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New indices, calculated on data from the widely used Dot Probe Task, were recently proposed to capture variability in biased attention allocation. We observed that it remains unclear which data pattern is meant to be indicative of dynamic bias and thus to be captured by these indices. Moreover, we hypothesized that the new indices are sensitive to SD differences at the response time (RT) level in the absence of bias. Randomly generated datasets were analyzed to assess properties of the Attention Bias Variability (ABV) and Trial Level Bias Score (TL-BS) indices. Sensitivity to creating differences in 1) RT standard deviation, 2) mean RT, and 3) bias magnitude were assessed. In addition, two possible definitions of dynamic attention bias were explored by creating differences in 4) frequency of bias switching, and 5) bias magnitude in the presence of constant switching. ABV and TL-BS indices were found highly sensitive to increasing SD at the response time level, insensitive to increasing bias, linearly sensitive to increasing bias magnitude in the presence of bias switches, and non-linearly sensitive to increasing the frequency of bias switches. The ABV index was also found responsive to increasing mean response times in the absence of bias. Recently proposed DPT derived variability indices cannot uncouple measurement error from bias variability. Significant group differences may be observed even if there is no bias present in any individual dataset. This renders the new indices in their current form unfit for empirical purposes. Our discussion focuses on fostering debate and ideas for new research to validate the potentially very important notion of biased attention being dynamic.

Conceptually, there may be some overlap between measures of voice hearing experiences and measures assessing broader outcome domains. Despite this possibility, it is unknown whether measures of voice hearing and broader outcomes are assessing similar or separate concepts. This study aimed to examine whether measures of voice hearing are distinct from measures of emotional states, well-being and recovery. Study 1 examined whether the Hamilton Program for Schizophrenia Voices Questionnaire is distinct from the Depression Anxiety Stress Scale-21 and the Short Warwick-Edinburgh Mental Well-being Scale using secondary data (n = 401). Study 2 examined whether the Psychotic Symptoms Rating Scale for Auditory Hallucinations is distinct from the Hospital Anxiety Depression Scale and the CHoice of Outcome in Cbt for psychoses short form using baseline data from two randomized controlled trials (n = 187). In Study 1, a six-factor model was found to be reasonable and accounted for 54.04% of the total variance (F1: 13%, F2: 11.26%, F3: 8.55%, F4: 4.04%, F5: 7.30%, F6: 9.9%). In Study 2, a five-factor model was identified and accounted for 39.99% of the total variance (F1: 15.52%, F2: 7.47%, F3: 6.53%, F4: 6.70%, F5: 3.78%). Within both studies, the items from the voice hearing measures loaded uniquely onto factors that contained no items from other measures. Findings show that measures of voice hearing are distinct from broad outcome measures and therefore are measuring separate concepts. This confirms the psychometric properties of the voice hearing measures and provides some clarity around outcomes and their measurement.

The general linear model (GLM) is the most frequently applied family of statistical models in psychology. Within the GLM, the effects under study are estimated using the ordinary least squares (OLS) estimation. In certain situations, OLS produces parameter estimates that are unbiased and optimal (with least possible error) and hypothesis tests that retain the expected rate of false positives (Type I errors). This happens when (1) outliers and influential cases are absent, and (2) assumptions of linearity and additivity, spherical errors, and normal errors are met. This paper first provides a technical description of OLS and an overview of its statistical assumptions. We then discuss the methods commonly employed to detect and address violations of assumptions, and how the current application of these methods can compromise the reproducibility of findings by allowing too many data-driven decisions to be made as part of the data analytic pipeline. We briefly introduce several robust estimation methods—namely bootstrapping, heteroscedasticity-consistent standard errors, M -estimators, and trimming—that can improve the accuracy of parameter estimates and the power of statistical tests. We provide guidance on how these methods can be used to transparently preregister a sensitivity analysis, reducing the opportunity for problematic researcher degrees of freedom to enter the analytic pipeline.

Health care workers experience high stress. Accessible, affordable, and effective approaches to reducing stress are lacking. In-person mindfulness-based interventions can reduce health care worker stress but are not widely available or accessible to busy health care workers. Unguided, digital, mindfulness-based self-help (MBSH) interventions show promise and can be flexibly engaged with. However, their effectiveness in reducing health care worker stress has not yet been explored in a definitive trial. This study aimed to investigate the effectiveness of an unguided digital MBSH app (Headspace) in reducing health care worker stress. This was a definitive superiority randomized controlled trial with 2182 National Health Service staff in England recruited on the web and allocated in a 1:1 ratio to fully automated Headspace (n=1095, 50.18%) or active control (Moodzone; n=1087, 49.82%) for 4.5 months. Outcomes were subscales of the Depression, Anxiety, and Stress (primary outcome) Scale short form; Short Warwick Edinburgh Mental Well-being Scale; Maslach Burnout Inventory; 15-item Five-Facet Mindfulness Questionnaire minus Observe items; Self-Compassion Scale-Short Form; Compassionate Love Scale; Penn State Worry Questionnaire; Brooding subscale of the Ruminative Response Scale; and sickness absence. Intention-to-treat analyses found that Headspace led to greater reductions in stress over time than Moodzone (b=-0.31, 95% CI -0.47 to -0.14; P<.001), with small effects. Small effects of Headspace versus Moodzone were found for depression (b=-0.24, 95% CI -0.40 to -0.08; P=.003), anxiety (b=-0.19, 95% CI -0.32 to -0.06; P=.004), well-being (b=0.14, 95% CI 0.05-0.23; P=.002), mindfulness (b=0.22, 95% CI 0.09-0.34; P=.001), self-compassion (b=0.48, 95% CI 0.33-0.64; P<.001), compassion for others (b=0.02, 95% CI 0.00-0.04; P=.04), and worry (b=-0.30, 95% CI -0.51 to -0.09; P=.005) but not for burnout (b=-0.19, -0.04, and 0.13, all 95% CIs >0; P=.65, .67, and .35), ruminative brooding (b=-0.06, 95% CI -0.12 to 0.00; P=.06), or sickness absence (γ=0.09, 95% CI -0.18 to 0.34). Per-protocol effects of Headspace (454/1095, 41.46%) versus Moodzone (283/1087, 26.03%) over time were found for stress, self-compassion, and compassion for others but not for the other outcomes. Engagement (practice days per week) and improvements in self-compassion during the initial 1.5-month intervention period mediated pre- to postintervention improvements in stress. Improvements in mindfulness, rumination, and worry did not mediate pre- to postintervention improvements in stress. No serious adverse events were reported. An unguided digital MBSH intervention (Headspace) can reduce health care workers' stress. Effect sizes were small but could have population-level benefits. Unguided digital MBSH interventions can be part of the solution to reducing health care worker stress alongside potentially costlier but potentially more effective in-person mindfulness-based interventions, nonmindfulness courses, and organizational-level interventions. International Standard Randomised Controlled Trial Number ISRCTN15424185; https://tinyurl.com/rv9en5kc.

Several researchers have proposed a causal relation between biased attention to threat and the development and maintenance of anxiety disorders in both children and adults. However, despite the widely documented correlation between attention bias to threat and anxiety, developmental research in this domain is limited. In this review, we highlight the importance of taking a developmental approach to studying attention biases to threat and anxiety. First, we discuss how recent developmental work on attention to threat fits into existing theoretical frameworks for the development of anxiety and how attention biases might interact with other risk factors across development. Then we review the developmental literature on attention bias to threat and anxiety and describe how classic methodologies can be modified to study attention biases in even the youngest infants. Finally, we discuss limitations and future directions in this domain, emphasizing the need for future longitudinal research beginning in early infancy that tracks concurrent developments in both biased attention and anxiety. Altogether, we hope that by highlighting the importance of development in the study of attention bias to threat and anxiety, we can provide a road map for how researchers might implement developmental approaches to studying a potential core mechanism in anxiety.

There is equivocal evidence on how being a child in a Black, Asian and Minority Ethnic (BAME) immigrant family affects internalizing symptoms such as anxiety. This cross-sectional study examined the relationships between peer friendships and anxiety/depression symptoms in BAME immigrant adolescents (IA) and white native adolescents (WNA). Method: Sixty-two adolescents from the UK (IA = 26, WNA = 36, mean age = 14 years) were assessed on close friendship, social competence, social anxiety, and depression. Immigrant family parents (n = 23) were also assessed on cultural orientation. There were no significant differences in anxiety and depression between groups. Bayes factors supported the conclusion that the groups did not differ. However, IA and WNA groups had different patterns of associations between close friendship/social competence and anxiety and depression symptoms. Close friendships were more strongly associated with lower anxiety/depression in IAs than WNAs, and social competence was more strongly associated with lower anxiety/depression in WNAs than IAs. Moderation analyses indicated that the relationship between close friendship and social and separation anxiety was significantly moderated by ethnic group, as was the relationship between social competence and generalized anxiety. The findings suggest that social and separation anxiety are more strongly associated with close friendships for BAME immigrant children than for non-immigrant adolescents. As such, activities that help BAME immigrant children to foster close relationships may have positive effects on their well-being.

Psychosocial interventions delivered by nonspecialists can be effective at reducing common adolescent mental health problems in low-resource settings. However, there is a lack of evidence on resource-efficient methods for building capacity to deliver these interventions. The objective of this study is to evaluate the effects of a digital training (DT) course, delivered in a self-guided format or with coaching, on nonspecialists' competency to deliver a problem-solving intervention intended for adolescents with common mental health problems in India. We will conduct a pre-post study with a nested parallel, 2-arm, individually randomized controlled trial. The study aims to recruit 262 participants, randomized 1:1 to receive either a self-guided DT course or a DT course with weekly individualized coaching provided remotely by telephone. In both arms, the DT will be accessed over 4 to 6 weeks. Participants will be nonspecialists (ie, without prior practice-based training in psychological therapies) recruited from among university students and affiliates of nongovernmental organizations in Delhi and Mumbai, India. Outcomes will be assessed at baseline and 6 weeks post randomization using a knowledge-based competency measure that incorporates a multiple-choice quiz format. The primary hypothesis is that self-guided DT will lead to increased competency scores among novices with no prior experience of delivering psychotherapies. The secondary hypothesis is that digital training with coaching will have an incremental effect on competency scores compared with DT alone. The first participant was enrolled on April 4, 2022. The study will address an evidence gap on the effectiveness of training methods for nonspecialist providers of adolescent mental health interventions in low-resource settings. The findings from this study will be used to support wider efforts to scale up evidence-based mental health interventions for young people. ClinicalTrials.gov NCT05290142; https://clinicaltrials.gov/ct2/show/NCT05290142. DERR1-10.2196/41981.

Background Pregnancy, birth and adjusting to a new baby is a potentially stressful time that can negatively affect women’s mental and physical health. Expressive writing, where people write about a stressful event for at least 15 min on three consecutive days, has been associated with improved health in some groups but it is not clear whether it is feasible and acceptable for use with postpartum women. This study therefore examined the feasibility and acceptability of expressive writing for postpartum women as part of a randomised controlled trial (RCT). Methods The Health After Birth Trial (HABiT) was an RCT evaluating expressive writing for postpartum women which included measures of feasibility and acceptability. At 6 to 12 weeks after birth 854 women were randomised to expressive writing, a control writing task or normal care, and outcome measures of health were measured at baseline, one month later and six months later. Feasibility was measured by recruitment, attrition, and adherence to the intervention. Quantitative and qualitative measures of acceptability of the materials and the task were completed six months after the intervention. Results Recruitment was low (10.7% of those invited to participate) and the recruited sample was from a restricted sociodemographic range. Attrition was high, increased as the study progressed (35.8% at baseline, 57.5% at one month, and 68.1% at six months) and was higher in the writing groups than in the normal care group. Women complied with instructions to write expressively or not, but adherence to the instruction to write for 15 min per day for three days was low (Expressive writing: 29.3%; Control writing: 23.5%). Acceptability measures showed that women who wrote expressively rated the materials/task both more positively and more negatively than those in the control writing group, and qualitative comments revealed that women enjoyed the writing and/or found it helpful even when it was upsetting. Conclusions The feasibility of offering expressive writing as a universal self-help intervention to all postpartum women 6 to 12 weeks after birth in the HABiT trial was low, but the expressive writing intervention was acceptable to the majority of women who completed it. Trial registration ISRCTN58399513, 10/09/2013.

We evaluated a digital learning programme for non-specialists to develop knowledge-based competencies in a problem-solving intervention for adolescents to examine the overall impact of training on knowledge-based competencies among learners; and to compare the effects of two training conditions (self-guided digital training with or without coaching) in a nested parallel, two-arm, individually randomised controlled trial. Eligible participants were 18 or older; fluent in Hindi or English; able to access digital training; and had no prior experience of delivering structured psychotherapies. 277 participants were enrolled from 31 March 2022 to 19 June 2022 of which 230 (83%) completed the study. There was a significant increase in competency score from pre-training (Mean = 7.01, SD = 3.29) to post-training (Mean = 8.88, SD = 3.80), 6 weeks after the pre-training assessment. Knowledge competency scores showed larger increase among participants randomised to the coaching arm (AMD = 1.09, 95% CI 0.26–1.92, p = 0.01) with an effect size (d) of 0.33 (95% CI 0.08–0.58). More participants completed training in the coaching arm (n = 96, 69.6%) compared to the self-guided training arm (n = 56, 40.3%). In conclusion, a coach-supported remote digital training intervention is associated with enhanced participation by learners and increased psychotherapeutic knowledge competencies.

Rachman's (Behaviour Research and Therapy 15:372-387, 1977; Clinical Psychology Review 11:155-173, 1991) three pathways theory proposed that childhood fears not only arise as a consequence of direct learning experiences, but can also be elicited by means of threat information transmission. This review looks at the scientific evidence for this idea, which has accumulated during the past three decades. We review research on the influences of media exposure on children's fears, retrospective parent and child reports on the role of threat information in fear acquisition, and experimental studies that explored the causal effects of threat information on childhood fears. We also discuss possible mechanisms by which threat information exerts its influence and the processes relevant to understand the role of this type of learning experience in the origins of fear. Finally, implications for the prevention and intervention of childhood fears are briefly explored, and potential leads for future research will be highlighted.