Understanding Repetitive Negative Thinking as a Pathway to Building Resilience in Young People

Mental ill-health presents a significant burden for the individual, severely impacting health, wellbeing and future prospects, resulting in a substantial societal burden. Mental health problems typically originate in adolescence and persist into adulthood. Unfortunately however, much of our research and understanding (and national mental health research spend) is directed at adult populations, leaving this vital life-stage of emotional vulnerability subject to substantial gaps in knowledge. Improving adolescent mental health is likely to lead to an enhanced quality of life and improves the overall well-being of society, both now and in the future. It is therefore important that research, such as that proposed here, can illuminate the cognitive basis for resilience to mental ill-health.

The proposed research will investigate the relationship between two connected aspects of adolescent mental ill-health; repetitive negative thinking, and affective flexibility. Repetitive negative thinking (RNT), which is typified by constant worry and rumination is very common in mental ill-health and is important across many different mental health conditions, e.g. depression and anxiety. RNT is characterised by uncontrolled, excessive, and repetitive thoughts. The novelty of our project is the focus on affective flexibility, which is the ability to flexibly process emotional information and perform cognitive tasks efficiently in the presence of emotional information. This is essential to protect against repetitive negative thinking. Our hope is that improving affective flexibility may plausibly act as a boost to psychological resilience against mental ill-health.

This research will employ a range of methods in order to gain a more complete picture of how affective flexibility influences repetitive negative thinking and consequently, mental-ill health. Computerised cognitive tasks will be used to determine individual differences in affective flexibility. Electroencephalography (EEG) will be used to provide an account of the brain activity involved in the processing of emotional information. We will also obtain, a detailed picture of adolescents' daily emotional landscape, including emotional reactions to life events, current ruminative and worrisome thoughts, and mood by undertaking Ecological momentary assessment (EMA). Using many techniques together allows us to investigate how cognitive and affective processing influences RNT under laboratory conditions as well as in natural contexts. The fact that we are obtaining measures on several differnen levels will give us a more detailed indication of how these processes are linked.

Three research studies are planned in this project. In study 1 we will test whether induced RNT causes impairments in affective flexibility in a laboratory setting. In study 2 we will investigate naturally occurring RNT over a 1-year period in adolescence and assess its relationship to naturally occuring changes in affective flexibility. Study 3 will pilot a task designed to modify affective flexibility to determine if it is indeed possible to change, and probe subsequent influences on RNT. Our research will help cultivate an account of the development of cognitive-affective processing and RNT in order to build our understanding of the development of mental ill-health in adolescence. The impact of mental ill-health is not unique to the UK and so, in turn, this research will be of direct relevance and use to a much wider community of researchers and mental health practitioners. Our research and the tasks that we develop will be shared with a wide community, including mental health researchers and practitioners, so that they can benefit from the knowledge generated. We will also engage secondary school students with a range of engagement activities to foster understanding and awareness about mental ill-health in adolescence.

Who will benefit
Mental health research is of pivotal importance to individual and societal wellbeing. As such, we seek to achieve the maximum impact generated from this project. Our engagement with secondary schools as part of the CogBIAS project (PI: Elaine Fox) has demonstrated that secondary school students and teachers have a deep interest in understanding mental ill-health, and many have expressed a keen interest in our research, especially in relation to worry and rumination and how these relate to resilience. Therefore, in conjunction with our planned research activities (outlined in the Case for Support attachment) and our research and engagement activities (outlined in the Pathways to Impact attachment), we have identified the following primary beneficiaries; secondary school students, teachers, schools, and the general public.

How they will benefit
Repetitive negative thinking (RNT) is extremely common in adolescents and is thought to be critical for the development and maintenance of psychiatric symptoms. Therefore, deepening our understanding of the cognitive processes implicated in adolescent mental ill-health is of direct benefit to secondary school students. Effective dissemination of this research and engaging in mental health communications with our target beneficiaries will benefit health and well-being by increasing understanding of mental ill-health (a typically little-understood, yet prevalent condition). Increasing knowledge of mental ill-health vulnerability, particularly during this period by increased vulnerability has the longer-term benefits of reducing the stigma associated with mental health issues and promoting health seeking behaviour. The communication strategies outlined in the Case for Support and Pathways to Impact attachments will ensure that the maximum impact of our research will be delivered to our primary beneficiaries.
These communications strategies will be undertaken throughout the duration of the project and include; public talks and presentations in schools and to the wider public, social media and blog postings, engagement workshops, and active participation in science festivals. Each activity aims to reach maximum impact to the targeted beneficiaries. Presentations in secondary schools will be tailored to the specific needs and interests in each school. We have established links with secondary schools which will be used to facilitate the dissemination of our research to these groups.
Further, we will be working with Bea Stevenson and the Nurturing Schools Network to facilitate the delivery of our engagement activities to secondary schools. We will also be involved in their teacher training courses and social and emotional health presentations. Likewise, presentations to the general public and the planned activities at science festivals impact the wider public via raising awareness and interest in cognitive approaches to mental health. Our planned engagement workshops aim to foster interest in the mental-health sciences at this vital stage with the hope of encouraging the next generation of mental-health researchers and practitioners. Finally, we have laid out plans to engage the widest range of mental health practitioners, clinicians and researchers across disciplines. This includes; openly publish research papers, materials, and data sets, and arrange symposia at prominent academic conferences in order to disseminate our research activities to the widest professional audience. To sum, we plan consistent and targeted engagement with each identified beneficiary across the duration of the proposed research in order to exploit each identified opportunity to maximise the impact of our research.