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Aims There is a need for innovative school-based mental health interventions to promote good mental health, healthy coping strategies, and engagement with support services. Consequently, Reprezent, a youth development organization, with mental health professionals and young people co-developed an online mental health intervention show, On The Level (OTL). This study assessed the acceptability and feasibility of delivering OTL to young people (aged 11–18 years) in 36 secondary schools across London and Essex, UK. Methods OTL was delivered online as part of the school curriculum, in classrooms at timepoint 1 (T1, 50 min). Follow-up data was collected at timepoint 2 (T2) 4–6 weeks later, during a 20-min OTL review show. For interactive OTL elements and data collection participants logged into an online survey. Measures of acceptability and engagement, mental health and well-being outcomes and intervention evaluation were taken at T1 and T2. We also assessed the feasibility of implementing the OTL intervention in secondary schools. Results 10,315 participants received the intervention (T1) and 3369 attended the follow-up session (T2), this high attrition, and potential selection bias, was due to only 30% of schools being able to take part in T2. Rates of acceptability were high among young people and school staff. At T1, 88% found OTL engaging, and 84% felt more confident they had the tools to help them better manage stress and anxiety. At T2, 66% viewed mental health in a more positive way, and 71% had better understanding of how to maintain good mental health. Rates of engagement with mental health tools and services were good, and significant reduction in levels of stress were found 4–6 weeks after the OTL show (T2). The low mental health and well-being indices reported by the school children at baseline strongly support the need and use for a mental health intervention such as OTL in secondary schools. Conclusion These findings indicated good feasibility and acceptability of OTL intervention and support the delivery of the OTL mental health intervention at UK-based secondary schools to educate young people about mental health and well-being and give them the necessary tools to support their mental health.

Established in March 2020, the C19PRC Study monitors the psychological and socio-economic impact of the pandemic in the UK and other countries. This paper describes the protocol for Wave 6 (August-September 2021).The survey assessed: COVID-19 related experiences; experiences of common mental health disorders; psychological characteristics; and social and political attitudes. Adult participants from any previous wave (N = 3170) were re-invited, and sample replenishment procedures helped manage attrition. Weights were calculated using a survey raking algorithm to ensure the on-going original panel (from baseline) was nationally representative in terms of gender, age, and household income, amongst other factors.1643 adults were re-interviewed at Wave 6 (51.8% retention rate). Non-participation was higher younger adults, those born outside UK, and adults living in cities. Of the adults recruited at baseline, 54.3% (N = 1100) participated in Wave 6. New respondent (N = 415) entered the panel at this wave, resulting in cross-sectional sample for Wave 6 of 2058 adults. The raking procedure re-balanced the longitudinal panel to within 1.3% of population estimates for selected socio-demographic characteristics.This paper outlines the growing strength of the publicly available C19PRC Study data for COVID-19-related interdisciplinary research.

Although the COVID-19 pandemic has impacted the psychological wellbeing of some people, there is evidence that many have been much less affected. The Ecological Model of Resilience (EMR) may explain why some individuals are not resilient whilst others are. In this study we test the EMR in a comparison of UK survey data collected from the Covid-19 Psychological Research Consortium longitudinal study of a representative sample of the UK adult population and data from an Italian arm of the study. We first compare data from the third wave (W3) of the UK arm of the study, collected in July/August 2020, with data from an equivalent sample (N = 1034) and stage of the pandemic in Italy in July 2020. Next, using UK longitudinal data collected from C19PRC Waves 1, 3 and 5, collected between March 2020 and April 2021 we identify the proportion of people who were resilient. Finally, we examine which factors, drawn from the ecological model, predict resilient and non-resilient outcomes.We find that the 72% of the UK sample was resilient, in line with the Italian study. In the cross-sectional logistic regression model, age and self-esteem were significantly associated with resilience whilst death anxiety thoughts, neuroticism, loneliness, and PTSD symptoms related to COVID-19 were significantly associated with Non-Resilient outcomes.In the longitudinal UK analysis, at Wave 5, 80% of the sample was Resilient. Service use, belonging to wider neighbourhood, self-rated health, self-esteem, openness, and externally generated death anxiety were associated with Resilient outcomes. In contrast, PTSD symptoms and loneliness were associated with Non-Resilient outcomes.The EMR effectively explained the results. There were some variables which are amenable to intervention which could increase resilience in the face of similar future challenges.

Although the COVID-19 pandemic has impacted the psychological wellbeing of some people, there is evidence that many have been much less affected. The Ecological Model of Resilience (EMR) may explain why some individuals are not resilient whilst others are. In this study we test the EMR in a comparison of UK survey data collected from the COVID-19 Psychological Research Consortium (C19PRC) longitudinal study of a representative sample of the United Kingdom (UK) adult population and data from an Italian arm of the study. We first compare data from the third wave of the UK arm of the study, collected in July/August 2020, with data from an equivalent sample and stage of the pandemic in Italy in July 2020. Next, using UK longitudinal data collected from C19PRC Waves 1, 3 and 5, collected between March 2020 and April 2021 we identify the proportion of people who were resilient. Finally, we examine which factors, drawn from the EMR, predict resilient and non-resilient outcomes. We find that the 72% of the UK sample was resilient, in line with the Italian study. In the cross-sectional logistic regression model, age and self-esteem were significantly associated with resilience whilst death anxiety thoughts, neuroticism, loneliness, and Post Traumatic Stress Disorder (PTSD) symptoms related to COVID-19 were significantly associated with Non-Resilient outcomes. In the longitudinal UK analysis, at Wave 5, 80% of the sample was Resilient. Service use, belonging to wider neighbourhood, self-rated health, self-esteem, openness, and externally generated death anxiety were associated with Resilient outcomes. In contrast, PTSD symptoms and loneliness were associated with Non-Resilient outcomes. The EMR effectively explained the results. There were some variables which are amenable to intervention which could increase resilience in the face of similar future challenges.

Research suggests that patients with Functional Neurological Symptom Disorder (pwFND) struggle to identify their own emotions and associated physiological cues (interoceptive sensitivity, IS). However, it is not known how this deficit interacts with stress. This study aimed to assess IS in pwFND at baseline and following stress induction, and relate the findings to self-reported emotion processing difficulties.Twenty-six pwFND and 27 healthy controls performed the Heart Beat Detection Task pre- and post-stress induction with the Cold Pressor Test. Participants also completed questionnaires assessing anxiety (GAD-7) and depressive symptomology (PHQ-9), as well as emotion processing (EPS-25).Patients reported deficits in emotion processing (Our findings suggest that pwFND are relatively impaired in the identification of their emotions at baseline and following stress induction. This may be related to the experience of functional sensory symptoms and has implications for the psychological treatment of emotion dysregulation in this population.

Purpose\ud \ud Previous research suggests that catastrophisation and perseverative, or repetitive negative thinking (RNT) could play an important role in the aetiology of Psychogenic Nonepileptic Seizures (PNES). This study was designed to explore whether these cognitive tendencies are more prevalent in patients with PNES than those with epilepsy and to examine the relationship between these cognitions, depression, anxiety, seizure frequency and diagnosis.\ud \ud \ud \ud Methods\ud \ud 26 patients with PNES (PWPNES) and 29 with epilepsy (PWE) self-reported RNT (Perseverative Thinking Questionnaire), catastrophisation tendencies (modified Safety Behaviors and Catastrophizing Scale), symptoms of anxiety (Generalised Anxiety Disorder Assessment 7) and depression (Primary Health Questionnaire 9) as well as seizure frequency.\ud \ud \ud \ud Results\ud \ud RNT and catastrophic thinking were highly correlated with each other and more prevalent in PWPNES than PWE. Positive correlations were also found between all other self-report measures and seizure frequency. The PNES diagnosis predicted RNT (perseverative thinking) independently of catastrophic thinking, anxiety, depression and seizure frequency.\ud \ud \ud \ud Conclusion\ud \ud PWPNES exhibit greater negative perseverative and catastrophising cognitive tendencies than PWE. PNES as a diagnosis independently predicted RNT. Hence, RNT and catastrophisation should be considered as possible specific targets for psychological interventions in patients with PNES.

Objectives: The COVID-19 Psychological Research Consortium (C19PRC) Study was established in March 2020 to monitor the psychological and socio-economic impact of the pandemic in the UK and other countries. This paper describes the protocol for Wave 6 (August-September 2021). Methods: The survey assessed: COVID-19 related experiences; experiences of common mental health disorders; psychological characteristics; and social and political attitudes. Adults who participated in any previous wave (N=3170) were re-invited to participate, and sample replenishment procedures were conducted to help manage attrition. Weights were calculated using a survey raking algorithm to ensure on-going original panel (commencing at baseline) was nationally representative in terms of gender, age, and household income, amongst other factors. Results: 1643 adults who participated in any previous wave were re-interviewed at Wave 6 (51.8% retention rate). Non-participation at Wave 6 was higher amongst women, younger adults, those in employment, those born outside UK, adults living in cities, and those not living alone. Of the adults recruited into the C19PRC study at baseline, 54.3% (N=1100) participated in Wave 6. An additional 415 new respondents entered the panel at this wave, resulting in cross-sectional sample for Wave 6 of 2058 adults. The raking procedure re-balanced the longitudinal panel to within 1.3% of population estimates for selected socio-demographic characteristics. Conclusion: This paper outlines the growing strength of the publicly available C19PRC Study data for COVID-19-related interdisciplinary research.

Objective\ud \ud Given the highly infectious nature of COVID-19, social distancing practices are key in stemming the spread of the virus. We aimed to assess the complex interplay among psychological factors, socio-demographic characteristics and social distancing behaviours within the framework of the widely used Capability, Opportunity, Motivation-Behaviour (COM-B) model.\ud \ud \ud \ud Design\ud \ud The present research employed network psychometrics on data collected during the first UK lockdown in April 2020 as part of the COVID-19 Psychological Research Consortium (C19PRC) Study. Using a network approach, we examined the predictions of psychological and demographic variables onto social distancing practices at two levels of analysis: macro and micro.\ud \ud \ud \ud Design\ud \ud The present research employed network psychometrics on data collected during the first UK lockdown in April 2020 as part of the COVID-19 Psychological Research Consortium (C19PRC) Study. Using a network approach, we examined the predictions of psychological and demographic variables onto social distancing practices at two levels of analysis: macro and micro.\ud \ud \ud \ud Results\ud \ud Our findings revealed several factors that influenced social distancing behaviour during the first UK lockdown. The COM-B model was successful in predicting particular aspects of social-distancing via the influence of psychological capability and motivation at the macro-and micro-levels, respectively. Notably, demographic variables, such as education, income, and age, were directly and uniquely predictive of certain social distancing behaviours.\ud \ud \ud \ud Conclusion\ud \ud Our findings reveal psychological factors that are key predictors of social distancing behaviour and also illustrate how demographic variables directly influence such behaviour. Our research has implications for the design of empirically-driven interventions to promote adherence to social distancing practices in this and future pandemics.

Aims: This study investigated the acceptability and feasibility of delivering the On The Level (OTL) mental health intervention to a sample of young people (aged 11-18 years) in secondary schools in London and Essex, UK.Methods: Participants were offered a OTL show intervention session as part of their class. Participants were followed up 4-6 weeks post-intervention session. Measures were completed for intervention acceptability and engagement, mental health outcomes and intervention evaluation at baseline/intervention (T1) and at follow-up (T2; 4-6 weeks post-intervention). Results: In total, 10,315 participants participated at T1. The results indicated good feasibility and acceptability of the OTL intervention among participants. It was feasible to recruit a large sample of young people and the OTL could be delivered during class at UK-based secondary schools as planned. Some adaptations to the study methods were identified in this study. Some preliminary differences were found for the mental health outcome measures between T1 and T2, notably with a significant reduction in levels of stress.Conclusion: This feasibility study provides preliminary evidence for the feasibility and acceptability of the OTL mental health intervention for young people in secondary schools in the UK.

This paper serves to alert IJPDS readers to the availability of a major new longitudinal survey data resource, the COVID-19 Psychological Research Consortium (C19PRC) Study, which is being released for secondary use via the Open Science Framework. The C19PRC Study is a rich and detailed dataset that provides a convenient and valuable foundation from which to study the social, political, and health status of European adults during an unprecedented time of change as a direct result of the COVID-19 pandemic and Brexit. Here, we provide an overview of the C19PRC Study design, with the purpose of stimulating interest about the study among social scientists and maximising use of this resource.

Adverse childhood experiences (ACEs) commonly co-occur, and researchers often estimate their impact using a cumulative risk approach. The person-centered approach offers another approach to operationalize the co-occurrence of ACEs. This study aims to estimate latent classes of ACEs in a sample of U.K. children, examine their relationship with emotional and behavioral problems, and compare the explanatory value of the latent classes to cumulative risk scores. Data were collected among a general population sample of British 10-year-old children extracted from the U.K. Household Longitudinal Study ( N = 601). Seven items characterized ACEs, comprising parent-report physical discipline, emotional abuse, supervisory neglect, maternal psychological distress, child-report parental educational disinterest, bullying victimization, and adverse neighborhood. Outcome measures were derived from the self-report Strengths and Difficulties Questionnaire including total difficulties, emotional symptoms, conduct problems, hyperactivity, peer problems, and prosocial behavior. Latent class analysis resulted in a three-class solution: low ACEs, household challenges, and community challenges. Compared to the other classes, the community challenges class scored substantially worse on total difficulties, emotional symptoms, and peer subscales. The cumulative risk score was associated with all outcomes except prosocial behavior. Cumulative risk models accounted for a larger proportion of variance compared with the latent class models, except for peer problems which the person-centered model explained better. This study confirms that ACEs are associated with impairment in child functioning, and that both person-centered and cumulative risk approaches can capture this relationship well. Specifically, the person-centered approach demonstrated how co-occurring risk factors in the community challenges class produced particularly poor internalizing outcomes.

This chapter will explore psychological and demographic influences on citizens’ ability to enact protective health behaviours during the COVID-19 pandemic. Such behaviours include social distancing and hygienic practices that have been recommended across the globe to reduce the spread of infection from the coronavirus. Such behaviours represent a seismic change in usual social behaviour and have been particularly difficult to adopt under urgent circumstances. However, human behaviour is the essential driver of the rate and spread of infection. Using evidence from a large-scale longitudinal survey conducted throughout the pandemic in the UK, this chapter explores protective behaviours in relation to the Capability, Opportunity, Motivation-Behaviour (COM-B) model of behaviour change, which presents a framework for understanding the influences on behaviour. We will illustrate how the components of the COM-B model can inform behaviour change interventions and the importance of the role of anxiety in shaping behavioural responses to the pandemic.

This paper serves to alert IJPDS readers to the availability of a major new longitudinal survey data resource, the COVID-19 Psychological Research Consortium (C19PRC) Study, which is being released for secondary use via the Open Science Framework. The C19PRC Study is a rich and detailed dataset that provides a convenient and valuable foundation from which to study the social, political, and health status of European adults during an unprecedent time of change as a direct result of the COVID-19 pandemic and Brexit. Here, we provide an overview of the C19PRC Study design, with the purpose of stimulating interest about the study among social scientists and maximising use of this resource.

Objective: The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) are self-report measures of major depressive disorder and generalised anxiety disorder. The primary aim of this study was to test for differential item functioning (DIF) on the PHQ-9 and GAD-7 items based on age, sex (males and females), and country.Method (or Design): Data from nationally representative surveys in UK, Ireland, Spain, and Italy (combined N = 6, 040) were used to fit confirmatory factor analytic and multiple-indictor multiple-causes models.Results: Spain and Italy had higher latent variable means than the UK and Ireland for both anxiety and depression, but there was no evidence for differential items functioning.Conclusions: The PHQ-9 and GAD-7 scores were found to be unidimensional, reliable, and largely free of DIF in data from four large nationally representative samples of the general population in the UK, Ireland, Italy and Spain.

Shevlin et al. (2021) recently demonstrated heterogeneity in mental health and psychological responses to the COVID-19 pandemic over time from a nationally representative sample of UK adults (March–July 2020). Five subpopulations representing either stability, deterioration or improvement in both anxiety-depression and COVID-19 PTSD were identified. The majority of the sample were characterised by low levels of anxiety-depression (56.6%) and COVID-19 traumatic stress (68.3%) during this early phase of the pandemic but some showed deterioration and some showed mental health benefits. Here we extend these findings using two additional survey waves from the C19PRC Study, thereby modelling mental health trajectories for the UK population within the entire first year of the pandemic.

Early neglect or maltreatment has been associated with changes in children's processing of emotional facial expressions, including a hypersensitivity to the emotion of anger. This may facilitate the avoidance of danger in a maltreating environment. However, few studies have examined whether experiences of early life stress (ELS) are associated with atypical avoidance responses towards emotional facial expressions, or whether the effects of ELS can be observed in adult participants. The present study therefore examined the effects of ELS on adults’ approach-avoidance tendencies towards angry, happy, and neutral facial expressions. Surprisingly, higher levels of ELS were associated with reduced avoidance of angry facial expressions among individuals with no evidence of mental illness. In contrast, there was no evidence of a relationship between ELS and avoidance of angry facial expressions among individuals with experience of mental illness. These novel findings suggest that ELS-related changes in social cognition can be observed years after the ELS itself occurred.

COVID-19 conspiracy theories have proliferated during the global pandemic, and their rapid spread among certain groups may jeopardize the public health response (e.g., undermining motivation to engage in social distancing and willingness to vaccinate against the virus). Using survey data from two waves of a nationally representative, longitudinal study of life in lockdown in the United Kingdom (N = 1,406), we analyze the factors associated with belief in three origin theories related to COVID-19, namely that it 1) originated in a meat market in Wuhan, China; 2) was developed in a lab in Wuhan, China; and 3) is caused by 5G mobile networks. Our findings suggest that political-psychological predispositions are strongly associated with belief in conspiracy theories about the virus, though the direction and effect sizes of these predictors vary depending on the specific content of each origin theory. For instance, belief in the Chinese lab conspiracy theory is strongly associated with right-wing authoritarianism (RWA), social dominance orientation (SDO), and general conspiracy ideation, as well as less reliable news sources, distrust in scientists, and anxiety about the pandemic. Belief in the 5G network conspiracy theory is strongly associated with SDO, distrust in scientists, while less strongly with conspiracy ideation and information from social networks/media; RWA is strongly negatively associated with belief in the 5G conspiracy theory, with older and more wealthy individuals somewhat less likely to endorse it. The meat market origin theory is predicted by intolerance of uncertainty, ethnocentrism, COVID-19 anxiety, and less so by higher income, while distrust in scientists is negatively associated with this origin story. Finally, belief in COVID-19 conspiracy theories is associated with negative public health behaviors such as unwillingness to social distance and vaccinate against the virus. Crucially, our findings suggest that the specific content of COVID-19 conspiracy theories likely determines which individuals may be most likely to endorse them.

Objectives\ud \ud The COVID-19 Psychological Research Consortium (C19PRC) Study aims to assess the impact of the COVID-19 pandemic in the adult population in multiple countries. This paper describes the third wave of the UK survey (the ‘parent’ strand of the Consortium) during July-August 2020.\ud \ud \ud Methods\ud \ud Adults (N = 2025) who participated in the baseline and/or first follow-up surveys were reinvited to participate in this survey, which assessed: (1) COVID-19 related knowledge, attitudes, and behaviours; (2) the occurrence of common mental disorders; as well as the role of (3) psychological factors and (4) social and political attitudes, in influencing the public’s response to the pandemic. Weights were calculated using a survey raking algorithm to ensure that the cross-sectional sample is nationally representative in terms of gender, age, and household income, and representative of the baseline sample characteristics for household composition, ethnicity, urbanicity and born/raised in UK.\ud \ud \ud Results\ud \ud 1166 adults (57.6% of baseline participants) provided full interviews at Wave 3. The raking procedure successfully re-balanced the cross-sectional sample to within 1% of population estimates across selected socio-demographic characteristics.\ud \ud \ud Conclusion\ud \ud This paper demonstrates the strength of the C19PRC Study data to facilitate and stimulate interdisciplinary research addressing important public health questions relating to the COVID-19 pandemic.

Despite the severe psychological impact of the COVID-19 pandemic, some individuals do not develop high levels of psychological distress and can be termed resilient. Using the ecological resilience model, we examined factors promoting or hindering resilience in the COVID-19 pandemic. Of the 1034 participants (49.9±16.2 years; females 51.2%) from Italian general population, 70% displayed resilient outcomes and 30% reported moderate-severe anxiety and/or depression. A binary regression model revealed that factors promoting resilience were mostly psychological (e.g., trait resilience, conscientiousness) together with social distancing. Conversely, factors hindering resilience included COVID-19-anxiety, COVID-19-related PTSD symptoms, intolerance of uncertainty, loneliness, living with children, higher education, and living in regions where the virus was starting to spread. In conclusion, the ecological resilience model in the COVID-19 pandemic explained 64% of the variance and identified factors promoting or hindering resilient outcomes. Critically, these findings can inform psychological interventions supporting individuals by strengthening factors associated with resilience.

Background The current study argues that population prevalence estimates for mental health disorders, or changes in mean scores over time, may not adequately reflect the heterogeneity in mental health response to the COVID-19 pandemic within the population. Methods The COVID-19 Psychological Research Consortium (C19PRC) Study is a longitudinal, nationally representative, online survey of UK adults. The current study analysed data from its first three waves of data collection: Wave 1 (March 2020, N = 2025), Wave 2 (April 2020, N = 1406) and Wave 3 (July 2020, N = 1166). Anxiety-depression was measured using the Patient Health Questionnaire Anxiety and Depression Scale (a composite measure of the PHQ-9 and GAD-7) and COVID-19-related posttraumatic stress disorder (PTSD) with the International Trauma Questionnaire. Changes in mental health outcomes were modelled across the three waves. Latent class growth analysis was used to identify subgroups of individuals with different trajectories of change in anxiety-depression and COVID-19 PTSD. Latent class membership was regressed on baseline characteristics. Results Overall prevalence of anxiety-depression remained stable, while COVID-19 PTSD reduced between Waves 2 and 3. Heterogeneity in mental health response was found, and hypothesised classes reflecting (i) stability, (ii) improvement and (iii) deterioration in mental health were identified. Psychological factors were most likely to differentiate the improving, deteriorating and high-stable classes from the low-stable mental health trajectories. Conclusions A low-stable profile characterised by little-to-no psychological distress (‘resilient’ class) was the most common trajectory for both anxiety-depression and COVID-19 PTSD. Monitoring these trajectories is necessary moving forward, in particular for the ~30% of individuals with increasing anxiety-depression levels.

The COVID-19 pandemic has brought about unprecedented global changes in individual and collective behaviour. To reduce the spread of the virus, public health bodies have promoted social distancing measures while attempting to mitigate their mental health consequences. The current study aimed to identify cognitive predictors of social distancing adherence and mental health symptoms, using computational models derived from delay discounting (the preference for smaller, immediate rewards over larger, delayed rewards) and patch foraging (the ability to trade-off between exploiting a known resource and exploring an unknown one). In a representative sample of the UK population (N = 442), we find that steeper delay discounting predicted poorer adherence to social distancing measures and greater sensitivity to reward magnitude during delay discounting predicted higher levels of anxiety symptoms. Furthermore, under-valuing recently sampled information during foraging independently predicted greater violation of lockdown guidance. Our results suggest that those who show greater discounting of delayed rewards struggle to maintain social distancing. Further, those who adapt faster to new information are better equipped to change their behaviour in response to public health measures. These findings can inform interventions that seek to increase compliance with social distancing measures whilst minimising negative repercussions for mental health.

A growing body of evidence suggests more catastrophising cognitions are present in patients with psychogenic non-epileptic seizures (pwPNES) compared to patients with epilepsy (PWE). However, the perseverative aspect of catastrophic thinking including repetitive negative thinking (RNT) has had little attention. In this study pwPNES (n=26) and PWE (n=29) completed self-reported questionnaires including Perseverative Thinking Questionnaire to assess levels of RNT and a modified version of the Safety Behaviors and Catastrophizing Scale to assess catastrophising of seizures. Participants also completed the PHQ-9 and GAD-7 to provide measures of anxiety and depression. Patients with PNES reported significantly higher levels of RNT, catastrophising of seizures, and depression and anxiety than patients with epilepsy. Additionally, the effect of RNT was independent to effects of all other factors in its contribution to PNES suggesting it would serve as a good target for psychological therapy.ajwhitfield1878@gmail.com

Adolescents' experience of heightened anxiety and increased vulnerability to develop anxiety disorders is believed to partly result from blunted fear extinction processes. However, whether this anxiety is mediated by adolescent-specific differences in perceptual responses to learned threat is not known. To investigate this, we used EEG to examine reinforcement-dependent changes in early visual event-related potentials in adolescents (N = 28, 13-14 years) and adults (N = 23, 25-26 years old) during a differential Pavlovian fear conditioning task, with one conditioned stimulus (CS+) paired with an aversive sound (unconditioned stimulus [US]) on 50% of trials, and another (CS-) never paired with the US. An immediate extinction phase followed, where both CSs were presented alone. We found age-dependent dissociations between explicit and implicit measures of fear learning. Specifically, both adolescents and adults demonstrated successful fear conditioning and extinction according to their explicit awareness of changes in CS contingencies and their evaluative CS ratings, and their differential skin conductance responses. However, for the first time we show age differences at the neural level in perceptual areas. Only adolescents showed greater visual P1 and N1 responses to the CS+ compared to the CS- during acquisition, a dissociation that for the N1 was maintained during extinction. We suggest that the adolescent perceptual hyper-responsivity to learned threat and blunted extinction reported here could be an adaptive mechanism to protect adolescents from harm. However, this hyper-responsivity may also confer greater vulnerability to experience pathological levels of anxiety at this developmental stage.

Depression is the leading cause of disability worldwide, yet rates of missed- and mis-diagnoses are alarmingly high. The introduction of objective biomarkers, to aid diagnosis, informed by depression’s physiological pathology may alleviate some of the burden on strained mental health services. Three minutes of eyes-closed resting state heart rate and skin conductance response (SCR) data were acquired from 27 participants (16 healthy controls, 11 with major depressive disorder (MDD)). Various classifiers were trained on state-of-the-art and novel features. We are aware of no previous studies analysing the utility of multimodal vs. individual modalities for classification. We found no improvement using multimodal classifiers over using heart rate variability (HRV) alone, which achieved 81% test accuracy. The best multimodal and SCR only classifiers were only slightly less accurate at 78%. Despite not improving depression detection, SCR features did show stronger correlation with suicidal ideation than HRV. SD1/SD22 is a novel HRV feature proposed in this paper, similar to the commonly used ratio SD1/SD2 but with more marked separation between classes, having the largest Rank Biserial Correlation of all examined features (p-value = 0.002, RBC = -0.73). We recommend further studies in this area.

There is increasing evidence implicating altered NMDA-receptor function in autism spectrum disorder (ASD). To investigate potential alterations in NMDA-dependent cortical plasticity in ASD, we examined the effect of visual high-frequency stimulation (HFS) on changes in plasticity in the visual cortex, measured by persistent changes in visual evoked potentials (VEPs), in individuals with ASD (n = 16) and neurotypical controls (NT; n = 15). VEPs were elicited by a checkerboard circle (0.83 Hz, 2-min blocks) at baseline and at 2, 4, and 20 min following exposure to HFS (8.87 Hz, 2 min), previously shown to induce LTP-like changes in the visual cortex. Difference waves were created by subtracting VEPs measured at baseline from each Post-HFS measure, and group differences assessed. We found that HFS resulted in reduced short-term potentiation of VEPs in ASD compared to NT participants. Thus, whilst ASD participants showed significant potentiation of the VEP immediately after HFS, this enhancement was not maintained, and only persisted into the second post-HFS assessment block in NT participants. Notably, ASD individuals who self-reported being more sensitive to visual stimuli showed greater shorter-term potentiation following visual HFS. Critically, there were no group differences in degree of neural entrainment to the visual HFS, or in attentional vigilance and task performance. These findings suggests that visual cortical plasticity is atypical in ASD, results consistent with reported altered NMDA receptor function in ASD.

Over-purchasing and hoarding of necessities is a common response to crises, especially in developed economies where there is normally an expectation of plentiful supply. This behaviour was observed internationally early on in the COVID-19 pandemic. In the absence of actual scarcity, this behaviour can be described as ‘panic buying’ and can lead to temporary shortages. However, there have been few psychological studies of this phenomenon. We propose a psychological model of over-purchasing informed by animal foraging theory and make predictions about variables that predict over-purchasing by either exacerbating or mitigating the anticipation of future scarcity. These variables include additional scarcity cues (e.g. loss of income), distress (e.g. depression), psychological factors that draw attention to these cues (e.g. neuroticism) or to reassuring messages (eg. analytical reasoning) or which facilitate over-purchasing (e.g. income).We tested our model in parallel nationally representative internet surveys of the adult general population conducted in the United Kingdom (UK: N = 2025) and the Republic of Ireland (RoI: N = 1041) 52 and 31 days after the first confirmed cases of COVID-19 were detected in the UK and RoI, respectively.About three quarters of participants reported no or very little over-purchasing. More over-purchasing in RoI may have reflected different government messaging or historical factors. When over-purchasing occurred, it was observed across a wide range of product categories and was accounted for by a single latent factor. It was positively predicted by household income, the presence of children at home, psychological distress (depression, death anxiety), threat sensitivity (right wing authoritarianism) and mistrust of others (paranoia). Analytic reasoning ability had an inhibitory effect. Predictor variables accounted for 36% and 34% of the variance in over-purchasing in the UK and RoI respectively. With some caveats, the data supported our model and point to strategies to mitigate over-purchasing in future crises.

COVID-19 has led to an unprecedented disruption of normal social relationships and activities, which are so important during the teen years and young adulthood, and to education and economic activity worldwide. The impact of this on young people’s mental health and future prospects may affect their need for support and services, and the speed of the nation’s social recovery afterwards. This study focused on the unique challenges facing young people at different points during adolescent development, which spans from the onset of puberty until the mid-twenties. Although this is an immensely challenging time and there is a potential risk for long term trauma, adolescence can be a period of opportunity, where the teenagers’ brain enjoys greater capacity for change. Hence, the focus on young people is key for designing age-specific interventions and public policies, which can offer new strategies for instilling resilience, emotional regulation, and self-control. In fact, adolescents might be assisted to not only cope, but excel, in spite of the challenges imposed by this pandemic. Our work will feed into the larger societal response that utilizes the discoveries about adolescence in the way we raise, teach, and treat young people during this time of crisis. Wave 1 data has already been collected from 2,002 young people aged 13-24, measuring their mental health (anxiety, depression, trauma), family functioning, social networks, and resilience, and social risk-taking at the time of the pandemic. Here we present a preliminary report of our findings, (Report 1). Data collected 21/4/20- 29/4/20 - a month after the lockdown started).

A brief follow on report (for Report 1, see https://psyarxiv.com/uq4rn/). This report presents data on parents and their children's well being as a result of the COVID-19 pandemic from our adult survey study. In addition to presenting additional data showing a potentially significant increase in anxiety and depression in young people aged 13-24, as a consequence of COVID-19. Data collection for our Adult Study (Wave 2) took place between 22nd April and was ended on Friday, May 1st, here we report headline figures for the impact of Covid-19 on parents and their children. We have described our methods in a separate report (https://psyarxiv.com/wxe2n) and released two reports on our mental health outcomes from wave 1 (https://psyarxiv.com/hb6nq, https://psyarxiv.com/ydvc7).

Background: Extant research relating to the psychological impact of infectious respiratory disease epidemics/pandemics suggests that frontline workers are particularly vulnerable.Methods: The current study used data from the first two waves of the United Kingdom (UK) survey of the COVID-19 Psychological Research Consortium (C19PRC) Study to compare frontline workers with the rest of the UK population on prevalence estimates of depression, anxiety, and PTSD during the first week of ‘lockdown’ (Wave 1) and one month later (Wave 2).Results: Compared to the rest of the population, frontline workers generally, and individual frontline worker groups, had significantly higher prevalence estimates of depression, anxiety, and PTSD during both wave 1 and wave 2. While prevalence estimates of depression significantly increased among Local & National Government Workers from Wave 1 (15.4%) to Wave 2 (38.5%), no significant improvement or deterioration in mental health status was recorded for any other frontline worker group. Multivariate binary logistic regression analysis showed that, beyond other risk factors, food workers were nearly twice as likely as others to screen positive for anxiety, while all frontline worker groups, other than transport workers, were significantly more likely to screen positive for PTSD (Odds Ratios ranged from 1.74 – 3.43). Finally, while frontline workers, generally, were significantly more likely than the general public to have received mental health advice during the pandemic (26.9% versus 20.3% respectively), this was largely reflective of health and social care workers (37.9%).Conclusions: These findings offer timely and valuable information on the psychological health status of UK’s frontline workforce during the early stages of the COVID-19 pandemic and may aid in preparations for their future psychological and mental health support.

The C19PRC Study aims to assess the psychological, social, and economic impact of the COVID-19 pandemic in the UK, Republic of Ireland, and Spain. This paper describes the the first two waves of the UK survey (the ‘parent’ strand of the Consortium) during March-April 2020. A longitudinal, internet panel survey assessed: (1) COVID-19 related knowledge, attitudes, and behaviours; (2) the occurrence of common mental health disorders (e.g. anxiety, depression); as well as the role of (3) psychological factors (e.g. personality, locus of control, resilience) and (4) social and political attitudes (e.g. authoritarianism, social dominance), in influencing the public’s response to the pandemic. Quota sampling was used to recruit a nationally representative (in terms of age, sex, and household income) sample of adults (N=2025), 1406 of whom were followed-up one month later (69.4% retention rate). The baseline sample was representative of the UK population in terms of economic activity, ethnicity, and household composition. Attrition was predicted by key socio-demographic characteristics, and an inverse probability weighting procedure was employed to ensure the follow-up sample was representative of the baseline sample. C19PRC Study data has strong generalisability to facilitate and stimulate interdisciplinary research on important public health questions relating to the COVID-19 pandemic.

Successful delivery of a COVID-19 vaccine may be undermined if populations are not receptive to inoculation as a primary public health strategy for combatting the virus. We gathered nationally representative data from the general adult populations of Ireland (N=1,041) and the United Kingdom (UK; N=2,025) to determine rates of hesitancy and resistance to a future COVID-19 vaccine and to identify and psychologically profile vaccine hesitant/resistant individuals in a way that might aid future public health messaging. Vaccine hesitancy was evident for 26% and 25% of Irish and UK samples, respectively, while vaccine resistance was evident for 9% and 6%, respectively. Vaccine hesitant/resistant respondents in Ireland and the UK differed in relation to a number of sociodemographic, political, and health-related variables, but were similar across a broad array of psychological constructs. In both populations, those who were resistant to a COVID-19 vaccine were less likely to obtain information about the pandemic from traditional and authoritative sources and had similar levels of mistrust in these sources. The current findings may help public health officials to more effectively target vaccine hesitant and resistant individuals, develop effective communication strategies that take into account their specific psychological dispositions, and leverage dissemination channels that can successfully reach these individuals.

The primary aim of this study was to estimate the rate of face mask use during the COVID-19 pandemic in a representative UK adult population sample and assess its association with demographic, health, and mental health variables. The rate of face mask wearing was 16.7% and was associated with being younger, male, living in an urban environment, having existing health problems, increased perceived risk of COVID-19, depression, traumatic stress, and COVID-19 related anxiety. The number of people prepared to wear face masks needs to increase significantly if the UK government recommends their use.

During task performance, our level of cognitive control is dynamically adjusted to task demands as reflected, for example, by the congruency sequence effect (CSE) in conflict tasks. Although brain areas related to cognitive control show protracted maturation across adolescence, previous studies found that adolescents show similar behavioral CSEs to adults. In the present study, we investigated whether there are age-related changes in the neural underpinnings of dynamic control adjustments using electroencephalography. Early adolescents (ages 12–14, N = 30) and young adults (ages 25–27, N = 29) completed a confound-minimized flanker task optimized for the detection of sequential control adjustments. The CSE was observed in midfrontal theta power thought to capture anterior cingulate cortex-mediated monitoring processes but was not modulated significantly by age. Adolescents, however, showed a smaller congruency effect in the power and cross-trial temporal consistency of midfrontal theta oscillations than adults. No age differences were observed in phase-based connectivity between midfrontal and lateral frontal regions in the theta band. These findings provide strong support for the role of midfrontal theta oscillations in conflict monitoring and reactive control and suggest that the cognitive system of early adolescents initially responds less reliably to the occurrence of conflict than that of adults.

Objectives The COVID-19 pandemic is one of the greatest global health threats facing humanity in recent memory. This study aimed to explore influences on hygienic practices, a set of key transmission behaviours, in relation to the Capability, Opportunity, Motivation-Behaviour (COM-B) model of behaviour change (Michie et al., 2011).Design Data from the first wave of a longitudinal survey study was used, launched in the early stages of the UK COVID-19 pandemic.Methods Participants were 2025 adults aged 18 and older, representative of the UK population, recruited by a survey company from a panel of research participants. Participants self-reported motivation, capability and opportunity to enact hygienic practices during the COVID-19 outbreak.ResultsUsing regression models, we found that all three COM-B components significantly predicted good hygienic practices, with motivation having the greatest influence on behaviour. Breaking this down further, the sub-scales psychological capability, social opportunity and reflective motivation positively influenced behaviour. Reflective motivation was largely driving behaviour, with those highest in reflective motivation scoring 51% more on the measure of hygienic practices compared with those with the lowest scores.ConclusionsOur findings have clear implications for the design of behaviour change interventions to promote hygienic practices. Interventions should focus on increasing and maintaining motivation to act and include elements that promote and maintain social support and knowledge of COVID-19 transmission. Groups in particular need of targeting for interventions to increase hygienic practices are males and those living in cities and suburbs.

Background The COVID-19 pandemic has created an unprecedented global crisis, necessitating drastic changes to living conditions, social life, personal freedom and economic activity. No study has yet examined the presence of psychiatric symptoms in the UK population under similar conditions. Aims We investigated the prevalence of COVID-19-related anxiety, generalised anxiety, depression and trauma symptoms in the UK population during an early phase of the pandemic, and estimated associations with variables likely to influence these symptoms. Method Between 23 and 28 March 2020, a quota sample of 2025 UK adults aged 18 years and older, stratified by age, gender and household income, was recruited by online survey company Qualtrics. Participants completed standardised measures of depression, generalised anxiety and trauma symptoms relating to the pandemic. Bivariate and multivariate associations were calculated for demographic and health-related variables. Results Higher levels of anxiety, depression and trauma symptoms were reported compared with previous population studies, but not dramatically so. Anxiety or depression and trauma symptoms were predicted by young age, presence of children in the home, and high estimates of personal risk. Anxiety and depression were also predicted by low income, loss of income and pre-existing health conditions in self and others. Specific anxiety about COVID-19 was greater in older participants. Conclusions This study showed a modest increase in the prevalence of mental health problems in the early stages of the pandemic, and these problems were predicted by several specific COVID-related variables. Further similar surveys, particularly of those with children at home, are required as the pandemic progresses.

Sense of agency (SoA), the fundamental feeling of control over our actions and their consequences, may show key developmental changes during adolescence. We examined SoA in childhood (9-10), mid-adolescence (13-14), late-adolescence (18-20) and adulthood (25-28) using two tasks (Libet Clock and Stream of Letters). SoA was implicitly indexed by intentional binding that reflects the agency effect on action-outcome temporal association. We found age effects on the sub-processes in both tasks. In the Libet Clock task, where performance was more reliable, we observed a U-shaped developmental trajectory of intentional binding suggesting an adolescent-specific reduction in the experience of control. This study provides evidence for the developmental effects on the implicit agency experience and suggests adolescence as a critical period. Our findings may have implications for understanding increased risk-taking behaviour and greater vulnerability for agency related disorders such as schizophrenia during adolescence.

The COVID-19 Psychological Research Consortium (C19PRC) Study aims to assess and monitor the psychological and social impact of the coronavirus (COVID-19) pandemic in the general population, using longitudinal surveys and mixed-methods studies in multiple countries. The first strand of the study, an internet-based panel survey, was launched in the UK in March 2020 during the earliest stages of the pandemic in that country (hereafter referred to as C19PRC-UKW1). This paper describes (1) the development, design and content for C19PRC-UKW1, which was informed by the extant evidence base on the psychosocial impact of previous global outbreaks of similar severe acute respiratory syndromes (e.g. SARS, H1N1, MERS); (2) the specific socio-economic and political context of the C19PRC-UKW1; (3) the recruitment of a large sample of UK adults aged 18 years and older (n=2025) via an internet-based panel survey; (4) the representativeness of the C19PRC-UKW1 sample compared to the UK adult population in terms of important sociodemographic characteristics (e.g. age, sex, household income, etc.); and (5) future plans for C19PRC Study including follow-up survey waves in the UK, supplementary non-survey based study strands linking from the C19PRC-UKW1 and the roll-out of the study to other countries.

Psychogenic nonepileptic seizures (PNES) are characterized by paroxysmal alterations in motor and sensory functions resembling epileptic seizures, but are not caused by epileptiform activity. In recent years, there has been increasing scientific interest in emotion dysregulation in patients with PNES (pwPNES), but the literature has not yet been interpreted within a broader model of emotion dysregulation. The aim of this review was therefore to synthesize the existing literature on emotion dysregulation in pwPNES within the extended process model (EPM) of emotion regulation. Methods PubMed and Web of Science were searched for studies relevant to emotion dysregulation as defined by the EPM. These studies were subjected to a bespoke quality appraisal tool. Studies of acceptable quality were categorized to the different stages of the EPM and critically appraised. Results Studies of emotion regulation in pwPNES were generally of low quality — a finding largely driven by small sample sizes. However, there was evidence of emotion dysregulation characterized by deficits in the identification of patients' own emotional states, as well as the selection and implementation of maladaptive regulatory strategies, and altered exteroceptive emotional processing. However, heterogeneity in findings suggests that emotion dysregulation is likely linked to other psychological factors and not common to all pwPNES. Significance This review suggests that while pwPNES are likely to experience emotion dysregulation as defined by the EPM, there is variability in the distribution of regulatory deficits in this patient population, and a person-centered approach should be taken when working with these patients. There is a need for more high quality and better-powered studies in this area.

Accurate perception of the emotional content of vocalisations is essential for successful social communication and interaction. However, it is not clear whether our ability to perceive emotional cues from vocal signals is specific to human signals, or can be applied to other species’ vocalisations. Here, we address this issue by evaluating the perception and neural response to affective vocalisations from different primate species (humans, chimpanzees and macaques). We found that the ability of human participants to discriminate emotional valence varied as a function of phylogenetic distance between species. Participants were most accurate at discriminating the emotional valence of human vocalisations, followed by chimpanzee vocalisations. They were, however, unable to accurately discriminate the valence of macaque vocalisations. Next, we used fMRI to compare human brain responses to human, chimpanzee and macaque vocalisations. We found that regions in the superior temporal lobe that are closely associated with the perception of complex auditory signals, showed a graded response to affective vocalisations from different species with the largest response to human vocalisations, an intermediate response to chimpanzees, and the smallest response to macaques. Together, these results suggest that neural correlates of differences in the perception of different primate affective vocalisations are found in auditory regions of the human brain and correspond to the phylogenetic distances between the species.

This study examined whether changes in perceptual processes can partially account for the increase in reward-orientated behaviour during adolescence. This was investigated by examining reinforcement-dependent potentiation to discriminative stimuli (SD) that predicted rewarding or threatening outcomes. To that end, perceptual event-related potentials that are modulated by motivationally salient stimuli, the N170 and Late Positive Potential (LPP), were recorded from 30 preadolescents (9–12 years), 30 adolescents (13–17 years), and 34 late adolescents (18–23 years) while they completed an instrumental task in which they emitted or omitted a motor response to obtain rewards and avoid losses. The LPP, but not the N170, showed age, but not gender, differences in reinforcement-dependent potentiation; preadolescents, adolescents, and late adolescents showed potentiation to SD that predicted a threat, whereas only preadolescents showed potentiation to SD that predicted a reward. Notably, the magnitude of threat-related LPP reinforcement-dependent potentiation decreased during the course of adolescence. In addition, greater sensation seeking was associated with greater LPP amplitudes in preadolescent males, but smaller LPP amplitudes in late adolescent males. Critically, these findings provide initial evidence for developmental differences in value-related coding in perceptual areas, where adolescents show greater perceptual biases to avoidance-related cues than to reward-related cues. Keywords: N170, Late positive potential, Adolescence, Reward, Threat, Approach, Avoidance, Reinforcement dependent potentiation

Background: Research is needed to examine change in general population mental health since the beginning of the pandemic, while accounting for heterogeneity in mental health response. Methods: The COVID-19 Psychological Research Consortium (C19PRC) Study is a longitudinal, nationally representative, internet-based survey of UK adults. The current study analysed data from its first three waves of data collection: Wave 1 (March 2020, N =2025), Wave 2 (April 2020, N =1406) and Wave 3 (July 2020, N =1166). Anxiety-depression was measured using the Patient Health Questionnaire Anxiety and Depression Scale (a composite measure of the PHQ-9 and GAD-7) and COVID-19 related PTSD with the International Trauma Questionnaire. Changes in mental health outcomes were modelled across the three waves. Latent class growth analysis was used to identify subgroups of individuals with different trajectories of change in anxiety-depression and COVID-19 PTSD. Latent class membership was regressed on baseline characteristics. Outcomes: Overall prevalence of anxiety-depression remained stable, while COVID-19 PTSD reduced between Waves 2 and 3. Heterogeneity in mental health response was found, and hypothesised classes reflecting (i) stability, (ii) improvement, and (iii) deterioration in mental health were identified. Psychological factors were most likely to differentiate the improving, deteriorating and high-stable classes from the low-stable mental health trajectories. Interpretation: A low-stable profile characterised by little-to-no psychological distress (‘resilient’ class) was the most common trajectory for both anxiety-depression and COVID-19 PTSD. Monitoring of these trajectories is necessary moving forward, in particular for the ~30% of individuals with increasing levels of anxiety-depression. Funding Statement: Economic and Social Research Council (ES/V004379/1). Declaration of Interests: We declare that no competing interests exist. Ethics Approval Statement: Ethical approval was granted by the University of Sheffield (Ref. 033759). All participants provided informed consent.

Models of cognitive development suggest that cognitive control, a complex construct that ensures goal-directedness even in the face of distractions, is still maturing across adolescence. In the present study, we investigated how the ability to dynamically adjust cognitive control develops in this period of life, as indexed by the magnitude of the congruency sequence effect (CSE) in conflict tasks, and how this ability might relate to lapses of attention (mind-wandering [MW]). To these ends, participants from four age groups (12-13, 14-15, 18-20 and 25-27 years old) completed confound-minimized variants of the flanker and Simon tasks, along with a Go/No-Go task with thought probes to assess their frequency of mind-wandering. The CSE was present in both tasks, but was not affected by age in either of them. In addition, the size of the CSE in the flanker, but not in the Simon task was negatively associated with the frequency of MW with awareness. Trait MW and the probability of reporting MW during the task was found to increase with age in accordance with cognitive resource views of MW. Our findings suggest that at the behavioral level there are no substantial developmental changes through the adolescent period in control adjustment ability as measured by the CSE. Response inhibition performance in the Go/No-Go task, however, improved significantly with age. The implications of the present results for the conflict monitoring account of the CSE and extant theories of MW are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Aims Exploration of the relationship between negative life experiences and patients with Functional Neurological Disorder (FND), by analysing patient and non-clinical group responses to a new questionnaire called the Lifespan of Negative Experiences Scale (LiNES). LiNES was designed to examine predisposing vulnerabilities and perpetuating factors in individuals with FND by retrospectively assessing experiences of interpersonal trauma, affect and relationship insecurity at three developmental stages – childhood, adolescence and adulthood. Methods LiNES, CATS (measure of childhood abuse and trauma), RSQ (measure of relationship insecurity) and PANAS (measure of affect) questionnaires were administrated to 71 individuals with FND. Analyses were conducted to assess the reliability of the LiNES, explore correlations between different psychological domains within the FND group and to test whether LiNES scores predicted FND group membership. In addition, FND patients’ responses where compared to 270 matched healthy controls. Results The LiNES subscales had high internal consistency and correlated with CATS, RSQ and PANAS. Levels of interpersonal trauma were higher in FND patients than controls during childhood, adolescence and adulthood. High levels of negative affect were found in FND patients in adulthood compared to controls but no significant differences were found between FND patients and controls in relationship insecurity at any developmental stage. On the RSQ, FND patients had higher anxious and avoidant relationship styles. LiNES trauma scores at each developmental stage predicted FND status with over 80% accuracy. Additionally, FND patients self-reported more symptoms (SDQ-20) and a higher prevalence of comorbid conditions compared to controls. Conclusions The LiNES is a new brief retrospective measure of negative life experiences. Although psychological factors may not be necessary to the diagnosis of FND, they are substantially more common in FND patients compared to controls. In particular, a history of interpersonal trauma seems to play an important role in those with FND. These factors therefore are likely to play a pathophysiological role in many patients and their recognition is important for treatment. This study provides new insights into the association between the timing of negative experiences and the subsequent effect on an individual. Furthermore, the results support the use of LiNES as a valid screening tool in the clinical setting in patients presenting with functional symptoms with diagnostic and therapeutic implications.

Objectives/Aims Self-report studies of alexithymic traits in individuals with Functional Neurological Symptom Disorder (FND), suggest that emotion dysregulation in this population is characterised by an impaired ability to detect and identify their own emotions (identification impairments).1 This regulatory deficit might be particularly problematic for a patient group with an increased incidence of stressful life events relative to healthy controls,2 for whom the ability to regulate emotions might therefore be more crucial. Examining sensitivity to changes in physiological cues associated with emotional experience (interoception) is a way of assessing one aspect of participants’ capacity to identify their own emotions. However, no studies have yet experimentally investigated how stress might interact with interoception in this population. Therefore, the aim of this study was to investigate patients’ interoceptive sensitivity both at baseline and under stress. Methods Twenty-six patients with FND and twenty-seven healthy controls performed the Heartbeat Detection Task (HBDT) pre- and post- stress-induction with the Cold Pressor Test. The HBDT is a behavioural paradigm, measuring participants’ sensitivity to a physiological cue associated with emotional experience - the heartbeat. Participants also completed a self-report measure of emotion dysregulation (The Emotional Processing Scale-25) which includes a subscale capturing ‘a detached experience of one’s emotions due to poor emotional insight’, and a measure of Major Depressive symptomology (The PHQ-9). Results Relative to healthy controls, patients with FND performed more poorly on the HBDT both at baseline and following stress-induction (p=0.032). Patients also reported greater impairments across all domains of the EPS-25 and higher scores on the PHQ-9 than healthy controls (both p Conclusions Impaired HBDT performance suggests that patients with FND lack sensitivity to their heartbeat, both under ‘normal’ conditions and following stress-induction. Physiological cues (like the heartbeat) are an important source of interoceptive information for emotional experience, for example during stress. Our findings therefore represent a form of identification impairment that may contribute to stress-vulnerability in this population. Raised levels of self- reported ‘impoverished emotional experience’ corroborate the suggestion that patients with FND have difficulty identifying and understanding their emotions. These findings have direct implications for understanding and treating emotion dysregulation in FND. References Williams IA, Levita L, Reuber M. Emotion dysregulation in patients with psychogenic nonepileptic seizures: A systematic review based on the extended process model. Epilepsy & Behavior. 2018;86:37–48. Ludwig L, Pasman JA, Nicholson T, Aybek S, David AS, Tuck S, et al. Stressful life events and maltreatment in conversion (functional neurological) disorder: systematic review and meta-analysis of case-control studies. The Lancet Psychiatry. 2018;5(4):307–20.

Sense of agency (SoA), the experience of being in control of our voluntary actions and their outcomes, is a key feature of normal human experience. Frontoparietal brain circuits associated with SoA undergo a major maturational process during adolescence. To examine whether this translates to neurodevelopmental changes in agency experience, we investigated two key neural processes associated with SoA, the activity that is leading to voluntary action (Readiness Potential) and the activity that is associated with the action outcome processing (attenuation of auditory N1 and P2 event related potentials, ERPs) in mid-adolescents (13-14), late-adolescents (18-20) and adults (25-28) while they perform an intentional binding task. In this task, participants pressed a button (action) that delivered a tone (outcome) after a small delay and reported the time of the tone using the Libet clock. This action-outcome condition alternated with a no-action condition where an identical tone was triggered by a computer. Mid-adolescents showed greater outcome binding, such that they perceived self-triggered tones as being temporally closer to their actions compared to adults. Suggesting greater agency experience over the outcomes of their voluntary actions during mid-adolescence. Consistent with this, greater levels of attenuated neural response to self-triggered auditory tones (specifically P2 attenuation) were found during mid-adolescence compared to older age groups. This enhanced attenuation decreased with age as observed in outcome binding. However, there were no age-related differences in the readiness potential leading to the voluntary action (button press) as well as in the N1 attenuation to the self-triggered tones. Notably, in mid-adolescents greater outcome binding scores were positively associated with greater P2 attenuation, and smaller negativity in the late readiness potential. These findings suggest that the greater experience of implicit agency observed during mid-adolescence may be mediated by a neural over-suppression of action outcomes (auditory P2 attenuation), and over-reliance on motor preparation (late readiness potential), which we found to become adult-like during late-adolescence. Implications for adolescent development and SoA related neurodevelopmental disorders are discussed.

This study investigated age-, gender-, and puberty-related changes in two cortical sources of spontaneous alpha during eyes-open and eyes-closed conditions in a cohort of adolescents aged 9-23 years. In total, 29 preadolescents (9-12 years, 14 females), 29 mid-adolescents (13-17 years, 14 females), and 33 late adolescents (18-23 years, 17 females) had their resting brain activity measured using electroencephalography (EEG) during eyes-open and eyes-closed conditions. Standardised Low Resolution Brain Electromagnetic Tomography (sLORETA) was used to estimate the cortical sources of spontaneous alpha. Two cortical sources were chosen as regions of interest (ROIs): prefrontal cortex and occipital cortex. Significant age-related changes in the cortical sources of alpha were found, particularly in prefrontal regions; prefrontal alpha power was greater during the eyes-open condition compared to the eyes-closed condition for late adolescents, but equivalent across the eyes-open and eyes-closed conditions for both pre- and mid-adolescents. In addition, more advanced pubertal stage predicted reduced alpha power in male, but not female, adolescents aged 9-17 years. This study provides an important initial step towards understanding developmental changes in the cortical sources of spontaneous alpha in the typically developing brain. Moreover, the results from this study underscore the need to tease out the effects of age, gender, and puberty when examining the cortical sources of alpha during the adolescent period.

This experiment (N = 49) is the first to show that imagined contact can buffer anticipatory physiological responses to future interactions, and improve the quality of these interactions. Participants imagined a positive interaction with a person with schizophrenia, or in a control condition, a person who did not have schizophrenia. They then participated in an interaction with a confederate whom they believed had schizophrenia. Participants in the imagined contact condition reported more positive attitudes and less avoidance of people with schizophrenia, displayed smaller anticipatory physiological responses, specifically smaller changes in interbeat interval and skin conductance responses, and had a more positive interaction as rated by the confederate. These findings support applying imagined contact to improve the treatment of people with severe mental health disorders.

Objectives This systematic review aims to contrast levels, manifestations and associations of depression in patients with psychogenic non-epileptic seizures (PNES) and those with epilepsy. Methods ScienceDirect and Web of Science were searched for primary research reports describing quantitative studies involving separate epilepsy and PNES samples (age 16+) and using a validated measure of depression. Results While 34 studies were identified, most were of low quality and had small sample sizes. Studies consistently found higher levels of self-reported depression in the PNES than epilepsy groups, with a meta-analysis demonstrating a significant difference between the groups. Although patients with PNES were also more likely to have a clinical diagnosis of depression than those with epilepsy, the difference between the groups was less pronounced in studies based on such diagnoses rather than self-report. Patients with PNES were more likely to report physical symptoms of depression than those with epilepsy. Interpersonal factors explained more variation in depression levels in patients with PNES than those with epilepsy, for whom illness related factors were more influential, but in both patient groups, depression had a significant impact on health related quality of life. Conclusions This systematic review demonstrates a higher prevalence of depression in patients with PNES compared to patients with epilepsy and suggests differences in the expression and possible causes of depression between these groups.

Humans are better at integrating desirable information into their beliefs than undesirable. This asymmetry poses an evolutionary puzzle, as it can lead to an underestimation of risk and thus failure to take precautionary action. Here, we suggest a mechanism that can speak to this conundrum. In particular, we show that the bias vanishes in response to perceived threat in the environment. We report that an improvement in participants’ tendency to incorporate bad news into their beliefs is associated with physiological arousal in response to threat indexed by galvanic skin response and self-reported anxiety. This pattern of results was observed in a controlled laboratory setting (Experiment I), where perceived threat was manipulated, and in firefighters on duty (Experiment II), where it naturally varied. Such flexibility in how individuals integrate information may enhance the likelihood of responding to warnings with caution in environments rife with threat, while maintaining a positivity bias otherwise, a strategy that can increase well-being.