The Emotional Burden of Loneliness and its Association with Mental Health Outcomes.

BACKGROUND: The present study examined, for the first time, the emotional burden of loneliness on dimensions of emotional valence and arousal, and its association with mental health outcomes. METHOD: A cross-sectional design was used, and data were collected from 503 adults across the UK with an online survey. Measures included socio-demographic characteristics, self-reported measures of loneliness and social isolation, affective ratings (i.e., valence and arousal) of loneliness experiences, and symptoms of depression and anxiety as mental health outcomes. RESULTS: The emotional burden of loneliness differed significantly across groups with differing loneliness experiences, and females scored significantly higher in the emotional burden of loneliness than males. The emotional burden of loneliness was associated with both depression and anxiety symptoms, and respectively added 4.7% and 6.2% of the variance, on top of measures of loneliness frequency and social isolation. CONCLUSIONS: Measuring the valence and arousal dimensions of loneliness experiences advances our understanding of loneliness experiences and its association with mental health outcomes. The theoretical, methodological, and practical implications of our study are discussed.

Loneliness is not a homogeneous experience: An empirical analysis of adaptive and maladaptive forms of loneliness in the UK.

Understanding loneliness is pivotal to informing relevant evidence-based preventive interventions. The present study examined the prevalence of loneliness in the UK, during the COVID-19 pandemic, and the association between loneliness, mental health outcomes, and risk and protective factors for loneliness, after controlling for the effects of social isolation. It was estimated that 18.1% of the population in our study experienced moderately high to very high loneliness. We also found that loneliness was positively associated with self-disgust and social inhibition, and negatively associated with trait optimism and hope. Cluster analysis indicated that two distinct groups emerged among those experiencing higher levels of loneliness: "adaptive" and "maladaptive" loneliness groups. The maladaptive loneliness group displayed psychological characteristics like self-disgust and social inhibition including symptoms of depression and anxiety that can potentially undermine their ability to connect with others and form meaningful social relationships. These findings suggest that not all people experience loneliness in the same way. It is possible that a one-size-fit-all approach to reducing loneliness, may be less effective because it does not take into account the differential psychological profiles and characteristics of lonely people, relevant to their capacity to connect with others.

Self-disgust as a potential mechanism underlying the association between body image disturbance and suicidal thoughts and behaviours.

This study examined whether self-disgust added incremental variance to and mediated the multivariate association between measures of body image disturbance and suicidal thoughts and behaviours. We hypothesized that self-disgust would be associated with suicidal ideation above the effects of body image disturbance, and that self-disgust would mediate the relationship between body image disturbance and suicidal ideation. A total of N=728 participants completed The Body Image Disturbance Questionnaire, The Self-Disgust Scale, and the Suicidal Behaviours Questionnaire-Revised. Suicidality was significantly related to increased levels of self-disgust and body image disturbance, whereas self-disgust was associated with greater body image disturbance. Linear regression analysis showed that self-disgust was associated with suicidal thoughts and behaviours, over and above the effects of body image disturbance. Multiple mediation modelling further showed that self-disgust mediated the relationship between body image disturbance and suicidal thoughts and behaviours. Our findings highlight the role of self-disgust in the context of body image disturbance and support the notion that body image disturbance is associated with aversive self-conscious emotions. Interventions aiming to reduce the risk of suicidality in people with body image disturbance may address self-disgust and negative self-conscious emotions.

Feelings of fear, sadness, and loneliness during the COVID-19 pandemic: Findings from two studies in the UK.

During the COVID-19 pandemic, exposure to COVID-related stimuli, has been enormous. Exposure to threat-related stimuli, can have a significant impact on people's wellbeing particularly in relation to COVID-related anxiety. The present research comprises two empirical studies. In Study 1, a newly developed Emotional Stroop Task (EST) and an Image Rating Task (IRT) were used to assess, automatic and non-automatic affective responses to COVID-related words and images during the first wave of the pandemic in the UK general population. In Study 2, the same tasks were used to evaluate the affective responses of University students during the second wave of the pandemic. Additionally, loneliness and pro-social behaviours were explored in relation COVID-related anxiety in the same population. Overall, the results showed that automatic affective responses as measured by interference effects on the EST, remained unaffected during the pandemic. However, non-automatic affective responses to COVID-related images measured by the IRT, indicated that participants rated these images as more fearful sadder and higher in anger, compared to non-COVID negative images matched for arousal and negativity and this was more evident in people with high COVID-anxiety. Trait anxiety was related to higher levels of loneliness, more prosocial behaviour and higher intentions to help others, while COVID-related anxiety mediated these effects, suggesting that for high levels of trait anxiety, participants were more likely to have helped someone in need during the pandemic when their COVID-anxiety levels were low.

Self-Disgust Is Associated With Loneliness, Mental Health Difficulties, and Eye-Gaze Avoidance in War Veterans With PTSD.

In the present study, we examined, for the first time, the association between self-disgust, loneliness, and mental health difficulties in war veterans diagnosed with PTSD. For this purpose, we used a mixed methods design, incorporating surveys and a novel eye-tracking paradigm, and compared the findings from the PTSD veteran group (n = 19) to those from a general population group (n = 22). Our results showed that the PTSD veteran group reported almost three times higher scores in self-disgust, and significantly higher scores in loneliness and mental health difficulties (anxiety and depression), compared to the general population. Furthermore, self-disgust mediated the association between loneliness and anxiety symptoms in both groups. The results from the eye-tracking paradigm further showed that veterans with PTSD displayed a self-avoidance gaze pattern, by looking significantly more toward pictures of faces of unknown others and away from their own face-a pattern that was not replicated in the general population group. Higher self-disgust scores were significantly associated with longer total gaze to the pictures of others (vs. the self). Our findings have implications for the role of self-disgust in the mental health of war veterans.

Emotion dysregulation mediates the relationship between nightmares and psychotic experiences: results from a student population.

Sleep disruption is commonly associated with psychotic experiences. While sparse, the literature to date highlights nightmares and related distress as prominent risk factors for psychosis in students. We aimed to further explore the relationship between specific nightmare symptoms and psychotic experiences in university students while examining the mediating role of emotion dysregulation. A sample (N = 1273) of student respondents from UK universities completed measures of psychotic experiences, nightmare disorder symptomology and emotion dysregulation. Psychotic experiences were significantly more prevalent in students reporting nightmares (n = 757) relative to those who did not (n = 516). Hierarchical linear regression analysis showed that psychotic experiences were significantly associated (Adjusted R2 = 32.4%) with perceived nightmare intensity, consequences and resulting awakenings, and with emotion regulation difficulties. Furthermore, multiple mediation analysis showed that the association between psychotic experiences and nightmare factors was mediated by emotion regulation difficulties. Adaptive regulation of dream content during rapid eye-movement sleep has previously been demonstrated to attenuate surges in affective arousal by controlling the intensity and variability of emotional content. Difficulties in emotion regulation may partially explain the experience of more intense and disruptive nightmares among individuals with psychotic experiences. Emotion regulation may represent an important control mechanism that safeguards dream content and sleep quality.

Prevalence and psychiatric correlates of suicidal ideation in UK university students.

BACKGROUND: Evidence highlights increased susceptibility to thoughts and behaviors related to suicide (i.e. suicidal ideation) in the student population, often in co-occurrence with mental health difficulties. Typically, studies focus on specific symptoms, with few providing comprehensive examination of risk factors. In this study we examined the prevalence of suicidal ideation among UK university students and assessed the association with multiple psychiatric risk factors. METHODS: A total of N = 1273 students completed online measures of suicidal ideation, anxiety, depression, insomnia, mania, psychosis, and perceived stress. RESULTS: 37.3% students were classified as high-risk for suicidal behaviour. Moreover, 42.2% of students contemplated suicide at least once within the past twelve months, and 25.1% reported telling someone about these thoughts at least once. Logistic regression analysis showed that suicidal ideation was significantly associated with symptoms of depression, mania, psychosis, and stress. LIMITATIONS: The cross-sectional nature of ours study does not allow us to infer causality in the observed associations. CONCLUSIONS: Our results indicate the prevalence of suicidal ideation in a large sample of university students in the UK, and highlight associated mental health risk factors associated with it. Our findings have implications for mental health practitioners working with University students.

Individual Differences in Performance Speed Are Associated With a Positivity/Negativity Bias. An ERP and Behavioral Study.

There is a current dispute over the origins, incidence, and development of Positivity Bias, i.e., preferential processing of positive relative to negative information. We addressed this question using a multi-method technique of behavioral, psychometric and event-related potential (ERP) measures in a lexical decision task (LDT). Twenty-four university students (11 female) participated (age range 18-26), but four were omitted owing to data issues. Participants were classified as Positivity Biased (PB) if their LDT responses to positive words were faster than negative words, and vice versa for those classified as Negativity Biased (NB), leading to a group of 11 PB participants and a group of 9 NB participants. Interestingly, the PB group was significantly faster overall than the NB group and had significantly shorter P2 component ERP latencies in the left occipital region. Furthermore, the PB group had significantly higher scores for expressive suppression (ES), together with higher scores for Crystallized Knowledge and for cognitive reappraisal (CR). These results suggest that around 55% of the students had Positivity Bias, and these were more efficient in processing information and had better emotion regulation abilities than those with a Negativity Bias.

Self-disgust, loneliness and mental health outcomes in older adults: An eye-tracking study.

BACKGROUND: Self-disgust has been associated with loneliness and mental health difficulties in clinical and non-clinical populations, but there is limited research on the role of self-disgust in loneliness and mental health outcomes in older adults. METHODS: In Study 1 (N = 102; M age = 68.4 years, SD = 10.9, 68% females) we used a cross-sectional survey to explore the association between loneliness, self-disgust and mental health outcomes. In Study 2 (N = 80; M age = 68.8 years, SD = 11.4, 57% females) we used eye-tracking to investigate attentional vigilance, maintenance and avoidance in individuals with high (vs. low) self-disgust. RESULTS: In study 1 we found that self-disgust mediated the associations of loneliness with anxiety and depressive symptoms, and in study 2 it was demonstrated that older adults with high (vs. low) self-disgust displayed attentional avoidance to their own faces, compared to the faces of unknown others, a process that may perpetuate loneliness. LIMITATIONS: The cross-sectional design used in Study 1 limits our potential to make causal inferences. Additionally, both studies included a wide age range of older adults. CONCLUSIONS: Our findings are novel and highlight the importance of self-disgust experiences in the context of loneliness and mental health outcomes in older adults. Implications for practice and interventions against loneliness in this age group are discussed.

A survey on the training needs of caregivers in five European countries.

AIM: This survey explored caregivers' perceived training needs in 5 European countries (United Kingdom, Greece, Bulgaria, Poland and Italy). BACKGROUND: Training can enhance the professional capacity of caregivers; however, caregivers' training needs within Europe have not been examined recently. METHODS: A survey conducted in 2015 captured data from 550 caregivers using a convenience sampling strategy, through a structured questionnaire and additional open-ended items and by conducting statistical and content analysis. RESULTS: The results indicated basic nursing skills and specialization, as well as training in psychology-related skills like time management, emotion regulation, communication and advanced health care systems as the emerging training needs. There were some country differences in specific training need areas. CONCLUSIONS: It was concluded that training in basic nursing skills and specialization in nursing specific conditions, in advanced health care systems and in psychology-related skills could add to the professional capacity of European caregivers employed in health and social care. IMPLICATIONS FOR NURSING MANAGEMENT: The findings inform about employed caregivers' training needs in Europe, which may contribute in the provision of quality care and organisational efficiency in health and social care.

Impulsive and Self-Regulatory Processes in Risky Driving Among Young People: A Dual Process Model.

The present study empirically examined a novel dual process model of self-reported aberrant driving behavior in young and novice drivers that incorporates both impulsive and self-regulatory processes. Four hundred and nine participants aged 18-25 years (M age = 21.18 years, SD = 2.12; 65.5% females) completed online questionnaires on impulsivity, normlessness, sensation seeking, emotion and self-regulation, and attitudes toward driving safety. Path analysis showed that motor impulsivity was associated with self-reported driving violations, errors, and lapses, whereas sensation seeking was uniquely directly associated with self-reported errors. Non-planning impulsivity, normlessness and sensation seeking had significant indirect effects on self-reported errors, via self-regulation. Finally, motor impulsivity and normlessness had a significant indirect effect on self-reported violations, errors and lapses, via attitudes to driving safety. Based on our findings we suggest that a dual-process approach is relevant to the study of aberrant driving behavior in young and novice drivers, and the results of the present study have important implications for initiatives to promote driving safety in this population.

Self-disgust as a potential mechanism explaining the association between loneliness and depression.

BACKGROUND: Loneliness and self-disgust have been considered as independent predictors of depressive symptoms. In the present study, we hypothesized that self-disgust can explain the association between loneliness and depression, and that emotion regulation strategies interact with self-disgust in predicting depressive symptoms. METHODS: Three hundred and seventeen participants (M = 29.29 years, SD = 14.11; 76.9% females) completed structured anonymous self-reported measures of loneliness, self-disgust, emotion regulation strategies, and depressive symptoms. RESULTS: One-way MANOVA showed that participants in the high-loneliness group reported significantly higher behavioural and physical self-disgust, compared to those in the middle and low-loneliness groups. Bootstrapped hierarchical linear regression analysis showed that self-disgust significantly improved predicted variance in depressive symptoms, after controlling for the effects of loneliness. Regression-based mediation modelling showed that both physical and behavioural self-disgust significantly mediated the association between loneliness and depression. Finally, moderated regression analysis showed that expressive suppression interacted with self-disgust in predicting depressive symptoms. LIMITATIONS: A cross-sectional design was used, and our study focused on expressive suppression and cognitive reappraisal but not on other aspects of emotion regulation or the modulation of emotional arousal and responses. CONCLUSIONS: We demonstrated, for the first time, that self-disgust plays an important role in the association between loneliness and depressive symptoms. Furthermore, variations in emotion regulation strategies can explain the association between self-disgust and depressive symptoms.

Enhancement of Visuospatial Working Memory by the Differential Outcomes Procedure in Mild Cognitive Impairment and Alzheimer's Disease.

In the present study we investigated the efficacy of the differential outcomes procedure (DOP) to improve visuospatial working memory in patients with Alzheimer's disease and mild cognitive impairment (MCI). The DOP associates correct responses to the to-be-remember stimulus with unique outcomes. Eleven patients diagnosed with Alzheimer's disease, 11 participants with MCI, and 17 healthy matched controls performed a spatial delayed memory task under the DOP and a control condition (non-differential outcomes -NOP-). We found that performance (terminal accuracy) was significantly better in the DOP condition relative to the NOP condition in all three groups of participants. AD patients performed worse, and took longer to benefit from the DOP. In line with previous animal and human research, we propose that the DOP activates brain structures and cognitive mechanisms that are less affected by healthy and pathological aging, optimizing in this way the function of the cognitive system.

The therapeutic potential of attentional bias modification training for insomnia: study protocol for a randomised controlled trial.

BACKGROUND: The efficacy of attentional bias modification (ABM) as a treatment for anxiety and depression has been extensively studied with promising results. Despite some evidence of sleep-related attentional biases in insomnia, only a small number of studies, yielding mixed results, have examined the application of ABM in insomnia. This study specifically aims to determine whether ABM can reduce (i) the presence of an attentional bias for sleep-related threatening words; (ii) insomnia symptom severity; (iii) sleep onset latency; and (iv) pre-sleep cognitive arousal amongst individuals with insomnia compared to a non-treatment control group of individuals with insomnia. METHODS/DESIGN: We propose a randomised controlled trial of 90 individuals from the general population who meet the criteria for Insomnia Disorder. Following an initial examination for the presence of a sleep-related attentional bias using the dot-probe paradigm, participants will be randomised to an online attentional bias modification training condition, or to a standard attentional bias task (non-treatment) control condition. Both conditions will be delivered online by a web platform. All participants allocated to the non-treatment control group will be offered ABM training once the study is complete. The primary outcome will be the attentional bias indices of vigilance and disengagement and self-reported insomnia symptoms, sleep onset latency and pre-sleep cognitive arousal. Attentional bias and insomnia symptoms will be assessed at baseline (day 1) and post-treatment (2 days after the final training session: day 9). Insomnia symptoms will be again assessed at follow-up (day 16). Secondary outcomes include examining whether sleep associated monitoring and worry are related to a sleep-related attentional bias in insomnia, and whether such reports reduce following ABM. All main analyses will be carried out on completion of follow-up assessments. The trial is supported by the Department of Psychology, Sociology and Politics at Sheffield Hallam University. DISCUSSION: This study will extend the research base examining the efficacy of attentional bias modification for insomnia. TRIAL REGISTRATION: ISRCTN ( ISRCTN11643569 , registered on 5 June 2018).

Anxiety and depression mediate the relationship between self-disgust and insomnia disorder.

OBJECTIVES: There is limited research on the association between insomnia and negative self-conscious emotions. This study assessed if individuals with insomnia reported higher scores in self-disgust than normal sleepers and if the association between insomnia and self-disgust was mediated by depression and anxiety. METHODS: Twenty-seven individuals with Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, insomnia disorder and 30 normal sleepers completed self-reported measures of self-disgust, anxiety, and depression. RESULTS: Individuals with insomnia reported significantly higher scores in self-disgust, anxiety, and depression than normal sleepers. Insomnia significantly predicted self-disgust, but this association was explained by higher scores in anxiety and depression among people with insomnia. CONCLUSIONS: This is the first study that demonstrated the association between clinically-diagnosed insomnia in young adults and self-disgust, and highlighted the mediating effects of anxiety and depression.

Sleep-Related Attentional Bias for Faces Depicting Tiredness in Insomnia: Evidence From an Eye-Tracking Study.

STUDY OBJECTIVES: To date, evidence of an attentional bias in insomnia has mostly been obtained through reaction time tasks, with a limited number of studies using eye tracking. Here, using an eye-tracking paradigm, this study sought to determine whether individuals with insomnia display an attentional bias for novel faces depicting tiredness. METHODS: Individuals with insomnia (n = 20) and normal sleepers (n = 20) viewed a series of face pairs depicting neutral and tired expressions each for periods of 4000 milliseconds. Eye movements were recorded using eye tracking, and first fixation onset, first fixation duration, total fixation duration, and total gaze duration were examined for three interest regions (eyes, nose, mouth). RESULTS: Significant group × face interactions for total fixation duration and total gaze duration indicated that, regardless of interest-region, participants with insomnia spent more time fixating on and observing tired faces relative to neutral faces when compared with normal sleepers. Additionally, significant group × face × interest-region interactions for total fixation duration and total gaze duration indicated that participants with insomnia spent more time observing the eye region of the tired faces than the eye region of the neutral faces when compared with normal sleepers. CONCLUSIONS: Individuals with insomnia display an attentional bias toward tired faces, more specifically for the eye region compared to normal sleepers. These findings contribute to our understanding of face perception in insomnia and provide more objective support for cognitive models of insomnia, suggesting that individuals with insomnia selectively attend to faces for tiredness cues.

Sleep-related attentional bias for tired faces in insomnia: Evidence from a dot-probe paradigm.

People with insomnia often display an attentional bias for sleep-specific stimuli. However, prior studies have mostly utilized sleep-related words and images, and research is yet to examine whether people with insomnia display an attentional bias for sleep-specific (i.e. tired appearing) facial stimuli. This study aimed to examine whether individuals with insomnia present an attentional bias for sleep-specific faces depicting tiredness compared to normal-sleepers. Additionally, we aimed to determine whether the presence of an attentional bias was characterized by vigilance or disengagement. Forty-one individuals who meet the DSM-5 criteria for Insomnia Disorder and 41 normal-sleepers completed a dot-probe task comprising of neutral and sleep-specific tired faces. The results demonstrated that vigilance and disengagement scores differed significantly between the insomnia and normal-sleeper groups. Specifically, individuals with insomnia displayed difficulty in both orienting to and disengaging attention from tired faces compared to normal-sleepers. Using tired facial stimuli, the current study provides novel evidence that insomnia is characterized by a sleep-related attentional bias. These outcomes support cognitive models of insomnia by suggesting that individuals with insomnia monitor tiredness in their social environment.

Pharmaceutical Cognitive Enhancement in Greek University Students: Differences Between Users and Non-Users in Social Cognitive Variables, Burnout, and Engagement.

Pharmaceutical cognitive enhancement (PCE) represents the non-medical use of prescribed medication for the improvement of cognitive functioning and academic performance. Although there are some studies about PCE prevalence, it is less clear how users and non-users of PCE substances differ with respect to their positive and negative student experiences (e.g. academic burnout and engagement with studies) and in social cognitive variables that relate to decision-making and self-regulation of PCE use. The present study assessed whether students with different experiences of PCE substance use displayed differences in academic burnout, study engagement, and social cognitive variables relevant to PCE use. Three hundred and forty-seven university students (mean age (M) = 22.15 years, SD = 1.69; 54% females) completed a battery of anonymous questionnaires on academic burnout, engagement with studies, social cognitive variables relevant to PCE use, and self-reported use of PCE substances and non-prescribed nutritional supplements. Three user groups emerged, namely non-users (51.9%, n = 180), single users of non-prescribed dietary supplements (25.4%, n = 88), and dual users of both non-prescribed dietary supplements and PCE (22.8%, n = 79). Multivariate analysis of variance indicated significant differences among the three user groups in intentions, attitudes, social norms, and anticipated regret toward PCE use. No significant differences were observed with respect to academic burnout and work engagement. The findings show that university students may engage in PCE use independent of their student experiences. Rather, a chemically assisted performance enhancement mindset seems to differentiate users from non-users of PCE substances.

Lateralized effects of hand and eye on anticipatory postural adjustments in visually guided aiming movements.

This study investigated hemisphere-specific processing of visually aimed movements and associated postural adjustments while controlling for handedness and eyedness. Eleven right-handed, right-eyed and right-footed healthy adult volunteers performed, from a standing position, an aiming task under two hand (right and left hand) and three visual conditions (binocular vision, right and left eye monocular vision). Centre of pressure (CoP) displacement, hand kinematics and the target's position were synchronously recorded during performance of the aiming task. Analysis revealed a lower RMS error, a later postural adjustment onset and a smaller centre of pressure dispersion when aiming was performed with the dominant right compared to the non-dominant left hand. On the other hand, no differences on either aiming performance or postural adjustments were noted under the three visual conditions. These results suggest a strong handedness and absence of an eyedness effect on the accuracy of aiming and associated postural adjustments.