliance and Treatment Outcome in Family-Involved Treatment for Youth Problems: A Three-Level Meta-analysis

Alliance has been shown to predict treatment outcome in family-involved treatment for youth problems in several studies. However, meta-analytic research on alliance in family-involved treatment is scarce, and to date, no meta-analytic study on the alliance–outcome association in this field has paid attention to moderating variables. We included 28 studies reporting on the alliance–outcome association in 21 independent study samples of families receiving family-involved treatment for youth problems (N = 2126 families, M age youth ranging from 10.6 to 16.1). We performed three multilevel meta-analyses of the associations between three types of alliance processes and treatment outcome, and of several moderator variables. The quality of the alliance was significantly associated with treatment outcome (r = .183, p < .001). Correlations were significantly stronger when alliance scores of different measurement moments were averaged or added, when families were help-seeking rather than receiving mandated care and when studies included younger children. The correlation between alliance improvement and treatment outcome just failed to reached significance (r = .281, p = .067), and no significant correlation was found between split alliances and treatment outcome (r = .106, p = .343). However, the number of included studies reporting on alliance change scores or split alliances was small. Our findings demonstrate that alliance plays a small but significant role in the effectiveness of family-involved treatment. Future research should focus on investigating the more complex systemic aspects of alliance to gain fuller understanding of the dynamic role of alliance in working with families.     

An examination of social and psychological influences on academic learning: a focus on self-esteem,social relationships,and personal interest

The present study focused on an examination of both global and domain-specific self-esteems in secondary mathematics learning. The extent to which self-esteem, in general, would account and explain educational success through social relationships with teachers and peers, and personal interest in learning tasks is the main inquiry of this correlational investigation. Two hundred and eighty-three year 10 students (128 girls, 155 boys) were asked to respond to a number of Likert-scale inventories. Causal modeling procedures, aided by the statistical software MPlus 7.3, were used to analyze the data and to test the hypothesized model. A series of a posteriori analyses yielded a modified model for discussion, producing a number of key findings, namely: (a) the differential influences of both global (e.g., →relationship with teachers) and domain-specific (e.g., →relationship with peers) self-esteems, (b) the positive influences of social relation with teachers (e.g., →exam result) and interest in learning tasks (e.g., →end-of-school term grade), and (c) the mediating functioning of relationship with peers and interest in learning tasks. This evidence, overall, provides additional theoretical insights into the operational nature and trajectories of effective learning.     

Overlapping and Distinct Cognitive Impairments in Attention-Deficit/Hyperactivity and Autism Spectrum Disorder without Intellectual Disability

Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are commonly comorbid, share genetic liability, and often exhibit overlapping cognitive impairments. Clarification of shared and distinct cognitive effects while considering comorbid symptoms across disorders has been lacking. In the current study, children ages 7–15 years assigned to three diagnostic groups:ADHD (n?=?509), ASD (n?=?97), and controls (n?=?301) completed measures spanning the cognitive domains of attention/arousal, working memory, set-shifting, inhibition, and response variability. Specific processes contributing to response variability were examined using a drift diffusion model, which separately quantified drift rate (i.e., efficiency of information processing), boundary separation (i.e., speed-accuracy trade-offs), and non-decision time. Children with ADHD and ASD were impaired on attention/arousal, processing speed, working memory, and response inhibition, but did not differ from controls on measures of delayed reward discounting, set-shifting, or interference control. Overall, impairments in the ASD group were not attributable to ADHD symptoms using either continuous symptom measures or latent categorical grouping approaches. Similarly, impairments in the ADHD group were not attributable to ASD symptoms. When specific RT parameters were considered, children with ADHD and ASD shared impairments in drift rate. However, children with ASD were uniquely characterized by a wider boundary separation. Findings suggest a combination of overlapping and unique patterns of cognitive impairment for children with ASD as compared to those with ADHD, particularly when the processes underlying reaction time measures are considered separately.     

Limitations in advance task preparation: Switching the relevant stimulus dimension in speeded same—different comparisons

When participants switch between relevant stimulus dimensions in speeded classification tasks, taskswitching cost is reduced by advance preparation. Previous studies in which speeded classification tasks were used have suggested that this effect results from attending to the relevant stimulus dimension. Because selective attention to the relevant stimulus dimension in same—different judgments is relatively poor (e.g., Santee &; Egeth, 1980), it was predicted that advance task preparation for a shift in the relevant stimulus dimension would be compromised. This prediction was borne out in two experiments comparing dimension shifts (shape vs.fill) with task rule shifts (same? vs.different?) and shifts in the mapping of right—left keys toyes and_to responses (yes—no vs.no—yes). The results indicate that advance attentional selection of the relevant dimension is an optional preparatory strategy in task switching, employed only in conditions enabling flexible refocusing of attention.     

Novice chimpanzees cooperate successfully in the presence of experts,but may have limited understanding of the task

Despite many observations of cooperation in nature, laboratory studies often fail to find careful coordination between individuals who are solving a cooperative task. Further, individuals tested are often naïve to cooperative tasks and there has been little exploration of partnerships with mixed expertise. In the current study, we examined acquisition of a cooperative pulling task in a group with both expert (N = 4) and novice (N = 11) chimpanzees (Pan troglodytes). We used five measures of competence and understanding: (1) success at the task, (2) latency to succeed, (3) efficiency, (4) uncoordinated pulling, and (5) pulling when a partner was present versus absent. We found that novices showed evidence of trial and error learning and developed competence over time, whereas the behavior of experts did not change throughout the course of the study. In addition to looking at patterns over time, we compared the performance of novices in this mixed-expertise group to an earlier study of novices in a group of all-novices. Novices in the mixed-expertise group pulled the same overall amount but for shorter periods of time, leading to higher pulling rates than individuals in the all-novice group. Taken together, these results suggest that learning in the presence of experts led to rapid and frequent success, although not necessarily careful coordination.     

On the Disambiguation of Meaning and the Effect of Cognitive Load

Most research supports a non-selective (or exhaustive) account of activation whereby multiple meanings of a word are initially activated (Degani and Tokowicz Quarterly Journal of Experimental Psychology, 63, 1266-1303, 2010). But what happens to the non-selected meaning of an ambiguous word (e.g., bark) and how is the decision made to select one meaning over the other? A great deal of research by Gernsbacher and colleagues (e.g., Gernsbacher and Faust 1991a) suggests that the non-selected meaning is “discarded” via active suppression. The present paper examines meaning-selection in ambiguous words using a word to elicit meaning context (rather than a sentence). Additionally, a manipulation of cognitive load (Experiment 2) was employed to examine these processes. Results support a suppression account of meaning selection. An updated conceptualization of ambiguity resolution is proposed.