Healthiness matters: Approach motivation for healthy food in overweight and obese individuals.

It is well documented that approach tendencies for appetitive substances play a role in certain unhealthy patterns of consumption. However, it remains uncertain whether overweight individuals differ from healthy-weight individuals in terms of their tendency to approach unhealthy foods. Thus, the present study aimed to empirically test the hypothesis that overweight individuals are characterised by an elevated behavioural tendency to approach unhealthy food, rather than healthy food, as compared to healthy-weight individuals. Participants were forty-one overweight individuals (Mean BMI = 30.40 kg/m2) and forty-five healthy-weight individuals (Mean BMI = 22.17 kg/m2) aged between 17 and 47. They completed an Approach-Avoidance Task to assess behavioural approach-avoidance tendencies towards healthy and unhealthy food. Contrary to the hypothesis under test, results revealed a greater approach tendency towards healthy food in overweight individuals, as compared to healthy-weight individuals, whereas there were no group differences in behavioural approach-avoidance tendencies towards unhealthy food. These novel findings suggest that overweight individuals are characterised by an approach motivation for healthy food. We provide suggestions concerning how future researchers can build on these findings to test whether this approach tendency contributes to consumption behaviour in overweight individuals.

Experiences and Support Needs of Bereaved Students in Higher Education.

Bereavement is commonly experienced by students in higher education and is associated with negative health and academic consequences. We conducted a systematic review of the literature to identify how grief affects students in higher education and the types of support they seek and/or find beneficial. A search of Health Collection, Medline, CINAHL Plus, Web of Science, Taylor and Francis online, ProQuest, and Open Grey resulted in 30 articles that met inclusion criteria. A narrative synthesis resulted in 11 themes focused on the university experience following bereavement (six themes) and supports following bereavement (five themes). Our review highlights how grief symptoms can have a negative impact on bereaved students' academic and social experiences. These difficulties are exacerbated by barriers to accessing grief supports, and unhelpful responses from staff and peers. Students' grief is often disenfranchised and so students learn to avoid grief related emotions, communications, and support-seeking.

Differential utility of teacher and parent-teacher combined information in the assessment of Attention Deficit/Hyperactivity Disorder symptoms.

BACKGROUND: Consistent research findings indicate that parents and teachers observe genuinely different Attention Deficit/Hyperactivity Disorder (ADHD) behaviours in their respective settings. OBJECTIVE: To evaluate the utility of information provided by teacher informant assessments (INFAs) of ADHD symptoms, and the implications of aggregation algorithms in combing parents' information, i.e. using 'or-rule' (endorsement by either one informant) versus 'and-rule' (endorsement by both informants). METHOD: Teacher ratings on Conners scales and clinical data from parental accounts on 1383 probands and their siblings from the IMAGE study were analysed. The psychometric properties of teacher and combined ratings using the item response theory model (IRT) are presented. Kappa coefficients, intraclass correlations and linear regression were employed. RESULTS: First, teacher endorsement of symptoms is located in a narrow part of the trait continuum close to the average levels. Symptoms exhibit comparable perception in the measurement of the trait(s) with similar discrimination ability and information (reliability). Second, the IRT properties of the 'or-rule' ratings are predominantly influenced by parent-INFAs; and the 'and-rule' ratings predominantly by teacher-INFAs ratings. Third, parent-teacher INFAs agreement was low, both for individual items (κ = 0.01-0.15) and for dimensional scores (r = 0.12-0.16). The 'or-rule' captured milder expressions of ADHD symptoms, whereas the 'and-rule' indexed greater severity of ADHD. CONCLUSIONS: Parent and teacher-INFAs provide different kinds of information, while both are useful. Teacher-INFA and the 'and-rule' provide a more accurate index of severity than an additive symptom count. Parent-INFA and the 'or-rule' are more sensitive for detecting cases with milder ADHD.

Movement difficulties in children with ADHD: Comparing the long- and short-form Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2).

AIMS: Up to 50% of children with attention deficit hyperactivity disorder (ADHD) also present with difficulties with motor proficiency. Several assessments of motor proficiency are available for occupational therapists, though the validity of these measures in an ADHD population requires further exploration. The aim of this paper was to evaluate the consistency of scores obtained using the long-form and short-form of the Bruininks-Oseretsky Test of Motor Proficiency-Second Edition (BOT-2) in a school-age ADHD sample. METHOD: The BOT-2 long-form was administered to 84 school-age children (78 males) with ADHD; short-form scores were extracted from the relevant long-form items. RESULTS: Long-form and short-form total scores were highly correlated (r = .87), though the average short-form score was significantly higher. As a categorical measure, 52 children were classified as "at-risk" for movement difficulties by the long-form; but only 36 by the short-form, yielding a false-negative rate of 30.77%. The sensitivity of short-form could be improved by raising the cut-off thresholds of short-form scores as identified by receiver operating characteristic curve analysis but did not yield practical utility. INTERPRETATION: As a continuous indicator (i.e. total scores), the short-form is comparable to the long-form. However, the short-form overestimates the child's motor proficiency relative to the long-form and yields an unacceptably high rate of false negatives as a categorical measure. The current revision of the short-form is therefore not recommended as a screening nor diagnostic instrument in an ADHD population. In the absence of ADHD-specific norms, use of the long-form provides greater opportunity for occupational therapists to identify those at-risk for movement difficulties. However, any assessment of motor proficiency should be accompanied by a broader comprehensive assessment to best understand a child's motor functioning.

Support for e-cigarette regulations among Australian young adults.

BACKGROUND: Surveying support for various regulatory options relating to e-cigarettes can assist policymakers to identify those that have broad support and are therefore likely to be easier to implement. However, data on support for potential e-cigarette regulations in Australia are limited. To inform regulatory efforts, the present study assessed attitudes to the regulation of e-cigarettes among Australian young adults, the most prevalent users of e-cigarettes and therefore the most likely population segment to be affected by e-cigarette regulations. METHODS: A total of 1116 Australians aged 18 to 25 years (59% female) completed an online survey where they were presented with various statements relating to the regulation of e-cigarettes and asked to report on the extent to which they agreed or disagreed with each. Statements presented either a restrictive or non-restrictive approach to e-cigarette regulation. RESULTS: Across all statements, 10-22% of respondents responded "don't know" while 23-35% neither agreed nor disagreed, indicating general ambivalence. There was a moderate level of support (33-37%) for regulating e-cigarette sales/use and treating e-cigarettes like tobacco products. Only 20% of respondents were in favour of allowing the use of e-cigarettes in smoke-free areas. Smokers, e-cigarette users, and those who did not believe in the harms associated with e-cigarettes were typically less likely than other respondents to support restrictive approaches. CONCLUSIONS: The young Australian adults surveyed were somewhat supportive of restrictions around the sale and use of e-cigarettes, but generally opposed outright bans and any need for a prescription from a medical practitioner. Increasing awareness of the harms associated with the use of e-cigarettes represents a potential strategy to gaining regulatory support.

Food healthiness versus tastiness: Contrasting their impact on more and less successful healthy shoppers within a virtual food shopping task.

A virtual shopping task was employed to illuminate why women who intend to shop healthily are differentially successful in doing so. Female undergraduates (N = 68) performed a modified approach and avoidance task that employed food items differing in healthiness and tastiness, and yielded relative speed to select and reject food items in a stylised supermarket. Participants categorised a food item either in terms of healthiness or tastiness, then pulled (selected) or pushed (rejected) the item using a joystick. Participants showed faster selection of tasty food after categorisation in terms of tastiness, irrespective of the food's healthiness. However, after categorisation in terms of healthiness, only more successful healthy food shoppers showed faster selection of healthy items regardless of tastiness. Less successful healthy food shoppers showed this effect only for tasty food, and displayed faster rejection of food items not considered tasty, regardless of their assessed healthiness. Thus, when participants who reported the greatest gap between their shopping intention and shopping behaviour were judging the healthiness of food items, their speed to select and reject items continued to be influenced by tastiness. This suggests that reducing incidental processing of food tastiness may reduce the intention-behaviour gap in healthy food shopping.

Differences in use of electronic nicotine delivery systems by smoking status and demographic characteristics among Australian young adults.

ISSUE ADDRESSED: Electronic nicotine delivery systems (ENDS) continue to grow in popularity, particularly among young adults. Understanding by whom various ENDS are being used and why within this population segment can assist the development of appropriate interventions targeting those most vulnerable to use and inform policy decisions in this area. Accordingly, this study assessed the demographic characteristics associated with ENDS use among Australian young adults, and reasons for current e-cigarette use. METHODS: An online survey was administered to 1116 Australians aged 18-25 years (59% female). RESULTS: Smokers were more likely than non-smokers to report (a) ever use of ENDS (67% vs 28%), (b) ever use of an e-cigarette (64% vs 24%), e-cigar (17% vs 8%) or e-hookah (15% vs 8%) and (c) current use of e-cigarettes (19% vs 6%). Male smokers were more likely than female smokers to be current e-cigarette users. The most common reason for current e-cigarette use was enjoyment. CONCLUSIONS: Young male adults appear to be particularly vulnerable to becoming regular e-cigarette users. This demographic group may need to be a primary focus of prevention and intervention efforts. Contrary to popular belief, smoking cessation was not a primary reason for e-cigarette use. SO WHAT?: Greater efforts are needed to educate young adults on the harms associated with ENDS use, especially if use is being driven by the perception that they are a harmless means of amusement. Maintaining existing regulations limiting the accessibility of these products is crucial to ensuring widespread use is minimised.

Confusing procedures with process when appraising the impact of cognitive bias modification on emotional vulnerability†.

If meta-analysis is to provide valuable answers, then it is critical to ensure clarity about the questions being asked. Here, we distinguish two important questions concerning cognitive bias modification research that are not differentiated in the meta-analysis recently published by Cristea et al (2015) in this journal: (1) do the varying procedures that investigators have employed with the intention of modifying cognitive bias, on average, significantly impact emotional vulnerability?; and (2) does the process of successfully modifying cognitive bias, on average, significantly impact emotional vulnerability? We reanalyse the data from Cristea et al to address this latter question. Our new analyses demonstrate that successfully modifying cognitive bias does significantly alter emotional vulnerability. We revisit Cristea et al's conclusions in light of these findings.

Biased attentional engagement with, and disengagement from, negative information: independent cognitive pathways to anxiety vulnerability?

Cognitive models of anxiety propose that selective attention to negative information plays a causal role in heightened anxiety vulnerability and dysfunction. However, there has been theoretical disagreement concerning whether anxiety-linked attentional biases reflect enhanced attentional engagement with, or impaired attentional disengagement from, negative information. We contend that previous methodologies have not been optimal in terms of their capacity to differentiate both types of bias. The present study introduces a refined methodology, in which the conventional dot-probe task is modified in a novel manner to enable the independent assessment of these components of attention. The findings demonstrate that facilitated attentional engagement and impaired attentional disengagement are both characteristic of elevated levels of anxiety vulnerability. Moreover, these prove to be unrelated facets of attentional selectivity that independently contribute to variation in anxiety vulnerability. We discuss the possibility that these two types of attentional bias may represent independent pathways to anxiety vulnerability.

The relationship between worry and academic performance: examining the moderating role of attention control.

BACKGROUND: Worry is frequently associated with reduced cognitive performance, through consumption of attention control resources. Assessing attention control during acute worry may better reflect cognitive performance in real-world scenarios. This study examined whether attention control (assessed at rest and under acute worry) moderates the relationship between worry and academic performance. METHODS: Worry (Penn State Worry Questionnaire) and academic performance (examination grades) were assessed in 87 undergraduates, with attention control (antisaccade performance) measured at baseline and following worry induction. RESULTS: When assessed at rest, attention control did not moderate the relationship between trait worry and academic performance. However, under acute worry, attention control significantly moderated the relationship between worry and academic performance (p = .05, f2 = 0.14), such that at low levels of attention control under worry, higher trait worry was significantly associated with lower academic performance. At high levels of attention control under worry, however, the relationship between trait worry and academic performance was not significant. CONCLUSIONS: Findings suggest that worry may shape performance according to attention control levels, with attention control's moderating role being more pronounced under conditions of acute worry. These results provide preliminary evidence that attention control assessed under worry may better predict real-world performance, compared to assessment at rest.

Anxiety-linked impairment in the ability to recode stimuli.

It has been proposed that elevated trait anxiety is associated with deficits in cognitive flexibility, which is required to enable people to switch between different ways of classifying information. Recent research has focused on a particular facet of cognitive flexibility that may be specifically impaired in high trait anxious individuals. This concerns the ability to recode stimulus information that has initially been categorized in terms of 1 stimulus dimension, in terms of an alternative dimension. However, limitations in previously employed assessment methodologies compromise the capacity to draw firm conclusions from prior research investigating this hypothesis. Across 2 studies we developed and delivered a novel stimulus information recoding assessment task to a sample of individuals who varied in trait anxiety, to test the hypothesis that elevated trait anxiety is specifically associated with a deficit in the ability to recode information that has already been classified. Across both studies we found evidence to support this hypothesis. The theoretical and practical implications of these findings are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Reliability and convergence of approach/avoidance bias assessment tasks in the food consumption domain.

Theories of motivation posit that people will more readily approach positive or appetitive stimuli, and there has been growing interest in the relationship between biases in approach and avoidance behaviours for food cues and food craving and consumption behaviour. Two paradigms commonly employed by research to investigate this relationship are the approach-avoidance task (AAT) and the stimulus-response compatibility task (SRCT). However, it is yet to be determined whether the measures yielded by these tasks reflect the same processes operating in the food craving and consumption domain. The present study examined the internal reliability and convergence of AAT and SRCT paradigms in their assessment of biased approach to unhealthy compared with healthy food stimuli, and whether the measures yielded by the AAT and SRCT paradigms demonstrated associations with individual differences in food craving and eating behaviour. One hundred twenty-one participants completed an SRCT, an AAT using an arm movement response mode, and an AAT using a key-press response mode. The measures yielded comparable and acceptable levels of internal consistency, but convergence between the different task bias scores was modest or absent, and only approach bias as measured with the AAT task using an arm movement response mode was associated with self-report measures of eating behaviour and trait food craving. Thus, tasks did not converge strongly enough to be considered equivalent measures of approach/avoidance biases, and the AAT task using an arm movement response seems uniquely suited to detect approach biases argued to characterise maladaptive eating behaviour and craving.

Enabling successful life engagement in young people with ADHD: new components beyond adult models of recovery.

PURPOSE: To examine the lived experiences of young people successfully managing life with ADHD and investigate the applicability of adult models of Recovery to these individuals. METHODS: Twenty-seven young people aged 15-31 years participated in qualitative interviews. Participants' success was indicated by employment, school attendance, absence of acute mental health episodes, or absence of chronic alcohol or drug use. Thematic analysis identified specific components of their life successes and challenges. RESULTS: The emergent framework comprised four elements: (i) Recovernance (RE) (a portmanteau merging 'Recovery' and 'Maintenance'; ongoing adjustment to maintain one's personal best without an end point); (ii) Personal Optimization (PO) (continuously striving to maximize function and adjust one's goals given fluctuating impairments and internal resources); (iii) Self (S) (facing internal challenges and developing internal resilience); and (iv) Environment (E) (facing external challenges and fostering external resilience). These four elements yielded the acronym 'REPOSE'. CONCLUSIONS: Recovery in young people with ADHD was not a linear journey, with many missteps leading to greater self-knowledge, life skills and mastery. Progress was leveraged on securely anchored internal and external resilience factors against the prospect of setbacks. Findings provide new concepts and novel lexicons to extend existing concepts in Recovery. Implications for rehabilitationCounselling and therapy for young people with ADHD should foster self-understanding, goal setting and self-vigilance as an ongoing process to build their capacity to tackle setbacks and adversities.Counselling and therapy for young people with ADHD focus on a strengths-based approach building internal and external resources, such as developing skills and establishing social connections that build infrastructure in the environment for meaningful participation.

Cognitive Biases in Type 2 Diabetes and Chronic Pain.

The aim of the present study was to investigate the role of cognitive processing biases in Type 2 diabetes (T2D) and chronic pain, 2 conditions that are highly co-morbid. The final sample comprised 333 individuals (86 with T2D and chronic pain, 65 with chronic pain, 76 with T2D, 106 without any form of diabetes or pain). Participants completed questionnaires assessing pain and diabetes-related outcomes, as well as measures of interpretation bias, attentional bias, and attentional bias variability. In a 2 (pain status) x 2 (T2D status) x 3 (bias valence) ANOVA design, interpretation biases were found to be stronger in individuals with chronic pain than individuals without pain, although there were no differences according to T2D status. No group differences in attentional biases were found. Among individuals with T2D, greater interpretation bias was associated with better blood glucose control, but also greater fear of hypoglycemia. For individuals with chronic pain, greater interpretation bias and attentional bias variability was associated with worse pain outcomes. Whilst interpretation bias may be present in chronic pain, it also appears to indicate better glycemic control in individuals with T2D. These findings suggest a more dynamic approach to understanding cognitive bias is needed, to consider when these biases are more or less adaptive, so that they can be better harnessed to improve outcomes for individuals with T2D who experience chronic pain. PERSPECTIVE: These findings suggest that cognitive biases can be associated with psychopathology in chronic pain and in T2D, but can also potentially be adaptive in those with T2D. Diabetes management interventions may require a careful balance between promoting sufficient concern to motivate engagement in adaptive diabetes self-management, whilst also minimizing fear of hypoglycemia.

Selective attention to threat, anxiety and glycaemic management in adolescents with type 1 diabetes.

Objective: Previous research has established that adolescents with type 1 diabetes (T1D) experience more anxiety symptoms than their healthy peers and are also more likely to develop an anxiety disorder. Research in cognitive psychology has found that selective attention favouring the processing of threatening information causally contributes to elevated levels of anxiety; however, this process has not been investigated in the context of T1D. The current study examined whether selective attention for threatening information contributes to the association between anxiety and glycaemic management in adolescents with T1D. Methods: Participants completed a dot-probe task to assess selective attention for diabetes-related threatening information and general non-diabetes-related threatening information and we examined the associations between these measures and measures of HbA1c and anxiety. Results: Findings suggest that individual differences in anxiety vulnerability do not predict HbA1c alongside the attentional bias for threatening information. Conclusions: The attentional bias for threatening information makes a contribution to the relationship between anxiety and glycaemic management and may represent a target for therapeutic intervention to both reduce anxiety and improve glycaemic management.

Are avoidance biases in social anxiety due to biases in stimulus coding or in post-coding behavioral tendencies?

On the Approach-Avoidance Task (AAT) high socially anxious (HSA) individuals exhibit increased behavioral avoidance of faces displaying emotional expressions. Two accounts could explain these findings: 1) HSA individuals have a heightened readiness to code faces in terms of emotionality, and all individuals behaviorally avoid faces coded as emotional (pre-behavior coding bias hypothesis), or 2) everyone is equally ready to code faces in terms of emotionality, but when faces are coded as emotional HSA have a heightened tendency to behaviorally avoid such stimuli (post coding behavioral bias hypothesis). To test these hypotheses, we created the Stimulus-Coding AAT. Participants categorized emotional and non-emotional faces in terms of either gender or emotional expression, before making a standard AAT response. Time to make each type of categorization, and to execute AAT responses following categorization, was assessed in 32 HSA and 32 LSA participants. Groups did not differ in their relative speed to categorize face stimuli on the two dimensions. When participants coded faces in terms of their emotionality, HSA relative to LSA participants demonstrated increased behavioral avoidance of emotional faces. We conclude that these findings are inconsistent with the pre-behavior coding bias hypothesis and support the post-coding behavioral bias hypothesis.

The Characteristics and Age Effects of Emotional Lability in ADHD Children With and Without Oppositional Defiant Disorder.

Objective: This study evaluated the concurrent validity of emotional lability (EL) in children with ADHD. Method: A total of 2,015 children with ADHD and 745 typically developed controls (TDCs) were assessed and compared on EL. Results: ADHD participants expressed higher EL scores than TDCs, not influenced by gender or IQ. Higher levels of EL symptoms were found in children with comorbid oppositional defiant disorder (ODD) and with ADHD-combined subtype. Receiver operating characteristic (ROC) analyses showed a strong screening efficacy of EL symptoms on ADHD. The effect of developmental age on EL showed a desisting pattern in TDCs, as opposed to a persisting pattern in ADHD (not influenced by ODD comorbid status). ODD symptoms in ADHD showed an ascending pattern. Conclusion: EL can potentially serve as a sentinel index for the presence of ADHD, especially when the ADHD presentation is atypical. ODD may embody a developmental entity distinct from EL.

Perceptions of the harm, addictiveness, and smoking cessation effectiveness of e-cigarettes among Australian young adults.

An extensive body of evidence indicates that e-cigarette use is highest among young adults, prompting concerns about the potential renormalization of smoking behaviors in a population segment that is particularly vulnerable to tobacco smoking initiation. Increasing levels of e-cigarette use among young adults are likely a reflection of favorable beliefs about the benefits and risks associated with use, but research assessing perceptions of e-cigarettes in this population segment is limited. The aim of the present study was to assess young adults' perceptions of (i) the absolute and relative harm associated with e-cigarette use and (ii) the efficacy of these devices for smoking cessation. In a sample of 1116 Australian 18 to 25 year olds, three-quarters believed e-cigarettes have some level of harm (72%), just over half believed them to be addictive (57%), and substantial minorities reported that they did not know whether these products are harmful (20%) or addictive (34%). Two-fifths believed e-cigarettes are effective at helping people quit smoking (42%). Differences were observed by smoking status and e-cigarette user status on several variables, with a general trend of more positive perceptions towards e-cigarettes among smokers and users, particularly in relation to cessation efficacy. Results suggest that a substantial minority of young adults are unaware of the harms that may be associated with e-cigarettes, underscoring the importance of public health efforts that aim to provide accurate information about these devices.