Sustaining attention in affective contexts during adolescence: age-related differences and association with elevated symptoms of depression and anxiety.

Sustained attention, a key cognitive skill that improves during childhood and adolescence, tends to be worse in some emotional and behavioural disorders. Sustained attention is typically studied in non-affective task contexts; here, we used a novel task to index performance in affective versus neutral contexts across adolescence (N = 465; ages 11-18). We asked whether: (i) performance would be worse in negative versus neutral task contexts; (ii) performance would improve with age; (iii) affective interference would be greater in younger adolescents; (iv) adolescents at risk for depression and higher in anxiety would show overall worse performance; and (v) would show differential performance in negative contexts. Results indicated that participants performed more poorly in negative contexts and showed age-related performance improvements. Those at risk of depression performed more poorly than those at lower risk. However, there was no difference between groups as a result of affective context. For anxiety there was no difference in performance as a function of severity. However, those with higher anxiety showed less variance in their reaction times to negative stimuli than those with lower anxiety. One interpretation is that moderate levels of emotional arousal associated with anxiety make individuals less susceptible to the distracting effects of negative stimuli.

The impact of mindfulness training in early adolescence on affective executive control, and on later mental health during the COVID-19 pandemic: a randomised controlled trial.

BACKGROUND: Previous research suggests that mindfulness training (MT) appears effective at improving mental health in young people. MT is proposed to work through improving executive control in affectively laden contexts. However, it is unclear whether MT improves such control in young people. MT appears to mitigate mental health difficulties during periods of stress, but any mitigating effects against COVID-related difficulties remain unexamined. OBJECTIVE: To evaluate whether MT (intervention) versus psychoeducation (Psy-Ed; control), implemented in after-school classes: (1) Improves affective executive control; and/or (2) Mitigates negative mental health impacts from the COVID-19 pandemic. METHODS: A parallel randomised controlled trial (RCT) was conducted (Registration: https://osf.io/d6y9q/; Funding: Wellcome (WT104908/Z/14/Z, WT107496/Z/15/Z)). 460 students aged 11-16 years were recruited and randomised 1:1 to either MT (N=235) or Psy-Ed (N=225) and assessed preintervention and postintervention on experimental tasks and self-report inventories of affective executive control. The RCT was then extended to evaluate protective functions of MT on mental health assessed after the first UK COVID-19 lockdown. FINDINGS: Results provided no evidence that the version of MT used here improved affective executive control after training or mitigated negative consequences on mental health of the COVID-19 pandemic relative to Psy-Ed. No adverse events were reported. CONCLUSIONS: There is no evidence that MT improves affective control or downstream mental health of young people during stressful periods. CLINICAL IMPLICATIONS: We need to identify interventions that can enhance affective control and thereby young people's mental health.

Susceptibility to prosocial and antisocial influence in adolescence.

INTRODUCTION: Adolescents are particularly susceptible to social influence and previous studies have shown that this susceptibility decreases with age. The current study used a cross-sectional experimental paradigm to investigate the effect of age and puberty on susceptibility to both prosocial and antisocial influence. METHODS: Participants (N = 520) aged 11-18 from London and Cambridge (United Kingdom) rated how likely they would be to engage in a prosocial (e.g. "help a classmate with their work") or antisocial (e.g. "make fun of a classmate") act. They were then shown the average rating (in fact fictitious) that other adolescents had given to the same question, and were then asked to rate the same behaviour again. RESULTS: Both prosocial and antisocial influence decreased linearly with age, with younger adolescents being more socially influenced when other adolescents' ratings were more prosocial and less antisocial than their own initial rating. Both antisocial and prosocial influence significantly decreased across puberty for boys but not girls (independent of age). CONCLUSIONS: These findings suggest that social influence declines with increasing maturity across adolescence. However, the exact relationship between social influence and maturity is dependent on the nature of the social influence and gender. Understanding when adolescents are most susceptible to different types of social influence, and how this might influence their social behaviour, has important implications for understanding adolescent social development.

The effect of social preference on academic diligence in adolescence.

In the current study, we were interested in whether adolescents show a preference for social stimuli compared with non-social stimuli in the context of academic diligence, that is, the ability to expend effort on tedious tasks that have long-term benefits. Forty-five female adolescents (aged 11-17) and 46 female adults (aged 23-33) carried out an adapted version of the Academic Diligence Task (ADT). We created two variations of the ADT: a social ADT and non-social ADT. Individuals were required to freely split their time between an easy, boring arithmetic task and looking at a show-reel of photographs of people (in the social ADT) or landscapes (in the non-social ADT). Individuals also provided enjoyment ratings for both the arithmetic task and the set of photographs they viewed. Adolescents reported enjoying the social photographs significantly more than the non-social photographs, with the converse being true for adults. There was no significant difference in the time spent looking at the social photographs between the adolescents and adults. However, adults spent significantly more time than adolescents looking at the non-social photographs, suggesting that adolescents were less motivated to look at the non-social stimuli. Further, the correlation between self-reported enjoyment of the pictures and choice behaviour in the ADT was stronger for adults than for adolescents in the non-social condition, revealing a greater discrepancy between self-reported enjoyment and ADT choice behaviour for adolescents. Our results are discussed within the context of the development of social cognition and introspective awareness between adolescence and adulthood.

A bad night's sleep on campus: an interview study of first-year university students with poor sleep quality.

BACKGROUND: Poor sleep quality is common in university students and increases the risk of mental illness and poor academic attainment. It is therefore critical to understand what may cause or aggravate poor sleep in students. First-year students living on campus are particularly worthy of attention due to their distinctive sleeping circumstances: they are adapting to a new lifestyle, sleep in close proximity to new peers, and experience environmental noise and academic stress. METHOD: Fifteen first-year undergraduates with poor sleep quality completed in-depth interviews in which they were asked about aspects of university life that might contribute to their poor sleep quality. RESULTS: Four main themes were constructed from the data using thematic analysis: the social context of noise problems; the lure of socializing with peers; the cost of having an unstructured academic lifestyle; and the wide-reaching impact of poor sleep quality on university life. Flatmates and friends were central to poor sleep quality on campus because they caused excessive noise and provided an easy opportunity to socialize late into the night. Academic factors, including students working late at night and spending all day in their bedrooms, were also key. CONCLUSION: Fundamental aspects of moving to university, including living with peers and adapting to a new academic schedule, may increase the risk of students' poor sleep quality. When designing interventions to minimize the risk of poor sleep quality in first-year students, unique aspects of the campus environment, including the close proximity to new peers, must be addressed.

Patients treated by homeopaths registered with the Society of Homeopaths: a pilot study.

BACKGROUND: There is little information on the types of symptoms for which patients request homeopathic treatment from Society of Homeopaths (SoH) homeopaths in the UK. OBJECTIVES: A preliminary study to gain information about characteristics of patients requesting treatment from SoH professional (non-medically qualified) homeopaths--including symptoms and general well-being. RESULTS: 37 homeopaths returned data on 482 patients covering 1419 consultations over a 2 year period. Patients were mostly female and predominantly aged 40-59. CONCLUSIONS: As well as obtaining preliminary data about these patients, this study has also resulted in greater knowledge of audit and research methods in the profession. The results of this preliminary descriptive study will inform a future, larger prospective controlled observational study.

Two-year prospective study of psychosocial outcomes and a cost-analysis of 'treatment-as-usual' versus an 'enhanced' (specialist liaison nurse) service for aneurysmal sub arachnoid haemorrhage (ASAH) patients and families.

An 18-month retrospective study of 'treatment-as-usual' of aneurysmal subarachnoid haemorrhage (ASAH, n = 142) used as control to compare prospective study (n = 184) of an 'enhanced' ('Specialist Liaison Nurse'-SLN) service to reduce psychosocial trauma. Consultant notes, Glasgow Coma Scores and 'High Risk' bleeds scores provided clinical data. A standardized patient/carer designed questionnaire provided psychosocial data, plus a cost-analysis. The cohorts were good clinical and social matches. Sixty-five per cent of patients had 'high risk' bleeds, and 81% were Grade 1 and 2 on the GCS, 54% aged less than 55 years, 83% belonged to social classes 1-3 and 32% had school-aged children. Satisfaction with SLN inpatient and discharge care increased significantly, with reduced psychosocial trauma. The SLN produced net 'savings' of pounds sterling 155,000 p.a., from reduced time-off work, medical time and re-admissions. Prospectively, pounds sterling 1.6 + million annual 'savings' were identified on 80% of employed patients returning to work. Long-term dysfunctional stress is not inevitable for most ASAH patients as a SLN is clinically and fiscally cost-effective.

Psychosocial outcomes for patients and carers after aneurysmal subarachnoid haemorrhage.

As part of a 'clinical governance' initiative, a patient/carer led study was designed to determine the psychosocial outcome of a consecutive cohort of 137 aneurysmal sub-arachnoid haemorrhage (ASAH) patients of whom 45% had experienced a severe haemorrhage. Most patients were middle class (51%), female (63%), aged under 54 years (53%) and 30% had school-age children. Information booklets did not meet the need for case-specific answers and communication problems were identified despite the high rating of in-patient treatment. Substantial problems occurred after discharge because of a hiatus in care and support by community-based services. Carers carried major psychosocial burdens, fifty-one per cent reporting that their work was negatively affected, and after a year, employment cost to carers was pounds sterling 182,000 and pounds sterling 590,000 for patients. 11% of patients lost their jobs as a direct consequence of the ASAH. A cost-feasible solution to improve the communication-support problems was identified by these 'consumers'.

Social support, family variables, and compliance in renal transplant children.

The relationship between family functioning, social support, and medication compliance in 32 renal transplant children and their parents was examined. Results indicated that children whose fathers gave more emotional support or were more informative were less compliant with azathioprine and cyclosporine (P < 0.05 for both). Children from families experiencing numerous stresses were also found to be less compliant with azathioprine (P < 0.05). Finally, compared with older children, younger children were found to be less compliant with cyclosporine (P < 0.005). Implications for predicting child adherence and for future research relating to compliance with multidrug regimens are discussed.