BURA Community:

Implicit core belief adaptation integrated cognitive behavioural therapy

2026-10-14T14:00:08Z

Title: Implicit core belief adaptation integrated cognitive behavioural therapy Authors: Dalton, Stefan Daniel Paul Abstract: Emotions have been at the forefront of philosophers’ and theoreticians’ curiosities for millennia. A great deal of influential research has described how emotions are defined, generated, and regulated, and many theoretical models have further described the processes underlying the maintenance of psychiatric disorders. Although implicit mechanisms are frequently documented, cognitive behavioural therapy (CBT) practices largely rely on explicit techniques such as cognitive reappraisal. Given the large body of evidence suggesting emotion generation, emotion regulation, and emotional disorders largely operate via implicit mechanisms, the present PhD thesis investigated implicit emotion processing and potential techniques for utilising implicit emotion regulation strategies within brief CBT interventions. This thesis adopted several methodological approaches, including meta-analyses, behavioural studies, and intervention studies. Several novel findings were reported. First, behavioural and fMRI meta-analyses reported maladaptive implicit emotion regulation in mood and anxiety disorder samples compared to healthy controls, further highlighting dysfunctional neural activation in patients within the medial prefrontal cortex. Second, implicit cognitive reappraisal was reported to be effective across symptom measures related to the cognitive model of emotional disorders, particularly at reducing maladaptive core beliefs. Third, the development of a standardised digital single-session cognitive behavioural therapy intervention for a presenting emotional complaint was effective on symptom measures, including GAD-7 scores, negative automatic thoughts, avoidance, and maladaptive core beliefs. Finally, the newly introduced implicit facial stimuli exposure integrated single-session CBT was reported to be increasingly effective on equivalent symptom measures. The findings are discussed within the context of influential theories and models of emotion generation, emotion regulation, emotional disorders, and goal-directed behaviours. From this, the emerging theory of implicit core belief adaptation is presented, which is hypothesised to be the implicit activation of adaptive core beliefs surrounding safety, acceptance, and connection via implicit exposure to facial stimuli. In conclusion, harnessing evolutionary mechanisms in response to facial stimuli may have important implications for adaptive cognitive, emotional, and behavioural responses, further highlighting their importance in both research, and potentially, psychiatric practice. Description: This thesis was submitted for the award of Doctor of Philosophy and was awarded by Brunel University London

Cognitive reserve and everyday functioning in cognitively unimpaired older adults: evidence from the CAN-PROTECT study

2026-10-14T02:01:17Z

Title: Cognitive reserve and everyday functioning in cognitively unimpaired older adults: evidence from the CAN-PROTECT study Authors: Ghahremani, Maryam; Guan, Dylan X; Ballard, Clive; Creese, Byron; Corbett, Anne; Pickering, Ellie; Smith, Eric E; Ismail, Zahinoor Abstract: Background: Cognitive reserve (CR) is thought to buffer against the clinical manifestation of dementia, preserving cognitive function despite accumulating pathology. However, less is known about how CR relates to the capacity to independently perform activities of daily living (ADL), particularly among cognitively unimpaired (CU) older adults. Here, we investigated this association. Methods: Baseline data from 1571 CU participants (mean age: 64.7 ± 7.6; 81.3% female) from the CAN-PROTECT study were analyzed. A composite CR score was derived from education, occupational complexity, and engagement in cognitively stimulating activities. Functional ability was measured using the Standard Assessment of Global Everyday Activities (SAGEA) scale, capturing cognitive, applied cognitive, instrumental, and basic ADL, and mobility. Negative binomial models examined associations between CR and global and domain-specific ADL, adjusting for age, sex, cognition, behavior, and physical/sensory limitations. Additional models tested the independent contribution of CR components to functional outcomes. Mediation analyses assessed the effect of CR on quality of life (QoL) through ADL abilities. Results: Higher CR was associated with lower global ADL impairment (count ratio = 0.58, 95% CI, 0.36-0.94, p = .027), driven by 49% less impairment in applied cognitive ADL (95% CI, 0.26-0.97, p = .038). Among CR domains, education showed the most consistent association with lower impairment across all ADL domains and was indirectly linked to better QoL through improved function. Conclusions: CR, particularly education, may play an important role in supporting functional abilities and QoL among CU older adults. Enhancing CR may be a promising avenue to promote functional independence and healthy aging, even in the absence of cognitive impairment. Description: Data availability: Due to the confidential nature of participant demographic health data, CAN-PROTECT study data are not publicly available in a data repository. However, individual access to the data may be provided upon reasonable request to the corresponding author.

Predictors of unhealthy aging

2026-10-14T02:01:16Z

Title: Predictors of unhealthy aging Authors: Creese, Byron Abstract: This Special Section of International Psychogeriatrics contains five papers relating to unhealthy aging. Four are epidemiological and seek to identify factors that predict poor health, frailty, mortality and loneliness. The fifth describes the initial stages of the development of an intervention to target loneliness. Collectively, then, and in a broad sense, they represent two parts of the pathway towards tackling poor health outcomes in later life. ...

“How can we help our children if no one’s helping us?”: Parent and clinician priorities for mental health support in children with rare genetic conditions who have intellectual and developmental disabilities – a framework analysis

2026-10-03T09:52:48Z

Title: “How can we help our children if no one’s helping us?”: Parent and clinician priorities for mental health support in children with rare genetic conditions who have intellectual and developmental disabilities – a framework analysis Authors: Wolstencroft, Jeanne; Housby, Harriet; Bhudia, Shriya; Lee, Irene; Vainieri, Isabella; Bednarczuk, Nadja; Oliver, Bonamy R; Wynn, Sarah L; Bennett, Sophie D; Chawner, Samuel; Hall, Jeremy; Hope-Bell, Josh; Owen, Michael; van den Bree, Marianne; Skuse, David; Raymond, F Lucy; Srinivasan, Ramya; IMAGINE-ID Consortium Abstract: Background: Next-generation sequencing technologies are now routinely used in the NHS to identify rare genetic conditions (RGCs) in children with intellectual and developmental disabilities (IDDs). As such, the proportion of children diagnosed in early childhood (<6 years) is rising rapidly. The risk of mental health conditions in this group is high, however anecdotal accounts suggest little mental health support is provided. The present study aimed to (1) define the challenges and facilitators in accessing mental health support for families caring for children with RGC and IDD, and (2) explore family and healthcare professional priorities for mental health support. Focus groups were conducted with parents of children with RGC and IDD and neurodisability medical professionals. De-identified transcripts of interviews were analysed using Framework Analysis. Eleven parents of children with RGC and IDD (anxiety problems n = 7; behavioural difficulties n = 4), and four professionals participated in the focus groups. Results: The framework analysis identified general healthcare challenges related to having an RGC, including an absence of information in ‘the big black hole’ of the post-diagnostic void, ‘falling between the cracks’ and being stuck in a loop of referrals. It also identified barriers that were specific to accessing mental health support, including difficulties in understanding how to navigate services, diagnostic overshadowing (where the RGC diagnosis acted as an exclusion criterion for accessing services) and the emotional burden of seeking mental health support. Facilitators in accessing mental health support included parental resilience, happenstance, finding key advocates and getting other diagnoses that were more widely recognised. Parent and practitioner priorities for support were aligned. They included support for families post-genetic diagnosis, training and education for healthcare professionals, early mental health support and care-co-ordination. Conclusion: Children with IDD and RGC diagnosed in early childhood and their caregivers face unique challenges in accessing mental health support for their child. Innovative approaches are needed to support parents caring for an IDD child diagnosed with RGC in early infancy and to provide better training for professionals on RGC management. Description: The publisher is sharing this article early to provide faster access to peer-reviewed, accepted research. It is citable and carries a permanent DOI. This version is subject to further edits and will be replaced automatically by the final Version of Record. All legal disclaimers apply.; IMAGINE-ID Consortium: Samuel Chawner, Jeremy Hall, Josh Hope-Bell, Michael Owen, Marianne van den Bree, David Skuse, F. Lucy Raymond & Ramya Srinivasan; Data availability: The transcripts generated during the current study are not publicly available to preserve confidentiality, but are available from the corresponding author on reasonable request.