The Association Between Locus of Control and Psychopathology: A Cross-Cohort Comparison Between a UK (Avon Longitudinal Study of Parents and Children) and a Japanese (Tokyo Teen Cohort) Cohort

Locus of Control as a Mediator of the Relationships Between Motivational Systems and Trait Anxiety

The Reinforcement Sensitivity Theory, first proposed by Gray and later revised, describes three motivational systems: Behavioral Inhibition System (BIS), Behavioral Activation System (BAS), and Fight-Flight-Freeze System (FFFS). Studies have shown that high BIS and FFFS activation are positively related to anxiety symptoms, yet the relationship between BAS and anxiety remains unclear. Research data have also suggested that anxiety symptoms occur with the loss of perceived control. Thus, although studies on the direct effect of locus of control (LOC) on trait anxiety have accumulated for many years, the issue of how LOC may mediate the relationship between BIS/BAS/FFFS sensitivity and anxiety has not been addressed. This study aimed to explore the mediating role of LOC orientation on trait anxiety among young adults in association with these three motivational systems. Cross-sectional data were obtained from 422 volunteers. The BIS/BAS Scale, Trait Anxiety Inventory, and Rotter's Internal-External LOC Scale were applied. A series of mediation analyses were performed to estimate total, indirect, and direct effects. The results showed that BIS and FFFS positively predicted trait anxiety. In addition, LOC positively predicted trait anxiety and BIS. The results of the mediation analyses indicated that LOC functioned as a partial mediator between BIS and trait anxiety. This finding revealed that a high BIS level, one of the motivational systems, was associated with external LOC, which in turn contributed to reporting high trait anxiety in young adults. Hence, BIS and external LOC orientation could be suggested as risk factors for trait anxiety. As the external LOC orientation of individuals with high punishment sensitivity increased, their trait anxiety levels also increased. Therefore, it was suggested that it might be useful to be aware that LOC orientations of individuals with BIS sensitivity may pose a risk for trait anxiety.

Childhood Adversity and Incident Psychotic Experiences in Early Adulthood: Cognitive and Psychopathological Mediators

BACKGROUND AND HYPOTHESIS

Childhood adversity is often described as a potential cause of incident psychotic experiences, but the underlying mechanisms are not well understood. We aimed to examine the mediating role of cognitive and psychopathological factors in the relation between childhood adversity and incident psychotic experiences in early adulthood.

STUDY DESIGN

We analyzed data from the Avon Longitudinal Study of Parents and Children, a large population-based cohort study. Childhood adversity was measured prospectively from birth to age 11 years, mediators (anxiety, depression, external locus of control [LoC], negative symptoms) were assessed at approximately 16 years of age, and incident psychotic experiences were assessed at ages 18 and 24 years. Mediation was examined via the counterfactual g-computation formula.

STUDY RESULTS

In total, 7% of participants had incident suspected or definite psychotic experiences in early adulthood. Childhood adversity was related to more incident psychotic experiences (ORadjusted = 1.34, 95% CI = 1.21; 1.49), and this association was partially mediated via all mediators examined (proportion mediated: 19.9%). In separate analyses for each mediator, anxiety, depression, external LoC, and negative symptoms were all found to mediate the link between adversity and incident psychotic experiences. Accounting for potential confounders did not modify our results.

CONCLUSIONS

Our study shows that cognitive biases as well as mood symptomatology may be on the causal pathway between early-life adversity and the development of psychotic experiences. Future studies should determine which mediating factors are most easily modifiable and most likely to reduce the risk of developing psychotic experiences.

Feasibility of a secondary school-based mental health intervention: Reprezents' On The Level

AIMS

There is a need for innovative school-based mental health interventions to promote good mental health, healthy coping strategies, and engagement with support services. Consequently, Reprezent, a youth development organization, with mental health professionals and young people co-developed an online mental health intervention show, On The Level (OTL). This study assessed the acceptability and feasibility of delivering OTL to young people (aged 11-18 years) in 36 secondary schools across London and Essex, UK.

METHODS

OTL was delivered online as part of the school curriculum, in classrooms at timepoint 1 (T1, 50 min). Follow-up data was collected at timepoint 2 (T2) 4-6 weeks later, during a 20-min OTL review show. For interactive OTL elements and data collection participants logged into an online survey. Measures of acceptability and engagement, mental health and well-being outcomes and intervention evaluation were taken at T1 and T2. We also assessed the feasibility of implementing the OTL intervention in secondary schools.

RESULTS

10,315 participants received the intervention (T1) and 3369 attended the follow-up session (T2), this high attrition, and potential selection bias, was due to only 30% of schools being able to take part in T2. Rates of acceptability were high among young people and school staff. At T1, 88% found OTL engaging, and 84% felt more confident they had the tools to help them better manage stress and anxiety. At T2, 66% viewed mental health in a more positive way, and 71% had better understanding of how to maintain good mental health. Rates of engagement with mental health tools and services were good, and significant reduction in levels of stress were found 4-6 weeks after the OTL show (T2). The low mental health and well-being indices reported by the school children at baseline strongly support the need and use for a mental health intervention such as OTL in secondary schools.

CONCLUSION

These findings indicated good feasibility and acceptability of OTL intervention and support the delivery of the OTL mental health intervention at UK-based secondary schools to educate young people about mental health and well-being and give them the necessary tools to support their mental health.

Case formulation-A vehicle for change? Exploring the impact of cognitive behavioural therapy formulation in first episode psychosis: A reflexive thematic analysis

OBJECTIVES

Formulation is considered a fundamental process of cognitive behavioural therapy for psychosis (CBTp). However, an exploration into the personal impact of different levels of case formulation (CF) from a service user perspective (SU) is lacking, particularly for those experiencing a first episode of psychosis.

DESIGN

This Big Q qualitative design used semi-structured interviews.

METHODS

Reflexive thematic analysis (TA) was used to analyse 10 participant interviews. NVivo 12 computer-assisted qualitative data analysis software aided data organisation and analysis.

RESULTS

One overarching theme 'CF - A vehicle for change?' was developed as a pattern of shared meaning across the data set. Three main themes related to the overarching theme: (1) Vicious cycles: 'I never really thought about it being me maintaining the problems' (including one subtheme - Self-empowerment: 'Only you can make the changes for yourself'); (2) Early life experiences: 'My experiences have shaped the person that I am, therefore, it's not my fault' (including one subtheme - Disempowerment: '[My] core beliefs have been damaged'); and (3) Keep it simple: 'Don't push it too far over the top in case it becomes like spaghetti'.

CONCLUSIONS

Maintenance formulations may be experienced as self-blaming, but also self-empowering, which may help to facilitate change. Longitudinal formulations may be experienced as non-blaming, but also disempowering, which may inhibit change. Simple CF diagrams may also facilitate change, whereas overly complex CFs may inhibit change. How CBTp therapists might look to improve the impact of different levels of CF for service users (SUs) in first episode psychosis (FEP) are described.