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Problem Solving

• David H. Jonassen 2 &
• Woei Hung 3  
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Cognition ; Problem typology ; Problem-based learning ; Problems ; Reasoning

Problem solving is the process of constructing and applying mental representations of problems to finding solutions to those problems that are encountered in nearly every context.

Theoretical Background

Problem solving is the process of articulating solutions to problems. Problems have two critical attributes. First, a problem is an unknown in some context. That is, there is a situation in which there is something that is unknown (the difference between a goal state and a current state). Those situations vary from algorithmic math problems to vexing and complex social problems, such as violence in society (see Problem Typology ). Second, finding or solving for the unknown must have some social, cultural, or intellectual value. That is, someone believes that it is worth finding the unknown. If no one perceives an unknown or a need to determine an unknown, there is no perceived problem. Finding...

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Jonassen, D.H., Hung, W. (2012). Problem Solving. In: Seel, N.M. (eds) Encyclopedia of the Sciences of Learning. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-1428-6_208

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Original research article, creative problem solving as overcoming a misunderstanding.

• Department of Psychology, University of Milano-Bicocca, Milan, Italy

Solving or attempting to solve problems is the typical and, hence, general function of thought. A theory of problem solving must first explain how the problem is constituted, and then how the solution happens, but also how it happens that it is not solved; it must explain the correct answer and with the same means the failure. The identification of the way in which the problem is formatted should help to understand how the solution of the problems happens, but even before that, the source of the difficulty. Sometimes the difficulty lies in the calculation, the number of operations to be performed, and the quantity of data to be processed and remembered. There are, however, other problems – the insight problems – in which the difficulty does not lie so much in the complexity of the calculations, but in one or more critical points that are susceptible to misinterpretation , incompatible with the solution. In our view, the way of thinking involved in insight problem solving is very close to the process involved in the understanding of an utterance, when a misunderstanding occurs. In this case, a more appropriate meaning has to be selected to resolve the misunderstanding (the “impasse”), the default interpretation (the “fixation”) has to be dropped in order to “restructure.” to grasp another meaning which appears more relevant to the context and the speaker’s intention (the “aim of the task”). In this article we support our view with experimental evidence, focusing on how a misunderstanding is formed. We have studied a paradigmatic insight problem, an apparent trivial arithmetical task, the Ties problem. We also reviewed other classical insight problems, reconsidering in particular one of the most intriguing one, which at first sight appears impossible to solve, the Study Window problem. By identifying the problem knots that alter the aim of the task, the reformulation technique has made it possible to eliminate misunderstanding, without changing the mathematical nature of the problem. With the experimental versions of the problems exposed we have obtained a significant increase in correct answers. Studying how an insight problem is formed, and not just how it is solved, may well become an important topic in education. We focus on undergraduate students’ strategies and their errors while solving problems, and the specific cognitive processes involved in misunderstanding, which are crucial to better exploit what could be beneficial to reach the solution and to teach how to improve the ability to solve problems.

Introduction

“A problem arises when a living creature has a goal but does not know how this goal is to be reached. Whenever one cannot go from the given situation to the desired situation simply by action, then there has to be recourse to thinking. (…) Such thinking has the task of devising some action which may mediate between the existing and the desired situations.” ( Duncker, 1945 , p. 1). We agree with Duncker’s general description of every situation we call a problem: the problem solving activity takes a central role in the general function of thought, if not even identifies with it.

So far, psychologists have been mainly interested in the solution and the solvers. But the formation of the problem remained in the shadows.

Let’s consider for example the two fundamental theoretical approaches to the study of problem solving. “What questions should a theory of problem solving answer? First, it should predict the performance of a problem solver handling specified tasks. It should explain how human problem solving takes place: what processes are used, and what mechanisms perform these processes.” ( Newell et al., 1958 , p. 151). In turn, authors of different orientations indicate as central in their research “How does the solution arise from the problem situation? In what ways is the solution of a problem attained?” ( Duncker, 1945 , p. 1) or that of what happens when you solve a problem, when you suddenly see the point ( Wertheimer, 1959 ). It is obvious, and it was inevitable, that the formation of the problem would remain in the shadows.

A theory of problem solving must first explain how the problem is constituted, and then how the solution happens, but also how it happens that it is not solved; it must explain the correct answer and with the same means the failure. The identification of the way in which the problem is constituted – the formation of the problem – and the awareness that this moment is decisive for everything that follows imply that failures are considered in a new way, the study of which should help to understand how the solution of the problems happens, but even before that, the source of the difficulty.

Sometimes the difficulty lies in the calculation, the number of operations to be performed, and the quantity of data to be processed and remembered. Take the well-known problems studied by Simon, Crypto-arithmetic task, for example, or the Cannibals and Missionaries problem ( Simon, 1979 ). The difficulty in these problems lies in the complexity of the calculation which characterizes them. But, the text and the request of the problem is univocally understood by the experimenter and by the participant in both the explicit ( said )and implicit ( implied ) parts. 1 As Simon says, “Subjects do not initially choose deliberately among problem representations, but almost always adopt the representation suggested by the verbal problem statement” ( Kaplan and Simon, 1990 , p. 376). The verbal problem statement determines a problem representation, implicit presuppositions of which are shared by both.

There are, however, other problems where the usual (generalized) interpretation of the text of the problem (and/or the associated figure) prevents and does not allow a solution to be found, so that we are soon faced with an impasse. We’ll call this kind of problems insight problems . “In these cases, where the complexity of the calculations does not play a relevant part in the difficulty of the problem, a misunderstanding would appear to be a more appropriate abstract model than the labyrinth” ( Mosconi, 2016 , p. 356). Insight problems do not arise from a fortuitous misunderstanding, but from a deliberate violation of Gricean conversational rules, since the implicit layer of the discourse (the implied ) is not shared both by experimenter and participant. Take for example the problem of how to remove a one-hundred dollar bill without causing a pyramid balanced atop the bill to topple: “A giant inverted steel pyramid is perfectly balanced on its point. Any movement of the pyramid will cause it to topple over. Underneath the pyramid is a $100 bill. How would you remove the bill without disturbing the pyramid?” ( Schooler et al., 1993 , p. 183). The solution is burn or tear the dollar bill but people assume that the 100 dollar bill must not be damaged, but contrary to his assumption, this is in fact the solution. Obviously this is not a trivial error of understanding between the two parties, but rather a misunderstanding due to social conventions, and dictated by conversational rules. It is the essential condition for the forming of the problem and the experimenter has played on the very fact that the condition was not explicitly stated (see also Bulbrook, 1932 ).

When insight problems are used in research, it could be said that the researcher sets a trap, more or less intentionally, inducing an interpretation that appears to be pertinent to the data and to the text; this interpretation is adopted more or less automatically because it has been validated by use but the default interpretation does not support understanding, and misunderstanding is inevitable; as a result, sooner or later we come up against an impasse. The theory of misunderstanding is supported by experimental evidence obtained by Mosconi in his research on insight problem solving ( Mosconi, 1990 ), and by Bagassi and Macchi on problem solving, decision making and probabilistic reasoning ( Bagassi and Macchi, 2006 , 2016 ; Macchi and Bagassi, 2012 , 2014 , 2015 , 2020 ; Macchi, 1995 , 2000 ; Mosconi and Macchi, 2001 ; Politzer and Macchi, 2000 ).

The implication of the focus on problem forming for education is remarkable: everything we say generates a communicative and therefore interpretative context, which is given by cultural and social assumptions, default interpretations, and attribution of intention to the speaker. Since the text of the problem is expressed in natural language, it is affected, it shares the characteristics of the language itself. Natural language is ambiguous in itself, differently from specialized languages (i.e., logical and statistical ones), which presuppose a univocal, unambiguous interpretation. The understanding of what a speaker means requires a disambiguation process centered on the intention attribution.

Restructuring as Reinterpreting

Traditionally, according to the Gestaltists, finding the solution to an insight problem is an example of “productive thought.” In addition to the reproductive activities of thought, there are processes which create, “produce” that which does not yet exist. It is characterized by a switch in direction which occurs together with the transformation of the problem or a change in our understanding of an essential relationship. The famous “aha!” experience of genuine insight accompanies this change in representation, or restructuring. As Wertheimer says: “… Solution becomes possible only when the central features of the problem are clearly recognized, and paths to a possible approach emerge. Irrelevant features must be stripped away, core features must become salient, and some representation must be developed that accurately reflects how various parts of the problem fit together; relevant relations among parts, and between parts and whole, must be understood, must make sense” ( Wertheimer, 1985 , p. 23).

The restructuring process circumscribed by the Gestaltists to the representation of the perceptual stimulus is actually a general feature of every human cognitive activity and, in particular, of communicative interaction, which allows the understanding, the attribution of meaning, thus extending to the solution of verbal insight problems. In this sense, restructuring becomes a process of reinterpretation.

We are able to get out of the impasse by neglecting the default interpretation and looking for another one that is more pertinent to the situation and which helps us grasp the meaning that matches both the context and the speaker’s intention; this requires continuous adjustments until all makes sense.

In our perspective, this interpretative function is a characteristic inherent to all reasoning processes and is an adaptive characteristic of the human cognitive system in general ( Levinson, 1995 , 2013 ; Macchi and Bagassi, 2019 ; Mercier and Sperber, 2011 ; Sperber and Wilson, 1986/1995 ; Tomasello, 2009 ). It guarantees cognitive economy when meanings and relations are familiar, permitting recognition in a “blink of an eye.” This same process becomes much more arduous when meanings and relations are unfamiliar, obliging us to face the novel. When this happens, we have to come to terms with the fact that the usual, default interpretation will not work, and this is a necessary condition for exploring other ways of interpreting the situation. A restless, conscious and unconscious search for other possible relations between the parts and the whole ensues until everything falls into place and nothing is left unexplained, with an interpretative heuristic-type process. Indeed, the solution restructuring – is a re -interpretation of the relationship between the data and the aim of the task, a search for the appropriate meaning carried out at a deeper level, not by automaticity. If this is true, then a disambiguant reformulation of the problem that eliminates the trap into which the subject has fallen, should produce restructuring and the way to the solution.

Insight Problem Solving as the Overcoming of a Misunderstanding: The Effect of Reformulation

In this article we support our view with experimental evidence, focusing on how a misunderstanding is formed, and how a pragmatic reformulation of the problem, more relevant to the aim of the task, allows the text of the problem to be interpreted in accordance with the solution.

We consider two paradigmatic insight problems, the intriguing Study Window problem, which at first sight appears impossible to solve, and an apparent trivial arithmetical task, the Ties problem ( Mosconi and D’Urso, 1974 ).

The Study Window problem

The study window measures 1 m in height and 1 m wide. The owner decides to enlarge it and calls in a workman. He instructs the man to double the area of the window without changing its shape and so that it still measures 1 m by 1 m. The workman carried out the commission. How did he do it?

This problem was investigated in a previous study ( Macchi and Bagassi, 2015 ). For all the participants the problem appeared impossible to solve, and nobody actually solved it. The explanation we gave for the difficulty was the following: “The information provided regarding the dimensions brings a square form to mind. The problem solver interprets the window to be a square 1 m high by 1 m wide, resting on one side. Furthermore, the problem states “without changing its shape,” intending geometric shape of the two windows (square, independently of the orientation of the window), while the problem solver interprets this as meaning the phenomenic shape of the two windows (two squares with the same orthogonal orientation)” ( Macchi and Bagassi, 2015 , p. 156). And this is where the difficulty of the problem lies, in the mental representation of the window and the concurrent interpretation of the text of the problem. Actually, spatial orientation is a decisive factor in the perception of forms. “Two identical shapes seen from different orientations take on a different phenomenic identity” ( Mach, 1914 ).

The solution is to be found in a square (geometric form) that “rests” on one of its angles, thus becoming a rhombus (phenomenic form). Now the dimensions given are those of the two diagonals of the represented rhombus (ABCD).

Figure 1. The study window problem solution.

The “inverted” version of the problem gave less trouble:

[…] The owner decides to make it smaller and calls in a workman. He instructs the man to halve the area of the window […].

Figure 2. The inverted version.

With this version, 30% of the participants solved the problem ( n = 30). They started from the representation of the orthogonal square (ABCD) and looked for the solution within the square, trying to respect the required height and width of the window, and inevitably changing the orientation of the internal square. This time the height and width are the diagonals, rather than the side (base and height) of the square.

Eventually, in another version (the “orientation” version) it was explicit that orientation was not a mandatory attribute of the shape, and this time 66% of the participants found the solution immediately ( n = 30). This confirms the hypothesis that an inappropriate representation of the relation between the orthogonal orientation of the square and its geometric shape is the origin of the misunderstanding .

The “orientation” version:

A study window measures 1 m in height and 1 m wide. The owner decides to make it smaller and calls in a workman. He instructs the man to halve the area of the window: the workman can change the orientation of the window, but not its shape and in such a way that it still measures one meter by one meter. The workman carries out the commission. How did he do it?

While with the Study window problem the subjects who do not arrive at the solution, and who are the totality, know they are wrong, with the problem we are now going to examine, the Ties problem, those who are wrong do not realize it at all and the solution they propose is experienced as the correct solution.

The Ties Problem ( Mosconi and D’Urso, 1974 )

Peter and John have the same number of ties.

Peter gives John five of his ties.

How many ties does John have now more than Peter?

We believe that the seemingly trivial problem is actually the result of the simultaneous activation and mutual interference of complex cognitive processes that prevent its solution.

The problem has been submitted to 50 undergraduate students of the Humanities Faculty of the University of Milano-Bicocca. The participants were tested individually and were randomly assigned to three groups: control version ( n = 50), experimental version 2 ( n = 20), and experimental version 3 ( n = 23). All groups were tested in Italian. Each participant was randomly assigned to one of the conditions and received a form containing only one version of the two assigned problems. There was no time limit. They were invited to think aloud and their spontaneous justifications were recorded and then transcribed.

The correct answer is obviously “ten,” but it must not be so obvious if it is given by only one third of the subjects (32%), while the remaining two thirds give the wrong answer “five,” which is so dominant.

If we consider the text of the problem from the point of view of the information explicitly transmitted ( said ), we have that it only theoretically provides the necessary information to reach the solution and precisely that: (a) the number of ties initially owned by P. and J. is equal, (b) P. gives J. five of his ties. However, the subjects are wrong. What emerges, however, from the spontaneous justifications given by the subjects who give the wrong answer is that they see only the increase of J. and not the consequent loss of P. by five ties. We report two typical justifications: “P. gives five of his to J., J. has five more ties than P., the five P. gave him” and also “They started from the same number of ties, so if P. gives J. five ties, J. should have five more than P.”

Slightly different from the previous ones is the following recurrent answer, in which the participants also consider the decrease of P. as well as the increase of J.: “I see five ties at stake, which are the ones that move,” or also “There are these five ties that go from one to the other, so one has five ties less and the other has five more,” reaching however the conclusion similar to the previous one that “J. has five ties more, because the other gave them to him.” 2

Almost always the participants who answer “five” use a numerical example to justify the answer given or to find a solution to the problem, after some unsuccessful attempts. It is paradoxical how many of these participants accept that the problem has two solutions, one “five ties” obtained by reasoning without considering a concrete number of initial ties, owned by P. and J., the other “ten ties” obtained by using a numerical example. So, for example, we read in the protocol of a participant who, after having answered “five more ties,” using a numerical example, finds “ten” of difference between the ties of P. and those of J.: “Well! I think the “five” is still more and more exact; for me this one has five more, period and that’s it.” “Making the concrete example: “ten” – he chases another subject on an abstract level. I would be more inclined to another formula, to five.”

About half of the subjects who give the answer “five,” in fact, at first refuse to answer because “we don’t know the initial number and therefore we can’t know how many ties J. has more than P.,” or at the most they answer: “J. has five ties more, P. five less, more we can’t know, because a data is missing.”

Even before this difficulty, so to speak, operational, the text of the problem is difficult because in it the quantity relative to the decrease of P. remains implicit (−5). The resulting misunderstanding is that if the quantity transferred is five ties, the resulting difference is only five ties: if the ties that P. gives to J. are five, how can J. have 10 ties more than P.?

So the difficulty of the problem lies in the discrepancy between the quantity transferred and the bidirectional effect that this quantity determines with its displacement. Resolving implies a restructuring of the sentence: “Peter gives John five of his ties (and therefore he loses five).” And this is precisely the reasoning carried out by those subjects who give the right answer “ten.”

We have therefore formulated a new version in which a pair of verbs should make explicit the loss of P.:

Peter loses five of his ties and John takes them.

However, the results obtained with this version, submitted to 20 other subjects, substantially confirm the results obtained with the original version: the correct answers are 17% (3/20) and the wrong ones 75% (15/20). From a Chi-square test (χ 2 = 2,088 p = 0.148) it results no significant difference between the two versions.

If we go to read the spontaneous justifications, we find that the subjects who give the answer “five” motivate it in a similar way to the subjects of the original version. So, for example: “P. loses five, J. gets them, so J. has five ties more than P.”

The decrease of P. is still not perceived, and the discrepancy between the lost amount of ties and the double effect that this quantity determines with its displacement persists.

Therefore, a new version has been realized in which the amount of ties lost by P. has nothing to do with J’s acquisition of five ties, the two amounts of ties are different and then they are perceived as decoupled, so as to neutralize the perceptual-conceptual factor underlying it.

Peter loses five of his ties and John buys five new ones.

It was submitted to 23 participants. Of them, 17 (74%) gave the answer “ten” and only 3 (13%) the answer “five.” There was a significant difference (χ 2 = 16,104 p = 0.000) between the results obtained using the present experimental version and the results from the control version. The participants who give the correct solution “ten” mostly motivate their answer as follows: “P. loses five and therefore J. has also those five that P. lost; he buys another five, there are ten,” declaring that he “added to the five that P. had lost the five that J. had bought.” The effectiveness of the experimental manipulation adopted is confirmed. 3

The satisfactory results obtained with this version cannot be attributed to the use of two different verbs, which proved to be ineffective (see version 2), but to the splitting, and consequent differentiation (J. has in addition five new ties), of the two quantities.

This time, the increase of J. and the decrease of P. are grasped as simultaneous and distinct and their combined effect is not identified with one or the other, but is equal to the sum of +5 and −5 in absolute terms.

The hypothesis regarding the effect of reformulation has also been confirmed in classical insight problems such as the Square and the Parallelogram ( Wertheimer, 1925 ), the Pigs in a Pen ( Schooler et al., 1993 ), the Bat & Ball ( Frederick, 2005 ) in recent studies ( Macchi and Bagassi, 2012 , 2015 ) which showed a dramatic increase in the number of solutions.

In their original version these problems are true brain teasers, and the majority of participants in these studies needed them to be reformulated in order to reach the solution. In Appendix B we present in detail the results obtained (see Table 1 ). Below we report, for each problem, the text of the original version in comparison with the reformulated experimental version.

Table 1. Percentages of correct solutions with reformulated experimental versions.

Square and Parallelogram Problem ( Wertheimer, 1925 )

Given that AB = a and AG = b, find the sum of the areas of square ABCD and parallelogram EBGD ( Figures 3 , 4 ).

Figure 3. The square and parallelogram problem.

Figure 4. Solution.

Experimental Version

Given that AB = a and AG = b , find the sum of the areas of the two partially overlapping figures .

Pigs in a Pen Problem ( Schooler et al., 1993 )

Nine pigs are kept in a square pen . Build two more square enclosures that would put each pig in a pen by itself ( Figures 5 , 6 ).

Figure 5. The pigs in a pen problem.

Figure 6. Solution.

Nine pigs are kept in a square pen. Build two more squares that would put each pig in a by itself .

Bat and Ball Problem ( Frederick, 2005 )

A bat and a ball cost $1.10 in total. The bat costs $ 1.00 more than the ball. How much does the ball cost? ___cents.

A bat and a ball cost $1.10 in total. The bat costs $ 1.00 more than the ball. Find the cost of the bat and of the ball .

Once the problem knots that alter the aim of the task have been identified, the reformulation technique can be a valid didactic tool, as it allows to reveal the misunderstanding and to eliminate it without changing the mathematical nature of the problem. The training to creativity would consist in this sense in training to have interpretative keys different from the usual, when the difficulty cannot be addressed through computational techniques.

Closing Thoughts

By identifying the misunderstanding in problem solving, the reformulation technique has made it possible to eliminate the problem knots, without changing the mathematical nature of the problem. With the experimental reformulated versions of paradigmatic problems, both apparent trivial tasks or brain teasers have obtained a significant increase in correct answers.

Studying how an insight problem is formed, and not just how it is solved, may well become an important topic in education. We focus on undergraduate students’ strategies and their errors while solving problems, and the specific cognitive processes involved in misunderstanding, which are crucial to better exploit what could be beneficial to reach the solution and to teach how to improve the ability to solve problems.

Without violating the need for the necessary rigor of a demonstration, for example, it is possible to organize the problem-demonstration discourse according to a different criterion, precisely by favoring the psychological needs of the subject to whom the explanation discourse is addressed, taking care to organize the explanation with regard to the way his mind works, to what can favor its comprehension and facilitate its memory.

On the other hand, one of the criteria traditionally followed by mathematicians in constructing, for example, demonstrations, or at least in explaining them, is to never make any statement that is not supported by the elements provided above. In essence, in the course of the demonstration nothing is anticipated, and indeed it happens frequently that the propositions directly relevant and relevant to the development of the reasoning (for example, the steps of a geometric demonstration) are preceded by digressions intended to introduce and deal with the elements that legitimize them. As a consequence of such an expositive formalism, the recipient of the speech (the student) often finds himself in the situation of being led to the final conclusion a bit like a blind man who, even though he knows the goal, does not see the way, but can only control step by step the road he is walking along and with difficulty becomes aware of the itinerary.

The text of every problem, if formulated in natural language, has a psychorhetoric dimension, in the sense that in every speech, that is in the production and reception of every speech, there are aspects related to the way the mind works – and therefore psychological and rhetorical – that are decisive for comprehensibility, expressive adequacy and communicative effectiveness. It is precisely to these aspects that we refer to when we talk about the psychorhetoric dimension. Rhetoric, from the point of view of the broadcaster, has studied discourse in relation to the recipient, and therefore to its acceptability, comprehensibility and effectiveness, so that we can say that rhetoric has studied discourse “psychologically.”

Adopting this perspective, the commonplace that the rhetorical dimension only concerns the common discourse, i.e., the discourse that concerns debatable issues, and not the scientific discourse (logical-mathematical-demonstrative), which would be exempt from it, is falling away. The matter dealt with, the truth of what is actually said, is not sufficient to guarantee comprehension.

Data Availability Statement

The datasets generated for this study are available on request to the corresponding author.

Ethics Statement

Ethical review and approval was not required for the study on human participants in accordance with the local legislation and institutional requirements. Written informed consent for participation was not required for this study in accordance with the national legislation and the institutional requirements.

Author Contributions

LM and MB devised the project, developed the theory, carried out the experiment and wrote the manuscript. Both authors contributed to the article and approved the submitted version.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

• ^ The theoretical framework assumed here is Paul Grice’s theory of communication (1975) based on the existence in communication of the explicit layer ( said ) and of the implicit ( implied ), so that the recognition of the communicative intention of the speaker by the interlocutor is crucial for comprehension.
• ^ A participant who after having given the solution “five” corrects himself in “ten” explains the first answer as follows: “it is more immediate, in my opinion, to see the real five ties that are moved, because they are five things that are moved; then as a more immediate answer is ‘five,’ because it is something more real, less mathematical.”
• ^ The factor indicated is certainly the main responsible for the answer “five,” but not the only one (see the Appendix for a pragmatic analysis of the text).
• ^ Versions and results of the problems exposed are already published in Macchi e Bagassi 2012, 2014, 2015.

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Pragmatic analysis of the problematic loci of the Ties problem, which emerged from the spontaneous verbalizations of the participants:

- “the same number of ties”

This expression is understood as a neutral information, a kind of base or sliding plane on which the transfer of the five ties takes place and, in fact, these subjects motivate their answer “five” with: “there is this transfer of five ties from P. to J. ….”

- “5 more, 5 less”

We frequently resort to similar expressions in situations where, if I have five units more than another, the other has five less than me and the difference between us is five.

Consider, for example, the case of the years: say that J. is five years older than P. means to say that P. is five years younger than J. and that the difference in years between the two is five, not ten.

In comparisons, we evaluate the difference with something used as a term of reference, for example the age of P., which serves as a basis, the benchmark, precisely.

- “he gives”

The verb “to give” conveys the concept of the growth of the recipient, not the decrease of the giver, therefore, contributes to the crystallization of the “same number,” preventing to grasp the decrease of P.

Appendix B 4

Given that AB = a and AG = b, find the sum of the areas of square ABCD and parallelogram EBGD .

Typically, problem solvers find the problem difficult and fail to see that a is also the altitude of parallelogram EBGD. They tend to calculate its area with onerous and futile methods, while the solution can be reached with a smart method, consisting of restructuring the entire given shape into two partially overlapping triangles ABG and ECD. The sum of their areas is 2 x a b /2 = a b . Moreover, by shifting one of the triangles so that DE coincides with GB, the answer is “ a b ,” which is the area of the resultant rectangle. Referring to a square and a parallelogram fixes a favored interpretation of the perceptive stimuli, according to those principles of perceptive organization thoroughly studied by the Gestalt Theory. It firmly sets the calculation of the area on the sum of the two specific shapes dealt with in the text, while, the problem actually requires calculation of the area of the shape, however organized, as the sum of two triangles rectangles, or the area of only one rectangle, as well as the sum of square and parallelogram. Hence, the process of restructuring is quite difficult.

To test our hypotheses we formulated an experimental version:

In this formulation of the problem, the text does not impose constraints on the interpretation/organization of the figure, and the spontaneous, default interpretation is no longer fixed. Instead of asking for “the areas of square and parallelogram,” the problem asks for the areas of “the two partially overlapping figures.” We predicted that the experimental version would allow the subjects to see and consider the two triangles also.

Actually, we found that 80% of the participants (28 out of 35) gave a correct answer, and most of them (21 out of 28) gave the smart “two triangles” solution. In the control version, on the other hand, only 19% (9 out of 47) gave the correct response, and of these only two gave the “two triangles” solution.

The findings were replicated in the “Pigs in a pen” problem:

Nine pigs are kept in a square pen . Build two more square enclosures that would put each pig in a pen by itself.

The difficulty of this problem lies in the interpretation of the request, nine pigs each individually enclosed in a square pen, having only two more square enclosures. This interpretation is supported by the favored, orthogonal reference scheme, with which we represent the square. This privileged organization, according to our hypothesis, is fixed by the text which transmits the implicature that the pens in which the piglets are individually isolated must be square in shape too. The function of enclosure wrongfully implies the concept of a square. The task, on the contrary, only requires to pen each pig.

Once again, we created an experimental version by reformulating the problem, eliminating the word “enclosure” and the phrase “in a pen.” The implicit inference that the pen is necessarily square is not drawn.

The experimental version yielded 87% correct answers (20 out of 23), while the control version yielded only 38% correct answers (8 out of 25).

The formulation of the experimental versions was more relevant to the aim of the task, and allowed the perceptual stimuli to be interpreted in accordance with the solution.

The relevance of text and the re-interpretation of perceptual stimuli, goal oriented to the aim of the task, were worked out in unison in an interrelated interpretative “game.”

We further investigated the interpretative activity of thinking, by studying the “Bat and ball” problem, which is part of the CRT. Correct performance is usually considered to be evidence of reflective cognitive ability (correlated with high IQ scores), versus intuitive, erroneous answers to the problem ( Frederick, 2005 ).

Bat and Ball problem

A bat and a ball cost $1.10 in total. The bat costs $ 1.00 more than the ball. How much does the ball cost?___cents

Of course the answer which immediately comes to mind is 10 cents, which is incorrect as, in this case, the difference between $ 1.00 and 10 cents is only 90 cents, not $1.00 as the problem stipulates. The correct response is 5 cents.

Number physiognomics and the plausibility of the cost are traditionally considered responsible for this kind of error ( Frederick, 2005 ; Kahneman, 2003 ).

These factors aside, we argue that if the rhetoric structure of the text is analyzed, the question as formulated concerns only the ball, implying that the cost of the bat is already known. The question gives the key to the interpretation of what has been said in each problem and, generally speaking, in every discourse. Given data, therefore, is interpreted in the light of the question. Hence, “The bat costs $ 1.00 more than” becomes “The bat costs $ 1.00,” by leaving out “more than.”

According to our hypothesis, independently of the different cognitive styles, erroneous responses could be the effect of the rhetorical structure of the text, where the question is not adequate to the aim of the task. Consequently, we predicted that if the question were to be reformulated to become more relevant, the subjects would find it easier to grasp the correct response. In the light of our perspective, the cognitive abilities involved in the correct response were also reinterpreted. Consequently, we reformulated the text as follows in order to eliminate this misleading inference:

This time we predicted an increase in the number of correct answers. The difference in the percentages of correct solutions was significant: in the experimental version 90% of the participants gave a correct answer (28 out of 31), and only 10% (2 out of 20) answered correctly in the control condition.

The simple reformulation of the question, which expresses the real aim of the task (to find the cost of both items), does not favor the “short circuit” of considering the cost of the bat as already known (“$1,” by leaving out part of the phrase “more than”).

It still remains to be verified if those subjects who gave the correct response in the control version have a higher level of cognitive reflexive ability compared to the “intuitive” respondents. This has been the general interpretation given in the literature to the difference in performance.

We think it is a matter of a particular kind of reflexive ability, due to which the task is interpreted in the light of the context and not abstracting from it. The difficulty which the problem implicates does not so much involve a high level of abstract reasoning ability as high levels of pragmatic competence, which disambiguates the text. So much so that, intervening only on the pragmatic level, keeping numbers physiognomics and maintaining the plausible costs identical, the problem becomes a trivial arithmetical task.

Keywords : creative problem solving, insight, misunderstanding, pragmatics, language and thought

Citation: Bagassi M and Macchi L (2020) Creative Problem Solving as Overcoming a Misunderstanding. Front. Educ. 5:538202. doi: 10.3389/feduc.2020.538202

Received: 26 February 2020; Accepted: 29 October 2020; Published: 03 December 2020.

Reviewed by:

Copyright © 2020 Bagassi and Macchi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

*Correspondence: Laura Macchi, [email protected]

This article is part of the Research Topic

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Problem Solving Therapy Improves Effortful Cognition in Major Depression

Chenguang jiang.

1 Wuxi Mental Health Center Affiliated to Nanjing Medical University, Wuxi, China

Hongliang Zhou

2 Nanjing Brain Hospital Affiliated to Nanjing Medical University, Nanjing, China

Zhenhe Zhou

Associated data.

The datasets generated for this study are available on request to the corresponding author.

Background: Effortful cognition processing is an intentionally initiated sequence of cognitive activities, which may supply top-down and goal-oriented reassessment of specific stimuli to regulate specific state-driven responses contextually, whereas automatic cognitive processing is a sequence of cognitive activities that is automatically initiated in response to an input configuration. The effortful–automatic perspective has implications for understanding the nature of the clinical features of major depressions. The aim of this study was to investigate the influence of problem solving therapy (PST) on effortful cognition in major depression (MD).

Methods: The participants included an antidepressant treatment (AT) group ( n = 31) or the combined antidepressant treatment and PST (CATP) group ( n = 32) and healthy controls (HCs) ( n = 30). Hamilton Depression Rating Scale (HAMD, 17-item version) and the face–vignette task (FVT) were measured for AT group and CATP group at baseline (before the first intervention) and after 12 weeks of interventions. The HC group was assessed with the FVT only once. At baseline, both patients and HCs were required to complete the basic facial emotion identification test (BFEIT).

Results: The emotion identification accuracy of the HC group was higher than that of the patient group when they performed BFEIT; patients with MD present poor FVT performances; compared to the antidepressant treatment, PST plus antidepressant treatment decreased HAMD scores and improved FVT performances in patients with MD.

Conclusions: Patients with MD present effortful cognition dysfunction, and PST can improve effortful cognitive dysfunction. These findings suggest that the measurement of effortful cognition might be one of the indexes for the therapeutic effect of PST in MD.

Introduction

Major depression (MD) is a common mental disorder with a higher disability rate, affecting 10–15% of the worldwide population every year. To date, some antidepressants, including several typical antidepressants and several atypical antidepressants, have been used to treat major depression; however, only 60–70% of patients respond to antidepressant treatment. Furthermore, 10–30% of these patients exhibit treatment-resistant symptoms such as suicidal thought, a low mood, a decline in interest, and a loss of happiness ( 1 ).

To improve the symptoms of MD, several treatment options have been developed, such as switching therapies, augmentation, combination, optimization, psychotherapies, modified electro-convulsive therapy (MECT), repetitive transcranial magnetic stimulation therapies, deep brain stimulation therapies, vagal nerve stimulation therapies, light-based therapies, acupuncture treatment, and yoga; these approaches have been considered and tailored for individual patients ( 2 – 4 ). Most important for the improvement of depressed patients' symptoms, many studies had reported that physical activity interventions are helpful to improve major depressive disorders because physical activity is associated with many mental health benefits ( 5 – 11 ). Assessments to determine symptom improvement for patients with MD often depend on decreased total Hamilton Depression Rating Scale (HAMD, 17 or 24 items) scores.

Problem solving therapy (PST) belongs to a type of cognitive behavioral therapy that mainly concentrates on training in appropriate problem-solving notions as well as skills. PST has been used for major depression ( 12 – 15 ). It has been confirmed that, in the depressed patient group, PST was equally effective as antidepressant treatments and more effective than no treatment and support or attention control patients ( 16 ). In clinical practice, the effective treatment program of PST in MD includes three aspects: [1] training in a positive problem orientation, [2] training in problem definition and formulation, the generation of alternatives, decision making, and solution implementation and verification, and [3] training in problem orientation plus problem definition and formulation, the generation of alternatives, decision making, and solution implementation and verification ( 16 ).

Cognitive function refers to mental processes involved in working memory, problem-solving, decision-making, the acquisition of knowledge, regulation of information, and reasoning. As a major symptom, cognitive function impairment is acknowledged as a clinical characteristic of major depression. Additionally, many studies of major depression have suggested a role for cognitive measures in predicting those at risk for poor outcomes ( 17 ). A previous study indicated that patients with major depression present negatively valanced emotional symptoms that are accompanied by cognitive deficits, and the emotional processing dysfunctions of the prefrontal cortex might lead to cognitive deficits in patients with MD ( 18 ). Adaptive emotional responding relies on both effortful cognition processing and automatic cognition processing. Effortful cognition processing is a controlled process and refers to an intentionally initiated sequence of cognitive activities, which may supply top-down as well as goal-oriented reassessment of emotional stimuli to regulate emotion-driven responses contextually ( 19 ). Effortful cognition was measured by the face–vignette task (FVT) ( 19 ). Relative to effortful cognitive processing, automatic cognitive processing is a sequence of cognitive activities that is automatically initiated in response to an input configuration ( 20 ). Automatic cognition processing requires near-zero attention for the task at hand and, in many instances, is executed in response to a specific stimulus.

Previous studies have shown that patients with MD present effortful cognitive dysfunction. For example, a previous study reported that, when patients with MD performed two contrasting cognitive tasks ( i.e ., one requiring sustained effort and information processing and the other requiring only superficial information processing that could be accomplished automatically), only the effort-demanding cognitive task was performed poorly ( 21 ). Additionally, two previous studies investigated the functions of automatic and effortful information processing in a visual search paradigm, and the results showed that the patients with MD exhibited longer reaction times on the tasks requiring more effortful information processing than the controls. However, there were no differences on tasks requiring automatic information processing ( 22 , 23 ).

Since cognitive function impairment plays a critical role in MD, the assessment of cognitive function is a better way to determine the treatment effect for MD. The effortful–automatic perspective has implications for understanding the nature of the clinical features of MD. Furthermore, the investigation of the influence of PST on effortful cognition in MD is helpful for improving the present understanding of the therapeutic mechanism and assess the therapeutic effect of PST. To date, no studies of PST on effortful cognition in MD have been reported. In this study, the participants included patients with MD and healthy controls (HCs). The MD group was treated with antidepressants or the combination of antidepressants with PST, and effortful cognition was rated by the FVT. The hypothesis of this study is that depressed patients display poor effortful cognition performance, and PST can improve effortful cognitive dysfunctions. The aim of this study was to investigate the effect of PST on effortful cognition in MD.

Materials and Methods

Time and setting.

This study was conducted in Wuxi Mental Health Center Affiliated to Nanjing Medical University, No. 156 Qianrong Road, Rongxiang Street, Binhu District, Wuxi City, P.R. China, from February 1, 2016 to February 27, 2020.

Diagnostic Approaches and Subjects

A total of 80 patients meeting the American Psychiatric Association's fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) criteria for major depression were recruited as the research group. The MD patients were randomly assigned to the antidepressant treatment (AT) group or the combined antidepressant treatment and PST (CATP) group. The allocation schedule was generated by using a list of random numbers. Thirty healthy persons were admitted to the HC group. All HCs had no personal history of mental disorders. Patients with MD were selected from Wuxi Mental Health Center Affiliated to Nanjing Medical University, No. 156 Qianrong Road, Rongxiang Street, Binhu District, Wuxi City, P.R. China; the normal controls were citizens of Wuxi City, Jiangsu Province, P.R. China, recruited by online and local community advertisements. Patients with MD and HC subjects were excluded from the study if they had been diagnosed with nicotine addiction or other psychoactive substance dependence, had suffered any systemic disease that may affect the central nervous system, or had received electroconvulsive therapy (including MECT) in the past 24 weeks. All patients and HC subjects were Chinese. All patients and HC subjects were paid 42.12 Euros plus travel costs.

Seven subjects in AT group and five subjects in CATP group were all diagnosed with bipolar disorder in the follow-up survey, and they were ultimately excluded from this study. Two subjects in AT group and three subjects in CATP group were also excluded from this study because they could not finish the follow-up assessment. Finally, the data from 31 subjects in AT group and 32 subjects in CATP group were used in the statistical analyses.

Measurements of Automatic and Effortful Cognition

Basic facial emotion identification test.

The basic facial emotion identification test (BFEIT) consists of eight examples of each of the seven basic facial emotions, e.g ., happy, angry, sad, fear, surprise, disgust, and calm, which were taken from the Chinese affective picture system ( 24 ). Male and female face pictures were balanced across each emotion category.

Face–Vignette Task

FVT was designed based on an effortful cognitive task that was used in the study on effortful vs . automatic emotional processing in patients with schizophrenia by Patrick et al. ( 19 ). E-Prime 2.0 software (Psychology software tools, INC, USA) was used to implement the experimental procedure. The face pictures were white and black photographs and included six emotional expressions, i.e ., happy, angry, sad, fear, surprise, and disgust, which were taken from the Chinese affective picture system ( 24 ). In each emotion, the male and female faces were equal. Within a given emotion category, the same identity was used only once. The situational vignettes communicated the six special emotions, i.e ., guilty, smug, hopeful, insulted, pain, and determined. Before the experiment, the intended emotion for each story (vignette) was verified by seven undergraduates, and the mean accuracy was 0.91 [standard deviation (SD) = 0.08], and the observed inter-rater reliability κ value was 0.75. The face–story pairs were matched such that each story was inconsistent with the facial expression according to the specially appointed emotional category ( e.g ., a happy facial expression paired with a smug story). Each specific emotion category depended on the situational context (see the listed example in Figure 1 ). The specially appointed face–story pairs included sad vs . guilty, happy vs . smug, fearful vs . painful, angry vs . determined, disgusted vs . insulted, and surprised vs . hopeful. During the FVT, the participants viewed a series of 24 face–story (vignette) pairs and were informed that each facial expression represented the subject of the vignette. The faces and vignettes were presented simultaneously. All participants were required to read the vignettes aloud. In each trial, all participants answered the question accompanied by face–vignette pairs through a specially appointed keypad in a multiple choice pattern. The 13 obtainable choices for each trial were as follows: angry, happy, sad, fearful, disgusted, surprised, smug, guilty, hopeful, determined, pain, insulted as well as no emotion.

Example of a trial on the face–vignette task. The situational vignettes in English are as follows: This is a story about a girl's birthday. The girl stayed in her room. She received a call from her beloved boyfriend: “You're waiting for me at home. I'll bring your favorite flowers to your birthday!” Several minutes later, she heard the knock of her boyfriend's arrival. The question was “What emotion is the person feeling?” Responding with “surprise” will be recorded as a face response and responding with “hopeful” will be recorded as a vignette response. Additionally, any other response will be recorded as a random response.

On the FVT, the responses of the participants were labeled as face responses, vignette responses, and random responses. The response data were converted to proportions, which were used for statistical analysis.

Problem Solving Therapy Procedure

The PST was performed as described in a previous study ( 25 ). All the patients with MD were scheduled for PST, which consists of six sessions administered every other week. The treatment sessions were conducted at the psychological therapy room of the Psychiatry Department. The PST was conducted by six psychotherapists, and visits were conducted by two psychiatric resident physicians. All the psychotherapists owned a therapy handbook and underwent training, including a short theoretical course, role playing in a clinical background as well as watching a training videotape. The PST includes three steps: [1] the patient's symptoms are linked with their problems in daily living, [2] the problems are defined and clarified, and [3] an attempt is made to solve the problems in a structured way. The sessions lasted 1 h for the first visit and half an hour for the subsequent visits.

Clinical Interventions and Clinical Assessment

Two psychiatric residents examined all the participants to confirm or exclude a major depression diagnosis based on DSM-5 criteria and to collect medication and sociodemographic data. A HAMD (17-item version) was applied to assess the depressive severity for patients. A decrease of more than 50% in HAMD (17-item version) scores from baseline to follow-up was defined as a treatment response, and HAMD (17-item version) scores <7 at follow-up were defined as clinical remission.

HAMD (17-item version) and the FVT data were measured for the AT group and CATP group at baseline (before the first intervention, time 1) and after 12 weeks of interventions (time 2). The HC group was assessed using the face–vignette task only once. At baseline, both patients and HCs were required to complete the BFEIT.

Statistical Analysis

Data are presented as mean (SD), and all data were analyzed with Statistical Product and Service Solution 18.0 statistical software (SPSS 18.0, International Business Machines Corporation). Comparisons of the demographic data, basic facial emotion identification test scores, face response proportions, vignette response proportions, and random response proportions at baseline among patients and healthy controls were conducted using the method of one-way analysis of variance (ANOVA) or the chi-square test. Comparisons of HAMD (17-item version) scores, face response proportions, vignette response proportions, and random response proportions between baseline (time 1) and after 12 weeks of interventions (time 2) in the patient group were performed using 2 × 2 repeated-measures ANOVA. In this study, all alpha values of 0.05 were considered as statistically significant throughout. Cohen's d effect sizes were used for t -tests. The cutoff values for Cohen's d 's were defined as trivial effect size when d < 0.19, small effect size when 0.2 < d < 0.49, medium effect size when 0.5 < d < 0.79, and large effect size when d > 0.8. Partial eta-square (η p 2 ) effect sizes were used for F -tests. Similarly, the cutoff values for η p 2 were set as trivial effect size when η p 2 < 0.019, small effect size when 0.02 < η p 2 < 0.059, medium effect size when 0.06 < η p 2 < 0.139, and large effect size when η p 2 > 0.14. Phi (ϕ) effect sizes were used for chi-square test. The cutoff values for ϕ were set as trivial effect size when ϕ < 0.09, small effect size when 0.10 < ϕ < 0.29, medium effect size when 0.30 < ϕ < 0.49, and large effect size when ϕ > 0.50.

The Demographic Data of All Participants

The demographic data of the participants are described in Table 1 . No significant differences were observed in sex ratio, mean age, age range, or mean education years among the AT group, CATP group, and HC group.

Demographic characteristics and clinical data of all participants.

AT, antidepressant treatment; CATP, the combination of antidepressant treatment and PST; HC, healthy control; SD, standard deviation; η p 2 , partial eta-square .

Antidepressant Treatments

In the AT group, 20 patients with MD were antidepressant-naïve, and 11 patients with MD were antidepressant-free (six for at least 24 weeks and five for at least 4 weeks); patients with MD received fluoxetine ( n = 8), paroxetine ( n = 7), fluvoxamine ( n = 7), sertraline ( n = 6), or escitalopram ( n = 3). The mean fluoxetine-equivalent dose was 30.5 (8.8) mg/day. In the CATP group, 19 patients with MD were antidepressant-naïve, and 13 patients with MD were antidepressant-free (eight for at least 24 weeks and five for at least 4 weeks); patients with MD received fluoxetine ( n = 9), paroxetine ( n = 8), fluvoxamine ( n = 8), sertraline ( n = 3), or escitalopram ( n = 4). According to a previous report ( 26 ), the mean fluoxetine-equivalent dose was 30.1 (7.9) mg/day. Neither of the patient groups used concomitant medications.

Comparisons of BFEIT Performance Among the AT Group, CATP Group, and HC Group

As shown in Figure 2 , one-way ANOVA revealed that there were significant differences in BFEIT performance (emotion identification accuracy) among the AT group, CATP group, and HC group ( F 2,90 = 27.729, df = 2, η p 2 = 0.33, p = 0.000). Least square difference tests were performed as post hoc analyses and showed significant differences between the HC group, AT group, and CATP group (all p = 0.000). The emotion identification accuracy of the HC group was higher than that of the AT group or CATP group. However, no significant difference was observed between the AT group and the CATP group ( p = 0.951).

Comparisons of BFEIT performance among the AT group, CATP group, and HC group. BFEIT, basic facial emotion identification test; ATG, antidepressant treatment group; CATPG, the combination of antidepressant treatment and PST group; HC, healthy control; SD, standard deviation.

Comparisons of HAMD (17-Item Version) Scores Before and After Clinical Interventions

As shown in Figure 3 , using HAMD (17-item version) scores as dependent variables, a 2 × 2 repeated-measures ANOVA with group (AT group vs . CATP group) as a between-subjects factor and time point (time 1 vs . time 2) as a within-subjects factor revealed that the interaction effect for group × time point was not significant ( F 1,61 = 1.697, η p 2 = 0.003, p = 0.198); however, the main effect for time point was significant ( F 1,61 = 206.419, η p 2 = 0.35, p = 0.000), and the main effect for group was significant ( F 1,61 = 170.914, η p 2 = 0.18, p = 0.038). The 12-week interventions decreased HAMD (17-item version) scores in the two patient groups.

Comparisons of HAMD scores before and after clinical interventions between the AT group and CATP group. HAMD, Hamilton Depression Rating Scale (17-item version); ATG, antidepressant treatment group; CATPG, the combination of antidepressant treatment and PST group; time 1, baseline; time 2, after 12 weeks of intervention; SD, standard deviation.

There were significant differences in the remission rate between the CATP group (19/32) and the AT group (14/31); the remission rate in the CATP group was higher than that of the AT group (χ 2 = 6.123, ϕ = 0.29, p = 0.028). There were significant differences in the treatment response rate between the CATP group (25/32) and AT group (18/31); the treatment response rate in the CATP group was higher than that of the AT group (χ 2 = 4.370, ϕ = 0.26, p = 0.035).

Comparisons of FVT Performance Among the AT Group, CATP Group, and HC Group

Baseline level.

As shown in Table 2 , one-way ANOVA revealed that there were significant differences in face response proportions and vignette response proportions among the AT group, CATP group, and HC group ( F 2,90 = 27.861, 18.234, all df = 2; η p 2 = 0.32, 0.36, all p = 0.000). Least square difference tests were performed as post hoc analyses and showed significant differences between the HC group and AT group or between the HC group and the CATP group (all p = 0.000). The face response proportions of the HC group were lower than those of the AT group and CATP group, and the vignette response proportions of the HC group were higher than those of the AT group and CATP group. For the above-mentioned two variables, no differences between the AT group and CATP group were observed ( p = 0.951, 0.913).

Face–vignette task performances (%, SD) among the AT group, CATP group, and healthy control group.

AT, antidepressant treatment; CATP, the combination of antidepressant treatment and PST; Time 1, baseline; Time 2, after 12 weeks of interventions; F, face response proportions; V, vignette response proportions; R, random response proportions .

However, there were no significant differences in random response proportions among the AT group, CATP group, and HC group ( F 2,90 = 0.979, df = 2, η p 2 = 0.006, p = 0.380).

Before and After Interventions

As shown in Table 2 , using face response proportions, vignette response proportions, and random response proportions as dependent variables, a 2 × 2 repeated-measures ANOVA with group (AT group vs . CATP group) as the between-subjects factor and time point (time 1 vs . time 2) as the within-subjects factor was performed.

Face Response Proportions

The interaction effect for group × time point was significant ( F 1,61 =25.174, df =1, η p 2 = 0.30, p = 0.000), the main effect for time point was significant ( F 1,61 = 138.086, df = 1, η p 2 = 0.32, p = 0.000), and the main effect for group was significant ( F 1,61 = 4.853, df = 1, η p 2 = 0.24, p = 0.031).

Vignette Response Proportions

The interaction effect for group × time point was significant ( F 1,61 = 29.450, df = 1, η p 2 = 0.31, p = 0.000), the main effect for time point was significant ( F 1,61 = 144.130, df = 1, η p 2 = 0.32, p = 0.000), and the main effect for group was significant ( F 1,61 = 3.083, df = 1, η p 2 = 0.18, p = 0.041).

Random Response Proportions

The interaction effect for group × time point was not significant ( F 1,61 = 1.003, df = 1, η p 2 = 0.001, p = 0.320), the main effect for time point was not significant ( F 1,61 = 1.519, df = 1, η p 2 = 0.001, p = 0.223), and the main effect for group was not significant ( F 1,61 = 0.017, df = 1, η p 2 = 0.000, p = 0.897).

This study is the first to survey the effect of problem-solving therapy on effortful cognition in MD using FVT; measurements of the basic facial emotion identification were also conducted. Our data showed that the emotion identification accuracy of HCs was higher than that of patients with MD; patients with MD exhibited poor FVT performance. Compared to antidepressant treatment, PST plus antidepressant treatment resulted in lower HAMD (17-item version) scores and better FVT performance.

This study also investigated the ability of patients with MD to employ contextual information when determining the intended or expressed or signified message of facial emotional expressions. In the FVT, target facial emotional expressions are preceded by stories describing situational messages which are discrepant in affective valence. What both patients with MD and HCs had judged reflects either the dominance of the emotional context or the facial emotional expression. Many studies on cognitive processing by patients with MD reported that depressive symptoms interfere with effortful processing, and the degree of interference is determined by the degree of effort required for the task, the severity of depression, and the valence of the stimulus material to be processed. However, depressive symptoms only interfere minimally with automatic processes ( 27 ).

Consistent with the findings of previous studies ( 21 – 23 ), our results showed that patients with MD could not utilize contextual information for specific face–vignette pairs. However, HCs more extensively made good judgments on emotion in line with contextual information, which indicates that patients with MD display poor effortful cognition performance. Cognition dysfunctions in MD include impairments of social cognition and neurocognition ( 28 , 29 ). Social cognition refers to a process or a function for an individual's mental operations underlying social behavior, while neurocognition refers to those basic information processing functions such as attention and executive processes. Effortful cognitive processing was involved in either social cognition or neurocognition. We verified our hypothesis, i.e ., patients with MD present effortful cognitive dysfunction.

In this study, we confirmed that PST plus antidepressant treatments leads to a greater reduction of depressive symptoms, a greater response rate, and a greater remission rate over a period of 12 weeks than antidepressant treatments only in patients with MD. We also indirectly verified our previous hypothesis, i.e ., PST can improve effortful cognitive dysfunction, namely, PST improved the severity of MD by improving effortful cognition. Our data provide supporting evidence for the conclusion that the facial affect processing ability could be a valuable predictor of successful social context integration in FVT in MD.

Conclusions

In conclusion, patients with MD present effortful cognitive dysfunction, and PST can improve effortful cognitive dysfunction. The measurement of effortful cognition might be one of the indexes for the therapeutic effect of PST in MD.

There are some limitations in the study. First, the findings must be considered preliminary due to the small sample size. Second, healthy controls were assessed with the FVT only once; therefore, the results of the FVT would be influenced by the practice effect in patients with MD. Future studies should augment the sample size and eliminate the practice effect to further confirm the relationship between effortful cognition and PST in MD. Finally, this study investigated the effect of PST plus antidepressant treatment on effortful cognition in MD. Therefore, no outcome of the pure PST effect on effortful cognition was obtained. The examination of the pure PST effect on effortful cognition in MD is necessary in a future study.

Data Availability Statement

Ethics statement.

The studies involving human participants were reviewed and approved by Affiliated Wuxi Mental Health Center of Nanjing Medical University. The patients/participants provided their written informed consent to participate in this study.

Author Contributions

CJ, HZ, and ZZ designed the study and wrote the paper. CJ, HZ, LC, and ZZ acquired and analyzed the data. All authors reviewed the content and approved the final version for publication.

Conflict of Interest

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Acknowledgments

The authors would like to thank the Key Medical Talent Training Project of Jiangsu Province for providing support (project Grant No. ZDRCC2016019) for this research.

Funding. This research was supported by the Wuxi Taihu Talent Project (No. WXTTP2020008) and the Key Medical Talent Training Project of Jiangsu Province (No. ZDRCC2016019).

The Journal of Problem Solving

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The Journal of Problem Solving (JPS) was a multidisciplinary journal that published empirical and theoretical papers on mental mechanisms involved in problem solving. This journal is no longer accepting submissions.

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