Feasibility, acceptability and clinical benefit of a trauma-focused stabilisation group for post-traumatic stress disorder patients with complex presentations on primary care waitlists.

BACKGROUND: Large numbers of people showing complex presentations of post-traumatic stress disorder (PTSD) in the NHS Talking Therapies services routinely require multi-faceted and extended one-to-one National Institute of Clinical Excellence (NICE) recommended treatment approaches. This can lead to longer waits for therapy and prolong patient suffering. We therefore evaluated whether a group stabilisation intervention delivered to patients on the waitlist for individual trauma-focused psychological treatment could help address this burden. AIMS: The study aimed to ascertain a trauma-focused stabilisation group's acceptability, feasibility, and preliminary clinical benefit. METHOD AND RESULTS: Fifty-eight patients with PTSD waiting for trauma-focused individual treatment were included in the study. Two therapists delivered six 5-session groups. The stabilisation group was found to be feasible and acceptable. Overall, PTSD symptom reduction was medium to large, with a Cohen's d of .77 for intent-to-treat and 1.05 for per protocol analyses. Additionally, for depression and anxiety, there was minimal symptom deterioration. CONCLUSIONS: The study provided preliminary evidence for the acceptability, feasibility and clinical benefit of attending a psychoeducational group therapy whilst waiting for one-to-one trauma therapy.

The potential of digital behavioural tests as a diagnostic aid for psychosis.

Timely interventions have a proven benefit for people experiencing psychotic illness. One bottleneck to accessing timely interventions is the referral process to the specialist team for early psychosis (STEP). Many general practitioners lack awareness or confidence in recognising psychotic symptoms or state. Additionally, referrals for people without apparent psychotic symptoms, although beneficial at a population level, lead to excessive workload for STEPs. There is a clear unmet need for accurate stratification of STEPs users and healthy cohorts. Here we propose a new approach to addressing this need via the application of digital behavioural tests. To demonstrate that digital behavioural tests can be used to discriminate between the STEPs users (SU; n = 32) and controls (n = 32, age and sex matched), we compared performance of five different classifiers applied to objective, quantitative and interpretable features derived from the 'mirror game' (MG) and trail making task (TMT). The MG is a movement coordination task shown to be a potential socio-motor biomarker of schizophrenia, while TMT is a neuropsychiatric test of cognitive function. All classifiers had AUC in the range of 0.84-0.92. The best of the five classifiers (linear discriminant classifier) achieved an outstanding performance, AUC = 0.92 (95%CI 0.75-1), Sensitivity = 0.75 (95%CI 0.5-1), Specificity = 1 (95%CI 0.75-1), evaluated on 25% hold-out and 1000 folds. Performance of all analysed classifiers is underpinned by the large effect sizes of the differences between the cohorts in terms of the features used for classification what ensures generalisability of the results. We also found that MG and TMT are unsuitable in isolation to successfully differentiate between SU with and without at-risk-mental-state or first episode psychosis with sufficient level of performance. Our findings show that standardised batteries of digital behavioural tests could benefit both clinical and research practice. Including digital behavioural tests into healthcare practice could allow precise phenotyping and stratification of the highly heterogenous population of people referred to STEPs resulting in quicker and more personalised diagnosis. Moreover, the high specificity of digital behavioural tests could facilitate the identification of more homogeneous clinical high-risk populations, benefiting research on prognostic instruments for psychosis. In summary, our study demonstrates that cheap off-the-shelf equipment (laptop computer and a leap motion sensor) can be used to record clinically relevant behavioural data that could be utilised in digital mental health applications.

Multisensory processing of emotional cues predicts intrusive memories after virtual reality trauma.

Research has shown that high trait anxiety can alter multisensory processing of threat cues (by amplifying integration of angry faces and voices); however, it remains unknown whether differences in multisensory processing play a role in the psychological response to trauma. This study examined the relationship between multisensory emotion processing and intrusive memories over seven days following exposure to an analogue trauma in a sample of 55 healthy young adults. We used an adapted version of the trauma film paradigm, where scenes showing a car accident trauma were presented using virtual reality, rather than a conventional 2D film. Multisensory processing was assessed prior to the trauma simulation using a forced choice emotion recognition paradigm with happy, sad and angry voice-only, face-only, audiovisual congruent (face and voice expressed matching emotions) and audiovisual incongruent expressions (face and voice expressed different emotions). We found that increased accuracy in recognising anger (but not happiness and sadness) in the audiovisual condition relative to the voice- and face-only conditions was associated with more intrusions following VR trauma. Despite previous results linking trait anxiety and intrusion development, no significant influence of trait anxiety on intrusion frequency was observed. Enhanced integration of threat-related information (i.e. angry faces and voices) could lead to overly threatening appraisals of stressful life events and result in greater intrusion development after trauma. Supplementary Information: The online version contains supplementary material available at 10.1007/s10055-023-00784-1.

Daily relationships among maternal rumination, mood and bonding with infant.

There is little research examining the association between maternal maladaptive emotion regulation strategies such as rumination and perceived maternal bonding and mood. This study investigated the concurrent and prospective relationship of both trait and daily rumination with daily perceived maternal bonding and mood. Ninety-three mothers of infants aged between 3 and 14 months completed a ten-day diary study investigating the relationship between daily and trait ruminative self-focus, negative affect and perceived maternal bonding, or her perceived feelings of closeness with her infant. The majority of mothers reported mild to moderate depressive symptoms. The data were analysed using Hierarchical Linear Modelling. Baseline depressive symptoms and trait rumination were each positively associated with mean levels of daily ruminative self-focus and mood over the ten-day sampling period. Bonding with infant at baseline was not associated with mean levels of daily rumination, mood or bonding over the sampling period. Concurrently, daily rumination and daily bonding were negatively correlated, after accounting for daily mood. Prospectively, lower levels of daily bonding predicted increases in daily rumination and depressive mood on the subsequent day. Interestingly, daily rumination did not predict increases in depressive mood or bonding on the subsequent day, suggesting that rumination occurred in response to perceived disruptions in feelings of closeness with the infant, but did not lead to prospective decreases in these feelings of closeness. These findings hold important implications for understanding the relationship between the mother-infant relationship, and maternal rumination and depressive mood, suggesting that disruptions in the way mothers perceive they are bonding to their infants may contribute to depressongenic processes.

Developmental pathways of depressive symptoms via parenting, self-evaluation and peer relationships in young people from 3 to 17 years old: evidence from ALSPAC.

PURPOSE: Self-evaluation and interpersonal factors are theoretically and empirically linked to depression in young people. An improved understanding of the multifactorial developmental pathways that explain how these factors predict depression could inform intervention strategies. METHODS: Using structural equation modeling, this study explored whether self-evaluation and interpersonal factors were associated with adolescent depressive symptoms in a population-based sample (n = 11,921; Avon Longitudinal Study of Parents and Children, ALSPAC), across four development stages: early and late childhood plus early and middle adolescence from 3 to 17 years old. RESULTS: Early good parenting practices predicted self-esteem, fewer peer difficulties, good friendships and fewer depressive symptoms in late childhood development outcomes. Higher self-esteem and less negative self-concept mediated the effect of early good parenting practice on reduced depressive symptoms in middle adolescence. The hypothesized erosion pathway from depressive symptoms in late childhood via higher levels of negative self-concept in early adolescence to depressive symptoms in middle adolescence was also confirmed. Additionally, peer difficulties played a mediation role in developing depressive symptoms. Contrary to the hypothesis, poor friendships predicted fewer depressive symptoms. The analysis supported a developmental pathway in which good parenting practices in early childhood led to fewer peer difficulties in late childhood and to less negative self-concept in early adolescence, which in turn predicted fewer depressive symptoms in middle adolescence. CONCLUSION: The social-developmental origin of youth depressive symptoms was supported via the effect of peer relationships in late childhood on self-evaluation in early adolescence.

Pain and suicidality in children and adolescents: a longitudinal population-based study.

Suicidality is a common public health concern in young people. Previous research has highlighted pain as a key correlate of suicidality in young people. However, the long-term experience of pain may vary between individuals, and the relationship between distinct pain trajectories and suicidality is poorly understood. This study aims to describe the number and nature of distinct pain trajectories, their demographic and clinical correlates, including baseline suicidality, and whether identified pain trajectories may predict future suicidality. Secondary data analyses were performed, using longitudinal data from the British Child and Adolescent Mental Health Survey (N = 7977), collected at five timepoints between 2004 and 2007 on a population-based sample of UK youth (5-16 years). Data were collected from up to three respondents (parents, teachers, and 11 + year-olds). Latent Class Growth Analysis was used to identify distinct pain trajectories, explore predictors of these trajectories, and establish whether trajectories predicted future suicidality. We identified the following four pain trajectories: increasing (33.6%), decreasing (4.5%), persistent/recurrent probability of pain (15.7%), and no pain (46.2%). Pain trajectories were associated with unique demographic and clinical correlates. Only the persistent/recurrent (vs. no-pain) trajectory was predicted by baseline suicidality (aOR = 2.24; 95% bootstrap-CI = 1.59-3.26). Furthermore, the persistent/recurrent trajectory predicted future suicidality (aOR = 1.03, 95% bootstrap-CI = 1.01-1.06), after controlling for baseline suicidality, psychiatric disorder, age, and gender. Findings provide a better understanding of correlates associated with distinct pain trajectories and long-term risk of suicidality in young people, suggesting a bidirectional pain-suicidality association and emphasising the need of targeted support for young people with persistent/recurrent pain.

Self-Compassion in Chinese Young Adults: Its Measurement and Measurement Construct.

OBJECTIVES: Self-compassion is the ability to be kind to oneself in adversity. This multidimensional construct is typically assessed by the Self-Compassion Scale (SCS). In Chinese samples, there have been inconsistent psychometric findings that impede cross-cultural research. This study aimed to explore the factor structure of the Chinese version (SCS-C). METHODS: Two samples of young Chinese adults were recruited (Sample 1, N = 465, 141 men, Mean age [Mage] = 20.26; Sample 2, N = 392, 71 men; Mage = 18.97). Confirmatory factor analyses and exploratory structural equation modeling (ESEM) were used to examine previously reported four- and six-factor structures of SCS-C. RESULTS: Although ESEM supported the six-factor structure when a problematic item was omitted, we found stronger evidence for a novel four-factor structure of the SCS-C revealed with self-kindness, common humanity, mindfulness, and uncompassionate self-responding. This suggests that Chinese individuals have a different understanding of the negative components of the original self-compassion definition, which was based on the United States and other mostly Western samples. Omega coefficients of the bifactor models suggested that using the SCS total score in Chinese samples is inappropriate. However, high factor determinacy and construct replicability indicated that the general factor of SCS-C could be used in a structural equation modeling context for both four-factor and six-factor structures. CONCLUSIONS: When using the existing SCS-C in path models, researchers should use a latent variable approach and establish the measurement construct rather than sum scores of the scale or subscales without checking the factor structure in future empirical studies. Also, the SCS-C needs to be revised, and we proposed directions forward for future research.

Study development and protocol for a cohort study examining the impact of baseline social cognition on response to treatment for people living with post-traumatic stress disorder.

Background: Social cognitive impairments, specifically in facial emotion processing and mental state attribution, are common in post-traumatic stress disorder. However few studies so far have examined whether social cognitive ability impacts on PTSD recovery. Objective: To examine whether baseline social cognitive abilities are associated with treatment outcomes following trauma-focused therapy for PTSD. Method: This is a cohort study that will relate treatment outcomes post-discharge to baseline measures of social cognition (five tasks: Emotion Odd-One-Out Task (Oddity), Reading the Mind in the Eyes Task (RMET), Social Shapes Test (SST), Spontaneous Theory of Mind Protocol (STOMP), and Reflective Functioning Questionnaire (RFQ-8)) in people starting a course of psychological therapy for PTSD (target N = 60). The primary outcome will be pre- to post-treatment change in PTSD symptom severity (assessed using the PTSD Checklist for DSM-5). Secondary outcomes include functional impairment (assessed using the Work and Social Adjustment Scale), drop-out rate, and analyses differentiating participants with DSM-5 PTSD and ICD-11 PTSD and CPTSD. Regression models will be used to examine associations between baseline social cognitive performance and outcome measures while adjusting for potential confounders. Two pilot studies informed the development of our study protocol. The first involved qualitative analysis of interviews with nine participants with lived experience of mental health problems to inform our research questions and study protocol. The second involved trialling social cognitive tasks on 20 non-clinical participants to refine our test battery. Discussion: This study will address a gap in the literature about whether abilities in social cognition in people living with PTSD are associated with treatment-related recovery. HIGHLIGHTS: Impairments in social cognition are recognised in people with PTSD.Few studies have examined whether social cognitive ability is associated with recovery from PTSD.We present a study protocol, developed after pilot testing, to address this question.

Antecedentes: Las deficiencias en la cognición social, específicamente en el procesamiento de las emociones faciales y de la atribución de estados mentales, son comunes en el trastorno de estrés postraumático (TEPT). Sin embargo, hasta el momento pocos estudios han evaluado si la habilidad cognitiva social tiene un impacto en la recuperación del TEPT.Objetivo: Evaluar si las habilidades de cognición social de base están asociadas con los resultados del tratamiento después de la terapia centrada en el trauma para el TEPT.Métodos: Este es un estudio de cohortes que relacionará los resultados posteriores al alta del tratamiento con las medidas de referencia de la cognición social mediante cinco pruebas: la tarea de la emoción no correspondiente ('Emotion Odd-One-Out Task (Oddity)'), la tarea de lectura de la mente a través de la mirada ('Reading the Mind in the Eyes Task (RMET)'), la prueba de las figuras sociales ('Social Shapes Test (SST)'), el protocolo para la teoría de la mente espontánea ('Spontaneous Theory of Mind Protocol (STOMP)'), y el cuestionario de funcionamiento reflexivo ('Reflective Functioning Questionnaire (RFQ-8)'. Estas pruebas fueron realizadas en personas al iniciar el transcurso de la terapia psicológica para el TEPT (N objetivo = 60). El resultado principal será el cambio en la severidad de los síntomas del TEPT antes y después del tratamiento (evaluado utilizando la lista de verificación de síntomas de TEPT del DSM-5). Los resultados secundarios incluyen al deterioro funcional (evaluado mediante el cuestionario de trabajo y ajuste social, 'Work and Social Adjustment Scale' en inglés), la tasa de abandono, así como los análisis que diferencien a los participantes con TEPT según el DSM-5, y diferencien el TEPT y el TEPT complejo (TEPT-C) según la CIE-11. Se utilizarán modelos de regresión para examinar las asociaciones entre el rendimiento cognitivo social de referencia y las medidas de resultado mientras se ajustan por posibles variables de confusión. Dos estudios piloto sustentaron el desarrollo del protocolo del estudio. El primero involucró un análisis cualitativo de las entrevistas realizadas a nueve participantes con experiencias de problemas de salud mental para sustentar nuestras preguntas de investigación y el protocolo de estudio. El segundo involucró evaluar las pruebas de cognición social en veinte participantes sin condiciones clínicas para refinar la batería de pruebas.Discusión: Este estudio busca estrechar la brecha en la literatura sobre si las habilidades en la cognición social en personas que viven con TEPT están asociadas con la recuperación vinculada al tratamiento.

Mood Disorders in Young People With Acquired Brain Injury: An Integrated Model.

Purpose/Objective: Young people with paediatric acquired brain injury (pABI) are twice as likely to develop a mood disorder as their peers, frequently have significant unmet socio-emotional needs, and are at over double the risk of going on to use adult mental health services. Recent years have seen significant advances in the development of interventions for young people with mood disorders. However, evidence-based approaches to mood disorders in pABI are lacking and surprisingly little work has evaluated clinical and neuro-developmental models of mood disorders in this population. Method: We review the literature regarding key mechanisms hypothesised to account for the increased vulnerability to mood disorders in pABI: First, we summarise the direct neurocognitive consequences of pABI, considering the key areas of the brain implicated in vulnerability to mood disorders within a neurodevelopmental framework. Second, we outline five key factors that contribute to the heightened prevalence of mood disorders in young people following ABI. Finally, we synthesise these, integrating neuro-cognitive, developmental and systemic factors to guide clinical formulation. Results and Implications: We present a framework that synthesises the key mechanisms identified in our review, namely the direct effects of pABI, neurocognitive and neuroendocrine factors implicated in mood and anxiety disorders, maladaptive neuroplasticity and trauma, structural and systemic factors, and psychological adjustment and developmental context. This framework is the first attempt to provide integrated guidance on the multiple factors that contribute to elevated life-long risk of mood disorders following pABI.

Emerging ecophenotype: reward anticipation is linked to high-risk behaviours after sexual abuse.

Adolescents frequently engage in high-risk behaviours (HRB) following childhood sexual abuse (CSA). Aberrant reward processes are implicated in HRB, and their underlying fronto-striatal networks are vulnerable to neurodevelopmental changes during adversity representing a promising candidate for understanding links between CSA and HRB. We examined whether fronto-striatal responses during reward anticipation and feedback (i) are altered in depressed adolescents with CSA compared to depressed, non-abused peers and (ii) moderate the relationship between CSA and HRB irrespective of depression. Forty-eight female adolescents {14 with CSA and depression [CSA + major depressive disorder (MDD)]; 17 with MDD but no CSA (MDD); 17 healthy, non-abused controls} completed a monetary reward task during functional magnetic resonance imaging. No differences in fronto-striatal response to reward emerged between CSA + MDD and MDD. Critically, high left nucleus accumbens activation during reward anticipation was associated with greater HRB in CSA + MDD compared to MDD and controls. Low left putamen activation during reward feedback was associated with the absence of HRB in CSA + MDD compared to MDD. Striatal reward responses appear to play a key role in HRB for adolescents with CSA irrespective of depression, providing initial support for a CSA ecophenotype. Such information is pivotal to identify at-risk youth and prevent HRB in adolescents after CSA.

Brain Responses to a Self-Compassion Induction in Trauma Survivors With and Without Post-traumatic Stress Disorder.

Self-compassion (SC) is a mechanism of symptom improvement in post-traumatic stress disorder (PTSD), however, the underlying neurobiological processes are not well understood. High levels of self-compassion are associated with reduced activation of the threat response system. Physiological threat responses to trauma reminders and increased arousal are key symptoms which are maintained by negative appraisals of the self and self-blame. Moreover, PTSD has been consistently associated with functional changes implicated in the brain's saliency and the default mode networks. In this paper, we explore how trauma exposed individuals respond to a validated self-compassion exercise. We distinguish three groups using the PTSD checklist; those with full PTSD, those without PTSD, and those with subsyndromal PTSD. Subsyndromal PTSD is a clinically relevant subgroup in which individuals meet the criteria for reexperiencing along with one of either avoidance or hyperarousal. We use electroencephalography (EEG) alpha-asymmetry and EEG microstate analysis to characterize brain activity time series during the self-compassion exercise in the three groups. We contextualize our results with concurrently recorded autonomic measures of physiological arousal (heart rate and skin conductance), parasympathetic activation (heart rate variability) and self-reported changes in state mood and self-perception. We find that in all three groups directing self-compassion toward oneself activates the negative self and elicits a threat response during the SC exercise and that individuals with subsyndromal PTSD who have high levels of hyperarousal have the highest threat response. We find impaired activation of the EEG microstate associated with the saliency, attention and self-referential processing brain networks, distinguishes the three PTSD groups. Our findings provide evidence for potential neural biomarkers for quantitatively differentiating PTSD subgroups.

Self-Compassion and Its Association With Ruminative Tendencies and Vagally Mediated Heart Rate Variability in Recurrent Major Depression.

Background: Recurrent Major Depressive Disorder (MDD) is one of the most disabling mental disorders in modern society. Prior research has shown that self-compassion protects against ruminative tendencies, a key feature of recurrent MDD. In addition, self-compassion has been found to be positively related to higher psychophysiological flexibility (indexed by a higher vagally mediated heart rate variability; vmHRV) in young, healthy adults. To our knowledge, there is a lack of studies on how self-compassion relates to vmHRV in patients with recurrent MDD. The aim of the current study was to investigate whether higher self-compassion would associate with (1) lower ruminative tendencies and (2) higher vmHRV in a sample of adults with recurrent MDD. Methods: We included a sample of 63 patients (46 females) between 20 and 71 years old (M = 40.24, SD = 12.8) with a history of three or more depressive episodes. They filled out the Self-Compassion Scale (SCS), Beck Depression Inventory (BDI), and Rumination Rating Scale (RRS). ECG (used to derive vmHRV) was acquired while resting and the square root of the mean squared differences of successive RR interval values (RMSSD) was calculated as measure of vmHRV. Results: As hypothesized, self-compassion was associated with lower ruminative tendencies. However, self-compassion was not associated with level of vmHRV. Several confounding variables were controlled for in the statistical analyses, and higher age predicted lower vmHRV across all statistical analyses. Conclusion: The results confirmed our hypothesis that higher self-compassion would be associated with lower ruminative tendencies in recurrent MDD. Contrary to our expectation, we did not find that the tendency to be more self-compassionate was associated with higher vmHRV. As such, higher self-compassion seems to relate with a lower tendency to ruminate about past mistakes and events but does not seem to relate to a flexible autonomic stress response (as indexed by higher vmHRV). Other potential explanatory factors for lower vmHRV in recurrent MDD is suggested as focus for exploration in future studies.

Rejection sensitivity and vulnerable attachment: associations with social support and PTSD symptoms in trauma survivors.

Background: Although social support has been consistently associated with recovery from psychological trauma and prevention of posttraumatic stress disorder (PTSD), individual differences in seeking or benefitting from social support in trauma survivors are not well understood. Factors associated with negative internal working models of self and others, emotion dysregulation, and interrupted bonds with an individual's social support groups such as vulnerable attachment and rejection sensitivity could contribute to lower experienced social support and higher levels of PTSD. Objective: The objective of this study was to test a theoretically informed model and investigate how psychosocial variables such as vulnerable attachment styles, rejection sensitivity, and social support are associated with PTSD. Method: Using a cross-sectional survey and path analyses in 141 survivors of trauma (aged 18-69, M = 25.20), the relationship between vulnerable attachment style, rejection sensitivity, and PTSD were investigated. Results: Higher vulnerable attachment, rejection sensitivity, and lower social support were found to be significant predictors of PTSD symptoms (f2 = 0.75). The relationships from vulnerable attachment to PTSD were mediated by rejection sensitivity and perceived social support. The results supported and extend theoretical models of PTSD that posit a role for predisposing factors in the development and maintenance of the disorder. Conclusion: The findings suggest a potential benefit of identifying vulnerable groups that could benefit from a refinement of existing PTSD interventions by targeting the maladaptive effects of vulnerable attachment and rejection sensitivity, thus allowing the individual to draw effectively on social support networks.

Antecedentes:Aunque el apoyo social se ha asociado consistentemente con la recuperación del trauma psicológico y la prevención del Trastorno de Estrés Postraumático (TEPT), las diferencias individuales en la búsqueda o beneficios del apoyo social en sobrevivientes del trauma no se comprenden bien. Factores asociados con modelos de trabajo internos negativos de sí mismo y de los otros, desregulación emocional, y vínculos interrumpidos con los grupos de apoyo social de un individuo; tal como el apego vulnerable y sensibilidad al rechazo pudiesen contribuir a un bajo apoyo social percibido y altos niveles de TEPT.Objetivo:el objetivo de este estudio fue probar un modelo informado teóricamente e investigar cómo las variables psicosociales tales como estilo de apegos vulnerables, sensibilidad al rechazo y apoyo social están asociados con el TEPT.Método:usando una encuesta transversal y Análisis de ruta en 141 sobrevivientes de trauma (edad 18­69, M = 25.20); se investigaron la relación entre estilo de apego vulnerable, sensibilidad al rechazo y TEPT.Resultados:Mayor apego vulnerable, sensibilidad al rechazo, y apoyo social bajo se encontraron que eran predictores significativos de síntomas de TEPT (f2 = 0.75). La relación entre apego vulnerable y TEPT fue mediada por la sensibilidad al rechazo y apoyo social percibido. Los resultados apoyan y amplían los modelos teóricos de TEPT que postulan un rol de los factores predisponentes en el desarrollo y la mantención del trastorno.Conclusión:Los hallazgos sugieren un potencial beneficio en identificar grupos vulnerables que pudiesen beneficiarse de un refinamiento de las intervenciones existentes de TEPT mediante focalización de los efectos desdaptativos del apego vulnerable y de la sensibilidad al rechazo, lo que permite que el individuo recurra de manera efectiva a las redes de apoyo social.

High trait anxiety enhances optimal integration of auditory and visual threat cues.

BACKGROUND: Emotion perception is essential to human interaction and relies on effective integration of emotional cues across sensory modalities. Despite initial evidence for anxiety-related biases in multisensory processing of emotional information, there is no research to date that directly addresses whether the mechanism of multisensory integration is altered by anxiety. Here, we compared audiovisual integration of emotional cues between individuals with low vs. high trait anxiety. METHODS: Participants were 62 young adults who were assessed on their ability to quickly and accurately identify happy, angry and sad emotions from dynamic visual-only, audio-only and audiovisual face and voice displays. RESULTS: The results revealed that individuals in the high anxiety group were more likely to integrate angry faces and voices in a statistically optimal fashion, as predicted by the Maximum Likelihood Estimation model, compared to low anxiety individuals. This means that high anxiety individuals achieved higher precision in correctly recognising anger from angry audiovisual stimuli compared to angry face or voice-only stimuli, and compared to low anxiety individuals. LIMITATIONS: We tested a higher proportion of females, and although this does reflect the higher prevalence of clinical anxiety among females in the general population, potential sex differences in multisensory mechanisms due to anxiety should be examined in future studies. CONCLUSIONS: Individuals with high trait anxiety have multisensory mechanisms that are especially fine-tuned for processing threat-related emotions. This bias may exhaust capacity for processing of other emotional stimuli and lead to overly negative evaluations of social interactions.

Abuse in Childhood and Cardiometabolic Health in Early Adulthood: Evidence From the Avon Longitudinal Study of Parents and Children.

Background Although childhood abuse has been consistently associated with cardiovascular disease in later adulthood, its associations with cardiometabolic health in younger adults are poorly understood. We assessed associations between childhood physical, sexual, and psychological abuse and cardiometabolic outcomes at 18 and 25 years. Methods and Results We used data on 3223 participants of the ALSPAC (Avon Longitudinal Study of Parents and Children). Exposure to childhood abuse was self-reported retrospectively at 22 years. We used linear regression to assess the associations between childhood abuse and cardiometabolic outcomes at 18 and 25 years. At 18 years, physical (ß 1.35 kg/m2; 95% CI, 0.66-2.05), sexual (ß 0.57 kg/m2; 95% CI 0.04-1.11), and psychological (ß 0.47 kg/m2; 95% CI 0.01-0.92) abuse were associated with higher body mass index. Physical abuse was also associated with lower high-density lipoprotein cholesterol (ß -0.07 mmol/L; 95% CI, -0.13 to -0.01) and higher C-reactive protein (31%; 95% CI, 1%-69%), and sexual abuse was associated with higher heart rate (ß 1.92 bpm; 95% CI 0.26-3.58). At age 25, all 3 types of abuse were additionally associated with higher insulin, and sexual abuse was associated with lower cholesterol (-0.14 mmol/L; 95% CI, -0.26 to -0.01). The age at which abuse occurred (<11or 11-17 years) had little influence on the associations, and when sex differences were evident, associations were stronger in men. Conclusions Childhood abuse is associated with negative cardiometabolic outcomes even by young adulthood. Further follow-up will determine whether associations strengthen across the life course and whether sex differences persist, which is essential for targeting effective screening programs and early interventions in those who suffered abuse in childhood.

Anxiety biases audiovisual processing of social signals.

In everyday life, information from multiple senses is integrated for a holistic understanding of emotion. Despite evidence of atypical multisensory perception in populations with socio-emotional difficulties (e.g., autistic individuals), little research to date has examined how anxiety impacts on multisensory emotion perception. Here we examined whether the level of trait anxiety in a sample of 56 healthy adults affected audiovisual processing of emotion for three types of stimuli: dynamic faces and voices, body motion and dialogues of two interacting agents, and circles and tones. Participants judged emotion from four types of displays - audio-only, visual-only, audiovisual congruent (e.g., angry face and angry voice) and audiovisual incongruent (e.g., angry face and happy voice) - as happy or angry, as quickly as possible. In one task, participants based their emotional judgements on information in one modality while ignoring information in the other, and in a second task they based their judgements on their overall impressions of the stimuli. The results showed that the higher trait anxiety group prioritized the processing of angry cues when combining faces and voices that portrayed conflicting emotions. Individuals in this group were also more likely to benefit from combining congruent face and voice cues when recognizing anger. The multisensory effects of anxiety were found to be independent of the effects of autistic traits. The observed effects of trait anxiety on multisensory processing of emotion may serve to maintain anxiety by increasing sensitivity to social-threat and thus contributing to interpersonal difficulties.

The effect of attachment security priming and oxytocin on physiological responses to trauma films and subsequent intrusions.

To further understand protective mechanisms to prevent post-traumatic stress disorder or assist recovery from psychological trauma, this study investigated whether pharmacological and psychological activation of a secure attachment representation elicits higher felt-security and a related response pattern of reduced physiological arousal and increased parasympathetic activation; and whether it protects individuals from developing intrusions and experiencing distress in the week following exposure to a trauma film. Using a double-blind, experimental mixed factorial design, 101 volunteers received either oxytocin or placebo and either secure attachment or neutral priming before watching a trauma film. We measured felt security as an indicator of the strength of activation of a secure attachment representation, skin conductance and heart rate as indicators of physiological arousal, and high frequency heart rate variability as an indicator of parasympathetic activation during the priming and the film. Participants then completed a seven-day intrusion diary. Secure attachment priming, but not oxytocin administration or the combination of both, was associated with reduced physiological arousal and increased parasympathetic activity during priming. Although secure attachment priming was not related to the absolute number of intrusions or to less perceived distress or physiological arousal during the trauma film, it was associated with lower intrusion-related distress in the 7-days post-testing. Our findings extend previous research that suggests the importance of interventions that address intrusion-related distress for recovery from trauma, and suggest a promising role for secure attachment priming in trauma-focused psychological therapies. We contribute to the growing literature that finds that higher subjective distress during a trauma is associated with higher intrusion-related distress. We discuss theoretical implications and possible mechanisms through which secure attachment priming may exert potential beneficial effects.

Heightened risk of posttraumatic stress disorder in adults with autism spectrum disorder: The role of cumulative trauma and memory deficits.

BACKGROUND: Individuals with Autism Spectrum Disorder (ASD) are known to be at increased risk of exposure to traumas such as maltreatment and abuse, however less is known about possible susceptibility towards the development of Posttraumatic Stress Disorder (PTSD) and associated risk factors. AIMS: This study investigated the rates of trauma exposure and PTSD, and the role of cumulative trauma exposure and memory as risk factors for PTSD in adults who self-reported having received an ASD diagnosis, compared to a typically developing (TD) comparison group. METHODS: Questionnaires assessing self-reported frequency of trauma exposure (LEC), PTSD symptomology (PCL-S) and memory (EMQ- R and BRIEF-A) were completed online by 38 ASD adults and 44 TD adults. RESULTS: Rates of trauma exposure and PTSD symptomatology were significantly higher in the ASD group, compared to the TD group, with deficits in working memory and everyday memory mediating this association. Interestingly, a cumulative effect of trauma exposure on PTSD symptom severity was only found in the ASD group. CONCLUSIONS: High rates of trauma and probable PTSD in ASD adults highlight the importance of routine screening. Cumulative trauma exposure and memory deficits may act to increase risk of PTSD in ASD; longitudinal research is called for.

Incidental fear reduces empathy for an out-group's pain.

Humans generally fear those different to them (i.e., an out-group) in the same way they fear natural predators. But fear pushes us to derogate others, whether they constitute a threat or not. Research has examined how fear associated with specific intergroup relations interferes with how individuals relate to in-group and out-group members. However, we know relatively little about how intergroup relations might be affected by incidental emotions. We tested how incidental fear affects empathy toward in-group and out-group members. We found that exposing participants to fearful imagery was sufficient to reduce empathy, but only in response to out-group suffering. We discuss how these findings provide insight into how fear is often leveraged to encourage social tribalism. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Psychophysiological Responses to a Brief Self-Compassion Exercise in Armed Forces Veterans.

Armed Forces personnel are exposed to traumatic experiences during their work; therefore, they are at risk of developing emotional difficulties such as post-traumatic stress disorder (PTSD), following traumatic experiences. Despite evidence to suggest that self-compassion is effective in reducing the symptoms of PTSD, and greater levels of self-compassion are associated with enhanced resilience, self-compassion in armed forces personnel and armed forces veterans remains under-researched. As a result, it is not known if therapeutic approaches that use self-compassion interventions are an acceptable and effective treatment for this population. Having previously shown that a one-off self-compassion exercise has temporary beneficial psychophysiological effects in non-clinical participants, we conducted this proof-of concept study to investigate whether this exercise is equally beneficial in veterans who had experienced deployment to a combat zone. Additionally, we examined if brief a self-compassion exercise can temporarily reduce hyperarousal symptoms and increase feelings of social connectedness. The current study also investigated the association between PTSD symptom severity, emotion regulation, and self-compassion in 56 veterans. All participants listened to a loving-kindness meditation for self-compassion (LKM-S) and psychophysiological recordings were taken throughout. Psychophysiological effects were observed including heart-rate (HR), skin conductance (SCL), and heart-rate variability (HRV) to determine associations with PTSD and changes in response associated with the self-compassion induction. PTSD symptom severity, dispositional emotion regulation, and self-compassion were measured, and participants also completed state measures of hyperarousal and social connectedness before and after the LKM-S. The findings partially demonstrated that self-compassion can be elicited in a veteran population but there were considerable individual differences in psychophysiological responses. The findings are discussed in light of existing theories of PTSD and self-compassion and the implications of using self-compassion based psychological approaches with veterans.