The Effects of Trait Extraversion on University Student Mental Health and Well-being During Lockdown: A Systematic Review

Personality traits such as extraversion and neuroticism are associated with mental health and well-being with trait extraversion positively associated with resilience, and negatively associated with a plethora of mental disorders including depression. Resilience was likely a useful trait during the COVID-19 pandemic which studies have shown negatively impacted the mental health of several different population groups, particularly university students. Mental health may also have been impacted differentially based on trait extraversion, with some evidence finding the mental health of extraverts was negatively impacted by lockdown. This review aimed to investigate whether trait extraversion was protective to university student mental health and well-being, operationalised by different symptom domains including stress and anxiety, during lockdown. We hypothesised that due to an extravert's proclivity to seek out and enjoy social interaction and the restriction of these very activities during lockdown, trait extraversion would no longer have a protective effect on mental health and well-being. Methods Six databases (EMBASE, MEDLINE, PSYCHINFO, SCOPUS, Web of Science and Cardiff University Full Text Journals) were consulted, and forty-five studies identified. Briefly, the eligibility criteria were studies of university students that had trait extraversion measured using either the Big Five or Eysenck's Personality Questionnaire in addition to a measure of mental health or well-being. Furthermore, at least 50% of the study must have been conducted under lockdown conditions with cross-sectional and longitudinal studies eligible for inclusion. After data screening, three longitudinal and seven cross-sectional studies were identified as eligible for inclusion. Following data extraction, a qualitative narrative synthesis was applied to the extracted data. Results Significant results were found for positive affect, negative affect, life satisfaction, quality of life enjoyment and satisfaction, anxiety and depression which suggested extraversion was protective. Non-significant results were also found for anxiety, depression, mental health, global quality of life, perceived stress, COVID-19 student stress and coronavirus anxiety. Conclusion The hypothesis that extraversion would be protective for mental health and well-being was accepted unanimously for life satisfaction and tentatively for anxiety. Furthermore, the hypothesis was rejected for depression and stress whose relationship with trait extraversion differed from pre-pandemic findings. The review recommended that extraverted university students should be mindful of the increased risk of depression and stress during lockdown. Additionally, further research should be carried out on extraversion's relationship with stress, an important factor in mental health, and also look at interactions of trait extraversion with other personality traits such as neuroticism

Stigma, Secrecy and Masculine Norms: A Systematic Review of How Perinatal Mental Illness in Men and Their Partners Is Experienced by Males

In recent years, fathers have become increasingly involved in pregnancy and childcare and the concept of paternal perinatal mental illness (PMI) has gained research interest. There has been increased recognition of the impact of parenthood on the mental health of males, particularly in first time fathers where feelings of helplessness and marginalisation are common. Prevalence of paternal PMI is thought to be 10–16%, with higher risk demonstrated when their partner too experiences PMI. The importance of this topic was highlighted in the NHS long term plan, which recognised the disparity in service provision between males and females and the need to address this. Aim: To conduct a systematic review to establish the knowledge, beliefs, and experiences of males with PMI and whose partners had PMI, and to understand the barriers associated with help-seeking for paternal PMI. Five databases including EMBASE, Web of Science, Ovid MEDLINE, Scopus and PsycINFO were searched for qualitative studies investigating the experiences of males affected by PMI personally or through their partner's illness. The research question and inclusion criteria were determined using the PICOSS (population, intervention, comparison, outcome, setting, study design) method. 11 studies met criteria for inclusion and were appraised for quality using the Critical Appraisal Skills Programme and Joanna Briggs Institute Qualitative checklists. Evidence was synthesised using thematic analysis and study quality and risk of bias were assessed using the Assessing the Methodological Quality of Systematic Reviews (AMSTAR 2) checklist and Risk of Bias in Systematic Reviews (ROBIS) too. 5 main themes and 17 sub-themes were identified, and demonstrated lack of knowledge and preparation for fatherhood, and distress and isolation experienced by males with PMI. Males were reluctant to seek help, and factors including stigma and lack of awareness regarding PMI and available support services were identified as barriers. The option to remain anonymous, flexibility of appointments and an emphasis on peer support were considered facilitators to engagement. Unhelpful and potentially damaging stereotypes regarding masculinity and PMI still exist, prohibit help-seeking for PMI and promote the marginalisation of males in perinatal settings. Support for males with PMI is warranted but lacking, and effective communication and education regarding paternal PMI for both professionals and the public is needed to allow successful expansion of services to include males

The effectiveness of mindfulness-based interventions for anxiety disorders in adults: a systematic narrative review

In recent years there has been accelerated clinical interest in Mindfulness based interventions (MBI's) leading to an upswell in research due the impact of its wide clinical application. Mindfulness Based Cognitive Therapy (MBCT) and Acceptance and Commitment Therapy (ACT) have recently been investigated for the beneficial treatment of anxiety-based disorders in adults. The aim of the current review was to appraise and synthesise findings of studies published within the last decade, in determining the efficacy of MBCT and ACT in treating anxiety disorders in adults, given gaps identified in the existing literature

Autism Spectrum Disorders-Recent Advances and New Perspectives

This chapter set out to present a comprehensive review on the prevalence of autism spectrum disorder (ASD) among 5–18-year-olds living in Europe. The review was based on studies published between 2015 and 2020. Separate meta-analyses were conducted for population studies and register-based studies to determine the random effects pooled prevalence rate (REPPR) for ASD. The European REPPR for ASD among young people was estimated at 0.8% based on register-based studies and 1.4% based on population. Comparative analysis was carried out to identify trends of prevalence rates across countries, gender, and level of education. The prevalence among primary school children was four times that of secondary school children. A male: female ratio of 3.5:1 was obtained. A range of challenges toward young people with ASD are portrayed, including diagnostic limitations, poor awareness on ASD, and socioeconomic inequality. Nationwide screening, early intervention services, and further research on gender and culture-specific presentations are recommended.peer-reviewe

The Prevalence of Autism Spectrum Disorder in Europe

This chapter set out to present a comprehensive review on the prevalence of autism spectrum disorder (ASD) among 5–18-year-olds living in Europe. The review was based on studies published between 2015 and 2020. Separate meta-analyses were conducted for population studies and register-based studies to determine the random effects pooled prevalence rate (REPPR) for ASD. The European REPPR for ASD among young people was estimated at 0.8% based on register-based studies and 1.4% based on population. Comparative analysis was carried out to identify trends of prevalence rates across countries, gender, and level of education. The prevalence among primary school children was four times that of secondary school children. A male: female ratio of 3.5:1 was obtained. A range of challenges toward young people with ASD are portrayed, including diagnostic limitations, poor awareness on ASD, and socioeconomic inequality. Nationwide screening, early intervention services, and further research on gender and culture-specific presentations are recommended

Investigating marker accuracy in differentiating between university scripts written by students and those produced using ChatGPT

The introduction of OpenAI’s ChatGPT has widely been considered a turning point for assessment in higher education. Whilst we find ourselves on the precipice of a profoundly disruptive technology, generative artificial intelligence (AI) is here to stay. At present, institutions around the world are considering how best to respond to such new and emerging tools, ranging from outright bans to re-evaluating assessment strategies. In evaluating the extent of the problem that these tools pose to the marking of assessments, a study was designed to investigate marker accuracy in differentiating between scripts prepared by students and those produced using generative AI. A survey containing undergraduate reflective writing scripts and postgraduate extended essays was administered to markers at a medical school in Wales, UK. The markers were asked to assess the scripts on writing style and content, and to indicate whether they believed the scripts to have been produced by students or ChatGPT. Of the 34 markers recruited, only 23% and 19% were able to correctly identify the ChatGPT undergraduate and postgraduate scripts, respectively. A significant effect of suspected script authorship was found for script content, X²(4, n=34) = 10.41, p<0.05, suggesting that written content holds clues as to how markers assign authorship. We recommend consideration be given to how generative AI can be responsibly integrated into assessment strategies and expanding our definition of what constitutes academic misconduct in light of this new technology

Investigating the association between obsessive-compulsive disorder symptom subtypes and health anxiety as impacted by the COVID-19 pandemic: a cross-sectional study

Background Since the COVID-19 outbreak was declared a global pandemic, public health messages have emphasised the importance of frequent handwashing in limiting the transmission of the virus. Whilst crucial in controlling transmission, such messaging may have an adverse effect on individuals with OCD. Methods A cross-sectional study was conducted, with a total of 332 participants recruited. Participants who scored above the optimal cut-off score on the Obsessive-Compulsive Inventory Revised edition (OCI-R) were included in the analysis (n = 254). Scores on the six subscales of the OCI-R were correlated with responses to a COVID-19 Impact measure. Results Factor analysis of the COVID-19 Impact measure revealed that items loaded on two components of the measure (handwashing and distress-avoidance). Canonical correlation analyses revealed significant associations between the OCI-R subscales and COVID-19 Impact measure, F (12, 490) = 8.14, p = 0.001, and the SHAI subscales with the COVID-19 Impact Measure, F (4, 498) = 8.18, p = 0.001). Specifically, washing and checking OCI-R subscales correlated with both components of the COVID-19 Impact measure, as did the health anxiety and beliefs SHAI subscales. Content analysis revealed disruption to treatment delivery and worsening symptom severity in participants with contamination-related OCD. Discussion Contamination and checking OCD subtypes have been associated with increased hand-washing behaviour and avoidance of distress-inducing cues. Consideration should be given to targeted support tailored to patients with these subtypes of OCD

Evidence against altered excitatory/inhibitory balance in the posteromedial cortex of young adult APOE E4 carriers: a resting state 1H-MRS study

A strategy to gain insight into early changes that may predispose people to Alzheimer's disease (AD) is to study the brains of younger cognitively healthy people that are at increased genetic risk of AD. The Apolipoprotein (APOE) E4 allele is the strongest genetic risk factor for AD, and several neuroimaging studies comparing APOE E4 carriers with non-carriers at age ∼20–30 years have detected hyperactivity (or reduced deactivation) in posteromedial cortex (PMC), a key hub of the default network (DN), which has a high susceptibility to early amyloid deposition in AD. Transgenic mouse models suggest such early network activity alterations may result from altered excitatory/inhibitory (E/I) balance, but this is yet to be examined in humans. Here we test the hypothesis that PMC fMRI hyperactivity could be underpinned by altered levels of excitatory (glutamate) and/or inhibitory (GABA) neurotransmitters in this brain region. Forty-seven participants (20 APOE E4 carriers and 27 non-carriers) aged 18–25 years underwent resting-state proton magnetic resonance spectroscopy (1H-MRS), a non-invasive neuroimaging technique to measure glutamate and GABA in vivo. Metabolites were measured in a PMC voxel of interest and in a comparison voxel in the occipital cortex (OCC). There was no difference in either glutamate or GABA between the E4 carriers and non-carriers in either MRS voxel, or in the ratio of glutamate to GABA, a measure of E/I balance. Default Bayesian t-tests revealed evidence in support of this null finding. Our findings suggest that PMC hyperactivity in APOE E4 carriers is unlikely to be associated with, or possibly may precede, alterations in local resting-state PMC neurotransmitters, thus informing our understanding of the spatio-temporal sequence of early network alterations underlying APOE E4 related AD risk

The impact of the COVID-19 pandemic on symptom subtypes of obsessive-compulsive disorder: a cross-sectional study

Since the COVID-19 outbreak was declared a global pandemic, public health messages have emphasised the importance of frequent handwashing in limiting the transmission of the virus. Whilst crucial in controlling transmission, such messaging may have an adverse effect on individuals with OCD. The primary aim of this study was to investigate any significant changes to handwashing behaviour, as well as other related hygiene behaviours, across all symptom dimensions of OCD. The frequency of engaging with pandemic-related media coverage was also considered across all symptom subtypes. A cross-sectional study was conducted, with a total of 332 participants recruited. Participants who scored above the optimal cut-off score on the Obsessive-Compulsive Inventory Revised edition (OCI-R) were included in the analysis (n = 254). Scores on the six subscales of the OCI-R were correlated with responses to a COVID-19 Impact measure. Factor analysis of the COVID-19 Impact measure revealed that items loaded on two components of the measure (handwashing and distress-avoidance). A significant correlation was revealed between the handwashing component and the OCI-R washing subscale (rs = 0.523, p = 0.0001), as well as between distress-avoidance and the OCI-R washing and ordering subscales (s = −0.227, p = 0.0001; rs = −0.159, p = 0.006). Content analysis revealed disruption to treatment delivery and worsening symptom severity in participants with contamination-related OCD. The pandemic has had a significant impact on individuals with contamination-related OCD symptoms, in relation to symptom severity and treatment disruption. Consideration should be given to targeted support tailored to patients with this subtype of OCD

Neurochemical correlates of scene processing in the precuneus/posterior cingulate cortex: A multimodal fMRI and 1H-MRS study

Precuneus/posterior cingulate cortex (PCu/PCC) are key components of a midline network, activated during rest but also in tasks that involve construction of scene or situation models. Despite growing interest in PCu/PCC functional alterations in disease and disease risk, the underlying neurochemical modulators of PCu/PCC's task‐evoked activity are largely unstudied. Here, a multimodal imaging approach was applied to investigate whether interindividual differences in PCu/PCC fMRI activity, elicited during perceptual discrimination of scene stimuli, were correlated with local brain metabolite levels, measured during resting‐state 1H‐MRS. Forty healthy young adult participants completed an fMRI perceptual odd‐one‐out task for scenes, objects and faces. 1H‐MRS metabolites N‐acetyl‐aspartate (tNAA), glutamate (Glx) and γ‐amino‐butyric acid (GABA+) were quantified via PRESS and MEGA‐PRESS scans in a PCu/PCC voxel and an occipital (OCC) control voxel. Whole brain fMRI revealed a cluster in right dorsal PCu/PCC that showed a greater BOLD response to scenes versus faces and objects. When extracted from an independently defined PCu/PCC region of interest, scene activity (vs. faces and objects and also vs. baseline) was positively correlated with PCu/PCC, but not OCC, tNAA. A voxel‐wise regression analysis restricted to the PCu/PCC 1H‐MRS voxel area identified a significant PCu/PCC cluster, confirming the positive correlation between scene‐related BOLD activity and PCu/PCC tNAA. There were no correlations between PCu/PCC activity and Glx or GABA+ levels. These results demonstrate, for the first time, that scene activity in PCu/PCC is linked to local tNAA levels, identifying a neurochemical influence on interindividual differences in the task‐driven activity of a key brain hub