Soothing dementia carers: a pilot evaluation of an imagery-based wellbeing app feature to support family carers of people with dementia during the COVID-19 pandemic

Background: The COVID-19 pandemic has presented unprecedented risks to the health of people living with dementia. Confinement to their homes and extra pressure on the health and social care system, left people with dementia and their carers with reduced access to care services. Accordingly, family carers assumed more caring responsibilities and faced a greater risk of social isolation and loneliness, negatively affecting their mental wellbeing. In response, we developed a new imagery-based feature called Project Soothe within an existing app, CogniCare, which aimed to support the wellbeing of family carers looking after someone with dementia at home. Methods: This new feature aimed to test the utility of our previous research which has shown that viewing soothing images has positive mood benefits on users. In this pilot, we examined the usage of the Project Soothe feature over a one-year period. Results: Our results indicate the feasibility of the imagery-based app feature as we found that most users found viewing the soothing images to have a positive influence on their mood. Conclusions: This finding illustrates feasibility of this imagery-based wellbeing app in this population of interest, and suggests that, upon further replication and research, the Project Soothe feature within the CogniCare app has potential to be developed as a digital wellbeing tool for family carers of people with dementia

Project Soothe: A pilot study evaluating the mood effects of soothing images collected using a citizen science approach

Background: Mentally-generated soothing imagery is a therapeutic technique to support mental wellbeing, but some individuals may require support using externally presented stimuli. Project Soothe was launched to collect soothing images using a citizen science approach. This online pilot study evaluated the first 575 soothing images collected, examining: 1) if the images were perceived to be soothing; 2) if viewing the images had a positive impact on mood; and 3) if mood effects were influenced by individual differences in age, gender and depressive symptoms. Methods: We recruited 1152 participants (13 – 79 years, M = 35.62, SD = 14.60; 77% female). Participants were randomly allocated to one of 23 sets, each containing 25 images (n = 50 per set) and asked to rate their emotional response (soothed, excited, and anxious) to each image. Participants also reported their mood states pre- and post-viewing the images (using the International Positive and Negative Affect Schedule – Short Form). Results: Project Soothe images were rated to be significantly more soothing than anxiety- or excitement-inducing. Further, viewing 25 images was significantly associated with an increase in positive affect and decrease in negative affect. These effects were associated with age and depressive symptoms, with older individuals and those with lower depressive symptoms being associated with more positive changes in mood. Conclusions: This pilot study provides preliminary evidence that these soothing images can promote positive mood changes. Further work can now replicate these findings in larger-scale studies with comparison groups and extended outcome variables. The images and associated data have been made available in a data repository (OSF) as a free resource for researchers and practitioners. It is hoped that these images can be developed into useful therapeutic resources

Risk for depression is associated with neural biases in emotional categorisation

Negative biases in emotional processing are a major characteristic of depression. Recent research has shown that such negative biases are evident in high risk individuals even in the absence of personal history of depression, suggesting that they may serve as key vulnerability markers of depression. However, the neural basis of these behavioural observations has not been fully explored. This study therefore aimed to (1) illustrate the neural processes involved in the categorisation of emotional personality-trait words; and (2) examine whether these neural mechanisms are biased towards negative information in high risk individuals. Risk for depression was defined by high neuroticism (N). We recruited a sample of high risk (high N) and low risk (low N) never-depressed young adults. Functional magnetic resonance imaging (fMRI) was acquired during the categorisation and memory for positive and negative self-referent personality-trait words (e.g. honest, rude). High risk volunteers showed greater responses in the right superior parietal cortex than low risk volunteers specifically during the categorisation of negative words. Moreover, neuroticism score was positively correlated with neural responses in the left anterior cingulate during the categorisation of negative words but negatively correlated within the same region during the retrieval of these words. These results highlight a role of the fronto-parietal circuitry in emotional processing and further suggest that negative biases in these neural processes may be involved in risk for depression

Patient satisfaction with mental and physical health services: Findings from a UK-wide online survey [version 1; peer review: 2 approved]

Introduction - Despite extensive debate surrounding mental health services in the UK, there is little empirical evidence regarding the views of those who use them. We therefore used data collected as part of a wider survey to examine satisfaction amongst those seeking treatment from mental and physical health services. Methods – An online survey designed with input from people with experience of mental illness was used to measure satisfaction with NHS mental and physical health services at first contact and in the previous 12 months. Results – A total of 2187 people responded. During the 12 months prior to the survey, 526 respondents had sought mental health care and 1379 had sought physical health care. Participants were significantly more satisfied with their most recent contact with mental health services (48.1% very/satisfied) than with their first contact (38.2% very/satisfied). More than 1 in 10 respondents who sought mental health care (11.4%) stated that they received no treatment/support from the NHS, compared to approximately 1 in 20 respondents who sought physical health care (4.6%). Of those who received the mental health treatment they requested (n = 424), most were satisfied or very satisfied with their care (54.7%), although this was lower than the corresponding figure (77.9%) for satisfaction with physical health care received (n = 1190). Conclusion –There was evidence that mental health services are satisfactory for a slim majority of users, but people were generally more satisfied with NHS physical health care. This survey was conducted in the year prior to the coronavirus disease 2019 pandemic. Future research could examine what influences satisfaction with care and whether this picture has changed following the emergence of the pandemic and consequent impact on health service delivery and daily life

The role of brain structure in the association between pubertal timing and depression risk in an early adolescent sample (the ABCD Study®): A registered report

Background: Earlier pubertal timing is associated with higher rates of depressive disorders in adolescence. Neuroimaging studies report brain structural associations with both pubertal timing and depression. However, whether brain structure mediates the relationship between pubertal timing and depression remains unclear. Methods: The current registered report examined associations between pubertal timing (indexed via perceived pubertal development), brain structure (cortical and subcortical metrics, and white matter microstructure) and depressive symptoms in a large sample (N = ~5,000) of adolescents (aged 9-13 years) from the Adolescent Brain Cognitive Development (ABCD) Study. We used three waves of follow-up data when the youth were aged 10-11 years, 11-12 years, and 12-13 years, respectively. We used generalised linear-mixed models (H1) and structural equation modelling (H2 & H3) to test our hypotheses. Hypotheses: We hypothesised that earlier pubertal timing at Year 1 would be associated with increased depressive symptoms at Year 3 (H1), and that this relationship would be mediated by global (H2a-b) and regional (H3a-g) brain structural measures at Year 2. Global measures included reduced cortical volume, thickness, surface area and sulcal depth. Regional measures included reduced cortical thickness and volume in temporal and fronto-parietal areas, increased cortical volume in the ventral diencephalon, increased sulcal depth in the pars orbitalis, and reduced fractional anisotropy in the cortico-striatal tract and corpus callosum. These regions of interest were informed by our pilot analyses using baseline ABCD data when the youth were aged 9-10 years. Results: Earlier pubertal timing was associated with increased depressive symptoms two years later. The magnitude of effect was stronger in female youth and the association remained significant when controlling for parental depression, family income, and BMI in females but not in male youth. Our hypothesised brain structural measures did not however mediate the association between earlier pubertal timing and later depressive symptoms. Conclusion: The present results demonstrate that youth, particularly females, who begin puberty ahead of their peers are at an increased risk for adolescent-onset depression. Future work should explore additional biological and socio-environmental factors that may affect this association so that we can identify targets for intervention to help these at-risk youth