Mirror Tracing Persistence Task

Background

The Mirror-Tracing Persistence Task (MTPT) is a classic psychological test of distress tolerance and behavioral perseverance. It leverages the classic and challenging Mirror Tracing Task (MTT) that requires participants to draw shapes while only viewing their hand's reflection in a mirror, which creates a highly frustrating and cognitively demanding mismatch between visual feedback and physical movement.

Edward P. Quinn and colleagues (1996) first shifted the focus of the MMT from motor learning to a behavioral measure of persistence. They used it to observe how long individuals with substance and nicotine addictions would persist through the frustration of the task before quitting. The MTPT was further updated as a computerized measure by David R. Strong and C.W. Lejuez (along with colleagues) who are credited with developing the Computerized Mirror-Tracing Persistence Task (MTPT-C) in 2003. Their digital version standardized the task's modern application as a viable tool for assessing clinical distress tolerance. Because the task itself was originally described only in an unpublished manual, a published description of the task is provided by Ruth Brown and colleagues in 2019 who used the MTPT-C as the distress tolerance measure in veterans.

The MTPT-C asks participants to work on three tracing tasks that get progressively more difficult. For example, participants start out on the relatively easy task of tracing a straight line before moving on to the more challenging task of tracing a square followed by a 5-pointed star. For each shape, participants are asked to complete the task perfectly in a set amount of time. Any time they make an error (e.g. taking to long to trace or tracing outside the shape), an aversive buzzer goes off and participants need to restart the shape tracing from the beginning. Timing restrictions, buzzer and error corrections are all used as aversive stimuli to increase an individual's stress level. Like other distress tolerance tests (e.g. PASAT-C, a quit button is provided for the last most challenging level, and the main measure is the time it takes participants to press it.

The Millisecond MTPT-C provides researchers the functionality to run the test with a fixed set of shapes or employ a more adaptive version that uses a participant's tracing abilities to allow for more comparable stress levels at each stage of the task. For example, a participant who already has difficulty completing the line drawing trial might be completely overwhelmed by tracing a square. In such a case, a right-angle task might be more appropriate.

Task Procedure

The screen in the Millisecond MTPT-C is divided into a mirror part (gray, on top) and a drawing canvas (white, on the bottom). Participants are asked to trace a shape (square, circle and 5-pointed star) on the drawing canvas (bottom) but can only see their tracing trail on the mirror image of the shape (on the top). Participants can trace the shape with the mouse (on non-touchscreen devices) or with a stylus/finger (on touchscreen devices). The visible tracing line in the 'mirror' part of the screen appears in green if the line is within the specified shape boundary. If the line goes outside the boundary, a buzzer sounds and participants are re-directed to the starting point.

The default settings of the task runs a fixed sequence of shapes: a line -> a square -> a 5-pointed star. The allotted timeouts for the shapes are 1 minute for the line, 3 minutes for the square and 10 minutes for the star. When participants reach level 3 (the star), an 'escape' button is provided that can be pressed at any time to end the task.

What it Measures

The Mirror Tracing Persistence Task (MTPT) is behavioral measure of distress tolerance.

Psychological Domains

• Emotion Regulation: Ability to monitor, evaluate, and modify one's emotional responses in a way that aligns with one's goals and values
• Distress Tolerance: Ability to stay on a goal-oriented task while enduring emotional distress
• Impulsivity: Tendency toward rapid reactions to internal or external stimuli without considerations of negative long-term consequences
• Procedural Memory: This is the "how-to" memory system responsible for motor skills, habits, and physical tasks (like riding a bike).
• Visuomotor Coordination: The brain’s ability to synchronize visual inputs with physical hand movements.
• Cognitive Flexibility: The capacity to override highly practiced, automatic habits and adapt to new, inverted rules.
• Inhibitory Control: The mental effort required to suppress the natural urge to move your hand in the direction you see in the mirror.

Main Performance Metrics

• Quitting: whether the escape button is pressed
• Level 3 Duration: time spent on the last, most challenging level

Psychiatric Conditions

The MTPT has been used with the following patient groups

• Substance Use Disorder (SUD)
• Generalized Anxiety Disorder (GAD)
• Major Depressive Disorder (MDD)
• Post-Traumatic Stress Disorder (PTSD)

References

Search Google Scholar for peer-reviewed, published research using the Inquisit Mirror Tracing Persistence Task.

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Strong, D. R., Lejuez, C. W., Daughters, S. B., Marinello, M., Kahler, C. W., & Brown, R. A. (2003). The computerized mirror tracing task, version 1. In Unpublished manual. Described in Brown et al (2019)

Brown, R. C., Overstreet, C., Sheerin, C., Berenz, E., Hawn, S., Pickett, T., McDonald, S., Danielson, C. K., & Amstadter, A. B. (2019). The Nomological Network of a Behavioral Distress Tolerance Task in Veterans. Journal of Traumatic Stress, 31(6), 876–885. https://doi.org/10.1002/jts.22349