Vividness of imagery and affective response to episodic memories and episodic future thoughts: a systematic review and meta-analysis.

Recalling personal past events and imagining personal future events are closely linked, yet also show differences. It has been claimed that episodic future thinking produces stronger intensity of in-the-moment affect than does recalling episodic memories [Schubert, T., Eloo, R., Scharfen, J., & Morina, N. (2020). How imagining personal future scenarios influences affect: Systematic review and meta-analysis. Clinical Psychology Review, 75, 101811. https://doi.org/10.1016/j.cpr.2019.101811]. In contrast, the literature indicates that memories are experienced more vividly than are episodic future thoughts, a quality that would be expected to produce a stronger rather than a weaker affective response. In this systematic review and meta-analysis, we examined (a) the intensity of affect, (b) the vividness and (c) the valence of emotion experienced in response to remembering personal past events compared to imagining personal future events. Sixteen studies with a combined sample of 1735 met criteria for inclusion. Remembered past events were experienced more vividly than imagined future events but there was no difference between the two types of representations on emotional intensity. Imagined future events were associated with more positive emotion than memories. Future research could examine factors responsible for the equivalent strength of emotional response in memories and future-thinking despite their differences in vividness.

'Maturing Out' as dilemmatic: Transitions towards relatively light drinking practices among UK University students.

OBJECTIVES: University students in the UK engage in relatively high alcohol consumption levels, yet young adults, including students, now drink less than previously and abstain more. Against this cultural backdrop, our objective was to further understanding of 'maturing out' of excessive drinking practices among students by focusing on drinking transitions that had taken place during university years. DESIGN: A qualitative interview study. METHODS: Semi-structured interviews were conducted with ten 18- to 27-year-old UK undergraduate university students who self-identified as light or non-drinkers. Interviews were audio-recorded, and anonymized interview transcripts were subjected to an experience-focused application of thematic analysis. RESULTS: Participants reported dilemmas involved in transitions from relatively high to low levels of alcohol consumption. One dilemma was characterized by managing to drink less (or nothing) without cutting off social options with university friends/peers. A second dilemma concerned not wishing to fully abandon the pleasures and increased social confidence that alcohol consumption could afford. Results also demonstrated that self-reported drinking could contradict participants' self-defined 'light drinker' status. CONCLUSIONS: This study reinforces the view that 'maturing out' involves more than simply having gained new responsibilities during young adulthood. Recognition of these dilemmatic features of drinking transitions could be drawn on in novel campus-based interventions. Such interventions may help strengthen realistic and sustainable moderate drinking by guiding students to anticipate potential difficulties involved in planned reductions in personal drinking but may also help foster students' ability to view drinking choices as in transition rather than as permanent and enduring.

IMPlementation of An online Relatives' Toolkit for psychosis or bipolar (IMPART study): iterative multiple case study to identify key factors impacting on staff uptake and use.

BACKGROUND: Despite the potential of digital health interventions to improve the delivery of psychoeducation to people with mental health problems and their relatives, and substantial investment in their development, there is little evidence of successful implementation into clinical practice. We report the first implementation study of a digital health intervention: Relatives Education And Coping Toolkit (REACT), into routine mental healthcare. Our main aim was to identify critical factors affecting staff uptake and use of this online self-management tool for relatives of people with psychosis or bipolar. METHODS: A mixed-methods, theory-driven (Normalisation Process Theory), iterative multiple case study approach using qualitative analysis of interviews with staff and quantitative reporting of uptake. Carer researchers were part of the research team. RESULTS: In all, 281 staff and 159 relatives from Early Intervention teams across six catchment areas (cases) in England registered on REACT; 129 staff took part in qualitative interviews. Staff were positive about REACT helping services improve support and meet clinical targets. Implementation was hindered by: high staff caseloads and difficulties prioritising carers; perception of REACT implementation as research; technical difficulties using REACT; poor interoperability with trust computer systems and care pathways; lack of access to mobile technology and training; restricted forum populations; staff fears of risk, online trolling, and replacement by technology; and uncertainty around REACT's long-term availability. CONCLUSIONS: Digital health interventions, such as REACT, should be iteratively developed, evaluated, adapted and implemented, in partnership with the services they aim to support, and as part of a long term national strategy to co-develop integrated technology-enabled mental healthcare. Implementation strategies must instil a sense of ownership for staff and ensure they have adequate IT training, appropriate governance protocols for online working, and adequate mobile technologies. Wider contextual factors including adequate funding for mental health services and prioritisation of carer support, also need to be addressed for successful implementation of carer focussed digital interventions. TRIAL REGISTRATION: Study registration: ISCTRN 16267685.