A systematic review of the effects of gut microbiota depletion on social and anxiety-related behaviours in adult rodents: Implications for translational research.

The microbiota-gut-brain axis is associated with several behaviours, including those relevant to anxiety or sociability in rodents, however, no conceptual framework has yet been available. Summary of the effects of antibiotic-mediated gut microbiota depletion on anxiety and sociability is essential to both inform further preclinical investigations and to guide translational research into human studies. The main objective is to examine the role of gut microbiota depletion on anxiety and sociability in rodents, and to consider how the findings can be translated to inform the design of research in humans. We reviewed 13 research articles, indicating significant changes in gut microbiota composition and diversity have been found in animals treated with a mix or a single antibiotic. Nonetheless, there is no consensus regarding the impact of gut microbiota depletion on anxiety-like or social behaviour. Gut microbiota depletion may be a useful strategy to examine the role of gut microbes in anxiety and sociability, but the lack of data from rigorous animal investigations precludes any definitive interpretations for a translational impact on human health.

Evaluation and update of the expert consensus guidelines for the assessment of the cortisol awakening response (CAR).

The cortisol awakening response (CAR) is frequently assessed in psychobiological (stress) research. Obtaining reliable CAR data, however, requires careful attention to methodological detail. To promote best practice, expert consensus guidelines on the assessment of the CAR were published (Stalder et al., 2016, PNEC). However, it is unclear whether these highly cited guidelines have resulted in actual methodological improvements. To explore this, the PNEC editorial board invited the present authors to conduct a critical evaluation and update of current CAR methodology, which is reported here. (i) A quantitative evaluation of methodological quality of CAR research published in PNEC before and after the guidelines (2013-2015 vs. 2018-2020) was conducted. Disappointingly, results reveal little improvement in the implementation of central recommendations (especially objective time verification) in recent research. (ii) To enable an update of guidelines, evidence on recent developments in CAR assessment is reviewed, which mostly confirms the accuracy of the majority of the original guidelines. Moreover, recent technological advances, particularly regarding methods for the verification of awakening and sampling times, have emerged and may help to reduce costs in future research. (iii) To aid researchers and increase accessibility, an updated and streamlined version of the CAR consensus guidelines is presented. (iv) Finally, the response of the PNEC editorial board to the present results is described: potential authors of future CAR research to be published in PNEC will be required to submit a methodological checklist (based on the current guidelines) alongside their article. This will increase transparency and enable reviewers to readily assess the quality of the respective CAR data. Combined, it is hoped that these steps will assist researchers and reviewers in assuring higher quality CAR assessments in future research, thus yielding more reliable and reproducible results and helping to further advance this field of study.

Advancing qualitative rare disease research methodology: a comparison of virtual and in-person focus group formats.

BACKGROUND: Rare disease research is hampered in part by the fact that patients are geographically dispersed. Rare disease patient communities are recognized for their use of the internet to learn about their condition and find peer-to-peer support. As such, web-based technologies offer promise for overcoming geographic barriers in rare disease research for many. Qualitative focus groups (FGs) are a widely used methodology used to understand patients and parents/families 'lived experience' and unmet needs is important to improve care for rare diseases. It is unclear if web-enabled (virtual) FGs are comparable to traditional in-person approaches. We conducted in-person (n = 3) and virtual (n = 3) FGs with rare disease patients to determine if virtual FGs produce similar results in-person FGs. RESULTS: Three in-person (n = 33 participants) and three virtual (n = 25 participants) FGs were conducted examining attitudes and beliefs regarding genetic testing and family communication of risk. Participants included 30 males, 18 females, and 10 parents/guardians. Two independent investigators identified excerpts (meaningful sections of text) and coded themes/sub-themes using a codebook. Inter-coder agreement across identified excerpts (n = 530) in both FG formats was 844/875 (96.5%). Two additional investigators reviewed coded excerpts and did not identify additional themes/sub-themes-supporting data saturation across FG formats. Virtual FGs accounted for 303/530 (57.2%) of total excerpts and 957/1721 (55.7%) of all identified themes/sub-themes. Formats were similar in terms of overall number of excerpts (101 ± 7.8 vs. 75.7 ± 18.8, p = 0.26) and themes/sub-themes (319 ± 6.1 vs. 254.7 ± 103.6, p = 0.34) between virtual and in-person FGs. However, virtual FGs had significantly more coded excerpts specifically relating to sensitive/intimate topics including 'attitudes and beliefs' (n = 320 vs. n = 235, p < 0.001), 'information and support' (n = 184 vs. n = 99, p < 0.001), and 'family communication' (n = 208 vs. n = 114, p < 0.001). CONCLUSIONS: Virtual FGs yielded similar numbers of coded excerpts compared to traditional in-person FGs. Virtual FGs appear to support the relative anonymity of participants, resulting in richer discussion of highly sensitive, intimate topics. Findings support the validity and methodologic rigor of using web-enabled technologies for conducting FGs in rare diseases.

Exploring Rare Disease Patient Attitudes and Beliefs regarding Genetic Testing: Implications for Person-Centered Care.

Most rare diseases are genetic in etiology and characterized by a 'diagnostic odyssey'. Genomic advances have helped speed up the diagnosis for many rare disorders, opening new avenues for precision therapies. Little is known about patient attitudes, experiences, and beliefs about genetic testing for the rare disease congenital hypogonadotropic hypogonadism (CHH). METHODS: We conducted six focus groups with patients with CHH (n = 58). Transcripts were coded by independent investigators and validated by external reviewers. RESULTS: Major themes relating to pre-test experiences were 'attitudes & beliefs' (most frequently cited theme), which revealed altruism as a strong motivator for pursuing research testing and 'information and support,' which revealed a striking lack of pre-testing decisional support/genetic counseling. Major post-test themes included 'return of results,' revealing frustration with the lack of return of results and limited emotional support, and 'family communication,' describing challenging intrafamilial communication. Themes describing ethical concerns (i.e., privacy, use of samples) were least frequently noted and related to pre- and post-test experiences. CONCLUSIONS: Patients with CHH are highly motivated by altruism when pursuing testing but have significant unmet needs for pre-test decisional support and post-test counseling. It is regarded that patient values, beliefs and experiences can inform more person-centered approaches to genetic testing for rare diseases.

Regulatory focus and perceptions of ageing: exploring the connections.

Objectives:Perceptions of ageing can become a self-fulfilling prophecy for older adults, with those who hold more negative views of ageing experiencing more negative consequences of the ageing process, including poorer health and cognitive declines. Exposure to negative stereotypes about their group can also affect older adults performance in cognitive tests, as they are more likely to adopt a prevention focus to avoid mistakes, therefore, performing poorly in tasks requiring them to adopt a gains-oriented focus. Based on regulatory focus theory, we hypothesised that negative perceptions of ageing and stereotype threat may be connected, specifically we hypothesised that those with more negative perceptions of ageing would also have a stronger trait prevention focus.Method: Two hundred adults aged 60+ took part in an online questionnaire examining their perceptions of ageing and their trait regulatory focus.Results and Conclusion: Results indicated that negative perceptions of ageing were predictive of a stronger trait prevention focus in a hierarchical multiple regression model. This provides evidence that older adults with more negative perceptions of ageing may adopt a stronger prevention focus, potentially influencing psychological attitudes to everyday tasks and behaviours. Perceptions of ageing and regulatory focus can have implications for the efficacy of health messaging for older adults.

Evaluating measures of allostatic load in adolescents: A systematic review.

BACKGROUND: Adolescents can experience heightened stress due to biopsychosocial changes that occur during this developmental stage. The 'wear and tear' of the physiological systems responsible for managing our stress response can lead to dysregulation of these systems, known as allostatic load (AL). AL is commonly measured within adult populations, however, inconsistencies exist across measures used to quantify the effects of stress on health. The aim of this review was to identify variations in measures across AL studies, and to consider how specific measures may be more appropriate for use within adolescent populations. METHOD: Pubmed, PsycINFO, PsycARTICLES, Academic Search Complete, were searched in July 2020, using search terms 'allostatic load' and 'adolescence'. AL studies (1988-2020) with an adolescent population (age 10-24 years) were included. 354 records were screened by two reviewers and 41 full-text articles were assessed for eligibility. RESULTS: 25 studies were included in final synthesis. Biomarkers of AL ranged from 1 to 14. The most common index of AL consisted of 6 biomarkers; cortisol, epinephrine, norepinephrine, systolic blood pressure, diastolic blood pressure, and body-mass index. FINDINGS: Defining measures of AL during adolescence may help to identify vulnerabilities specific to adolescents, which may shape their lifelong health trajectories.

Reducing drug-use harms among higher education students: MyUSE contextual-behaviour change digital intervention development using the Behaviour Change Wheel.

BACKGROUND: Digital harm-reduction interventions typically focus on people with severe drug-use problems, yet these interventions have moderate effectiveness on drug-users with lower levels of risk of harm. The difference in effectiveness may be explained by differences in behavioural patterns between the two groupings. Harnessing behavioural theories to understand what is at the core of drug-use behaviours and mapping the content of new interventions, may improve upon the effectiveness of interventions for lower-risk drug-users. To the best of our knowledge, this is the first study to systematically apply the Behaviour Change Wheel (BCW) approach to understand the components, influencing capabilities, opportunities, and motivations (COM-B) of higher education students to change their drug-use behaviors. It is also the first study which identifies specific patterns of behaviours that are more responsive to harm reduction practices through the use of the Theoretical Domain Framework (TDF). METHODS: We employed an explanatory sequential mix-method design. We first conducted an on-line survey and a Delphi exercise to understand the factors influencing COM-B components of higher education students to change their drug-use. Subsequently, we mapped all evidence onto the COM-B components and the TDF domains to identify clusters of behaviours to target for change, using a pattern-based discourse analysis. Finally, a series of multidisciplinary group meetings identified the intervention functions-the means by which the intervention change targeted behaviours and the Behavioural Change Techniques (BCTs) involved using the behaviour change technique taxonomy (v.1). RESULTS: Twenty-nine BCTs relevant to harm-reduction practices were identified and mapped across five intervention functions (education, modelling, persuasion, incentivization, and training) and five policy categories (communication/marketing, guidelines, regulation, service provision, and environmental/social planning). These BCTs were distributed across eight identified saturated clusters of behaviours MyUSE intervention attempts to change. CONCLUSIONS: The BCTs, identified, will inform the development of a digitally delivered behaviour change intervention that focuses on increasing mindful decision-making with respect to drug-use and promotes alternatives to drug-use activities. The findings can also inform implementation scientists in applying context-specific harm-reduction practices in higher education. We present examples of how the eight identified clusters of target behaviours are mapped across the COM-B components and the TDF, along with suggestions of implementation practices for harm reduction at student population level.

Developing an open educational resource for open research: Protocol for the PaPOR TRAIL project.

Background: Open research involves actions at all stages of the research cycle to make the research process and outputs more transparent and accessible. Though a number of initiatives exist for researchers at PhD, post-doctoral and more senior levels, there remains a critical need for educational resources for research students at earlier career stages and across disciplines. The aim of the Principles and Practices of Open Research: Teaching, Research, Impact, and Learning (PaPOR TRaIL) project is to develop an open educational resource (OER) on the principles and practice of open research for undergraduate and master's students. Methods: In stage 1, interviews and surveys of students and supervisors are being conducted to explore students' and supervisors' knowledge, attitudes, and experiences of open research, in addition to needs and preferences for the content and delivery of the OER. Stage 2 involves development of the OER content and delivery, based on Stage 1 engagement and national and international guidance on best practice in conducting and teaching open research. In Stage 3, students and supervisors will evaluate the developed OER and provide feedback in terms of OER usability, learning experience and learning outcomes. This feedback will guide revisions and finalisation of the OER content, format and learning activities. Discussion: The PaPOR TRaIL project will develop an evidence-based OER that provides a foundation in all aspects of open research theory & practice. Teaching undergraduate and master's students open research will promote development of core research values and equip them with transferable competencies and skills, including how to conduct and use research in a trustworthy and ethical manner within and beyond academia. Enhancing teaching and learning of open research will promote better teaching and research outcomes that will benefit individuals, universities, and science more broadly.

A Digital Substance-Use Harm Reduction Intervention for Students in Higher Education (MyUSE): Protocol for Project Development.

BACKGROUND: Digital interventions have been identified as a possible tool for reducing the harm caused by illicit drug use among students attending higher education (ie, college students). However, the success of interventions in this area has been hampered by a lack of user involvement and behavior change theory in their design. The My Understanding of Substance use Experiences (MyUSE) project combines a rigorous user-centered design (UCD) methodology and a robust behavioral change framework to develop a digitally delivered harm reduction intervention for illicit drug use among students in higher education. OBJECTIVE: This project aims to design and develop a digital intervention that targets drug use-related harm among students in higher education. METHODS: The MyUSE project will take place over 3 phases. The first phase was exploratory in nature, involving 3 systematic reviews, a large survey, and student workshops to gather a comprehensive evidence base to guide the project. The second phase is the development stage of the project, involving the use of the Behavior Change Wheel theoretical framework to determine the behavior change techniques of the intervention and the use of the UCD methodology to guide the development of the digital intervention. The third phase is the evaluation stage, whereby the intervention will undergo a 5-stage evaluation process to comprehensively evaluate its impacts. RESULTS: The exploratory phase 1 of the MyUSE project was completed in December 2018. Phase 2 is currently underway, and phase 3 is due to begin in September 2020. CONCLUSIONS: Higher education institutions (HEIs) are ideally placed to intervene and support students in the area of illicit drug use but are constrained by limited resources. Current digital interventions in this area are sparse and have several weaknesses. The MyUSE project combines a UCD approach with a robust behavior change framework to develop a digitally delivered intervention that is economically viable, effective in changing behavior, usable and acceptable to students, and able to sustain long-term implementation in HEIs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/17829.

Theory in practice: identifying theory-based techniques in health coaches' tailored feedback during a weight loss intervention.

Objective: A taxonomy of ninety-three functionally different behaviour change techniques (BCTs) has been identified. However, it is not fully clear how these and other theory-based techniques are applied in the day-to-day practice of people delivering health behaviour change interventions. This study examines feedback provided by expert health coaches in a behavioural weight-loss intervention, to describe; a) what theory-based techniques are used in sessions, b) which techniques are used most frequently, c) what occurs in sessions, beyond existing theory-based techniques. Main Outcome Measures: Theory-based techniques (BCTs/tailoring strategies); relational/content-based techniques. Design: 10 tailored feedback videos from two health coaches were coded using a hybrid thematic analysis approach. Theory-based techniques were coded deductively; content not matching definitions of theory-based techniques but that addressed a determinant of behaviour change were coded inductively and relational codes were connected into themes. Results: Seventeen BCTs were coded M = 20.88 times (range:1-109). Eight tailoring techniques were coded M = 25.25 times (range:1-91). Relational themes included; 'Autonomous interpersonal coaching style,' 'Supportive accountability,' and 'Coach as expert'. Additional behavioural techniques were also identified. Conclusion: This work highlights what and how theory-based techniques are implemented in a weight-loss intervention, drawing attention to the role of tailoring techniques and health coaches in supporting behaviour change.

The Consideration of Future Consequences: Evidence for Domain Specificity Across Five Life Domains.

The consideration of future consequences (CFC) is a cognitive-motivational construct describing the extent to which individuals consider the future outcomes of behavior during decision-making. The current research examined the extent to which CFC may be a domain-specific, as opposed to global, temporal construct. Across three surveys, adults (n = 498; 66.9% female; 41.2% students) completed the 14-item general CFC scale, five newly adapted domain-specific CFC scales, and self-report measures of behavior in five substantive domains (work, health, the environment, money, and college). Confirmatory factor analyses replicated the two-factor model in the CFC-14, supporting the distinction between CFC-Future and CFC-Immediate in domain-specific CFC-14 scales. Hierarchical regression analyses indicated that domain-specific, and not the general, CFC subscales were most strongly associated with the relevant domain-specific behavior and revealed differential patterns of association between domain-specific CFC subscales and behaviors in particular domains. The applied implications for behavioral interventions are discussed.

Measuring the Psychobiological Correlates of Daily Experience in Adolescents.

Mapping the psychobiological correlates of social contexts, experiences, and emotional responses of adolescents in their daily lives provides insight into how adolescent well-being shapes, and is shaped by, experience. Measures of these psychobiological correlates are enabled by devices and technologies that must be precise and suitable for adolescent participants. The present report reviews the most often used research measures, and suggests strategies for best practice, drawn from practical experience. The rapid advances in technological methods to collect attuned measures of psychological processes, social context, and biological function indicate the promise for multimodal measures in ecological settings. Attaining these methodological goals will support research to secure comprehensive, quality data, and advance the understanding of psychobiological function in ambulatory settings.

A systematic review of the effectiveness of digital interventions for illicit substance misuse harm reduction in third-level students.

BACKGROUND: Illicit substance misuse is a growing public health problem, with misuse peaking among 18-25 year-olds, and attendance at third-level education identified as a risk factor. Illicit substance misuse has the potential to harm mental and physical health, social relationships, and impact on academic achievements and future career prospects. Digital interventions have been identified as a vehicle for reaching large student populations and circumventing the limited capacity of student health services for delivering face-to-face interventions. Digital interventions have been developed in the area of alcohol and tobacco harm reduction, reporting some effectiveness, but the evidence for the effectiveness of digital interventions targeting illicit substance misuse is lacking. This review aims to systematically identify and critically appraise studies examining the effectiveness of digital interventions for illicit substance misuse harm reduction in third-level students. METHODS: We systematically searched ten databases in April 2018 using keywords and database specific terms under the pillars of "mHealth," "substance misuse," and "student." To be eligible for inclusion, papers had to present a measure of illicit substance misuse harm reduction. Included articles were critically appraised and included in the qualitative synthesis regardless of quality. RESULTS: A total of eight studies were included in the qualitative synthesis. Studies reported harm reduction in terms of substance misuse or initiation, as consequences or problems associated with substance misuse, or as correction of perceived social norms. Overall, five out of the eight studies reported at least one positive outcome for harm reduction. The critical appraisal indicated that the study quality was generally weak, predominantly due to a lack of blinding of study participants, and the use of self-reported substance misuse measures. However, results suggest that digital interventions may produce a modest reduction in harm from illicit substance misuse. CONCLUSIONS: The results of this review are positive, and support the need for further high-quality research in this area, particularly given the success of digital interventions for alcohol and tobacco harm reduction. However, very few studies focused solely on illicit substances, and those that did targeted only marijuana. This suggests the need for further research on the effectiveness of this type of intervention for other illicit substances. TRIAL REGISTRATION: This review is registered on PROSPERO, ID number: CRD42018097203 .

Puberty and the Evolution of Developmental Science.

In recent decades, theoretical and methodological advances have operated synergistically to advance understanding of puberty and prompt increasingly comprehensive models that engage with the temporal, psychosocial, and biological dimensions of this maturational milepost. This integrative overview discusses these theoretical and methodological advances and their implications for research and intervention to promote human development in the context of changing maturational schedules and massive ongoing social transformations.

Interdisciplinary Work Is Essential for Research on Puberty: Complexity and Dynamism in Action.

Puberty is associated with changes in behavior and psychosocial well-being, and is important in lifelong health. We present five different facets regarding interdisciplinary research that are important to puberty. A short history of philosophical issues instrumental in promoting early interdisciplinary research is first presented. We discuss then what is hard and what is easy about interdisciplinary research, the purpose of which is to alert scientists to challenges and opportunities for interdisciplinary research on puberty. Readers then are introduced to advances and obstacles in interdisciplinary research on development. Recommendations for tailoring graduate education toward interdisciplinarity are introduced. Finally, issues related to publication, education of scientists, and policy makers are described. The report concludes with a discussion of funding and policy issues.

A systematic review of tailored eHealth interventions for weight loss.

OBJECTIVE: The aim of this study is to review the evidence for tailored eHealth weight-loss interventions, describing in detail: 1. how tailoring was implemented in these studies and 2. whether these tailored approaches were effective in producing weight loss compared with generic or inactive controls. METHODS: A systematic review was carried out. Five databases were searched up until 15 March, 2018, including: EBSCO, Science Direct, Pubmed, EMBASE and Web of Science, using combinations of the concepts 'tailoring', 'eHealth' and 'overweight'. RESULTS: Eight articles relating to six interventions were accepted. Tailoring was carried out in a number of ways, based on, for example, anthropometric data, health-related behaviours (e.g. dietary intake, physical activity), goals (e.g. weight goal), theoretical determinants (e.g. confidence/willingness to change behaviours), psychosocial factors (e.g. social support) and participant location. Systems acquired data using strategies that ranged from online questionnaire administration, to the dynamic gathering of data from web-based diaries, websites, mobile applications and SMS messaging. Tailored interventions were more effective in supporting weight loss than generic or waitlist controls in four of the six articles. Effect sizes were very small to moderate, with evidence for fluctuations in effect sizes and differences of effect between tailoring and non-tailoring interventions, and between tailoring types, over time. CONCLUSIONS: We contribute an enhanced understanding of the variety of methods used for the tailoring of eHealth interventions for weight loss and propose a model for categorising tailoring approaches.

The consideration of future consequences and health behaviour: a meta-analysis.

The aim of this meta-analysis was to quantify the direction and strength of associations between the Consideration of Future Consequences (CFC) scale and intended and actual engagement in three categories of health-related behaviour: health risk, health promotive, and illness preventative/detective behaviour. A systematic literature search was conducted to identify studies that measured CFC and health behaviour. In total, 64 effect sizes were extracted from 53 independent samples. Effect sizes were synthesised using a random-effects model. Aggregate effect sizes for all behaviour categories were significant, albeit small in magnitude. There were no significant moderating effects of the length of CFC scale (long vs. short), population type (college students vs. non-college students), mean age, or sex proportion of study samples. CFC reliability and study quality score significantly moderated the overall association between CFC and health risk behaviour only. The magnitude of effect sizes is comparable to associations between health behaviour and other individual difference variables, such as the Big Five personality traits. The findings indicate that CFC is an important construct to consider in research on engagement in health risk behaviour in particular. Future research is needed to examine the optimal approach by which to apply the findings to behavioural interventions.

The Trier Social Stress Test: Principles and practice.

Researchers interested in the neurobiology of the acute stress response in humans require a valid and reliable acute stressor that can be used under experimental conditions. The Trier Social Stress Test (TSST) provides such a testing platform. It induces stress by requiring participants to make an interview-style presentation, followed by a surprise mental arithmetic test, in front of an interview panel who do not provide feedback or encouragement. In this review, we outline the methodology of the TSST, and discuss key findings under conditions of health and stress-related disorder. The TSST has unveiled differences in males and females, as well as different age groups, in their neurobiological response to acute stress. The TSST has also deepened our understanding of how genotype may moderate the cognitive neurobiology of acute stress, and exciting new inroads have been made in understanding epigenetic contributions to the biological regulation of the acute stress response using the TSST. A number of innovative adaptations have been developed which allow for the TSST to be used in group settings, with children, in combination with brain imaging, and with virtual committees. Future applications may incorporate the emerging links between the gut microbiome and the stress response. Future research should also maximise use of behavioural data generated by the TSST. Alternative acute stress paradigms may have utility over the TSST in certain situations, such as those that require repeat testing. Nonetheless, we expect that the TSST remains the gold standard for examining the cognitive neurobiology of acute stress in humans.

Effects of a novel positive psychological intervention on prenatal stress and well-being: A pilot randomised controlled trial.

PROBLEM: Low prenatal well-being has adverse outcomes for mother and infant but few interventions currently exist to promote and maintain prenatal well-being. BACKGROUND: Mindfulness and gratitude based interventions consistently demonstrate benefits in diverse populations. Interventions integrating these constructs have potential to improve psychological and physiological health during pregnancy. AIM: The aim of this pilot study is to examine the effect of a novel gratitude and mindfulness based intervention on prenatal stress, cortisol levels, and well-being. METHODS: A pilot randomised controlled trial was conducted with 46 pregnant women. Participants used an online mindfulness and gratitude intervention 4 times a week for 3 weeks. Measures of prenatal stress, salivary cortisol, gratitude, mindfulness, and satisfaction with life were completed at baseline, 1.5 weeks later, and 3 weeks later. FINDINGS: Intervention participants demonstrated significant reductions in prenatal stress in comparison to the control condition (p=.04). Within subjects reductions in waking (p=.004) and evening cortisol (p>.001) measures were observed for intervention participants. Significant effects were not observed for other well-being outcomes. DISCUSSION: Reducing self-report and physiological stress in pregnancy can improve maternal and infant outcomes. The findings of this pilot study indicate potential direct effects of the intervention on self-reported stress in comparison to a treatment-as-usual control. Effects on a biomarker of stress, cortisol, were also observed within the intervention group. CONCLUSION: A brief mindfulness and gratitude based intervention has the potential to reduce stress in pregnancy. Future research is needed to further explore mechanisms and potential benefits of such interventions.

Positive prenatal well-being: conceptualising and measuring mindfulness and gratitude in pregnancy.

Little research has examined the usefulness of positive well-being factors during pregnancy. Recent mindfulness research demonstrates that inconsistencies and the suitability of extant measures have yet to be examined in pregnancy. Effects of gratitude during pregnancy have yet to be examined despite consistently reported benefits in non-pregnant groups. The aims of this paper were to develop the Gratitude during Pregnancy (GDP) scale, validate the Mindfulness Awareness Attention Scale (MAAS) and examine the importance of gratitude and mindfulness during pregnancy. In study 1, 375 pregnant women completed gratitude and mindfulness measures. The one-factor structure of the MAAS was retained and demonstrated good reliability α = 0.88. Using exploratory factor analysis, an 18-item GDP scale was developed, demonstrating good reliability α = 0.89. The four GDP factors are as follows: general gratitude, physical changes, antenatal care and social support. In study 2, 87 pregnant women completed well-being questionnaires, including the GDP and MAAS. Gratitude correlated with positive affect, life satisfaction and pregnancy uplifts (p < .001); mindfulness correlated negatively with negative affect and pregnancy hassles (p < .001) and positively correlated with positive affect and pregnancy uplifts (p < .05). These findings highlight the importance of mindfulness and gratitude and provide a reliable means to measure both constructs during pregnancy.