Page 22 - JSOM Fall 2023

signal tasks measure controlled inhibition through volitional a cognitive surveillance program. Special Operations cognitive
stopping power. 16,17 Inhibitory control has Special Operations assessments require more speed both to limit the burden on
applications through shoot/don’t-shoot decisions, but the sim- Operator time to complete the assessment and reduced logisti-
ple go/no-go tasks do not adequately represent additional com- cal burden to process the outcome.
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ponents inherent to a shoot/don’t-shoot decision. Specifically,
the subjective nature of a threat assessment incorporates ad- Taken together, these three requirements—operational rele-
ditional interpretation steps in decision-making beyond what vance, optimization, and speed—identify the core characteris-
the simple stimuli present during laboratory inhibition tasks. tics of a Special Operations cognitive assessment. They define
The easiest intervention involves using more operationally rel- the purpose of any evaluation and the lens through which
evant stimuli to help the outcome connect to impact, although any test should be evaluated. Even so, these criteria are not
the paradigm itself will better resemble operational decisions inherently a cognitive assessment. As such, the discussion shall
as further sensorimotor concerns can be integrated, such as now move to a cognitive assessment that could meet all three
the use of a firearm. In short, many laboratory- designed, go/ criteria.
no-go tasks are effective measurements of the cognitive ability
in question, yet these tasks do not necessarily convey opera- Developing a Special Operations
tional relevance without further manipulation. 19
Cognitive Assessment
Optimization is the second major requirement of cognitive as- Cognitive assessments are often built upon response time
sessments in Special Operations. This purpose carries several tasks, and although there are more complex methods avail-
implications for both the type of assessment and its application. able, this simple approach can be employed to much greater
Foremost, optimization requires a task without robust ceiling effect than currently used in the ANAM or similar tasks.
effects, or else the room for improvement cannot be properly Therefore, the base task will resemble the go/no-go construct
documented. The MoCA example is excellent in illustrating in the ANAM and many other cognitive batteries. However,
the problem. It is a cognitive assessment, yes, but it is designed the stimuli can be altered to depict pictures of threatening and
to measure the depth of impairment—not optimal function- non- threatening stimuli rather than red and green squares.
ing. Special Operations may require a higher level of cognitive Whereas the latter shapes require an arbitrary designation of
performance than typical military duties, and, indeed, the ex- no-go and go stimuli, threat images can align with threat as-
isting normative data support a higher level of baseline cogni- sessment as expected based on the unit mission or rules of
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tive functions among Special Operations personnel. In turn, engagement. This simple stimulus switch makes the response
this need requires a test wherein it is exceptionally difficult to time task more operationally relevant, which satisfies the first
achieve a maximum score. A related concern is thus that cogni- criterion of a Special Operations cognitive assessment—go/
tive assessments in Special Operations should be aligned with no-go becomes shoot/don’t-shoot, and arbitrary assignment
cognitive enhancement more than cognitive decline. 20,21 Cog- for no-go criteria can be directly replaced by rules of engage-
nitive decline requires a simpler test to document the depth ment during a threat assessment.
of impairment, whereas optimization requires a more diffi-
cult test to stratify differences among high performers. This Optimization could be satisfied by a response time task through
approach further differentiates a Special Operations cognitive faster correct responses to threat stimuli and fewer errors as
assessment from typical neurocognitive assessments such as responses to non-threatening stimuli. A hit factor approach
the ANAM. A given test may be useful in exploring baseline (i.e., using speed divided by accuracy as an outcome measure)
functioning and impairments due to traumatic brain injury or would likewise be another step forward toward optimization
other blast exposure, but measuring decline and achieving op- since it would incorporate both speed and accuracy into a uni-
timal performance are functionally different purposes. A Spe- fied construct. Still, this approach would not be the best avail-
cial Operations test requires something that can both identify able option. Instead, the millisecond-accurate response timing
high performers and monitor potential decline. can support drift diffusion modeling (DDM). 24,25 Rather than
simply presenting a response time, DDM is a cognitive com-
The third major requirement is speed, which identifies the putational modeling approach to decision-making that identi-
logistical and pragmatic concerns for any Special Operations fies more precise parameters than the speed or accuracy of a
cognitive assessment. Consider the stop signal task as an excel- decision. These parameters can include drift rate, or the rate
lent method of capturing inhibitory control and impulsive be- of information processing; decision threshold, or how much
haviors, where a signal begins as the “go signal” that warrants information an individual needs to make a decision; starting
a behavioral response before quickly changing into a “stop sig- bias, or the individual differences in willingness to make some
nal” that demands the participant withhold a response. This given response; and, non-decisional factors, such as motor re-
paradigm is commonly used to measure response inhibition sponse speed. Accuracy and average speed are still captured,
because an individual initiates a motor response and then must but these additional parameters provide further insight into
quickly try to stop mid-action. Even though it is superior to individual decisions.
the go/no-go task when measuring volitional stopping ability,
the measurement itself is often quite complicated with many For example, consider two Operators who might make a
nuanced, but important concerns that can significantly impact threat assessment within 500 milliseconds (Figure 1). A sim-
the outcome. 22,23 Measuring an outcome score may require ple response time cannot differentiate their decisions param-
hundreds of trials and deliver only a single data point. From a eters. However, one Operator may accumulate information
military evaluation perspective, this process is both inefficient much faster while setting a higher threshold to make a positive
in Operator time required to collect the data and in analyst threat identification, whereas the other Operator may accumu-
time to properly process the data. Both of these apply to a sin- late information more slowly while requiring less information
gle assessment, let alone the multiple assessments required for to make a response. Slower information accumulation and a

20 | JSOM Volume 22, Edition 3 / Fall 2023