Review Reports - Effects of a Multimodal Psychophysiological Training Intervention on Cognitive Fitness, Hardiness and Wellbeing of Corporate Professionals

Round 1

Reviewer 1 Report

Comments and Suggestions for Authors

This manuscript presents a well-conducted randomized waitlist-controlled intervention study with a clear rationale, robust methodology, and relevant implications for workplace well-being and cognitive performance. The writing is clear and concise, and the inclusion of both psychological and cognitive outcomes strengthens the contribution. I have only a few suggestions to further improve clarity and methodological transparency:

1. Engagement metrics

While the web application component is well described, no quantitative data on participants’ engagement (e.g., frequency of use, rituals completed, time spent on the platform) are reported. It would be interesting if the authors could provide an overview of these engagement patterns, as this would help contextualize adherence and potentially enrich the interpretation of the intervention’s effects.

2. Internal consistency

Although the authors cite strong Cronbach’s alpha values from validation studies, it would be advisable to report internal consistency calculated on the current sample for each self-report scale.

3. Item examples across scales

For consistency and clarity, it would be helpful to include one example item or task description from each cognitive performance measure (e.g., Go/No-go, N-back), as was done for the self-report instruments (e.g., Hardiness, Gratitude). This would help readers to better understand the nature of the cognitive constructs assessed.

4. Effect sizes

Including effect size metrics (e.g., Cohen’s d or confidence intervals) alongside p-values would help readers better interpret the magnitude and practical relevance of the observed effects. This could be incorporated in the Results section when describing pre–post intervention differences

5. Potential self-selection bias

The authors may wish to briefly acknowledge the possibility of self-selection bias, as participation in the study was voluntary and likely attracted individuals already motivated to improve their well-being or resilience. A short note on this could be included in the Limitations section, as it would help qualify the generalizability of the findings.

Author Response

Comments 1: Engagement metrics

Response 1: Good point - a table of the available engagement metrics from the app is now included (Table 3).

Comments 2: Internal consistency: Although the authors cite strong Cronbach’s alpha values from validation studies, it would be advisable to report internal consistency calculated on the current sample for each self-report scale.

Response 2: This has now been inserted into section 6 (measures).

Comments 3: Item examples across scales: For consistency and clarity, it would be helpful to include one example item or task description from eachcognitive performance measure (e.g., Go/No-go, N-back), as was done for the self-report instruments (e.g., Hardiness, Gratitude). This would help readers to better understand the nature of the cognitive constructs assessed.

Response 3: This is now included in section 6.1., as outlined below:

6.1. Cognitive Performance

The cognitive assessment battery was was assembled to assess the elements of Cognitive Fitness, including working memory, attention and cognitive control, established by the transdisciplinary expert consensus [37] as key drivers of performance in high-pressure operational contexts. The battery took around forty-five minutes to perform and was administered via the Inquisit web application. The 2-back version of the N-back letter test [41] was used to assess working memory. This 2-back version required participants to monitor a continuous stream of letters and respond whenever the current stimulus matched the one presented two trials earlier. Accuracy was calculated as the proportion of correct responses across three 30-trial blocks. The change detection task [42] was also used to assess working memory. Participants viewed a brief array of coloured squares followed by a second array and had to detect any change in spatial position of the squares. Two blocks of 60 trials each were administered without feedback. The Go/No-go test [43] assessed response inhibition and sustained attention. Participants to the presentation of “M” or “W” letters on screen in an 80/20 Go/No-go ratio over 250 trials, with the key outcome measure of commission errors indexing inhibitory control. The multisource interference test [44] was used to assess interference resolution and attentional control. Participants were presented with a sequence of three-digit numerical arrays (e.g., "1 0 1") and asked to indicate the identity of the unique digit (i.e., the digit that differed from the other two) by pressing the corresponding key on a keyboard. Participants responded to numeric stimuli under control, Simon, flanker, and combined interference conditions. The primary score of interest was the flanker interference effect, where the interfering digits flanking the target created spatial conflict by appearing in non-target positions, requiring participants to inhibit surrounding distractions - serving as an index of attention and cognitive interference control. Finally, the continuous performance test, identical pairs (CTP-IP) [45] measured sustained attention and impulsivity control. Participants responded when two identical four-digit numbers were presented in sequence, across 150 trials. The key outcomes were hit rate and false alarms, the latter indexing inhibitory failure.

Comments 4: Effect sizes: Including effect size metrics (e.g., Cohen’s dor confidence intervals) alongside p-values would help readers better interpret the magnitude and practical relevance of the observed effects. This could be incorporated in the Results section when describing pre–post intervention differences.

Response 4: Good point - confidence intervals now included for all measures.

Comments 5: Potential self-selection bias

Response 5: Good idea. This has now been added in as a limitation in the limitations section, with the following text inserted:

“Fourthly, participation in the study was voluntary and would likely attract individuals already motivated to improve their wellbeing, introducing the possibility of self-selection bias.

Reviewer 2 Report

Comments and Suggestions for Authors

Very interesting article because of the subject matter. The workplace is inextricably linked to the experience of stress. It is triggered by various elements of the situation, such as difficult or onerous working conditions, the content of the tasks performed, and the specific organisation of work. Stress can also be caused by subjective factors such as health, relationships with other people, and personality traits. Therefore, this article is crucial for every employee.

The article described: effects of a multimodal psychophysiological training intervention on cognitive fitness, hardiness and wellbeing of Corporate Professionals.

The paper contains significant information adequate to justify publication.

The article makes appropriate use of the literature - 67 sources were used.

This article evaluated the effectiveness of an eight-week multimodal psychophysiological intervention designed to improve psychological hardiness, cognitive function, and well-being in a corporate employee cohort.

One should agree with the authors that „workplace stress and burnout are known as major contributors to deficits in cognitive functioning, including memory, attention, and executive functioning, leading to impairments in both well-being and performance”.

It has been rightly noted that workplace stress and burnout are known as major contributors to deficits in cognitive functioning, including memory, attention, and executive functioning, leading to impairments in both well-being and performance.

The authors emphasise that „90% of employees reporting heightened work challenges since the pandemic”.

The results of research carried out on 58 (54) people (experiment) are presented, of which the most important are, among others:

- High-hardiness individuals demonstrate greater stress resilience, cognitive flexibility, and overall mental well-being, particularly in high-stakes occupations;

- An increase in hardiness following multimodal training suggests that interventions incorporating structured cognitive and physical training may enhance individuals’ ability to reframe stressors as challenges, exert greater control over their responses to stress, and sustain motivation under pressure;

- Hardiness can be enhanced through targeted interventions, and these improvements can simultaneously positively impact both cognitive performance and psychological well-being outcomes.

The topic discussed in the article is important for all those who deal with the issues of stress and burnout at work, for HR managers, for senior management, for entrepreneurs, for employees, and for everyone.

The article is very valuable and does not require any corrections.

Author Response

Thank-you for your comprehensive review. We are pleased that you judge the article to be valuable.

Reviewer 3 Report

Comments and Suggestions for Authors

The intervention includes numerous components (exercise, breathing techniques, cold showers, nutrition guidance, meditation, cognitive reframing, plus a mobile app). This makes it impossible to determine which elements drive the observed effects. From a practical standpoint, organizations will want to know which components are essential versus optional. The authors should either test individual components or acknowledge this limitation more directly.

The study relies heavily on self-report measures for key outcomes (hardiness, resilience, mood, stress, gratitude). In workplace contexts, participants may feel implicit pressure to report improvements, especially when their employer is involved in recruiting participants. Including some objective measures (cortisol levels, actual work performance metrics, and absenteeism data) would strengthen the findings considerably.

Measuring outcomes immediately post-intervention tells us little about whether these changes persist when they would actually matter - during future workplace stressors. Given that the intervention aims to build resilience, follow-up assessments, e.g. at 3 and 6 months follow-up, seem essential.

The authors claim improvements in "cognitive fitness" and "inhibitory control," but the evidence is mixed. Some inhibitory control tasks improved while others didn't, and working memory showed no improvement. The cognitive battery also seems somewhat arbitrary - why these specific tasks rather than others? The connection between these laboratory tasks and real workplace cognitive demands needs better justification.

While statistically significant, several effect sizes are modest (e.g., 7.9% improvement in hardiness control subscale). The authors don't adequately discuss whether these changes are practically meaningful in workplace contexts. What does a 7.9% improvement in hardiness actually mean for an employee's daily work experience?

The connection between the Cognitive Fitness Framework and psychological hardiness could be articulated more clearly. Why should these particular constructs improve together?

If possible, could you please provide participant engagement with the mobile app and potential confounding factors during the study period?

The research addresses an important problem and uses generally sound methodology, but the conclusions should be more cautiously stated given the limitations in measurement approach and follow-up duration.

Author Response

Thank you for your thorough review and constructive feedback. Please see below our point-by-point response.

Comments 1: The intervention includes numerous components (exercise, breathing techniques, cold showers, nutrition guidance, meditation, cognitive reframing, plus a mobile app). This makes it impossible to determine which elements drive the observed effects. From a practical standpoint, organizations will want to know which components are essential versus optional. The authors should either test individual components or acknowledge this limitation more directly.

Response 1: This limitation has now been acknowledged in the limitations section with the following text added:

“Thirdly, the multimodal nature of the intervention made it impossible to isolate the specific elements responsible for the observed effects. Given the growing evidence in favour of combined/multimodal interventions (refs) our intervention assembled several elements known for their stand-alone efficacy, but we did not attempt to isolate their respective effects. This may be worth pursuing in future studies, particularly with the aim of shedding those elements with weak contribution to the overall combined effect”

Comments 2: The study relies heavily on self-report measures for key outcomes (hardiness, resilience, mood, stress, gratitude). In workplace contexts, participants may feel implicit pressure to report improvements, especially when their employer is involved in recruiting participants. Including some objective measures (cortisol levels, actual work performance metrics, and absenteeism data) would strengthen the findings considerably.

Response 2: This limitation is now acknowledged in the limitations section – with the following text added.

Firstly, although validated scales were used, reliance on self-reported psychological measures may introduce subjective biases and there is potential that participants may have felt implicit pressure to report improvements due to the workplace context. However, the cognitive tests produced objective performance measures that are known to be immune to response distortions – either by deliberate manipulations or automatic biases. Work performance and absenteeism metrics would be worth adding to future studies, but these were not available for this study due to ethical constraints on participant recruitment.

Comments 3: Measuring outcomes immediately post-intervention tells us little about whether these changes persist when they would actually matter - during future workplace stressors. Given that the intervention aims to build resilience, follow-up assessments, e.g. at 3 and 6 months follow-up, seem essential.

Response 3: Agreed - and we did highlight this already as a limitation and recommended future research should include follow-up assessments – see text below. The scope was limited due to financial and time constraints and a follow-up was not possible.

‘Secondly, the study assessed outcomes immediately post-intervention, but long- term effects remain unclear. Future studies should include follow-up assessments at 6- month and 12-month intervals to establish how these gains persist or fade over time and what refresher training may be required to sustain these gains.’

Comments 4: The authors claim improvements in "cognitive fitness" and "inhibitory control," but the evidence is mixed. Some inhibitory control tasks improved while others didn't, and working memory showed no improvement. The cognitive battery also seems somewhat arbitrary - why these specific tasks rather than others? The connection between these laboratory tasks and real workplace cognitive demands needs better justification.

Response 4: The typo stating that the Change Detection task measured inhibition, is now corrected to state that it measures working memory. The selection of cognitive tests was informed by the expert consensus derived from the Delphi study of key cognitive drivers of performance under pressure [37].

Comments 5: While statistically significant, several effect sizes are modest (e.g., 7.9% improvement in hardiness control subscale). The authors don't adequately discuss whether these changes are practically meaningful in workplace contexts. What does a 7.9% improvement in hardiness actually mean for an employee's daily work experience?

Response 5: The current study is one of several studies to show improved hardiness from an intervention. Given the systematic review of hardiness effects in the workplace by Senewiratne et al identified a wide range of benefits of hardiness in the workplace for both employees and organisations, we consider that, despite difficulties in measuring the practical flow-through, improvements should translate to meaningful benefits for employer and individuals alike. Our interpretation is as follows in the manuscript:

“Given the wide range of benefits of hardiness in the workplace identified by Senewiratne et al.’s [28] systematic review in the categories of Performance Outcomes, Work Behaviour, Work Attitude and Health and Wellbeing (as per Table 1), the improvements in hardiness observed in this study would likely, if sustained over time, result in significant benefits to both the individual and the organisation.”

Comments 6: The connection between the Cognitive Fitness Framework and psychological hardiness could be articulated more clearly. Why should these particular constructs improve together?

Response 6: The CF2 is a comprehensive map of the cognitive mechanisms that contribute to effective functioning and resilience in the face of stress and challenge. These outcomes are relevant in various domains of life, including work and personal pursuits. Hardiness is one of these outcomes: measured as a self-reported trait, it is known to be closely associated with measures of resilience and stress tolerance. Self-report hardiness measures are traditional in workplace research, while the CF2 (now enhanced by the expert consensus) offers a more objective account of the neuro-cognitive mechanisms underlying the observed behaviours and traits, including workplace hardiness.

Comments 7: If possible, could you please provide participant engagement with the mobile app and potential confounding factors during the study period?

Response 7: A table of available app engagement metrics is now included.

Comments 8: The research addresses an important problem and uses generally sound methodology, but the conclusions should be more cautiously stated given the limitations in measurement approach and follow-up duration.

Response 8: We have adjusted the conclusion to state that the intervention represents ‘a model for a scalable, evidence-based solution for mitigating workplace stress and improving performance.’