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Objective: The assessment of mood after brain injury is more challenging when people have ongoing severe cognitive and receptive communication impairments. There is no gold standard on how these assessments should be undertaken. This study aimed to reach a consensus on this among specialists working with this population. Design: Focus groups were completed using a structured nominal group technique. Groups were compared for overlapping themes and agreed processes. Participants: Five focus groups with a total of 14 participants who work with the population of interest were completed. Participants included 12 clinical psychologists, one psychiatrist and one consultant in rehabilitation medicine. Results: Each of the five groups reached a consensus on a process for assessing mood in this population. Results overlapped and were combined into a proposed circular and iterative model of assessment that includes: (pre) information gathering, (peri) assessment processes, and (post) treatment; with formulation being seen as a vital part of the process. Standardised measures were not recommended for use with this population. Beyond the consensus processes, three implicit themes were identified: (1) depression is different after severe brain injury, (2) overlapping tasks and roles, and (3) looking at the bigger picture. Conclusions: A good level of consensus was achieved across the five groups on processes to follow when assessing mood when people have ongoing cognitive and receptive communication impairments after severe brain injury. We recommend that this formulation-based model be followed when assessing people in this clinical population. [ABSTRACT FROM AUTHOR]

Objective: Mood assessment is challenging when people have cognitive and receptive communication impairments after severe brain injury. This study explored how UK-based medical and psychology professionals working with people with severe cognitive and communication impairments after brain injury assess mood in this population. Design: Following their participation in an online survey, professionals were invited to participate in individual semi-structured interviews. Interviews were analysed using thematic analysis to label explicit data (semantic themes) and implicit data (latent themes). Participants: Twenty-three clinical psychologists and nine medical professionals participated in online or in-person interviews. Results: Both groups explicitly reported using a combination of collateral information, history, observations, and patient interviews when assessing mood in this population. Medical professionals did not routinely use standardised measures and clinical psychologists often adjusted them when they used them. The respondents discussed difficulties conceptualising depression after brain injury, the experience needed by the assessor, and the need for an individualised approach for this population. Clinical psychologists discussed the pressures of working in healthcare systems and medical professionals discussed how symptoms may influence prescription choices. Seven latent themes were labelled which highlighted additional challenges and complexities experienced by those assessing mood, beyond the actual assessment process itself. Conclusions: No 'gold standard' approach to assessing mood in those with cognitive and communication difficulties after severe brain injury was identified. There was overlap in assessment approaches but no clear consensus. Interviewees felt that mood assessment must be approached differently in this population and that self-report measures are not useful. [ABSTRACT FROM AUTHOR]

Background: Lifestyle interventions can prevent type 2 diabetes (T2D) by successfully inducing behavioral changes (eg, avoiding physical inactivity and sedentariness, increasing physical activity and/or healthy eating) that reduce body weight and normalize metabolic levels (eg, HbA1c). For interventions to be successful, it is important to influence "behavioral mechanisms" such as self-efficacy, which motivate behavioral changes. Theory-based expectations of how self-efficacy, chronic stress, and mood changed over time were investigated through a group-based behavior change intervention (PREMIT). At 8 intervention sites, PREMIT was offered by trained primary care providers in 18 group-sessions over a period of 36 months, divided into 4 intervention phases. Adherence to the intervention protocol was assessed. Method: Participants (n = 962) with overweight and prediabetes who had achieved ≥8% weight loss during a diet reduction period and completed the intervention were categorized into 3 groups: infrequent, frequent, or very frequent group sessions attendance. The interactions between participation in the group sessions and changes in self-efficacy, stress, and mood were multivariate tested. Intervention sites were regularly asked where and how they deviated from the intervention protocol. Results: There was no increase in the participants' self-efficacy in any group. However, the level of self-efficacy was maintained among those who attended the group sessions frequently, while it decreased in the other groups. For all participants, chronic stress and the frequency of attending group sessions were inversely related. Significant differences in mood were found for all groups. All intervention centers reported specific activities, additional to intervention protocol, to promote participation in the group sessions. Conclusions: The results suggest that the behavioral changes sought by trained primary care providers are related to attendance frequency and follow complex trajectories. The findings also suggest that group-based interventions in naturalistic primary care settings aimed at preventing T2D require formats and strategies that encourage participants to attend group sessions regularly. [ABSTRACT FROM AUTHOR]

Background: Mentalizing refers to the ability to understand one's own and others' mental states. Mentalizing is considered a key component of social cognition and healthy personality development. A multinational assessment tools able to appraise the multidimensional and multifaceted aspects of this complex construct are needed. Objective: The present study had two aims: (a) validate an English version of the Multidimensional Mentalizing Questionnaire (MMQ, 33 items) which was designed to assess mentalizing based on an integrated and multilevel model of mentalizing; (b) explore the correlational relationships between the six dimensions of the MMQ and a set of sociodemographic, psycho-cognitive, mental health, and socio-functional variables. Methods: Overall, 1823 individuals (age: 19–76 years old [M = 45; SD = 16]; sex: male = 48.51%, female = 50.57%, non-binary = 0.9%) participated in an online survey. While the participants came from 77 different countries, most of them were residents in UK and USA (95%). Data analytics include confirmatory factorial analysis and Pearson correlations. Results: The CFA results validated the factorial structure of a 28-items MMQ-English version, with acceptable goodness of fit indices. Regarding the psychometric properties, the MMQ-English version showed good internal reliability and significant positive correlation with another scale designed to assess an analogue construct showing a fair convergent validity. The findings indicated that males, individuals with lower levels of education, lower socio-economic status, depressed, and with a higher score of loneliness are significantly more likely to report poor mentalizing compared with females, individuals with higher education level, greater SES, happier, and with lower scores of loneliness. Conclusion: The present study validated the English version of the MMQ. [ABSTRACT FROM AUTHOR]

During March 2020, the UK entered a national lockdown, causing a sudden change in undergraduate students' routines. This study uses this event to investigate the impact routine change had on students' mental wellbeing; in particular looking at depression, anxiety, sleep disturbance, and eating behaviors. Participants reported their daily routine timings (waking, breakfast, lunch, evening meal and bedtime) and activities (e.g. exercise amount, time with friends, time studying, etc) on a typical Monday, Wednesday and Saturday during term time and lockdown. Additionally they completed the PROMIS measures of anxiety, depression, and sleep disturbance, and the Eating Pathology Symptom Inventory. Lockdown saw small but significant shifts in routine timing (on average 1.5 h) However, there was no clear overall pattern of relationships between mental wellbeing and routine structure or magnitude of routine change. There was some evidence of changes in amount of exercise relating to reported anxiety. These findings are consistent with the current literature reporting lockdown effects on behavior. Routine timings shifted, but this change was small and largely did not affect the mental wellbeing reported by undergraduate students. The change in amount of exercise posed by lockdown did appear to be an important factor in wellbeing, and more research should focus on the wellbeing implications of closing places for exercise. [ABSTRACT FROM AUTHOR]

Our understanding of the impact of copy number variants (CNVs) on psychopathology and their joint influence with polygenic risk scores (PRSs) remains limited. The UK Biobank recruited 502,534 individuals ages 37 to 73 years living in the United Kingdom between 2006 and 2010. After quality control, genotype data from 459,855 individuals were available for CNV calling. A total of 61 commonly studied recurrent neuropsychiatric CNVs were selected for analyses and examined individually and in aggregate (any CNV, deletion, or duplication). CNV risk scores were used to quantify intolerance of CNVs to haploinsufficiency. Major depressive disorder and generalized anxiety disorder PRSs were generated for White British individuals (N = 408,870). Mood/anxiety factor scores were generated using item-level questionnaire data (N = 501,289). CNV carriers showed higher mood/anxiety scores than noncarriers, with the largest effects seen for intolerant deletions. A total of 11 individual deletions and 8 duplications were associated with higher mood/anxiety. Carriers of the 9p24.3 (DMRT1) duplication showed lower mood/anxiety. Associations remained significant for most CNVs when excluding individuals with psychiatric diagnoses. Nominally significant CNV × PRS interactions provided preliminary evidence that associations between select individual CNVs, but not CNVs in aggregate, and mood/anxiety may be modulated by PRSs. CNVs associated with risk for psychiatric disorders showed small to large effects on dimensional mood/anxiety scores in a general population cohort, even when excluding individuals with psychiatric diagnoses. CNV × PRS interactions showed that associations between select CNVs and mood/anxiety may be modulated by PRSs. [ABSTRACT FROM AUTHOR]

Background and Objectives: Examination anxiety is a common occurrence, and is potentially detrimental to student attainment. In recent theorizing, it has been suggested that cognitive appraisals, as put forth in cognitive appraisal theory, and irrational beliefs, as put forth in rational emotive behavior therapy, may interact to predict affectivity. The current research examines the antecedents and associates of examination affect and academic self-concept in undergraduate students., Design: A preliminary study applied confirmatory factor analysis (CFA) to test the factor structure of an irrational beliefs inventory. Study 1 utilized a cross-sectional and correlational approach to testing core theoretical assumptions. Study 2 took a two-wave longitudinal and path analytical approach to examine temporal effects between target variables., Method: All self-report data collection took place in the United Kingdom with university students. We recruited n  = 1150, n  = 362, n  = 662 for preliminary, study 1, and study 2, respectively., Results: Across studies, data indicated that a pattern of adaptive cognitive appraisal was associated with more advantageous affectivity, and better academic self-concept., Conclusions: Reciprocal temporal relationships were revealed between many variables, supporting an interactive and bidirectional view of how cognition and affect are related pertaining to examination anxiety.

Background: Light has powerful effects on mood, sleep, and the circadian system. Humans evolved in an environment with a clear distinction between day and night, but our modern environments have blurred this distinction. Negative effects of light exposure at night have been well characterized. The importance of daytime light exposure has been less well characterized. Here we examine the cross-sectional and longitudinal associations of time spent in daytime outdoor light with mood, sleep, and circadian-related outcomes.Methods: Participants were drawn from the UK Biobank cohort, a large study of UK adults (n = 502,000; 37-73 years old; 54% women).Results: UK Biobank participants reported spending a median of 2.5 daylight hours (IQR = 1.5-3.5 h) outdoors per day. Each additional hour spent outdoors during the day was associated with lower odds of lifetime major depressive disorder (95% CI OR:0.92-0.98), antidepressant usage (OR:0.92-0.98), less frequent anhedonia (OR:0.93-0.96) and low mood (OR:0.87-0.90), greater happiness (OR:1.41-1.48) and lower neuroticism (incident rate ratio, IRR:0.95-0.96), independent of demographic, lifestyle, and employment covariates. In addition, each hour of daytime light was associated with greater ease of getting up (OR:1.46-1.49), less frequent tiredness (OR:0.80-0.82), fewer insomnia symptoms (OR:0.94-0.97), and earlier chronotype (adjusted odds ratio; OR:0.75-0.77). Auto-Regressive Cross-Lagged (ARCL) models were used to examine the longitudinal association of time spent in outdoor light at baseline with later mood-, sleep- and circadian-related outcomes reported at time point 2. Overall, longitudinal associations support cross-sectional findings, though generally with smaller effect sizes.Limitations: Future studies that examine the intensity of daytime light exposure at the ocular level are needed.Conclusions: Our findings suggest that low daytime light exposure is an important environmental risk factor for mood, sleep, and circadian-related outcomes. [ABSTRACT FROM AUTHOR]

Background: There is increasing evidence for music-based interventions in neurorehabilitation, improving mood and functional outcomes. In response, there is growing interest from health-care providers in setting up Neurologic Music Therapy (NMT) services. This paper presents some preliminary data on the feasibility and acceptability of NMT in the acute stroke, multidisciplinary team setting, about which little is known. Objectives: To assess the feasibility and acceptability of a two-day per-week NMT service over 24 months. Methods: Data were collected on the number of referrals received, sessions attended, sessions declined and reasons why. Staff completed questionnaires, and collected them from patients and their relatives, rating interventions: 1. Not helpful, 2. Quite helpful, 3. Helpful, 4. Very helpful. Patients completed the Visual Analogue Mood Scale (VAMS) pre-/post- a single session. Results: Of 201 patients referred, 177 received treatment and 675 sessions were delivered. Twenty-four patients were discharged before sessions were scheduled and 28 sessions were declined, predominantly due to fatigue. Mean scores (SD) from questionnaire data were: patients (n = 99) 3.34 (0.825), relatives (n = 13) 3.83 (0.372), staff (n = 27) 3.85 (0.388). Mean, post-session VAMS data (n = 52) showed a non-significant reduction in 'Sad' (7.5, p =.007, CI = 2.1, 12.9) and an increase in 'Happy' (+ 6.2, p =.013, CI = −11.0, −1.4). Conclusions: Data suggest the service was feasible and helpful, particularly for patient mood, possibly improving engagement in rehabilitation. Research to determine generalizability in different stroke environments and treatment effects within them is warranted. [ABSTRACT FROM AUTHOR]

The United Kingdom and Scottish governments instigated a societal lockdown in response to the COVID-19 pandemic. Subsequently, many experienced substantial lifestyle changes alongside the stresses of potentially catching the virus or experiencing bereavement. Stressful situations and poorer health behaviors (e.g., higher alcohol consumption, unhealthy diet, poorer sleep quality, physical inactivity) are frequently linked to poor mental health. Our objective was to examine changes in health behaviors and their relationship with negative mood during COVID-19 lockdown. We also considered associations between health behaviors and socio-demographic differences and COVID-19-induced changes. 399 participants completed a questionnaire asking about their personal situation and health behaviors during lockdown as well as a negative mood scale. The significance threshold for all analyses was α = 0.05. Poorer diet was linked to more-negative mood, and to changes to working status. Poorer sleep quality was linked with more-negative mood, and with 'shielding' from the virus. Being less physically active was related to more-negative mood and student status, whereas being more physically active was linked to having or suspecting COVID-19 infection within the household. Increased alcohol consumption was linked to living with children, but not to negative mood. Changes to diet, sleep quality, and physical activity related to differences in negative mood during COVID-19 lockdown. This study adds to reports on poor mental health during lockdown and identifies lifestyle restrictions and changes to health behaviors which may, to some extent, be responsible for higher negative mood. Our data suggests that it is advisable to maintain or improve health behaviors during pandemic-associated restrictions. [ABSTRACT FROM AUTHOR]

• Perinatal photoperiod associations with bipolar and depression disorders are novel. • Associations were observed in the extensive UK Biobank database. • Findings are compatible with season of birth and depression studies. • Perinatal photoperiod may reconcile inconsistencies in season of birth studies. • Findings build on previous research by ourselves and other groups. • More extreme photoperiods need to be accounted for. • If associations are true, the door is opened to simple preventive strategies. Season-of-birth associations with psychiatric disorders point to environmental (co-)aetiological factors such as natural photoperiod that, if clarified, may allow interventions toward prevention. We systematically reviewed the literature concerning season-of-birth and bipolar disorder and depression and explored associations between the perinatal natural photoperiod and these outcomes in a cross-sectional analysis of the UK Biobank database. We used mean daily photoperiod and relative photoperiod range (relative to the mean) in the 3rd trimester and, separately, in the first 3 months post birth as metrics. From review, increased risk of depression with late spring birth is compatible with increased odds of probable single episode-, probable recurrent-, and diagnosed depression (OR 2.85 95 %CI 1.6–5.08, OR 2.20 95 %CI 1.57–3.1, and OR 1.48 95 %CI 1.11–1.97, respectively) with increasing 3rd trimester relative photoperiod range for participants who experienced relatively non-extreme daily photoperiods. Risk of bipolar disorder with winter-spring birth contrasted with no consistent patterns of perinatal photoperiod metric associations with bipolar disorder in the UK Biobank. As natural photoperiod varies by both time-of-year and latitude, perinatal natural photoperiods (and a hypothesized mechanism of action via the circadian timing system and/or serotonergic circuitry associated with the dorsal raphe nucleus) may reconcile inconsistencies in season-of-birth associations. Further studies are warranted. [ABSTRACT FROM AUTHOR]

Past research suggests that use of psychedelic substances such as LSD or psilocybin may have positive effects on mood and feelings of social connectedness. These psychological effects are thought to be highly sensitive to context, but robust and direct evidence for them in a naturalistic setting is scarce. In a series of field studies involving over 1,200 participants across six multiday mass gatherings in the United States and the United Kingdom, we investigated the effects of psychedelic substance use on transformative experience, social connectedness, and positive mood. This approach allowed us to test preregistered hypotheses with high ecological validity and statistical precision. Controlling for a host of demographic variables and the use of other psychoactive substances, we found that psychedelic substance use was significantly associated with positive mood--an effect sequentially mediated by self-reported transformative experience and increased social connectedness. These effects were particularly pronounced for those who had taken psychedelic substances within the last 24 h (compared to the last week). Overall, this research provides robust evidence for positive affective and social consequences of psychedelic substance use in naturalistic settings. [ABSTRACT FROM AUTHOR]

Objective: To identify factors associated with post-stroke fatigue in a sample of stroke survivors without depression. Design: Cross-sectional cohort study. Setting: Recruitment was from four stroke units in the UK. Subjects: Participants were assessed within four to six weeks of first stroke; those with high levels of depressive symptoms (score ≥7 Brief Assessment Schedule Depression Cards) were excluded. Main measures: Participants were assessed after stroke on the Fatigue Severity Scale of the Fatigue Assessment Inventory, the Rivermead Mobility Index, Nottingham Extended Activities of Daily Living scale, Beck Anxiety Index, Sleep Hygiene Index, 6m walk test, and measures of cognitive ability. Results: Of the 371 participants recruited, 103 were excluded and 268 were assessed. Of the latter, the mean age was 67.7 years (SD 13.5) and 168 (63%) were men. The National Institutes of Health Stroke Scale mean score was 4.96 (SD 4.12). Post-stroke fatigue was reported by 115 (43%) of participants, with 71 (62%) reporting this to be a new symptom since their stroke. Multivariate analysis using the Fatigue Severity Scale as the outcome variable found pre-stroke fatigue, having a spouse/partner, lower Rivermead Mobility Index score, and higher scores on both the Brief Assessment Schedule Depression Cards and Beck Anxiety Index were independently associated with post-stroke fatigue, accounting for approximately 47% of the variance in Fatigue Severity Scale scores. Conclusions: Pre-stroke fatigue, lower mood, and poorer mobility were associated with post-stroke fatigue. [ABSTRACT FROM AUTHOR]

Past studies show that life events (LE) predict mental distress. This research tested whether hemispheric lateralization (HL) moderated the relationship between LE and mental distress. In studies 1 and 2, different instruments for assessing HL were used (questionnaire and neuropsychological test). In both studies, LE or daily hassles were positively correlated with distress (study 1) and with anxiety and depression (study 2), only in people with right but not left HL, controlling for effects of gender. In study 3, experimentally induced stress led to increased perceived stress, again only in participants with right but not left HL. These results show consistently that left HL may protect against adverse effects of LE, hassles or acute stress on well‐being. We propose possible mechanisms and future research directions. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Purpose: Although previous research has associated the glycaemic load (GL) of a meal with cognitive functioning, typically the macro-nutrient composition of the meals has differed, raising a question as to whether the response was to GL or to the energy, nutrients or particular foods consumed. Therefore, the present study contrasted two breakfasts that offered identical levels of energy and macro-nutrients, although they differed in GL. Methods: Using a repeated-measures, double-blind design, 75 children aged 5-11 years, from socially deprived backgrounds, attended a school breakfast club and on two occasions, at least a week apart, they consumed a meal sweetened with either isomaltulose (Palatinose™) (GL 31.6) or glucose (GL 59.8). Immediate and delayed verbal memory, spatial memory, sustained attention, reaction times, speed of information processing and mood were assessed 1 and 3 h after eating. Results: The nature of the meals did not influence any measure of cognition or mood after an hour; however, after 3 h, children's memory and mood improved after the lower-GL breakfast. If children had eaten the lower-GL meal on the second day of testing, they were able to process information faster and had better spatial memory later in the morning. Conclusions: Towards the end of a morning in school, having consumed a lower-GL breakfast resulted in better mood and aspects of cognitive functioning. [ABSTRACT FROM AUTHOR]

Using a repeated measures design, 16 females recorded hunger, distraction, mood and perceived work performance on two consecutive fast days, on two earlier and on two subsequent consecutive non-fast days, during intermittent fasting. Using regression analyses, low positive mood was associated with higher distraction (β = −0.38, p < 0.01), and lower perceived work performance was associated with higher distraction (β = −0.50, p < 0.01) and lower positive mood (β = 0.59, p = 0.01). No associations were found with hunger (largest β = −0.11, p = 0.15). Associations between mood, perceived work performance and distraction but not hunger mirror those found in traditional dieting and suggest no benefit for attention from intermittent fasting-type regimes. [ABSTRACT FROM AUTHOR]

In order to safely and effectively extinguish fires and rescue life, firefighters are required to routinely wear self-contained breathing apparatus (SCBA), yet little is known about the specific physiological and psychological demands associated with repeated exposure to tasks that require SCBA. A total of 12 experienced firefighters took part in a series of commonly encountered SCBA activities: free search, guideline search and live firefighting tasks under room temperature (∼20°C) and extreme heat (∼180°C) conditions to assess changes in heart rate, blood pressure, mood, perceived workload and air usage. Findings demonstrate that live firefighting is associated with greater perceived exhaustion than free search or guideline exercises; however, all tasks lead to high cardiovascular demand regardless of the presence of heat. No significant impact of task upon mood and no significant differences between the perceived demands of guideline, free search and live firefighting exercises were found. Practitioner Summary:This study considered the physiological and psychological responses of firefighters undertaking SCBA exercises. Although live firefighting is associated with greater perceived exertion, the absence of differences in psychological domains between exercises demonstrates that task demands are not always dependent upon the presence of fire and that all tasks are mentally challenging. [ABSTRACT FROM PUBLISHER]

Research evidence for cognitive remediation therapy's (CRT) effectiveness for anorexia nervosa (AN) has been gathering. This approach is also increasingly being implemented in other disorders including major depressive disorder, obsessive-compulsive disorder and autistic spectrum disorder that share commonalities with AN in neuropsychological profiles and clinical presentations. This systematic literature review identified and appraised the current evidence base to see whether evidence from related conditions could be integrated into the theoretical understanding of CRT for AN as well as future AN treatment developments and research. Overall, CRT studies in AN report promising findings, and CRT appears to be associated with improvements in set-shifting and in central coherence. Cognitive remediation approaches in other conditions also show promising evidence in associated improvements in areas of executive functioning and information processing; links are made between AN treatment and what future treatment developments could consider. Copyright © 2014 John Wiley & Sons, Ltd and Eating Disorders Association. [ABSTRACT FROM AUTHOR]

BackgroundOxidative stress and neurotrophic factors have been implicated in the pathophysiology of bipolar disorder. Our objective was to determine whether plasma glutathione or brain-derived neurotrophic factor (BDNF) levels were abnormal in bipolar disorder and therefore useful as possible biomarkers.MethodBlood samples were collected from subsyndromal, medicated bipolar I patients (n = 50), recruited from OXTEXT, University of Oxford, and from 50 matched healthy controls. Total and oxidized glutathione levels were measured using an enzymatic recycling method and used to calculate reduced, percentage oxidized, ratio of reduced:oxidized and redox state. BDNF was measured using an enzyme-linked immunoassay. Self-monitored mood scores for the bipolar group were available (Quick Inventory of Depressive Symptomatology and the Altman Self-Rating Mania Scale) over an 8-week period.ResultsCompared with controls, bipolar patients had significantly lower levels of total glutathione and it was more oxidized. BDNF levels were not different. Age of illness onset but not current mood state correlated with total glutathione levels and its oxidation status, so that lower levels of total and reduced glutathione were associated with later onset of disease, not length of illness.ConclusionsPlasma glutathione levels and redox state detect oxidative stress even in subsyndromal patients with normal BDNF. It may relate to the onset and development of bipolar disorder. Plasma glutathione appears to be a suitable biomarker for detecting underlying oxidative stress and for evaluating the efficacy of antioxidant intervention studies. [ABSTRACT FROM AUTHOR]

The EarlyBird diabetes study has followed over 300 healthy children and their parents for 12 years. The aim has been to understand which children would be most at risk of adult onset diabetes. Repeated measures in the same individuals reveal trends which may be associated with diabetes risk, and will help determine the direction of causality. This report draws on 12 years of EarlyBird data, giving an insight into diabetes risk in three areas: Trends in both insulin supply (secretion) and demand (tissue resistance) over the period of pubertal development affect diabetes risk. This paper compares insulin resistance and beta cell function in children who develop impaired fasting glucose with those whose glucose levels remain within the normal range., Epigenetics is a new area of research. While genetic make-up cannot change, the way genes are expressed (turned on or off) can vary in relation to environmental stressors. This paper reviews preliminary analyses of epigenetic variation in a gene associated with diabetes risk, and how this variation affects adiposity during childhood., The association between low mood (tendency towards depression) and diabetes risk in teenagers is explored. [ABSTRACT FROM AUTHOR]

The article presents a study which validates the findings indicating the contribution of illness perception, coping, and optimism to the quality of live and mood among patients with muscle disease. A multi-centre postal survey was conducted on 226 completed questionnaires based on the quality of life, mood, coping, and functional impairment. Results indicate psychological factors as the most dominant with greater amounts of variance in all other quality of life and mood domains.

In light of descriptive accounts of attenuating effects of physical activity on tics, we used an experimental design to assess the impact of an acute bout of aerobic exercise on tic expression in young people (N = 18) with Tourette Syndrome (TS). We compared video-based tic frequency estimates obtained during an exercise session with tic rates obtained during pre-exercise (baseline) and post-exercise interview-based sessions. Results showed significantly reduced tic rates during the exercise session compared with baseline, suggesting that acute exercise has an attenuating effect on tics. Tic rates also remained reduced relative to baseline during the post-exercise session, likely reflecting a sustained effect of exercise on tic reduction. Parallel to the observed tic attenuation, exercise also had a beneficial impact on self-reported anxiety and mood levels. The present findings provide novel empirical evidence for the beneficial effect of exercise on TS symptomatology bearing important research and clinical implications. [ABSTRACT FROM AUTHOR]

Multiday ultra-endurance races present athletes with a significant number of physiological and psychological challenges. We examined emotions, the perceived functionality (optimal-dysfunctional) of emotions, strategies to regulate emotions, sleep quality, and energy intakeexpenditure in a four-man team participating in the Race Across AMerica (RAAM); a 4856km continuous cycle race. Cyclists reported experiencing an optimal emotional state for less than 50% of total competition, with emotional states differing significantly between each cyclist over time. Coupled with this emotional disturbance, each cyclist experienced progressively worsening sleep deprivation and daily negative energy balances throughout the RAAM. Cyclists managed less than one hour of continuous sleep per sleep episode, high sleep latency and high percentage moving time. Of note, actual sleep and sleep efficiency were better maintained during longer rest periods, highlighting the importance of a race strategy that seeks to optimise the balance between average cycling velocity and sleep time. Our data suggests that future RAAM cyclists and crew should: 1) identify beliefs on the perceived functionality of emotions in relation to best (functional-optimal) and worst (dysfunctional) performance as the starting point to intervention work; 2) create a plan for support sufficient sleep and recovery; 3) create nutritional strategies that maintain energy intake and thus reduce energy deficits; and 4) prepare for the deleterious effects of sleep deprivation so that they are able to appropriately respond to unexpected stressors and foster functional working interpersonal relationships. [ABSTRACT FROM AUTHOR]

We evaluated the proportion of individuals with Down syndrome (DS: N = 108) who met criteria for autism spectrum disorder (ASD) on the Social Communication Questionnaire and the severity of ASD-related symptomatology in this group. The proportions of individuals with DS meeting the cut-off for ASD and autism in this sample were 19% and 8%, respectively. We then evaluated the behavioural profile of individuals with DS who scored above cut-off for ASD (DS+ASD; N = 17) compared with those with DS-only (N = 17) and individuals with idiopathic ASD (N = 17), matched for adaptive behaviour skills and ASD symptom severity (ASD group only). Individuals in the DS+ASD and ASD-only groups showed more stereotyped behaviour, repetitive language, overactivity and self-injury than the DS-only group (p < .001). Individuals in the DS+ASD and DS-only groups appeared less withdrawn from their surroundings than those with ASD (p < .004). These findings indicate differences in the behavioural and cognitive profile of individuals with DS+ASD compared with those with DS-only, when controlling for adaptive behaviour skills. Individuals with DS+ASD show broad similarities with individuals with idiopathic ASD with regard to ASD and behavioural characteristics but may also show some areas of subtle difference from this group. [ABSTRACT FROM PUBLISHER]

Background: Women of lower educational attainment tend to have poorer quality diets and lower food involvement (an indicator of the priority given to food) than women of higher educational attainment. The present study reports a study of the role of food involvement in the relationship between educational attainment and quality of diet in young women. Methods: The first phase uses six focus group discussions ( n = 28) to explore the function of food involvement in shaping the food choices of women of lower and higher educational attainment with young children. The second phase is a survey that examines the relationship between educational attainment and quality of diet in women, and explores the role of mediating factors identified by the focus group discussions. Results: The focus groups suggested that lower food involvement in women of lower educational attainment might be associated with negative affect (i.e. an observable expression of negative emotion), and that this might mean that they did not place a high priority on eating a good quality diet. In support of this hypothesis, the survey of 1010 UK women found that 14% of the effect of educational attainment on food involvement was mediated through the woman's affect ( P ≤ 0.001), and that 9% of the effect of educational attainment on quality of diet was mediated through food involvement ( P ≤ 0.001). Conclusions: Women who leave school with fewer qualifications may have poorer quality diets than women with more qualifications because they tend to have a lower level of food involvement, partly attributed to a more negative affect. Interventions to improve women's mood may benefit their quality of diet. [ABSTRACT FROM AUTHOR]

There is an evidential link between diet, mood and behaviour, but a shortage of formalised educational literature covering the role of nutritional science and its application in the care and treatment of mental health problems. In the UK, a limited amount of a few types of fruit and vegetables, few wholegrains and little oily fish are consumed. Instead, large quantities of refined carbohydrates, altered fats, intensively reared meat and dairy products are eaten, along with unknown combinations of synthetic chemicals and residues. In some individuals, specific nutritional and environmental factors generate physiological responses which may influence mood, promote anti-social behaviour and trigger overwhelming cravings for certain foods or substances. Nutritional Therapists are not currently part of the multidisciplinary team assessing people suffering from mental health problems. They generally work in private practice with clients on an individual basis. Their role is to improve diet and identify potential food intolerances, hormone imbalances, blood sugar issues, enzyme deficiencies, compromised gut immunity, increased nutrient requirements, a toxic metal burden or chemical sensitivities. Each case is examined on its own merits, given the variety of genetic and environmental differences among individuals. The considerable challenge for the nutritional therapist remains to intervene safely and effectively in mental health conditions which involve multiple complex and interacting mechanisms. [ABSTRACT FROM AUTHOR]

The purpose of this study was to assess the mood profile of successful and less successful aikidoka (aikido athletes). Subjects (45 men, 30.51 + 8.06 years, and 17 women, 27.29 + 6.94 years) were administered the Brunel Mood Scale at a regional open aikido tournament in the south of England about one hour prior to competition. A 2-way (Gender x Performance) ANOVA was employed to determine the differences in mood between male and female winning and losing aikidoka. The women scored higher on tension (5.58 + 2.74 vs. 4.04 + 3.02) (p = 0.049, eta2 = 0.065). The data were collapsed over performance and mood was compared between gender. The men (0.76 + 1.81 vs. 0.06 + 0.24) were more depressed (p = 0.015; d = 0.68) and fatigued (3.16 + 4.17 vs. 1.53 + 1.18, p = 0.021; d = 0.61). The depressed mood males scored higher on anger (2.27 + 4.84 vs. 0.24 + 0.82, p = 0.021, d = 0.72) and were more fatigued (5.45 + 4.37 vs. 2.41 + 3.89, p = 0.034, d = 0.74). It is concluded that the model by Lane and Terry [5] was supported by the current investigation. [ABSTRACT FROM AUTHOR]

The benefits of long-term oxygen therapy (LTOT) on mood in Chronic Obstructive Pulmonary Disease (COPD) are unproven. Longitudinal studies are affected by disease progression, the increased package of care (with LTOT) and may not control for known confounders on mood. We compared the point prevalence and severity of mood disturbance in patients with severe COPD, not on LTOT (the -LTOT group) to those with COPD on LTOT (the +LTOT group). We mailed the Hospital Anxiety and Depression (HAD) Score to 182 consecutive patients with severe COPD, identified from respiratory case notes in three UK Hospitals. We compared 57 patients not prescribed LTOT to 57 patients on LTOT, and used stratified sampling to match the groups as far as possible for age, gender, lung function and other possible confounders on mood. Or these, 25% of patients in both groups scored in the 'definite' case range for anxiety (HAD score ≥ 11). 37% of the -LTOT group and 33% of the +LTOT group scored in the 'definite' range for depression (HAD score ≥ 11) (p = N.S). In both groups, only 11% of responders were prescribed anxiolytics and/or antidepressants. Further multiregression analysis confirmed that socio-demographic variables (e.g., lives alone, feels isolated or recent life events) were stronger predictors of mood than the prescription of LTOT or other traditionally accepted factors such as co-morbidity or the use of antidepressants or anxiolytics. High levels of anxiety and depression are present in severe COPD and appear under-treated. The +LTOT and -LTOT patients had a similar high prevalence of anxiety and depression. [ABSTRACT FROM AUTHOR]

Background: Recent research on adults suggests that ‘beneficial’ psychostimulant effects of caffeine are found only in the context of caffeine deprivation; that is, caffeine improves psychomotor and cognitive performance in habitual caffeine consumers following caffeine withdrawal. Furthermore, no net benefit is gained because performance is merely restored to ‘baseline’ levels. The effects of caffeine in children is an under-researched area, with only a handful of studies being carried out in the US where children's consumption of caffeine appears to be lower on average than in the UK. Method: Twenty-six children aged between 9 and 11 years completed a double-blind, placebo-controlled study. Habitual caffeine consumers (mean daily caffeine intake = 109 mg) and non/low-consumers (12 mg) were tested on two separate days following overnight caffeine abstinence. On each day measures of cognitive performance (a number search task), and self-rated mood and physical symptoms, including alertness and headache, were taken before and after administration of 50 mg of caffeine, or placebo. Results: At baseline (before treatment), the habitual consumers showed poorer performance on the cognitive test than did the non/low-consumers, although no significant differences in mood or physical symptoms were found between the two groups. There were significant habit by treatment (caffeine vs. placebo) interactions for accuracy of performance and headache, and a significant main effect of treatment for alertness. Post hoc comparisons showed that caffeine administration improved the consumers’ accuracy on the cognitive test (to near the level displayed by the non/low-consumers at baseline), but that it had no significant effect on the non/low-consumers’ performance. In the consumers, caffeine prevented an increase in headache that occurred after placebo, and it increased alertness relative to placebo. Again, however, caffeine did not significantly affect levels of headache or alertness in the non/low-consumers. Conclusions: These results suggest that, like adults, children probably derive little or no benefit from habitual caffeine intake, although negative symptoms associated with overnight caffeine withdrawal are avoided or rapidly reversed by subsequent caffeine consumption. [ABSTRACT FROM AUTHOR]

Although seasonal changes in amygdala volume have been demonstrated in animals, seasonal differences in human amygdala subregion volumes have yet to be investigated. Amygdala volume has also been linked to depressed mood. Therefore, we hypothesised that differences in photoperiod would predict differences in amygdala or subregion volumes and that this association would be linked to depressed mood. 10,033 participants ranging in age from 45 to 79 years were scanned by MRI in a single location. Amygdala subregion volumes were obtained using automated processing and segmentation algorithms. A mediation analysis tested whether amygdala volume mediated the relationship between photoperiod and mood. Photoperiod was positively associated with total amygdala volume (p < .001). Multivariate (GLM) analyses revealed significant effects of photoperiod across all amygdala subregion volumes for both hemispheres (p < .001). Post hoc univariate regression analyses revealed significant associations of photoperiod with each amygdala subregion volume (p < .001). PLS showed the highest loadings of amygdala subregions in lateral nucleus, ABN, basal nucleus, CAT, PLN, AAA, central nucleus, cortical nucleus and medial nucleus for left hemisphere and ABN, lateral nucleus, CAT, PLN, cortical nucleus, AAA, central nucleus and medial nucleus for right hemisphere. There were no significant associations between photoperiod and mood nor between mood scores and amygdala volumes, and due to the lack of these associations, the mediation hypothesis was not supported. This study is the first to demonstrate an association between photoperiod and amygdala volume. These findings add to the evidence supporting the role of photoperiod on brain structural plasticity., (© 2022 The Authors. European Journal of Neuroscience published by Federation of European Neuroscience Societies and John Wiley & Sons Ltd.)

Introduction: We aimed to examine the prevalence of insomnia symptoms (IS), sleep duration, and associated risk factors in participants with hazardous/harmful alcohol use (HAU), major depressive disorders (MDD), and HAU+MDD., Methods: Data from the UK Biobank (UKB) (n = 55,000) were utilized to categorize participants into those with MDD (n = 5612), HAU (n = 15,893), MDD+HAU (n = 3738), and controls (n = 29,511). We examined whether rates of IS and sleep duration differed among the groups and determined the clinical predictors of IS. Rates of IS and sleep duration were compared using regression analyses accounting for demographic (age, sex, ethnicity, Townsend deprivation index) and clinical (body mass index, neuroticism score, alcohol consumption) factors., Results: The unadjusted prevalence of IS was 26.5%, 27%, 39.5%, and 43% in control, HAU, MDD, and MDD+HAU categories respectively. Rates of IS in controls versus HAU and MDD versus MDD+HAU did not differ in unadjusted models (p = 0.45 and 0.075, respectively). Prevalence of IS differed in the four groups (p < 0.0001 for all pairwise comparisons) after adjusting for demographic confounders. After further adjustment for clinical factors, effect sizes were reduced, but pairwise comparisons remained significant. After adjusting for demographic and clinical factors, sleep duration did not differ among the groups. After accounting for diagnostic category and demographic/clinical factors, older age (OR=1.33 per 10 year increase; p < 0.0001), female sex (OR=1.39; p < 0.0001), obesity (OR=1.17 compared to normal; p < 0.0001), higher neuroticism score (OR=1.13; p < 0.0001), and alcohol consumption (OR=1.01 per serving increase; p < 0.0001) were associated with IS., Conclusion: Sleep-related morbidity is the greatest in the MDD+HAU group, followed by the MDD group. Demographic and clinical characteristics explain some, but not all of the differences in the prevalence of IS in MDD±HAU. Genetic and other factors capable of influencing IS in those with MDD, HAU, and MDD+HAU merit future investigation., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background In November 2018 the paediatric rheumatology team in Belfast attended the Bridges self-management course. Bridges reflects on what works well as a team and how you can build upon current practice, with an emphasis upon a self-management approach. There are eleven Bridges principles aiming to help interdisciplinary team's co-ordinate their service around the patient. Bridges believes that the language we use can improve our clinical practice, especially with regards to problem solving, encouraging self-discovery, encouraging patients to reflect and enabling them to take action. Our team felt that we should use this approach to enhance our inpatient rehabilitation service. We chose this group of patients as we felt that this can be a challenging group to treat and it can take a long time to build supportive and trusting relationships. Methods Prior to commencing this project each member of the multidisciplinary team assessed the patient individually on the first day of admission. In retrospect we discovered that this led to repetition for the patient and this assessment was very clinician led. It also focused on clinician led (SMART) goals and achieving these. We furthermore realised we did not separately ask patients and parents what they wanted to gain from our service. Our method of improvement was to devise three questionnaires. One for a parent, one for a child under fourteen and over fourteen. These are distributed prior to being assessed by the team, allowing us to gather information and negating the need for repetition. The questionnaire gathers information regarding family members, education, school attendance, additional educational assistance, past medical history. For the patient we ask, what are their main concerns, what has helped so far, what support the patient has, what activities they enjoy as a family and what they hope to gain from their inpatient stay. The patient must fill out a description of their typical day, including their mood. Questions specifically for the parents are asking why their child has been referred, what their main concerns are, to outline their typical day, what do they feel has helped and what do they aim to gain from our team. Results We have utilised the questionnaires for every inpatient since January 2019. All team members feel that this new approach allows us to gain valuable information from patients and their parents thus encouraging them to adopt a self-management approach and to prioritise the patient's story. As a team we feel that we learn a lot about our patients using this method and that it is more time effective. It allows us to identify unrealistic hopes and discuss these. Conclusion We believe that using the Bridges approach and by mainly adapting our language skills and organisation we have improved this service. Conflicts of Interest The authors declare no conflicts of interest. [ABSTRACT FROM AUTHOR]

Exposure to natural outdoor environments (NOE) has been shown in population-level studies to reduce anxiety and psychological distress. This study investigated how exposure to one's everyday natural outdoor environments over one week influenced mood among residents of four European cities including Barcelona (Spain), Stoke-on-Trent (United Kingdom), Doetinchem (The Netherlands) and Kaunas (Lithuania). Participants (n = 368) wore a smartphone equipped with software applications to track location and mood (using mobile ecological momentary assessment (EMA) software), for seven consecutive days. We estimated random-effects ordered logistic regression models to examine the association between mood (positive and negative affect), and exposure to green space, represented by two binary variables indicating exposure versus no exposure to NOE using GPS tracking and satellite and aerial imagery, 10 and 30 min prior to participants' completing the EMA. Models were adjusted for home city, day of the week, hour of the day, EMA survey type, residential NOE exposure, and sex, age, education level, mental health status and neighbourhood socioeconomic status. In addition, we tested for heterogeneity of effect by city, sex, age, residential NOE exposure and mental health status. Within 10 min of NOE exposure, compared to non-exposure, we found that overall there was a positive relationship with positive affect (OR: 1.39, 95% CI: 1.06, 1.81) of EMA surveys, and non-significant negative association with negative affect (OR: 0.80, 95% CI: 0.58, 1.10). When stratifying, associations were consistently found for Stoke-on-Trent inhabitants and men, while findings by age group were inconsistent. Weaker and less consistent associations were found for exposure 30 min prior to EMA. Our findings support increasing evidence of psychological and mental health benefits of exposure to natural outdoor environments, especially among urban populations such as those included in our study., (Published by Elsevier Ltd.)

Psychological models of bipolar disorder (BD), such as the self-regulation model (SRM; Leventhal, Nerenz, & Steele, 1984), highlight the crucial role of beliefs about mood in relapse vulnerability. To date, no studies have directly compared these beliefs between people with and without BD. Based on the SRM, the current research examined beliefs about mood in people with and without BD and explored the impact of current affect on these beliefs. Fifty euthymic people with a diagnosis of BD and 50 controls were recruited through an online screening study, clinical services, and support organizations. Experience sampling methodology (ESM) was used to assess beliefs (according to the Brief Illness Perceptions Questionnaire; Broadbent, Petrie, Main, & Weinman, 2006) across a typical week of everyday life. Data were analysed using multilevel modelling. Forty-two people with a diagnosis of BD and 50 controls were included in the analyses. Results indicated that the BD group reported less control over mood, a shorter duration of mood, and less understanding of mood and were more likely to report the cause of depressive symptoms as something internal, compared with controls. When controlling for current affect, the BD group also reported more positive consequences, made more internal attributions for hypomanic symptoms, and reported less concern about mood, compared with controls. Findings suggest important differences in beliefs about mood between people with and without BD that are not the result of current affect. These beliefs may be particularly important in understanding underlying vulnerability to future relapse into depression and/or mania., (© 2019 The Authors. Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd.)

We tested the hypothesis that mindwandering and external distraction are both manifestations of a common state of reduced attention focus, and examined how both relate to reported level of happiness. We conducted real-time sampling of people's experience of mindwandering, irrelevant distraction (e.g. by music, phone, etc.), and happiness levels, in two studies with 524 people undertaking common daily-life activities. All irrelevant external distractions were positively correlated with mindwandering. Indeed mindwandering duration could be predicted from the reported duration of external distraction, when controlling for a range of background variables. An exploratory factor analysis of mindwandering and distraction reports suggested a single underlying construct. In addition, duration of irrelevant distraction by both mobile phones and mindwandering was significantly associated with reduced reported levels of happiness. The results are consistent with the hypothesis that that a state of reduced attention focus underlies both mindwandering and distractibility and clarify the link with happiness., (Copyright © 2019 Elsevier Inc. All rights reserved.)

Background: Cardiac rehabilitationis effective in promoting physical/psychological recovery following acute coronary syndrome. Yet, rates of attendance at outpatient cardiac rehabilitation by eligible patients are low., Objectives: This study examined the determinants of attendance at outpatient cardiac rehabilitation in acute coronary syndrome patients following discharge until cardiac rehabilitation commencement., Design: A weekly electronic diary measured cardiac-related cognitions and mood and examined their relation to attendance at outpatient cardiac rehabilitation., Settings: Three United Kingdom National Health Service secondary care settings in two Health Board areas in Scotland., Participants: Acute coronary syndrome patients were recruited from March 2012 to June 2013 prior to hospital discharge. Of 488 eligible patients referred for cardiac rehabilitation, 214 consented., Methods: Consecutive patients completed a pre-hospital discharge questionnaire targeting age, diagnosis, social class and smoking history. Acute coronary syndrome patients then completed a weekly electronic diary from the first week of discharge until the start of cardiac rehabilitation. Multilevel structural equation models estimated the effects of initial, i.e. baseline and rate of change in cardiac-related cognition and mood on attendance. Intention to attend cardiac rehabilitation was reflected, log transformed, reported thereafter as "do not intend". The role of "do not intend" was explored as a mediator of the relationship between cardiac-related cognition and mood on attendance., Results: 166 participants provided, on average, 5 weeks of diary entries before cardiac rehabilitation commenced. High intention (i.e. low "do not intend") to attend CR and its rate of increase over time predicted attendance. Low negative emotional representation, high perceived necessity, high confidence in maintaining function, low negative affect, and high positive affect following discharge predicted attendance at cardiac rehabilitation. The rate of change in cardiac-related mood and these cognitions was not predictive. Baseline and rate of change in "do not intend" entirely mediated relationships between a) perceived necessity, b) negative affect and attendance at cardiac rehabilitation., Conclusions: Negative affect in the first weeks following discharge represents the key challenge to a patient maintaining their intention to attend cardiac rehabilitation. Intervention to improve attendance should focus on improving intention to attend following discharge and during recovery by improving patient understanding of cardiac rehabilitation and reducing negative affect., (Copyright © 2018 Elsevier Ltd. All rights reserved.)