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BACKGROUND: The primary objective of this randomized controlled trial (RCT) is to establish the effectiveness of time-restricted eating (TRE) compared with the Mediterranean diet for people with bipolar disorder (BD) who have symptoms of sleep disorders or circadian rhythm sleep-wake disruption. This work builds on the growing evidence that TRE has benefits for improving circadian rhythms. TRE and Mediterranean diet guidance will be offered remotely using self-help materials and an app, with coaching support. METHODS: This study is an international RCT to compare the effectiveness of TRE and the Mediterranean diet. Three hundred participants will be recruited primarily via social media. Main inclusion criteria are: receiving treatment for a diagnosis of BD I or II (confirmed via DIAMOND structured diagnostic interview), endorsement of sleep or circadian problems, self-reported eating window of ≥ 12 h, and no current mood episode, acute suicidality, eating disorder, psychosis, alcohol or substance use disorder, or other health conditions that would interfere with or limit the safety of following the dietary guidance. Participants will be asked to complete baseline daily food logging for two weeks and then will be randomly allocated to follow TRE or the Mediterranean diet for 8 weeks, during which time, they will continue to complete daily food logging. Intervention content will be delivered via an app. Symptom severity interviews will be conducted at baseline; mid-intervention (4 weeks after the intervention begins); end of intervention; and at 6, 9, and 15 months post-baseline by phone or videoconference. Self-rated symptom severity and quality of life data will be gathered at those timepoints, as well as at 16 weeks post baseline. To provide a more refined index of whether TRE successfully decreases emotional lability and improves sleep, participants will be asked to complete a sleep diary (core CSD) each morning and complete six mood assessments per day for eight days at baseline and again at mid-intervention. DISCUSSION: The planned research will provide novel and important information on whether TRE is more beneficial than the Mediterranean diet for reducing mood symptoms and improving quality of life in individuals with BD who also experience sleep or circadian problems. TRIAL REGISTRATION: ClinicalTrials.gov ID NCT06188754.

Anti-gravity treadmills have been used in rehabilitation to manipulate exposure to loading and to prescribe return to outside running. Analysis is typically restricted to the vertical plane, but tri-axial accelerometry facilitates multi-planar analysis with relevance to injury mechanism. In this case a professional male soccer player, 4 weeks post-operative surgery to repair a medial meniscectomy, 8 months after Anterior Cruciate Ligament reconstruction to the same knee, completed anti-gravity treadmill running at 70–95% bodyweight (BW) at 5% increments. Tri-axial accelerometers were placed proximal to the Achilles tendon of the injured and healthy leg, and at C7. The planar acceleration at touchdown highlighted an increase at 85% BW, identifying 70% and 85% BW as discrete loading progressions. C7 (3.21 ± 0.68 m·s−2) elicited lower (P < 0.001) vertical acceleration than the lower limb (9.31 ± 1.82 m·s−2), with no difference between limbs suggesting bilateral symmetry. However, in the medio-lateral plane the affected limb (−0.15 ± 1.82 m·s−2) was exposed to lower (P = 0.001) medio-lateral acceleration than the non-affected limb (2.92 ± 1.35 m·s−2) at touchdown, indicative of bilateral asymmetry. PlayerLoad during foot contact was sensitive to accelerometer location, with the affected limb exposed to greater loading in all planes (P ≤ 0.082), exacerbated at 90–95% BW. Tri-axial accelerometry provides a means of assessing multi-planar loading during rehabilitation, enhancing objective progression. [ABSTRACT FROM AUTHOR]

Given the highly infectious nature of COVID-19, social distancing practices are key in stemming the spread of the virus. We aimed to assess the complex interplay among psychological factors, socio-demographic characteristics and social distancing behaviours within the framework of the widely used Capability, Opportunity, Motivation-Behaviour (COM-B) model. The present research employed network psychometrics on data collected during the first UK lockdown in April 2020 as part of the COVID-19 Psychological Research Consortium (C19PRC) Study. Using a network approach, we examined the predictions of psychological and demographic variables onto social distancing practices at two levels of analysis: macro and micro. Our findings revealed several factors that influenced social distancing behaviour during the first UK lockdown. The COM-B model was successful in predicting particular aspects of social-distancing via the influence of psychological capability and motivation at the macro-and micro-levels, respectively. Notably, demographic variables, such as education, income, and age, were directly and uniquely predictive of certain social distancing behaviours. Our findings reveal psychological factors that are key predictors of social distancing behaviour and also illustrate how demographic variables directly influence such behaviour. Our research has implications for the design of empirically-driven interventions to promote adherence to social distancing practices in this and future pandemics. Supplemental data for this article is available online at [ABSTRACT FROM AUTHOR]

Objectives: Established in March 2020, the C19PRC Study monitors the psychological and socio‐economic impact of the pandemic in the UK and other countries. This paper describes the protocol for Wave 6 (August–September 2021). Methods: The survey assessed: COVID‐19 related experiences; experiences of common mental health disorders; psychological characteristics; and social and political attitudes. Adult participants from any previous wave (N = 3170) were re‐invited, and sample replenishment procedures helped manage attrition. Weights were calculated using a survey raking algorithm to ensure the on‐going original panel (from baseline) was nationally representative in terms of gender, age, and household income, amongst other factors. Results: 1643 adults were re‐interviewed at Wave 6 (51.8% retention rate). Non‐participation was higher younger adults, those born outside UK, and adults living in cities. Of the adults recruited at baseline, 54.3% (N = 1100) participated in Wave 6. New respondent (N = 415) entered the panel at this wave, resulting in cross‐sectional sample for Wave 6 of 2058 adults. The raking procedure re‐balanced the longitudinal panel to within 1.3% of population estimates for selected socio‐demographic characteristics. Conclusions: This paper outlines the growing strength of the publicly available C19PRC Study data for COVID‐19‐related interdisciplinary research. [ABSTRACT FROM AUTHOR]

Although the COVID-19 pandemic has impacted the psychological wellbeing of some people, there is evidence that many have been much less affected. The Ecological Model of Resilience (EMR) may explain why some individuals are not resilient whilst others are. In this study we test the EMR in a comparison of UK survey data collected from the COVID-19 Psychological Research Consortium (C19PRC) longitudinal study of a representative sample of the United Kingdom (UK) adult population and data from an Italian arm of the study. We first compare data from the third wave of the UK arm of the study, collected in July/August 2020, with data from an equivalent sample and stage of the pandemic in Italy in July 2020. Next, using UK longitudinal data collected from C19PRC Waves 1, 3 and 5, collected between March 2020 and April 2021 we identify the proportion of people who were resilient. Finally, we examine which factors, drawn from the EMR, predict resilient and non-resilient outcomes. We find that the 72% of the UK sample was resilient, in line with the Italian study. In the cross-sectional logistic regression model, age and self-esteem were significantly associated with resilience whilst death anxiety thoughts, neuroticism, loneliness, and Post Traumatic Stress Disorder (PTSD) symptoms related to COVID-19 were significantly associated with Non-Resilient outcomes. In the longitudinal UK analysis, at Wave 5, 80% of the sample was Resilient. Service use, belonging to wider neighbourhood, self-rated health, self-esteem, openness, and externally generated death anxiety were associated with Resilient outcomes. In contrast, PTSD symptoms and loneliness were associated with Non-Resilient outcomes. The EMR effectively explained the results. There were some variables which are amenable to intervention which could increase resilience in the face of similar future challenges. [ABSTRACT FROM AUTHOR]

Background: The current study argues that population prevalence estimates for mental health disorders, or changes in mean scores over time, may not adequately reflect the heterogeneity in mental health response to the COVID-19 pandemic within the population. Methods: The COVID-19 Psychological Research Consortium (C19PRC) Study is a longitudinal, nationally representative, online survey of UK adults. The current study analysed data from its first three waves of data collection: Wave 1 (March 2020, N = 2025), Wave 2 (April 2020, N = 1406) and Wave 3 (July 2020, N = 1166). Anxiety-depression was measured using the Patient Health Questionnaire Anxiety and Depression Scale (a composite measure of the PHQ-9 and GAD-7) and COVID-19-related posttraumatic stress disorder (PTSD) with the International Trauma Questionnaire. Changes in mental health outcomes were modelled across the three waves. Latent class growth analysis was used to identify subgroups of individuals with different trajectories of change in anxiety-depression and COVID-19 PTSD. Latent class membership was regressed on baseline characteristics. Results: Overall prevalence of anxiety-depression remained stable, while COVID-19 PTSD reduced between Waves 2 and 3. Heterogeneity in mental health response was found, and hypothesised classes reflecting (i) stability, (ii) improvement and (iii) deterioration in mental health were identified. Psychological factors were most likely to differentiate the improving, deteriorating and high-stable classes from the low-stable mental health trajectories. Conclusions: A low-stable profile characterised by little-to-no psychological distress ('resilient' class) was the most common trajectory for both anxiety-depression and COVID-19 PTSD. Monitoring these trajectories is necessary moving forward, in particular for the ~30% of individuals with increasing anxiety-depression levels. [ABSTRACT FROM AUTHOR]

Objectives: The COVID‐19 Psychological Research Consortium (C19PRC) Study was established in March 2020 to monitor the psychological and socio‐economic impact of the pandemic in the UK and other countries. This paper describes the protocol for Wave 5 (March–April 2021). Methods: The survey assessed: COVID‐19 related experiences; experiences of common mental health disorders; psychological characteristics; and social and political attitudes. Adults who participated in any previous wave (N = 4949) were re‐invited to participate. Weights were calculated using a survey raking algorithm to ensure the longitudinal panel was nationally representative in terms of gender, age, and household income, amongst other factors. Results: Overall, 2520 adults participated. A total of 2377 adults who participated in the previous survey wave (November–December 2020) were re‐interviewed at Wave 5 (61.5% retention rate). Attrition between these two waves was predicted by younger age, lower household income, children living in the household, and treatment for mental health difficulties. Of the adults recruited into the C19PRC study at baseline, 57.4% (N = 1162) participated in Wave 5. The raking procedure re‐balanced the longitudinal panel to within 1.5% of population estimates for selected socio‐demographic characteristics. Conclusion: This paper outlines the growing strength of the publicly available C19PRC Study data for COVID‐19‐related interdisciplinary research. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease 2019 (COVID-19) emergency has led to numerous attempts to assess the impact of the pandemic on population mental health. The findings indicate an increase in depression and anxiety but have been limited by the lack of specificity about which aspects of the pandemic (e.g. viral exposure or economic threats) have led to adverse mental health outcomes. Methods: Network analyses were conducted on data from wave 1 (N = 2025, recruited 23 March–28 March 2020) and wave 2 (N = 1406, recontacts 22 April–1 May 2020) of the COVID-19 Psychological Research Consortium Study, an online longitudinal survey of a representative sample of the UK adult population. Our models included depression (PHQ-9), generalized anxiety (GAD-7) and trauma symptoms (ITQ); and measures of COVID-specific anxiety, exposure to the virus in self and close others, as well as economic loss due to the pandemic. Results: A mixed graphical model at wave 1 identified a potential pathway from economic adversity to anxiety symptoms via COVID-specific anxiety. There was no association between viral exposure and symptoms. Ising network models using clinical cut-offs for symptom scores at each wave yielded similar findings, with the exception of a modest effect of viral exposure on trauma symptoms at wave 1 only. Anxiety and depression symptoms formed separate clusters at wave 1 but not wave 2. Conclusions: The psychological impact of the pandemic evolved in the early phase of lockdown. COVID-related anxiety may represent the mechanism through which economic consequences of the pandemic are associated with psychiatric symptoms. [ABSTRACT FROM AUTHOR]

Two theoretical perspectives have been proffered to explain changes in alcohol use during the pandemic: the 'affordability-availability' mechanism (i.e., drinking decreases due to changes in physical availability and/or reduced disposable income) and the 'psychological-coping' mechanism (i.e., drinking increases as adults attempt to cope with pandemic-related distress). We tested these alternative perspectives via longitudinal analyses of the COVID-19 Psychological Consortium (C19PRC) Study data (spanning three timepoints during March to July 2020). Respondents provided data on psychological measures (e.g., anxiety, depression, posttraumatic stress, paranoia, extraversion, neuroticism, death anxiety, COVID-19 anxiety, intolerance of uncertainty, resilience), changes in socio-economic circumstances (e.g., income loss, reduced working hours), drinking motives, solitary drinking, and 'at-risk' drinking (assessed using a modified version of the AUDIT-C). Structural equation modelling was used to determine (i) whether 'at-risk' drinking during the pandemic differed from that recalled before the pandemic, (ii) dimensions of drinking motives and the psychosocial correlates of these dimensions, (iii) if increased alcohol consumption was predicted by drinking motives, solitary drinking, and socio-economic changes. The proportion of adults who recalled engaging in 'at-risk' drinking decreased significantly from 35.9% pre-pandemic to 32.0% during the pandemic. Drinking to cope was uniquely predicted by experiences of anxiety and/or depression and low resilience levels. Income loss or reduced working hours were not associated with coping, social enhancement, or conformity drinking motives, nor changes in drinking during lockdown. In the earliest stage of the pandemic, psychological-coping mechanisms may have been a stronger driver to changes in adults' alcohol use than 'affordability-availability' alone. [ABSTRACT FROM AUTHOR]

Objectives: This paper outlines fieldwork procedures for Wave 4 of the COVID‐19 Psychological Research Consortium (C19PRC) Study in the UK during November–December 2020. Methods: Respondents provided data on socio‐political attitudes, beliefs, and behaviours, and mental health disorders (anxiety, depression, and posttraumatic stress). In Phase 1, adults (N = 2878) were reinvited to participate. At Phase 2, new recruitment: (i) replenished the longitudinal strand to account for attrition; and (ii) oversampled from the devolved UK nations to facilitate robust between‐country analyses for core study outcomes. Weights were calculated using a survey raking algorithm to ensure the longitudinal panel was representative of the baseline sample characteristics. Results: In Phase 1, 1796 adults were successfully recontacted and provided full interviews at Wave 4 (62.4% retention rate). In Phase 2, 292 new respondents were recruited to replenish the panel, as well as 1779 adults from Wales, Scotland, and Northern Ireland, who were representative of the socio‐political composition of the adult populations in these nations. The raking procedure successfully re‐balanced the longitudinal panel to within 1% of population estimates for selected socio‐demographic characteristics. Conclusion: The C19PRC Study offers a unique opportunity to facilitate and stimulate interdisciplinary research addressing important public health questions relating to the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Alterations to striatal reward pathways have been identified in individuals with psychosis. They are hypothesized to be a key mechanism that generate psychotic symptoms through the production of aberrant attribution of motivational salience and are proposed to result from accumulated childhood adversity and genetic risk, making the striatal system hyper-responsive to stress. However, few studies have examined whether children with psychotic-like experiences (PLEs) also exhibit these alterations, limiting our understanding of how differences in reward processing relate to hallucinations and delusional ideation in childhood. Consequently, we examined whether PLEs and PLE-related distress were associated with reward-related activation in the nucleus accumbens (NAcc). The sample consisted of children (N = 6718) from the Adolescent Brain Cognitive Development (ABCD) study aged 9–10 years who had participated in the Monetary Incentive Delay (MID) task in functional MRI. We used robust mixed-effects linear regression models to investigate the relationship between PLEs and NAcc activation during the reward anticipation and reward outcome stages of the MID task. Analyses were adjusted for gender, household income, ethnicity, depressive symptoms, movement in the scanner, pubertal development, scanner ID, subject and family ID. There was no reliable association between PLEs and alterations to anticipation- or outcome-related striatal reward processing. We discuss the implications for developmental models of psychosis and suggest a developmental delay model of how PLEs may arise at this stage of development. [ABSTRACT FROM AUTHOR]

COVID-19 continues to pose a threat to global public health. Multiple safe and effective vaccines against COVID-19 are available with one-third of the global population now vaccinated. Achieving a sufficient level of vaccine coverage to suppress COVID-19 requires, in part, sufficient acceptance among the public. However, relatively high rates of hesitance and resistance to COVID-19 vaccination persists, threating public health efforts to achieve vaccine-induced population protection. In this study, we examined longitudinal changes in COVID-19 vaccine acceptance, hesitance, and resistance in two nations (the United Kingdom and the Republic of Ireland) during the first nine months of the pandemic, and identified individual and psychological factors associated with consistent non-acceptance of COVID-19 vaccination. Using nationally representative, longitudinal data from the United Kingdom (UK; N = 2025) and Ireland (N = 1041), we found that (1) COVID-19 vaccine acceptance declined in the UK and remained unchanged in Ireland following the emergence of approved vaccines; (2) multiple subgroups existed reflecting people who were consistently willing to be vaccinated ('Accepters': 68% in the UK and 61% in Ireland), consistently unwilling to be vaccinated ('Deniers': 12% in the UK and 16% in Ireland), and who fluctuated over time ('Moveable Middle': 20% in the UK and 23% in Ireland); and (3) the 'deniers' and 'moveable middle' were distinguishable from the 'accepters' on a range of individual (e.g., younger, low income, living alone) and psychological (e.g., distrust of scientists and doctors, conspiracy mindedness) factors. The use of two high-income, Western European nations limits the generalizability of these findings. Nevertheless, understanding how receptibility to COVID-19 vaccination changes as the pandemic unfolds, and the factors that distinguish and characterise those that are hesitant and resistant to vaccination is helpful for public health efforts to achieve vaccine-induced population protection against COVID-19. [ABSTRACT FROM AUTHOR]

Objectives: The COVID‐19 Psychological Research Consortium (C19PRC) Study aims to assess the impact of the COVID‐19 pandemic in the adult population in multiple countries. This paper describes the third wave of the UK survey (the 'parent' strand of the Consortium) during July‐August 2020. Methods: Adults (N = 2025) who participated in the baseline and/or first follow‐up surveys were reinvited to participate in this survey, which assessed: (1) COVID‐19 related knowledge, attitudes, and behaviours; (2) the occurrence of common mental disorders; as well as the role of (3) psychological factors and (4) social and political attitudes, in influencing the public's response to the pandemic. Weights were calculated using a survey raking algorithm to ensure that the cross‐sectional sample is nationally representative in terms of gender, age, and household income, and representative of the baseline sample characteristics for household composition, ethnicity, urbanicity and born/raised in UK. Results: 1166 adults (57.6% of baseline participants) provided full interviews at Wave 3. The raking procedure successfully re‐balanced the cross‐sectional sample to within 1% of population estimates across selected socio‐demographic characteristics. Conclusion: This paper demonstrates the strength of the C19PRC Study data to facilitate and stimulate interdisciplinary research addressing important public health questions relating to the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

Objectives: The C19PRC study aims to assess the impact of the COVID‐19 pandemic in the adult population of the UK, Republic of Ireland, and Spain. This paper describes the conduct of the first two waves of the UK survey (the "parent" strand of the Consortium) during March–April 2020. Methods: A longitudinal, internet panel survey was designed to assess: (1) COVID‐19 related knowledge, attitudes, and behaviors; (2) the occurrence of common mental health disorders as well as the role of (3) psychological factors and (4) social and political attitudes, in influencing the public's response to the pandemic. Quota sampling (age, sex, and household income) was used to recruit a nationally representative sample of adults. Results: Two thousand and twenty five adults were recruited at baseline, and 1406 were followed‐up one‐month later (69.4% retention rate). The baseline sample was representative of the UK population in relation to economic activity, ethnicity, and household composition. Attrition was predicted by key socio‐demographic characteristics, and an inverse probability weighting procedure was employed to ensure the follow‐up sample was representative of the baseline sample. Conclusion: The C19PRC study data has strong generalizability to facilitate and stimulate interdisciplinary research on important public health questions relating to the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

The over-purchasing and hoarding of necessities is a common response to crises, especially in developed economies where there is normally an expectation of plentiful supply. This behaviour was observed internationally during the early stages of the Covid-19 pandemic. In the absence of actual scarcity, this behaviour can be described as 'panic buying' and can lead to temporary shortages. However, there have been few psychological studies of this phenomenon. Here we propose a psychological model of over-purchasing informed by animal foraging theory and make predictions about variables that predict over-purchasing by either exacerbating or mitigating the anticipation of future scarcity. These variables include additional scarcity cues (e.g. loss of income), distress (e.g. depression), psychological factors that draw attention to these cues (e.g. neuroticism) or to reassuring messages (eg. analytical reasoning) or which facilitate over-purchasing (e.g. income). We tested our model in parallel nationally representative internet surveys of the adult general population conducted in the United Kingdom (UK: N = 2025) and the Republic of Ireland (RoI: N = 1041) 52 and 31 days after the first confirmed cases of COVID-19 were detected in the UK and RoI, respectively. About three quarters of participants reported minimal over-purchasing. There was more over-purchasing in RoI vs UK and in urban vs rural areas. When over-purchasing occurred, in both countries it was observed across a wide range of product categories and was accounted for by a single latent factor. It was positively predicted by household income, the presence of children at home, psychological distress (depression, death anxiety), threat sensitivity (right wing authoritarianism) and mistrust of others (paranoia). Analytic reasoning ability had an inhibitory effect. Predictor variables accounted for 36% and 34% of the variance in over-purchasing in the UK and RoI respectively. With some caveats, the data supported our model and points to strategies to mitigate over-purchasing in future crises. [ABSTRACT FROM AUTHOR]

Objective: To examine the effects of training intensity and environmental condition on the hydration status of Elite football players. Methods: Eleven elite football players completed three training sessions of varying intensity in cool (12°C) and warm (23°C) environments. Training demands was measured by Global Positioning System, sweat rate and sweat sodium concentration were measured using dermal patches and body mass change. Results: Warm condition increased sweat rate (0.9 ± 0.3 vs 1.7 ± 0.3 L.h-1, P<0.001), fluid intake (0.7 ± 0.1 vs 1.5 ± 0.2 L, P<0.001), total sodium loss (1405 ± 340 vs 2946 ± 958 mg, P<0.001) and total sweat loss (1.4 ± 0.5 vs 2.5 ± 0.4 L, P<0.001) compared to cool. Training intensity increased sweat sodium concentration (16.1 ± 6.6 vs 54.6 ± 22.2 mmol.L-1, P<0.001) and sodium loss (779 ± 231 vs 1405 ± 340 mg) in both environmental conditions. Total sweat loss and sodium loss were positively correlated with total distance covered (r=0.48, P=0.005 and r=0.4, P=0.023, respectively), meanwhile sodium loss was also positively correlated with the total number of high-intensity efforts (r=0.35, P=0.045). Conclusions: The results show that training load and environmental condition have a major impact on the hydration status of elite football players, hence hydration strategies should be developed accordingly. [ABSTRACT FROM AUTHOR]

Objectives: The COVID-19 pandemic is one of the greatest global health threats facing humanity in recent memory. This study aimed to explore influences on hygienic practices, a set of key transmission behaviours, in relation to the Capability, Opportunity, Motivation-Behaviour (COM-B) model of behaviour change (Michie et al., 2011).Design: Data from the first wave of a longitudinal survey study were used, launched in the early stages of the UK COVID-19 pandemic.Methods: Participants were 2025 adults aged 18 and older, representative of the UK population, recruited by a survey company from a panel of research participants. Participants self-reported motivation, capability, and opportunity to enact hygienic practices during the COVID-19 outbreak.Results: Using regression models, we found that all three COM-B components significantly predicted good hygienic practices, with motivation having the greatest influence on behaviour. Breaking this down further, the subscales psychological capability, social opportunity, and reflective motivation positively influenced behaviour. Reflective motivation was largely driving behaviour, with those highest in reflective motivation scoring 51% more on the measure of hygienic practices compared with those with the lowest scores.Conclusions: Our findings have clear implications for the design of behaviour change interventions to promote hygienic practices. Interventions should focus on increasing and maintaining motivation to act and include elements that promote and maintain social support and knowledge of COVID-19 transmission. Groups in particular need of targeting for interventions to increase hygienic practices are males and those living in cities and suburbs. [ABSTRACT FROM AUTHOR]

This study aimed to estimate the association between anxiety associated with COVID-19 and somatic symptoms, using data from a large, representative sample (N = 2,025) of the UK adult population. Results showed that moderate to high levels of anxiety associated with COVID-19 were significantly associated with general somatic symptoms and in particular with gastrointestinal and fatigue symptoms. This pattern of associations remained significant after controlling for generalized anxiety disorder (GAD), pre-existing health problems, age, gender, and income. This is the first evidence that anxiety associated with COVID-19 makes a unique contribution to somatization, above and beyond the effect of GAD. [ABSTRACT FROM AUTHOR]

Psychological therapies, such as CBT, are an important part of the treatment of a range of psychiatric disorders such as depression and anxiety. There is a growing desire to understand the mechanisms by which such therapies effect change so as to improve treatment outcomes. Here we argue that adopting a computational framework may be one such approach. Computational psychiatry aims to provide a theoretical framework for moving between higher-level psychological states (like emotions, decisions and beliefs) to neural circuits, by modeling these constructs mathematically. These models are explicit hypotheses that contain quantifiable variables and parameters derived from each individual's behavior. This approach has two advantages. Firstly, some of the variables described by these models appears to reflect the neural activity of specific brain regions. Secondly, the parameters estimated by these models may offer a unique description of a patient's symptoms which can be used to both tailor therapy and track its effect. In doing so this approach may offer some additional granularity in understanding how psychological therapies, such as CBT, are working. Although this field shows significant promise, we also highlight several of the key hurdles that must first be overcome before clinical translation of computational insights can be realized. [ABSTRACT FROM AUTHOR]

Psychological therapy, psychotherapy, mechanisms, neuroimaging, brain, cbt, cognitive behavioural, computational psychiatry Keywords: psychological therapy; psychotherapy; mechanisms; neuroimaging; brain; cbt; cognitive behavioural; computational psychiatry EN psychological therapy psychotherapy mechanisms neuroimaging brain cbt cognitive behavioural computational psychiatry 1 3 3 05/26/21 20210524 NES 210524 Many pivotal techniques from evidence-based psychological interventions for other disorders grew from basic research into mechanistic processes. [Extracted from the article]

Objective: While there is now strong evidence that psychological therapies can alter the activity of individual brain regions, their impact on the functional integration between regions has not yet been systematically evaluated. This area is important given that brain dysconnectivity has been implicated across almost all psychiatric disorders. Accordingly, we sought to establish connectivity predictors and mechanisms of effective psychological therapies. We further establish whether connectivity changes represent normalisation of disorder pathophysiology or compensatory changes. Method: We reviewed studies examining structural and functional connectivity longitudinally as either a predictor or outcome variable of successful psychological therapies across psychiatric disorders. Results: Fifteen studies met our inclusion criteria. All but three related to cognitive behavioural therapy. Of these, five assessed resting state, nine probed affective processing and one probed cognitive processing. Twelve studies reported evidence of functional connectivity as a significant predictor or outcome of cognitive behavioural therapy, with prefronto-limbic circuitry most commonly implicated. Only six studies included healthy participants, limiting direct inferences about normalisation as opposed to compensatory changes. Anxiety disorders were overrepresented, totalling 13 of the studies reviewed. No studies examined structural connectivity or utilised analyses allowing the directionality of functional connectivity to be inferred. Conclusion: While the evidence base is still in its infancy for other therapy approaches, there was clearer evidence that functional connectivity both predicts and is altered by cognitive behavioural therapy. Connections from prefrontal cortex appear especially key, perhaps given their role in cognitive appraisal of lower order affective, motivational and cognitive processes. A number of recommendations are made for this rapidly developing literature. [ABSTRACT FROM AUTHOR]

Background: Allocation of trainee therapist cases is often performed based on intuition and clinical circumstances, with lack of empirical evidence on the role of severity of presenting problem. This has the potential to be anxiety-provoking for supervisors, trainees and service users themselves. Aims: To determine how therapist experience interacts with symptom severity in predicting client outcomes. Method: An intention-to-treat analysis of annual outcome data for primary and secondary care clients seen by a specialist anxiety disorders service. 196 clients were stratified into mild, moderate and baseline severe symptoms of anxiety (GAD-7) and depression (PHQ-9). We measured percentage change on these measures, as well as number of sessions and therapy dropout. We also examined rates of reliable and clinically significant change on disorder-specific measures. We hypothesized that qualified therapists would achieve better outcomes than trainees, particularly for severe presentations. Results: Overall, outcomes were comparable between trainee and qualified therapists on all measures, and trainees additionally utilized fewer therapy sessions. There was however an interaction between anxiety severity (GAD-7) and therapist group, such that severely anxious clients achieved greater symptom improvement with qualified as compared to trainee therapists. Further, for trainee but not qualified therapists, baseline anxiety was negatively associated with rate of reliable and clinically significant change on disorder-specific measures. Conclusions: These findings indicate generally favourable outcomes for trainee therapists delivering manualized treatments for anxiety disorders. They additionally suggest that trainee therapists may benefit from additional support when working with clients that present with severe anxiety. [ABSTRACT FROM PUBLISHER]

Background There is amassing evidence that risky decision-making in bipolar disorder is related to reward-based differences in frontostriatal regions. However, the roles of early attentional and later cognitive processes remain unclear, limiting theoretical understanding and development of targeted interventions. Methods Twenty euthymic bipolar disorder and 19 matched control participants played a Roulette task in which they won and lost money. Event-related potentials and source analysis were used to quantify predominantly sensory-attentional (N1), motivational salience (feedback-related negativities [FRN]), and cognitive appraisal (P300) stages of processing. We predicted that the bipolar disorder group would show increased N1, consistent with increased attentional orienting, and reduced FRN, consistent with a bias to perceive outcomes more favorably. Results As predicted, the bipolar disorder group showed increased N1 and reduced FRN but no differences in P300. N1 amplitude was additionally associated with real-life risk taking, and N1 source activity was reduced in visual cortex but increased activity in precuneus, frontopolar, and premotor cortex, compared to those of controls. Conclusions These findings demonstrate an early attentional bias to reward that potentially drives risk taking by priming approach behavior and elevating reward salience in the frontostriatal pathway. Although later cognitive appraisals of these inputs may be relatively intact in remission, interventions targeting attention orienting may also be effective in long-term reduction of relapse. [ABSTRACT FROM AUTHOR]

Both theoretical models and functional imaging studies implicate the involvement of emotions within the delay discounting process. However, defining this role has been difficult to establish with neuroimaging techniques given the automaticity of emotional responses. To address this, the current study examined electrophysiological correlates involved in the detection and evaluation of immediate and delayed monetary outcomes. Our results showed that modulation of both early and later ERP components previously associated with affective stimuli processing are sensitive to the signalling of delayed rewards. Together with behavioural reaction times that favoured immediacy, we demonstrated, for the first time, that time delays modify the incentive value of monetary rewards via mechanisms of emotional bias and selective visual attention. Furthermore, our data are consistent with the hypothesis that delayed and thus intangible rewards are perceived less saliently, and rely on emotion as a common currency within decision making. This study provides a new approach to delay discounting and highlights a potential novel route through which delay discounting may be investigated. [ABSTRACT FROM AUTHOR]

Background: Mania is characterised by increased impulsivity and risk-taking, and psychological accounts argue that these features may be due to hypersensitivity to reward. The neurobiological mechanisms remain poorly understood. Here we examine reinforcement learning and sensitivity to both reward and punishment outcomes in hypomania-prone individuals not receiving pharmacotherapy. Method: We recorded EEG from 45 healthy individuals split into three groups by low, intermediate and high self-reported hypomanic traits. Participants played a computerised card game in which they learned the reward contingencies of three cues. Neural responses to monetary gain and loss were measured using the feedback-related negativity (FRN), a component implicated in motivational outcome evaluation and reinforcement learning. Results: As predicted, rewards elicited a smaller FRN in the hypomania-prone group relative to the low hypomania group, indicative of greater reward responsiveness. The hypomania-prone group also showed smaller FRN to losses, indicating diminished response to negative feedback. Conclusion: Our findings indicate that proneness to hypomania is associated with both reward hypersensitivity and discounting of punishment. This positive evaluation bias may be driven by aberrant reinforcement learning signals, which fail to update future expectations. This provides a possible neural mechanism explaining risk-taking and impaired reinforcement learning in BD. Further research will be needed to explore the potential value of the FRN as a biological vulnerability marker for mania and pathological risk-taking. [ABSTRACT FROM AUTHOR]

Background: Hypomania is associated with impulsive decision making and risk taking, characteristics that may arise from hypersensitivity to reward. To date, the neural dynamics underlying intertemporal reward processing have neither been characterized clinically nor in the general population. Taking vulnerability to hypomania as a surrogate model of impulsivity, we utilized event-related potentials to study the neural mechanisms of delay discounting. Methods: In the first experiment, 32 participants completed an established Two Choice Impulsivity Paradigm in which free choice between immediate and delayed rewards was used to quantify impulsivity behaviorally. In the second experiment, electroencephalography was recorded while 32 separately recruited participants completed a speeded response task involving gains and losses of monetary incentives to be paid at three different delays after the experiment. Results: In the first experiment, the hypomania-prone group made significantly more immediate choices than the control group. In the second experiment, the hypomania-prone group evidenced greater differentiation between delayed and immediate outcomes in early attention-sensitive (N1) and later reward-sensitive (feedback-related negativity) components. Proneness to hypomania was also associated with greater N1 amplitude to rewards per se. Conclusions: These results indicate steeper delay discounting in hypomania at multiple stages of information processing. The N1 modulation by valence and delay suggests an attentional bias to immediate rewards, which may drive subsequent cognitive appraisal of outcomes (feedback-related negativity). These results highlight the early influence of attention on reward processing and provide support for reward dysregulation accounts of bipolar disorder. Potential implications for mindfulness training and other therapeutic interventions are highlighted. [Copyright &y& Elsevier]

\nHighlightsTo better understand the in-match fuelling practices of elite football players and compare against current guidelines, we quantified the carbohydrate, fluid, and caffeine intake of players from an English Premier League club (n = 22) during 90 min of competitive match-play. Mean carbohydrate intake across match-play was 17 ± 11 g.h−1 with players demonstrating a preference towards CHO-containing fluids (58%) when compared with semi-solids (38%) and solids (14%), respectively. CHO intake was significantly lower than reported by players (17 ± 11 vs 24.8 ± 11 g.h−1, p < 0.001) during initial consultation. Fluid was ingested at a rate of 0.45 ± 0.14 L.h−1, with 54, 40 and 6% of ingested fluid coming from water, carbohydrate, and electrolyte-only solutions, respectively. The majority of players (91%) met the UEFA guidelines for fluid consumption. Of the players who consumed caffeine across match-play (55%) the average dose was 233 ± 148 mg (2.8 ± 1.1 mg.kg−1 body mass [BM]), which meets the UEFA consensus guidelines for caffeine intake. Caffeine capsules (42%) and caffeine containing fluids (30%) were the preferred format prior to the warm-up whilst caffeine gum was exclusively used prior to kick-off and during the half-time period (100%). We conclude that 81% of the total playing squad failed to meet the current UEFA CHO intake recommendations of 30–60 g.h−1, which may be attributed to the preference towards fluid-based CHOs as the chosen format of delivery. Soccer players demonstrate sub-optimal in-match fuelling practices, with 81% of players failing to meet current UEFA CHO intake recommendations of 30-60 g.h−1Players demonstrate a preference towards fluid as the primary mode of CHO delivery over the use of semi-solid and solid formats.These data highlight the need for future research to test the efficacy of lower doses of CHO on elements of both physical and technical soccer performance in a dose-response manner.Future research is also necessary to investigate the impact of traditional guidelines and recommendations within football-specific contexts to assess their effectiveness and relevance in practical applications.Soccer players demonstrate sub-optimal in-match fuelling practices, with 81% of players failing to meet current UEFA CHO intake recommendations of 30-60 g.h−1Players demonstrate a preference towards fluid as the primary mode of CHO delivery over the use of semi-solid and solid formats.These data highlight the need for future research to test the efficacy of lower doses of CHO on elements of both physical and technical soccer performance in a dose-response manner.Future research is also necessary to investigate the impact of traditional guidelines and recommendations within football-specific contexts to assess their effectiveness and relevance in practical applications. [ABSTRACT FROM AUTHOR]

Background: Individuals with psychosis display an attenuated response to reward. However, it has not yet been established whether individuals with psychotic-like experiences (PLEs) also exhibit alterations in reward anticipation. Methods: The present study examined whether non-distressing and distressing PLEs were associated with functional activity in the nucleus accumbens during reward anticipation. The sample consisted of 10313 children from the ABCD study aged 9–10 who had participated in the Monetary Incentive Delay task. PLEs were measured using the Prodromal Questionnaire Brief Child version and functional activity was measured using regional fMRI summary statistics for reward anticipation activation (data release 2.0, contrast of expected large reward versus neutral expectation). Linear mixed-effects models were used to investigate the relationship between reward anticipation and PLEs (distressing and non-distressing), whilst controlling for gender, household income, ethnicity, BMI and affective symptoms. The analyses were weighted by the average standard error of the mean activation in the accumbens. Separate linear mixed-effects models were conducted for the right and left hemisphere. Results: 6169 (59.8%) of the children did not report any PLEs, compared to 2270 (22.0%) with non-distressing PLEs and 1874 (18.2%) with distressing PLEs. We ran a regression to examine the association between reward anticipation and PLEs (distressing or non-distressing) and found that nondistressing PLEs were related to reduced reward anticipation in the right nucleus accumbens (P = 0.009). However, there was no significant association between reward anticipation and PLEs when adjusting for potential confounders. Discussion: In the present study of 9–10 year olds, reward anticipation was not associated with PLEs. As previous research has found reductions in reward anticipation in individuals with schizophrenia, further follow-up studies of the ABCD cohort are needed to explore whether these associations emerge during adolescence. [ABSTRACT FROM AUTHOR]

Background: Elite-level football requires an array of physical, technical, psychological, and tactical skills. The aim of this study was to measure the association between physical outputs (distance, decelerations, accelerations) and the match outcome (win, draw, lose) in professional football. This research also examined whether the same association is influenced if a team adopts a possession or transition-based playing style., Methods: Thirty-six elite-outfield football players from an English Championship team participated in the study during the 2020/2021 and 2021/2022 seasons using physical and event data collected from an English Championship club over the 2020-2021 and 2021-2022 seasons, this study conducted a univariate analysis of variance (ANOVA) and Hedge g effect size (ES) to measure the research aims., Results: The results showed no significant differences were found between match outcomes for each physical output metric calculated. There was a trivial ES shown for all conditions except decelerations, with win/lose having a moderate ES (g=0.53). When playing a possession-based playing style there was no significant difference or non-trivial ES found for any physical output and match outcomes. When playing a transition-based playing style there was a moderate ES found for win/draw (P=0.38, g=0.90) and win/loss (P=0.98, g=0.64)., Conclusions: This research provides important evidence for utilizing intense deceleration actions as a physical KPI during match play for teams adopting a transitional playing style. Subsequently, training interventions should be adopted to physically prepare players to complete and sustain intense deceleration actions during match play.

Background: The SARS-CoV-2 agent initiated a global pandemic. The initial response to the pandemic was severe disruption to the public and private sector including sports. The resultant was that soccer clubs had to prescribe that the players trained in isolation for a prolonged period of time in an attempt to maintain fitness. The aim of the present study was to evaluate the impact of a 10-week period of training in isolation on aerobic fitness, body composition and injury incidence on the return to preseason team-training in a group of elite, male soccer players., Methods: Twenty-two professional soccer players (age: 25.2±4.4 years) who played for an English Championship first team participated in this study. A weekly training program was sent to each player at the start of each week. Prior to the start of the isolated training period, all players underwent a maximal aerobic speed test (MAS), and Body Mass Index data (BMI) were obtained. These measurements were repeated on the return to team training., Results: There was a significant (P<0.05) increase in MAS pre-post isolated training (pre: 4.71±0.15 vs. post: 4.92±0.17 m/s), no change in BMI (pre: 24.3±1.3 vs. post: 24.1±1.1 kg/m 2 ) and a low non-contact, soft-tissue injury incidence on the return to team training., Conclusions: The evidence from this study suggests that a more prolonged preseason schedule can enhance aerobic conditioning and mitigate the injury risk on the return to competitive match-play in elite soccer players.

This paper serves to alert IJPDS readers to the availability of a major new longitudinal survey data resource, the COVID-19 Psychological Research Consortium (C19PRC) Study , which is being released for secondary use via the Open Science Framework. The C19PRC Study is a rich and detailed dataset that provides a convenient and valuable foundation from which to study the social, political, and health status of European adults during an unprecedented time of change as a direct result of the COVID-19 pandemic and Brexit. Here, we provide an overview of the C19PRC Study design, with the purpose of stimulating interest about the study among social scientists and maximising use of this resource., Competing Interests: Conflicts of interest: The authors report no conflict of interest.