The role of cognitive biases and executive functions in adolescent worry

Worry is common in childhood and adolescence. In moderation, worry can serve as an adaptive response in anticipation to perceived threat. However, some young people experience excessive, uncontrollable, and persistent worries that cause significant distress and impairments to daily functioning. Research presented in this thesis investigated the role of cognitive biases and executive functions in adolescent worry. In Chapter Two, a systematic review examined the existing literature on child and adolescent worry and found that cognitive biases and executive functions were associated with worry in youth. The systematic review identified some of the gaps in the child and adolescent literature on worry, which provided a research framework for subsequent studies in this thesis. Chapters Three and Four presented data from the CogBias Longitudinal study and showed that interpretation and memory biases were closely interrelated cognitive processes associated with adolescent worry. Furthermore, Chapter Four found that negative biases played a causal role in the manifestation of worry from early to mid-adolescence. Chapters Five and Six, investigated the role of executive functions in adolescent worry. Findings in Chapter Five, indicated that attentional control and working memory were not associated with worry in adolescence. Moreover, these executive functions did not moderate the association between cognitive biases and worry. In Chapter Six, an experimental study was designed to assess the effect of active worry on working memory capacity using a worry induction paradigm in a community sample of adolescents. In line with the findings of Chapter Five, active worry did not impair working memory capacity in adolescents. The research presented in this thesis indicates that cognitive biases are mechanisms underlying worry in adolescence, however evidence that executive functions play a role in adolescent worry was not supported. Future research using longitudinal and experimental designs would provide further insight into the causal mechanisms underlying worry in adolescence and how these cognitive processes interact and develop over time.</p

Emotional information-processing correlates of mental health in adolescence: A network analysis approach

The Combined Cognitive Bias Hypothesis proposes that emotional information processing biases may conjointly influence mental health. Yet, little is known about the interrelationships amongst cognitive biases, particularly in adolescence. We used data from the CogBIAS longitudinal study (Booth et al. 2017), including 450 adolescents who completed measures of interpretation bias, memory bias, and a validated measure of general mental health in a typically developing population. We used a moderated network modelling approach to examine positive mental health related moderation of the cognitive bias network. We found that mental health was directly associated with positive and negative memory biases, and positive interpretation biases, but not negative interpretation biases. Further, we observed some mental health related moderation of the network structure. Network connectivity decreased with higher positive mental health scores. Network approaches allow us to model complex relationships amongst cognitive biases and develop novel hypotheses for future research

Oxford ARC study

Oxford Achieving Resilience during COVID-19 (ARC) stud

The effects of life experiences and polygenic risk for depression on the development of positive and negative cognitive biases across adolescence: The CogBIAS hypothesis

Background: Little is understood about the development of cognitive biases, despite their influential role in psychopathology and wellbeing. The Cognitive Bias (CogBIAS) hypothesis proposes that cognitive biases develop as a function of environmental influences (which determine the valence of biases), and the genetic susceptibility to those influences (which determines the potency of biases). The current study employed adolescent data from the CogBIAS Longitudinal Study to examine the CogBIAS hypothesis, using a polygenic-by-environment approach. Methods: Measures of life experiences and polygenic scores for depression were used to examine the development of memory and interpretation biases in a three-wave sample of adolescents (12-16 years). Mixed effects modeling was used to examine whether (negative and positive) life experiences, polygenic scores, and their interaction predicted various forms of the memory and interpretation biases. Results: Positive life experiences were shown to, respectively, diminish and enhance the negative and positive forms of memory recall and interpretation biases. Against expectation, negative life experiences and depression polygenic scores were not significant predictors of any cognitive outcomes, upon adjusting for psychopathology. Nonetheless, the interaction between polygenic risk and positive life events predicted a stronger positive social interpretation bias. Conclusions: These results provide the first line of polygenic evidence to support the CogBIAS and vantage sensitivity hypotheses, by demonstrating that polygenic risk for depression could interact with positive environmental influences to produce positive psychological outcomes during adolescence

Social and cognitive vulnerability to COVID-19-related stress in pregnancy: A case-matched-control study of antenatal mental health.

Emerging evidence shows that compared to pre-pandemic norms pregnant women report significant increases in clinical levels of depressive and anxiety symptoms during COVID-19. This pre-registered study examined cognitive and social vulnerability factors for poor mental health in pregnancy during COVID-19. Understanding vulnerability profiles is key to identifying women at risk for deteriorating peripartum mental health. N = 742 pregnant women and N = 742 age and country-matched controls from the COVID-19 Risks Across the Lifespan Study were included. Using a case-match control design allowed us to explore whether the cognitive vulnerability profiles would differ between pregnant and non-pregnant women. The findings showed that COVID-19-related stress was associated with heightened levels of depression and anxiety during pregnancy. Its impact was greatest in women with cognitive (i.e., higher intolerance of uncertainty and tendency to worry) and social (i.e., higher level of self-reported loneliness) vulnerabilities. Importantly, our data show that the mental health impacts of the pandemic were greater in pregnant women compared to women who were not pregnant, especially those with cognitive and social vulnerabilities. The results highlight the urgent need to prioritize mental health care for pregnant women to mitigate the impact of COVID-19-related stress on women's postpartum mental health and their infants' well-being

Affect and mental health across the lifespan during a year of the COVID-19 pandemic: The role of emotion regulation strategies and mental flexibility.

During the COVID-19 pandemic, there has been a rise in common mental health problems compared to prepandemic levels, especially in young people. Understanding the factors that place young people at risk is critical to guide the response to increased mental health problems. Here we examine whether age-related differences in mental flexibility and frequency of use of emotion regulation strategies partially account for the poorer affect and increased mental health problems reported by younger people during the pandemic. Participants (N = 2,367; 11-100 years) from Australia, the UK, and US were surveyed thrice at 3-month intervals between May 2020 and April 2021. Participants completed measures of emotion regulation, mental flexibility, affect, and mental health. Younger age was associated with less positive (b = 0.008, p < .001) and more negative (b = -0.015, p < .001) affect across the first year of the pandemic. Maladaptive emotion regulation partially accounted for age-related variance in negative affect (β = -0.013, p = .020), whereby younger age was associated with more frequent use of maladaptive emotion regulation strategies, which, in turn, was associated with more negative affect at our third assessment point. More frequent use of adaptive emotion regulation strategies, and in turn, changes in negative affect from our first to our third assessment, partially accounted for age-related variance in mental health problems (β = 0.007, p = .023). Our findings add to the growing literature demonstrating the vulnerability of younger people during the COVID-19 pandemic and suggest that emotion regulation may be a promising target for intervention. (PsycInfo Database Record (c) 2023 APA, all rights reserved)

Protocol for a proof-of-principal study comparing engagement with a gamified versus standard affective control training app targeting emotional wellbeing in adolescents

Introduction Emotion regulation is central to mental wellbeing and depends on good affective control. Training affective control has been shown to improve emotion regulation and have downstream benefits on mental health in adolescents. However, uptake and adherence to affective control training in adolescents has been low. In this study, we will explore the potential of a novel gamified affective control training program (G-AffeCT), the Social Brain Train app, to increase training adherence compared to a standard affective control training (AffeCT) program in adolescents. Methods and Analysis In total, 144 adolescents aged 13-16 years will train for 12 days on either the G-AffeCT or AffeCT. The G-AffeCT comprises an affective control training component: the dual n-back task. Together with typical gamification (incl. badges and points) a second cognitive interpretation bias modification (CBM-I) component was introduced as social puzzles to make the training more game-like. These puzzles include ambiguous social scenarios that participants must learn to resolve positively. The AffeCT includes only the dual n-back task. The two training groups will be compared on time spent training as well as gains in affective control, interpretation bias, emotion regulation, and symptoms of anxiety and depression. Ethics and Dissemination This study has been approved by the University of New South Wales Human Research Ethics Committee (HC230164). If the G-AffeCT successfully increases training uptake and adherence and improves affective control and emotion regulation in adolescents as predicted, future definitive trials should investigate its utility to prevent and reduce adolescent mental health problems