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Reed ZE, Suddell S, Eastwood A, Thomas L, Dwyer I, Penton-Voak IS, Jarrold C, Munafò MR, Attwood AS. Assessing the effectiveness of online emotion recognition training in healthy volunteers. R Soc Open Sci 2023; 10:230372. [PMID: 37771966 PMCID: PMC10523077 DOI: 10.1098/rsos.230372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 08/29/2023] [Indexed: 09/30/2023]
Abstract
Facial emotion recognition (ER) difficulties are associated with mental health and neurodevelopmental conditions, including autism and poorer social functioning. ER interventions may therefore have clinical potential. We investigated the efficacy of ER training (ERT). We conducted three online studies with healthy volunteers completing one ERT session. Studies 1 and 2 included active and control/sham training groups and tested the efficacy of (i) four-emotion ERT (angry, happy, sad and scared) (n = 101), and (ii) six-emotion ERT (adding disgusted and surprised) (n = 109). Study 3 tested generalizability of ERT to non-trained stimuli with groups trained and tested on the same stimuli, or different stimuli (n = 120). Training effects on total correct hits were estimated using linear mixed effects models. We did not observe clear evidence of improvement in study 1 but note the effect was in the direction of improvement (b = 0.02, 95% confidence interval (CI) = -0.02 to 0.07). Study 2 indicated greater total hits following training (b = 0.07, 95% CI = 0.03-0.12). Study 3 demonstrated similar improvement across groups (b = -0.01, 95% CI = -0.05 to 0.02). Our results indicate improved ER (as measured by our task), which generalizes to different facial stimulus sets. Future studies should further explore generalizability, longer-term effects and ERT in populations with known ER difficulties.
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Affiliation(s)
- Zoe E. Reed
- School of Psychological Science, University of Bristol, Bristol BS8 1QU, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 1QU, UK
| | - Steph Suddell
- School of Psychological Science, University of Bristol, Bristol BS8 1QU, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 1QU, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol BS8 2BN, UK
- Trinity College Institute of Neuroscience, Trinity College Dublin, College Green, Dublin 2, Ireland
| | - Andy Eastwood
- Psychology, Department of Social Sciences, UWE, Bristol BS16 1QY, UK
| | - Lilian Thomas
- School of Psychological Science, University of Bristol, Bristol BS8 1QU, UK
| | - Imogen Dwyer
- School of Psychological Science, University of Bristol, Bristol BS8 1QU, UK
| | - Ian S. Penton-Voak
- School of Psychological Science, University of Bristol, Bristol BS8 1QU, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol BS8 2BN, UK
| | | | - Marcus R. Munafò
- School of Psychological Science, University of Bristol, Bristol BS8 1QU, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 1QU, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol BS8 2BN, UK
| | - Angela S. Attwood
- School of Psychological Science, University of Bristol, Bristol BS8 1QU, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol BS8 1QU, UK
- National Institute for Health Research Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust and University of Bristol, Bristol BS8 2BN, UK
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Suddell S, Mahedy L, Skirrow C, Penton-Voak IS, Munafò MR, Wootton RE. Cognitive functioning in anxiety and depression: results from the ALSPAC cohort. R Soc Open Sci 2023; 10:221161. [PMID: 37564071 PMCID: PMC10410209 DOI: 10.1098/rsos.221161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 07/20/2023] [Indexed: 08/12/2023]
Abstract
Anxiety and depression are associated with a range of impairments in cognitive functioning. Understanding the nature of these deficits may identify targets for intervention and prevent functional decline. We used observational and genetic methods to investigate the relationship of anxiety and depression with three cognitive domains: emotion recognition, response inhibition, and working memory, in the Avon Longitudinal Study of Parents and Children (ALSPAC). We examined: (i) cross-sectional associations between anxiety, depression, and cognition at age 24 (n = 2187), (ii) prospective associations between anxiety and depression at age 18 and cognition at age 24 (n = 1855), and (iii) the casual effect of anxiety and depression on cognition using Mendelian randomization (MR). Both disorders were associated with altered emotion recognition; anxiety with decreased happiness recognition (b = -0.27 [-0.54,0.01], p = 0.045), and depression with increased sadness recognition (b = 0.35 [0.07,0.64], p = 0.016). Anxiety was also associated with poorer working memory (b = -0.14 [-0.24,0.04], p = 0.005). There was no evidence for an association with response inhibition. MR provided no clear evidence of causal relationships between mental health and cognition, but these analyses were underpowered. Overall, there was little evidence for impairments in executive functioning, but moderate alterations in emotion recognition. This may inform the development of psychosocial interventions.
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Affiliation(s)
- Steph Suddell
- School of Psychological Science, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
- MRC Integrative Epidemiological Unit, University of Bristol, Bristol, UK
| | - Liam Mahedy
- School of Psychological Science, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
- MRC Integrative Epidemiological Unit, University of Bristol, Bristol, UK
| | - Caroline Skirrow
- School of Psychological Science, University of Bristol, Bristol, UK
- Cambridge Cognition, Cambridge, UK
| | - Ian S. Penton-Voak
- School of Psychological Science, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
| | - Marcus R. Munafò
- School of Psychological Science, University of Bristol, Bristol, UK
- National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK
- MRC Integrative Epidemiological Unit, University of Bristol, Bristol, UK
| | - Robyn E. Wootton
- School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiological Unit, University of Bristol, Bristol, UK
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
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Suddell S, Müller-Glodde M, Lumsden J, Looi CY, Granger K, Barnett JH, Robinson OJ, Munafò MR, Penton-Voak IS. Emotional bias training as a treatment for anxiety and depression: evidence from experimental medicine studies in healthy and medicated samples. Psychol Med 2023; 53:696-705. [PMID: 34057058 PMCID: PMC9975995 DOI: 10.1017/s0033291721002014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 02/28/2021] [Accepted: 04/29/2021] [Indexed: 11/07/2022]
Abstract
BACKGROUND Anxiety and depression are leading causes of disability worldwide, yet individuals are often unable to access appropriate treatment. There is a need to develop effective interventions that can be delivered remotely. Previous research has suggested that emotional processing biases are a potential target for intervention, and these may be altered through brief training programs. METHODS We report two experimental medicine studies of emotional bias training in two samples: individuals from the general population (n = 522) and individuals currently taking antidepressants to treat anxiety or depression (n = 212). Participants, recruited online, completed four sessions of EBT from their own home. Mental health and cognitive functioning outcomes were assessed at baseline, immediately post-training, and at 2-week follow-up. RESULTS In both studies, our intervention successfully trained participants to perceive ambiguous social information more positively. This persisted at a 2-week follow-up. There was no clear evidence that this change in emotional processing transferred to improvements in symptoms in the primary analyses. However, in both studies, there was weak evidence for improved quality of life following EBT amongst individuals with more depressive symptoms at baseline. No clear evidence of transfer effects was observed for self-reported daily stress, anhedonia or depressive symptoms. Exploratory analyses suggested that younger participants reported greater treatment gains. CONCLUSIONS These studies demonstrate the effectiveness of delivering a multi-session online training program to promote lasting cognitive changes. Given the inconsistent evidence for transfer effects, EBT requires further development before it can be considered as a treatment for anxiety and depression.
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Affiliation(s)
- Steph Suddell
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Maren Müller-Glodde
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK
| | - Jim Lumsden
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Chung Yen Looi
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK
- Cambridge Cognition Ltd., Tunbridge Court, Tunbridge Lane, Bottisham, Cambridge CB25 9TU, UK
| | - Kiri Granger
- Cambridge Cognition Ltd., Tunbridge Court, Tunbridge Lane, Bottisham, Cambridge CB25 9TU, UK
| | - Jennifer H. Barnett
- Cambridge Cognition Ltd., Tunbridge Court, Tunbridge Lane, Bottisham, Cambridge CB25 9TU, UK
- Department of Psychiatry, University of Cambridge, Herchel Smith Building, Robinson Way, Cambridge CB2 0SZ, UK
| | - Oliver J. Robinson
- Institute of Cognitive Neuroscience, University College London, Alexandra House, 17-19 Queen Square, Bloomsbury, London WC1N 3AR, UK
| | - Marcus R. Munafò
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
- Medical Research Council (MRC) Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Ian S. Penton-Voak
- School of Psychological Science, University of Bristol, 12a Priory Road, Bristol BS8 1TU, UK
- NIHR Bristol Biomedical Research Centre, University Hospitals Bristol and Weston NHS Foundation Trust, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
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Mahedy L, Wootton R, Suddell S, Skirrow C, Field M, Heron J, Hickman M, Munafò MR. Testing the association between tobacco and cannabis use and cognitive functioning: Findings from an observational and Mendelian randomization study. Drug Alcohol Depend 2021; 221:108591. [PMID: 33618197 PMCID: PMC8047806 DOI: 10.1016/j.drugalcdep.2021.108591] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Revised: 12/17/2020] [Accepted: 01/17/2021] [Indexed: 01/08/2023]
Abstract
BACKGROUND Although studies have examined the association between tobacco and cannabis use in adolescence with subsequent cognitive functioning, study designs are usually not able to distinguish correlation from causation. METHODS Separate patterns of tobacco and cannabis use were derived using longitudinal latent class analysis based on measures assessed on five occasions from age 13-18 in a large UK population cohort (Avon Longitudinal Study of Parents and Children). Cognitive functioning measures comprised of working memory, response inhibition, and emotion recognition assessed at 24 years of age. Mendelian randomization was used to examine the possible causal relationship between smoking initiation, lifetime cannabis use and cognitive functioning. RESULTS We found evidence of a relationship between tobacco and cannabis use and diminished cognitive functioning for each of the outcomes in the observational analyses. There was evidence to suggest that late-onset regular tobacco smokers (b=-0.29, 95 %CI=-0.45 to -0.13), early-onset regular tobacco smokers (b=-0.45, 95 %CI=-0.84 to -0.05), and early-onset regular cannabis users (b=-0.62, 95 %CI=-0.93 to -0.31) showed poorer working memory. Early-onset regular tobacco smokers (b = 0.18, 95 %CI = 0.07 to 0.28), and early-onset regular cannabis users (b = 0.30, 95 %CI = 0.08 to 0.52) displayed poorer ability to inhibit responses. Late-onset regular (b=-0.02, 95 %CI=-0.03 to - 0.00), and early-onset regular tobacco smokers (b=-0.04, 95 %CI=-0.08 to -0.01) showed poorer ability to recognise emotions. Mendelian randomization analyses were imprecise and did not provide additional support for the observational results. CONCLUSION There was some evidence to suggest that adolescent tobacco and cannabis use were associated with deficits in working memory, response inhibition and emotion recognition. Better powered genetic studies are required to determine whether these associations are causal.
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Affiliation(s)
- Liam Mahedy
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
| | - Robyn Wootton
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
| | - Steph Suddell
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
| | - Caroline Skirrow
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; Cambridge Cognition, Cambridge, UK.
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, S1 2LT, UK.
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, BS8 2BN, UK.
| | - Marcus R Munafò
- School of Psychological Science, University of Bristol, Bristol, BS8 1TU, UK; MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK; National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK.
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Mahedy L, Suddell S, Skirrow C, Fernandes GS, Field M, Heron J, Hickman M, Wootton R, Munafò MR. Alcohol use and cognitive functioning in young adults: improving causal inference. Addiction 2021; 116:292-302. [PMID: 32335969 DOI: 10.1111/add.15100] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Revised: 03/23/2020] [Accepted: 04/20/2020] [Indexed: 12/23/2022]
Abstract
BACKGROUND AND AIMS There have been few longitudinal studies of association between alcohol use and cognitive functioning in young people. We aimed to examine whether alcohol use is a causal risk factor for deficient cognitive functioning in young adults. DESIGN Linear regression was used to examine the relationship between longitudinal latent class patterns of binge drinking and subsequent cognitive functioning. Two-sample Mendelian randomization (MR) tested evidence for the causal relationship between alcohol use and cognitive functioning. SETTING South West England. PARTICIPANTS The observational study included 3155 adolescents and their parents (fully adjusted models) from the Avon Longitudinal Study of Parents and Children (ALSPAC). Genetic instruments for alcohol use were based on almost 1 000 000 individuals from the genome-wide association studies (GWAS) and Sequencing Consortium of Alcohol and Nicotine use (GSCAN). Genome-wide association studies for cognitive outcomes were based on 2500 individuals from ALSPAC. MEASUREMENTS Binge drinking was assessed at approximately 16, 17, 18, 21 and 23 years. Cognitive functioning comprised working memory, response inhibition and emotion recognition assessed at 24 years of age. Ninety-nine independent genome-wide significant single nucleotide polymorphisms (SNPs) associated with 'number of drinks per week' were used as the genetic instrument for alcohol consumption. Potential confounders were included in the observational analyses. FINDINGS Four binge drinking classes were identified: 'low-risk' (41.3%), 'early-onset monthly' (19.1%), 'adult frequent' (22.5%) and 'early-onset frequent' (17.0%). The association between early-onset frequent binge drinking and cognitive functioning: working memory (b = -0.42, 95% confidence interval (CI) = -1.24 to 0.41), response inhibition (b = 31.9, 95% CI = -25.3 to 89.2), and emotion recognition (b = 0.02, 95% CI = -0.07 to 0.10) in comparison to low-risk drinkers were inconclusive as to whether a difference was present. Two-sample MR analyses similarly provided little evidence that alcohol use is associated with deficits in working memory using the inverse variance weight (b = 0.29, 95% CI = -0.42 to 0.99), response inhibition (b = -0.32, 95% CI = -1.04 to 0.39) and emotion recognition (b = 0.03, 95% CI = -0.55 to 0.61). CONCLUSIONS Binge drinking in adolescence and early adulthood may not be causally related to deficiencies in working memory, response inhibition or emotion recognition in youths.
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Affiliation(s)
- Liam Mahedy
- School of Psychological Science, University of Bristol, Bristol, UK.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Steph Suddell
- School of Psychological Science, University of Bristol, Bristol, UK.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Caroline Skirrow
- School of Psychological Science, University of Bristol, Bristol, UK.,Cambridge Cognition, Cambridge, UK
| | - Gwen S Fernandes
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Matt Field
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Jon Heron
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Robyn Wootton
- School of Psychological Science, University of Bristol, Bristol, UK.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
| | - Marcus R Munafò
- School of Psychological Science, University of Bristol, Bristol, UK.,MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.,National Institute for Health Research Biomedical Research Centre at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol, Bristol, UK
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