Dr. Trueblood has written several informational sheets on different cognitive conditions and topics related to neuropsychology, which may be a helpful resource for you in your research.
You or a loved one may have been told by your doctor, or maybe a doctor in the emergency room, that you had a mild traumatic brain injury (MTBI). Here is some information about MTBI.
Things to know about MTBI
1. An MTBI is when a person is hit in the head or experiences a violent motion of the head ("whiplash") and is either unconscious for up to 30 minutes, or is not unconscious but has brief memory loss (amnesia) or confusion. Brain scan is usually normal.
2. Common symptoms after MTBI include concentration problems, memory problems, headaches, fatigue, irritability, anxiety, and insomnia. These symptoms usually go away in 3 months or less following an MTBI. This is why the World Health Organization says that the prognosis is "highly favorable" with MTBI.
3. The term "concussion" means basically the same things as MTBI.
4. Nerve cells or neurons in the brain may be injured in an MTBI, but they generally return to normal functioning. Also, the brain has a "reserve capacity" that it can draw upon.
5. If you MTBI was less than 3 months ago, you are very likely to recover fully. In the first days to weeks after MTBI, a person often is advised to get extra rest and keep his stress level low. Your doctor and you can decide what is best for you; it is important that you follow the advice of your treating doctor. (Also, if your MTBI was less than 3 months ago, the rest of the information presented here doesn't really apply to you.)
When symptoms persist after MTBI
Even if your symptoms have lasted more than 3 months after MTBI, you are still very likely to recover fully. It is just taking a little longer. You probably should go back to your doctor if you have not seen him or her for a while.
There is good science on MTBI but also a lot that isn't understood yet.
1. While the science is clear that at least 9 our of 10 people get better within 3 months following MTBI, it's not entirely clear why symptoms last longer than that for other people.
2. Getting better might take longer for some (but not most) people who have had 3 or more MTBIs, although research isn't settled on this issue.
3. Recovery after MTBI may take longer for a person who already had something that affected their brain before the MTBI, such as having had a stroke at some point in their life.
4. Memory and concentration problems that started at the time of the MTBI might actually be caused by headaches, insomnia, anxiety, or depression, any or all of which may have started at the same time as the MTBI or shortly after. On the other hand, brain imaging techniques (functional MRI and diffusion tensor imaging or DTI) have shown subtle brain dysfunction in some people who have symptoms for more than 3 months after MTBI, raising the possibility that the subtle brain dysfunction and the symptoms might be due to MTBI. Functional MRI and DTI aren't used in clinincal settings at this point, though.
Assessment of MTBI can be complicated
Your doctor just wants to figure out what to do to help you. However, the information presented above shows why evaluating MTBI can be complicated. Each individual's symptoms, history and characteristics need to be carefully considered. There can be legitimate differences of opinion between doctors, because science doesn't always provide a clear answer. This can be frustrating and even confusing for you, though. There may be evaluations by different types of doctors and other professionals, such as a rehabilitation physician (a physiatrist), neurologist, optometrist, neuropsychologist, speech-language pathologist, and physical therapist. These professionals can work to piece together a more complete picture of what is going on.
Treatment of MTBI may be comprehensive
- Medical/ neurological treatment may focus on headaches and other pain, insomnia, vision, symptoms, depression and anxiety, and perhaps other problems. Improvement in one area can lead to gains in a different area or problem; for example, reduction in headaches may contribute to better concentration and memory.
-Cognitive Rehabilitation is usually done by a speech-language pathologist and aims to improve memory and concentration, including providing a person with "tools" to use for better memory or concentration in his day-to-day life or on his job.
-Psychological Treatment may involve counseling to reduce depression and anxiety, as well as information and recommendations for coping with MTBI.
Advice for coping with MTBI
1. Become knowledgeable about MTBI.
2. Be open-minded about the information you receive about MTBI.
3. Keep in mind that there is still a degree of medical uncertainty, and even scientific controversy, about MTBI.
4. Work closely with your doctors and other treatment providers, including your primary medical provider, and this might also include a physiatrist, neurologist, optometrist, neuropsychologist, speech-language pathologist, and others.
If a person has a significant memory disorder, then treatment may be necessary; please see information on this under FAQs. But a lot of people who do not have a memory disorder would also like to learn and remember better. Here are three skills that you can develop that will help you to do that. (The scientific support for these skills will be presented at the very end of this section.)
1. ATTENTION/CONCENTRATION: The better you concentrate (that is, focus and sustain your attention) on something, the better you will learn and remember it. If something seems to be lowering your concentration, figure out what it is and change it; and take steps to improve your concentration, including mindfulness meditation and physical exercise.
How to use the skill of improving your attention/concentration. Concentration is focused and sustained attention. If you have a lot of difficulty remembering things you intend to do, or learning and remembering new things, it may be that your concentration is low. So the first thing to do is to figure out if something is affecting your concentration. If so, change whatever is reducing your concentration. You can also take steps to strengthen your concentration.
Concentration Checklist: for identifying factors that may be affecting your concentration:
-Multitasking: Doing several or a number of things at one time, or changing back and forth frequently between them;
-Overloading Yourself: Having a long list (either written or in your mind) of things you want to get done (this differs from multitasking because you are not necessarily doing them all at the same time);
-Anxiety: Worrying, or feeling nervous or tense; having a lot of stress in your life;
-Depression can cause a person to have difficulty concentrating or focusing;
-Distractions, such as the TV being on;
-Fatigue, which could be due to lack of sleep, or maybe you are having trouble learning or remembering at certain times of the day when you are more tire, such as the evening;
-Lack of Interest: Are you interested in what you are trying to learn and remember?
-Organization Problems: Some of us aren't very organized and don't plan very well, which can contribute to low concentration as well as learning and memory problems;
-Possible attention deficit hyperactivity disorder (ADHD): If you have had a lot of difficulty throughout your life in keeping your concentration on tasks, you might consider talking to your doctor about this, and they could explore whether a diagnosis of ADHD is a possibility.
If any factors on the above checklist are contributing to concentration problems for you, then you may have to put some work into changing them. For example, this might involve reducing your anxiety or stress, or changing your behavior patterns, such as if you often overload yourself.
Ways to strengthen your concentration:
1. Mindfulness meditation contributes to better concentration as well as learning and memory.
2. Aerobic exercise contributes to improved attention and thinking speed. Aerobic exercises include cycling and swimming; also, walking is an aerobic exercise if you walk fast enough to increase your heart rate and breathing rate, but you should still be able to carry on a conversation.
2. IMPLEMENTATION INTENTIONS: For something you want to remember to do, think of what it is, and when and where you want to do it. Picture this in your mind.
How to use implementation intentions
1. If there is something that you want to make sure to remember to do, say to yourself what you are going to do, and when and where you are going to do it.
2. Also, picture this in your mind, that is, play out an image of you carrying out the intended action at that place and time.
The whole procedure of talking to yourself and playing out that mental image would usually just take about a minute. There are two key aspects, specificity- being specific regarding what, when, and where- and forming a mental image.
Example of implementation intentions. Susan needs to remember that she has to leave a meeting at work half an hour early to pick up Cindy at the airport. Perhaps there is no handy place for Susan to put a note to remind herself, or she prefers to use implementation intentions and feels it works better than notes or electronic reminders, so she forms an implementation intention by saying the following to herself:
What: "I will leave"
When: "At 3:30 (1/2 hour early)"
Where: "The meeting at work"
She pictures herself in her seat at the meeting, seeing the clock showing the time of 3:30, and getting up and leaving.
Additional points related to implementation intentions:
-Implementation intentions can be used for something you want to remember to do once, like something to pick up on your way home, or something you want to tell your friend.
-It also could be something you want to remember to do regularly, like check your blood pressure every Wednesday night, or prepare three vegetables with every dinner.
-People who feel that other ways to keep from forgetting things don't work well, such as electronic reminders or writing notes, might opt for using implementation intentions.
3. SPACED RETRIEVAL: If you want to learn and remember information about a topic, repeatedly practice recalling that information at spaced time intervals.
How to use spaced retrieval
Spaced retrieval involves practicing remembering the information (that is, retrieving it rather than just rereading it) at spaced time intervals. The steps are:
1. Read the information you're trying to learn, such as a list or a set of fats. Put it aside.
2. A few minutes later, try to recall all that you can from the list or those facts. Check to see which ones you missed and for any mistakes.
3. Do the same thing a few hours later.
4. Do it again the next day.
You can decide how much time there is between your retrieval attempts. Usually this involves making the time intervals longer gradually. The first time should be soon after you have gone over the information.
Example of using spaced retrieval. Mandy wants to remember the names of the people whom she met at the company party. This is a new job for her, and she wants to learn people's names as quickly as she can, including people whom she does not have regular or frequent contact with on the job. The party was the night before, and she was too tired afterward to try to remember everyone, but she still can use this technique. The next morning she takes a few minutes to retrieve as many as she can. She may try to retrieve information about each person, too, and she could try to picture them. She could write down the names and information about them. Later in the day she again tries to retrieve the names and other information, and she checks this with what she had written down. She does the same thing the next day.
We sometimes have problems getting started on things, being productive, and taking action toward our goals. These can be single tasks or small goals, like cleaning the garage, and they can be goals that take months, years, or a lifetime. We procrastinate and avoid. If we do get a task started, we may not carry through and complete it. Here are three skills to change all that.
1. Choose long-term gain over feeling better in the short-term: When you are not taking action related to your goal, because you "don't want to" or "don't feel like it," do this: Recognize that those feelings are often the only thing standing in the way of following through in your efforts toward your goal, and that you have a choice, which is to give in to those feelings or to act toward your goal. Choose the latter, and ask yourself "what is my next action?"
How to use the strategy of choosing long-term gain over feeling better in the short-term.
When you have a goal or something to get done, but you are not taking action toward it, do the following:
1. Check to see what you are saying to yourself and how you are feeling about acting toward your goal. If you find that you are thinking that you "dont want to" or that you "don't feel like it,: proceed to the following steps.
2. Recognize that those feelings are contributing to your lack of action.In fact, those feelings are often the only thing standing in the way of following through.
3. Recognize that you have a choice. One option is to have your behavior be determined by those feelins and thus not follow through, and instead do something that makes you feel good for the moment (such as play a game on your phone). This is called "giving in to feeling good." The other option is to take action toward your goal. Choose that.
4. Then turn your thinking toward your behavior or action. Ask yourself "what is my next action?" This is just that very first small action that you take.
Example of the use of choosing long-term gain over feeling better in the short-term.Jenny is waffling on her goal of walking three miles before dinner. She is usually faithful in doing this, but today she just doesn't feel like it. Her energy level is low. She knows that there is a really good TV show right at this time. She could watch that and then when it's over she may feel more like walking. But she then recognizes that the only thing stopping her from acting toward her goal is that she doesn't feel like it. She realizes that she has a choice, to either give in to feel good in the short term by watching TV or feel good in the longer term b y going for that walk. She knows that the thing to do is ask herself what is the next step. Her answer to that is to get her walking shoes from the closet. Once she has them in her hands, the step after that is easier: to put them on. One step leads to another: open the door, and go outside... And an hour later she has completed a lot of steps, about 7,000 of them.
Additional points related to choosing long-term gain over feeling better in the short-term.
-Our behavior does not have to always be based on our feelings. Feelings are important, of course, but they also often shift quickly. Furthermore, feelings are not always grounded in accurate information. Always basing our actions entirely on our feelings would not be at all an effective way of doing things.
-Feelings often follow behavior, even though it seems like it is the other way around. Thus, if you act according to your goal, your feelings are likely to change as a result of your action.
-Other ways that we "give in to feel good" including eating, drinking, gambling, and shopping.
2. Self-compassion: When you don't take action on a goal (i.e., you procrastinate), be compassionate in the things you say to yourself; do that instead of the negative self-talk that you probably inflict on yourself at those times, as that negative self-talk is likely a main cause of developing a strong pattern of procrastinating.
How to use self-compassion to increase goal attainment
This point about being compassionate toward ourselves applies to any of us, if we are finding ourselves not taking action toward our goal, but it may be especially important to anyone who has a strong pattern of procrastinating. When you are putting off something, and particularly if you procrastinate a lot, do the following.
1. Listen to what you say to yourself about your procrastination in general or about putting off the project at hand. These could be things you say to yourself about your lack of willpower, or calling yourself weak. Write down these thoughts or self-statements.
2. Say compassionate things about yourself, instead of the negative self-talk One way to do this is to come up with a supportive and compassionate thing to say to yourself in response to each negative self-statement. You could also remind yourself that the negative self-statements contribute to your tendency to procrastinate and that it works much better to be kind to yourself.
3. It is worth considering going further than was described in the previous step, that is, really putting some time into developing self-compassion. Self-compassion is one of the parts of mindfulness, so you could read a book on mindfulness or participate in a mindfulness training program. By the way, its useful to have a description of what self-compassion is; it is "taking a kind and understanding stance toward oneself in instances of pain or failure rather than being harshly self-critical." [1]
Examples of using self-compassion to increase goal attainment Matt's bills are due; some are even past due. Finally, Matt gets himself to sit down and pay them. He also was late paying his bills the previous month, and the month before that. Then there is the garage, which he has been intending to clean for months now. Actually, there are lots of other examples of things he puts off. Matt carries out the steps listed above: He listens to what he says to himself about his procrastination, and he writes down those thoughts. He's pretty shocked at how negative he is toward himself. He comes up with a compassionate thing to say to himself in response to each of those negative thoughts. Matt decides on a handful of compassionate self-statements that he will use whenever he is putting something off. He also attends a class on mindfulness. It doesn't happen overnight, but gradually Matt gets better at stopping the negative self-statements and instead saying compassionate things to himself. He improves in getting things done, and he realizes that his negative thoughts about himself had been a part of the problem.
An additional comment on reducing procrastination by being compassionate toward yourself
Presumably part of our reason for talking negatively to ourselves when we procrastinate is to try to change that tendency, to make sure it doesn't happen next time. But instead it increases the likelihood it will happen next time. Here's how: The negative self-talk in reaction to procrastinating contributes to negative feelings (I'm stating the obvious). When we are again in a situation of trying to get ourselves to follow through and take action toward a goal, our anxiety (or other negative emotion such as sadness or discouragement) is likely to be all the greater because our negative self-talk caused it to be such an unpleasant experience the last time. The negative feelings increase the likelihood that we will '"give in to feel good," that is, do something that makes us feel good for the moment. This cycle repeats and strengthens each time.
3. Commitment Devices: Ways to lock yourself in to taking action toward your goal, to not putting off action. This can involve making declarations to others of what you are going to do, and there are also other types of commitment devices.
How to use the goal attainment skill of commitment devices
1. Social commitment or social contract: This can be as simple as telling a friend or family member what action(s) you are going to take toward a goal. It also could be more involved, such as an agreement between you and a friend or family member. This could be that the friend also makes a commitment of some kind, or there is a contract in terms of consequences for you, involving rewards for following through with the action, or penalties for not doing it. Just making a social commitment of some kind increases our chances of following through; we don't like to come up short in the eyes of others, nor to let others down. Dr. Pychyl (who is an expert on procrastination) makes this point about a social contract, in relation to the example of meeting a friend for an early morning run; "Whereas you might roll over and go back to sleep if its just you, it's less likely you'll leave your friend stranded out in front of your house." [2]
2. Make it public: [3] You could post your goal on Facebook, something like this: "I am going to pay off my credit card debt in 12 months and I will be posting monthly status reports. If you don't see me doing that, feel free to ask me about it." This obviously will lead to pressure to follow through, but perhaps even more important is that it will likely lead to waves of support.
3. Only commitment services: An example of an online commitment service is Stickk.com, which is free. It requires you to put something on the line when you set a goal, either money or reputation, or both. If you do not follow through with your goal, you either lose money, or you lose face with family and friends, because this site lets them know! The following are the specific steps that the site takes you through:
-Select your goal: either losing weight, exercising regularly, quitting smoking, racing, maintaining weight, or you can customize a goal.
-Set the stakes (money, who will be informed).
-Get a referee (!).
-Add friends for support.
Scientific evidence for the three learning/memory and three goal attainment skills
The science on attention/concentration.There is a lot of evidence that our attention capacity is limited. A classic study is the following. [4] People were shown a video and asked to count the number of times that the basketball players on the video passed the ball. At one point in the video, a woman in a gorilla suit walked in, faced the camera (and she was right in the middle of the screen), thumped her chest, and walked away. About half the people who watched the video never saw the gorilla. This was presumably because their attention was focused on counting the times that the basketball was passed. This result, of only about half of people seeing the gorilla, has been shown in many studies. Multitasking leads to slower, and poorer, performance than doing tasks one at a time: A study showed that people who multitasked during cognitive tests experienced about the degree of IQ decline that would be expected if they had stayed up all night. [5] Another study indicated that in-class texting by college students was related to recalling less of the class content. [6]
Human resource managers who participated in 8 weeks of mindfulness-based meditation training performed better than two comparison groups of human resource managers (one of which had 8 weeks of body relaxation training and the other had no training) on a test that included doing multiple work-related tasks such as using email, calendars, telephone, and word processing. That is, managers in the mindfulness group stayed on task longer and were less likely to become distracted, and they remembered the tasks better. [7] College students who did 6 minutes of written meditation exercises before a class lecture scored better on a quiz about the class content than did students who didn't meditate before class. [8]
A review of 29 studies led to the conclusion that aerobic exercise cause modest improvements in attention and memory, as well as other thinking skills. [9] One year of aerobic exercise training (compared to a stretching/toning program) led to a 2% increase in hippocampal volume in elderly people. That increase is even more noteworthy because hippocampal volume is known to shrink 1-2% annually in older adults. Aerobic exercise caused an actual physical changed in a key memory structure! [10]
The science on implementation intentions.When a group of scientists looked at a number of studies of implementation intentions (a total of 36 comparisons) [11], they found a "medium to large" effect in terms of improving prospective memory performance in older adults, and a "medium" effect in young adults. The combined verbal and imagery form of implementation intentions had a stronger effect. Prospective memory is memory that pertains to the future; that is, memory isn't always related to the past. Remembering to do something that we intend to do is a type of prospective memory.
A specific study of implementation intentions and prospective memory is the following. [12] Study participants (who ranged from age 60 to 81) were asked to remember to follow the schedule of testing their blood sugar level, at 4 specified times each day for 3 weeks, without outside assistance such as timers or alarms. The implementation intention group members were trained to form a specific plan as to when and where they would do the testing, and they mentally imagined it. A "rehearsal" control group was instructed to repeat to themselves "at 12, I will test my blood sugar level; at 1:30, I will test my blood sugar level..." (Note that this does not involve the mental picturing nor specifying where.) A "deliberation" group was instructed to think of the pros (e.g., better health) and cons (e.g., time-consuming) of testing their blood sugar level. Each group participated in training for 3 minutes. The implementation intentions group executed 50% more tests on time than did the other 2 groups. This study suggests that implementation intentions might increase elderly individuals' rate of carrying out important medical self-care tasks.
The science on spaced retrieval. A group of scientists in 2013 looked at all of the studies that had been done on spaced retrieval and concluded that it is "very effective under a wide array of situations." [13] Actually, that was the rating that they gave for two strategies called "distributed practice" and "practice testing"; both of these are so similar to spaced retrieval that they can be considered the same thing.
A group that was taught to use spaced retrieval did much better in remembering names of people they met at a party 1 to 3 days earlier, than did a group that was taught to use imagery to remember people's names, as well as a group that was told to try to memorize the people's names but were given no instructions. [14]
People watched 21 videos that had been posted on YouTube. Those people went over the events in most of the videos for 40 seconds each, either mentally or out loud. A week later, people recalled nearly twice as much from the videos they had rehearsed compared to the other videos. [15] Twice as much recall, as a result of just 40 seconds!
The science on choosing long-term gain over feeling better in the short-term. This strategy comes from Dr. Pychyl. [16] A study [17] found that college students who were in bad moods procrastinated much more about studying for an upcoming test than did students who were in good moods. To first describe this in a little more detail and then discuss the findings, this was a laboratory or experimental study, rather than being a "real world" study. That is, it involved students volunteering for the study, and of course the real purpose of the study was disguised to the students. Good versus bad mood was induced by having students read either a distressing story or a happy one. Students who were in a bad mood participated in fun activities for an average of 13.7 of the 15 minutes prior to a test, instead of the alternative of studying for the test. A group comprised of students who were in a bad mood and only had boring alternative activities available, and also the good mood groups, didn't procrastinate nearly as much as the bad mood/fun activities group.
The science on being compassionate toward yourself when you procrastinate.Results of a study by Dr. Sirois [18] demonstrated that procrastination was associated with lower levels of self-compassion. This was based on 674 undergraduates and 94 community adults completing a measure of procrastination (on which they rated items such as "I'm not very good at meeting deadlines" and "I generally delay before starting work have to do") and the Self-Compassion Scale (on which they rated items such as "I try to be loving toward myself when I'm feeling emotional pain" and "I'm disapproving and judgmental about my own flaws and inadequacies"). Dr. Sirois acknowledge that the results do not show that lower levels of self-compassion cause procrastination, but she did conclude that there is some suggestive evidence in other research for the role of low self-compassion in the development of a tendency to procrastinate. She pointed out that such a role seems plausible, she also stated that "negative self-evaluations could promote a cycle or procrastination," and she referred to "a possible multi-directional relationship between procrastination and self-compassion." She also went on to say that mindfulness-based stress reduction and mindful self-compassion programs are effective in increasing self-compassion. [19] You can see that the procrastination measure used in the above study reflects people's views of themselves in general, how they usually act. This is based on the idea that procrastination is a trait, a tendency to act in a similar manner across time and situations. It also can be regarded as a behavior in a situation, which is referred to as a "state." So procrastination can be both a trait and a state. For example, a person who doesn't have a strong pattern of procrastinating would not be considered to have that as a trait, but he might procrastinate now and then. There is support for viewing procrastination as a trait: a study found that identical twins were significantly similar regarding their tendency to procrastinate. [20] A study [21] provides evidence that people who are higher in trait procrastination make more self-deprecating statements compared to non-procrastinators. This study involved students logging in to a website and making text entries describing what was going through their minds as they were procrastinating. As an example, a procrastinator reported "I'm thinking now that I'm simply too stupid to benefit from more studying, so I'll just hang out on Facebook."
The science on using commitment devices to increase goal attainment. An article that reviewed nine studies on social support approaches to increasing physical activity concluded that the strategies used in all nine studies were effective in getting people to be more physically active. [18] Those strategies included setting up a buddy system, making contracts with others to complete specified levels of physical activity, and setting up walking and other groups to provide friendship and support.
Commitment device is a term coined by Stephen Dunbar and Steven Levitt, the authors of Freakonomics. [22] They define this as "a means with which to lock yourself into a course of action that you might not otherwise choose but produces a desired result." It is useful to mention that Stikk.com, offers the following statistics: $30 million have been put on the line on the website; 326,000 commitments have been made; 880,000 workouts have been completed; and 19 million cigarettes have been not smoked.
[1] Sirois, F. (2013). Procrastination and stress: Exploring the role of self-compassion. Self and Identity, 12, 1-18. (Sirois cites the following: Neff, KD. (2003). Self-compassion: An alternative conceptualization of a healthy attitude toward oneself. Self and Identity, 2, 85-101.)
[2] Pychyl, T. (2009). Closing the intention gap. Psychology Today.
[3] Kennedy, N. (2016). 4 commitment devices to help you set and achieve financial goals. moneycrashers.com
[4] Simons, D.J., & Chabris, C.F. (1999). Gorillas in our midst: sustained inattentional blindness for dynamic events. Perception, 28, 1059-1074.
[5] Crews, D. & Russ, M. (2012). The impact of multitasking on human and organizational efficiency. Leadership and Organizational Management, 2012, 54-68.
[6] Kuznekoff, J,. Munz, S., & Titworth, S. (2015). Mobile phones in the classroom: Examining the effects of texting, twitter, and message content on student learning. Communication Educations, 64, 344-65.
[7] Levy, D., Wobbrock, J., Kaszniak, A. & Ostergren, M. (2012). The effects of mindfulness meditation training on multitasking in a high-stress information environment. Proceedings of Graphic Interface, 45-52.
[8] Ramsburg, J.T., & Youmans, R.J.. (2013). Meditation in the higher-education classroom: meditation training improves student knowledge retention during lectures. Mindfulness, 5, 431-41.
[9] Smith, PJ, Blumenthal, JA, Hoffman, BM, Cooper, H, Strauman, TA, Welsh-Bohmen, K, Browndyke, JN, & Sherwood, A. (2010). Aerobic exercise and neurocognitive performance: A meta-analytic review of randomized control trials. Psychosomatic Medicine, 72, 239-252.
[10] Erickson, KI, Voss, MW, Prakash, RS. (2011). Exercise training increases size of hippocampus and improves memory. Proceedings of the National Academy of Sciences, 108, 3017-22.
[11] Chen, X., Wang, X. et al. (2015). The effect of implementation intention on prospective memory: A systematic and meta-analytic review. Psychiatry Research, 226, 14-22.
[12] Liu, L.L., & Park, D.C. (2004). Aging and medical adherence: the use of automatic processes to achieve effortful things. Psychology and Aging, 19, 318-25.
[13] Dunlosky, J. (2013). Strengthening the student toolbox: study strategies to boost learning. American Educator, 37, 12-21.
[14] Morris, Pe, Fritz, Co, Jackson, L, Nichol, E, & Roberts, E. (2005). Strategies for learning proper names: Expanding retrieval practice, meaning and imagery. Applied Cognitive Psychology, 19, 779-798.
[15] Bird, CM, Keidel, JL, Ing, LP, Horner, AJ & Burgess, N. (2015). Consolidation of complex events via reinstatement in posterior cingulate cortex. The Journal of Neuroscience, 35, 1426-34.
[16] Pychyl, T. (2016). Procrastination 101: It's not about feeling like it. Psychology Today.
[17] Tice, D, Bratslavsky, E, & Baumeister, R. (2001). Emotional distress regulation takes precedence over impulse control: If you feel bad, do it! Journal of Personality and Social Psychology, 80, 53-67.
[18] Sirois, F. (2013). Exploring the role of self-compassion. Self and Identity, 12, 1-18.
[19] Neff, ND & Germer, CK. (2012). A pilot study and randomized control trial of the Mindful Self-Compassion Program. Journal of Clinical Psychology, 69, 28-44.
[20] Steel, P. (2007). The nature of procrastination: A meta-analytic and theoretical review of quintessential self-regulatory failure. Psychological Bulletin, 133, 65-94.
[21] McCown, W, Blake, IK & Keiser, RJ. (2012). Content analyses of the beliefs of academic procrastinators. Journal of Rational-Emotive and Cognitive-Behavioral Therapy, 4, 213-222.
[22] Levitt, SD & Dubner, SJ. (2005). Freakonomics: A rogue economist explores the hidden side of everything. New York: HarperCollins.