2Using cognitive control to ignore distractions is essential for successfully achieving our goals. In emotionallyneutral contexts, motivation can reduce interference from irrelevant stimuli by enhancing cognitive control.However, attention is commonly biased towards emotional stimuli, making them potent distractors. Can motivation aid control of emotional distractions, and does it do so similarly for positive and negative stimuli?Here, we examined how task motivation influences control of distraction from positive, negative, and neutral scenes. Participants completed a simple perceptual task while attempting to ignore task-irrelevant images. One group received monetary reward for fast and accurate task performance; another (control) group did not.Overall, both negative (mutilation) and positive (erotic) images caused greater slowing of responses than neutral images of people, but emotional distraction was reduced with reward. Crucially, despite the different motivational directions associated with negative and positive stimuli, reward reduced negative and positive distraction equally. Our findings suggest that motivation may encourage the use of a sustained proactive control strategy that can effectively reduce the impact of emotional distraction.

Attention is biased toward emotional stimuli, even when they are irrelevant to current goals. Motivation, elicited by performancecontingent reward, reduces behavioural emotional distraction. In emotionally neutral contexts, reward is thought to encourage use of a proactive cognitive control strategy, altering anticipatory attentional settings to more effectively suppress distractors. The current preregistered study investigates whether a similar proactive shift occurs even when distractors are highly arousing emotional images. We monitored pupil area, an online measure of both cognitive and emotional processing, to examine how reward influences the time course of control. Participants (n = 110) identified a target letter flanking an irrelevant central image. Images were meaningless scrambles on 75% of trials; on the remaining 25%, they were intact positive (erotic), negative (mutilation), or neutral images. Half the participants received financial rewards for fast and accurate performance, while the other half received no performance-contingent reward. Emotional distraction was greater than neutral distraction, and both were attenuated by reward. Consistent with behavioural findings, pupil dilation was greater following emotional than neutral distractors, and dilation to intact distractors (regardless of valence) was decreased by reward. Although reward did not enhance tonic pupil dilation (an index of sustained proactive control), exploratory analyses showed that reward altered the time course of control-eliciting a sharp, rapid, increase in dilation immediately preceding stimulus onset (reflecting dynamic use of anticipatory control), that extended until well after stimulus offset. These findings suggest that reward alters the time course of control by encouraging proactive preparation to rapidly disengage from emotional distractors.

Attention is biased toward emotional stimuli, even when they are irrelevant to current goals. Motivation, elicited by performance-contingent reward, reduces behavioural emotional distraction. In emotionally-neutral contexts, reward is thought to encourage use of a proactive cognitive control strategy, altering anticipatory attentional settings to more effectively suppress distractors. The current preregistered study investigates whether a similar proactive shift occurs even when distractors are highly arousing emotional images. We monitored pupil area, an online measure of both cognitive and emotional processing, to examine how reward influences the timecourse of control. Participants (n = 110) identified a target letter flanking an irrelevant central image. Images were meaningless scrambles on 75% of trials; on the remaining 25%, they were intact positive (erotic), negative (mutilation), or neutral images. Half the participants received financial rewards for fast and accurate performance, while the other half received no performance-contingent reward. Emotional distraction was greater than neutral distraction, and both were attenuated by reward. Consistent with behavioural findings, pupil dilation was greater following emotional than neutral distractors, and dilation to intact distractors (regardless of valence) was decreased by reward. Although reward did not enhance tonic pupil dilation (an index of sustained proactive control), exploratory analyses showed that reward altered the timecourse of control – eliciting a sharp, rapid, increase in dilation immediately preceding stimulus-onset (reflecting dynamic use of anticipatory control), that extended until well after stimulus-offset. These findings suggest that reward alters the timecourse of control by encouraging proactive preparation to rapidly disengage from emotional distractors.

Irrelevant emotional stimuli often capture attention, disrupting ongoing cognitive processes. In two experiments, we examined whether availability of rewards (monetary and non-monetary) can prevent this attentional capture. Participants completed a central letter identification task while attempting to ignore negative, positive, and neutral distractor images that appeared above or below the targets on 25% of trials. Distraction was indexed by slowing on distractor-present trials. Half the participants completed the task with no performance-contingent reward, while the other half earned points for fast and accurate performance. In Experiment 1, points translated into monetary reward, but in Experiment 2, points had no monetary value. In both experiments, reward reduced capture by emotional distractors, showing that even non-monetary reward can aid attentional control. These findings suggest that motivation encourages use of effective cognitive control mechanisms that effectively prevent attentional capture, even when distractors are emotional.

IntroductionMild cognitive impairment remains substantially underdiagnosed, especially in disadvantaged populations. Failure to diagnose deprives patients and families of the opportunity to treat reversible causes, make necessary life and lifestyle changes and receive disease‐modifying treatments if caused by Alzheimer's disease. Primary care, as the entry point for most, plays a critical role in improving detection rates.MethodsWe convened a Work Group of national experts to develop consensus recommendations for policymakers and third‐party payers on ways to increase the use of brief cognitive assessments (BCAs) in primary care.ResultsThe group recommended three strategies to promote routine use of BCAs: providing primary care clinicians with suitable assessment tools; integrating BCAs into routine workflows; and crafting payment policies to encourage adoption of BCAs.DisscussionSweeping changes and actions of multiple stakeholders are necessary to improve detection rates of mild cognitive impairment so that patients and families may benefit from timely interventions.