• Attentional bias towards threatening and neutral facial expressions in high trait anxious children.

      Kelly, Lauren; Maratos, Frances A.; Lipka, Sigrid; Croker, Steve; University of Derby (2016-07-03)
      Research suggests anxious children display increased attentional biases for threat-related stimuli. However, findings based upon spatial domain research are equivocal. Moreover, few studies allow for the independent analysis of trials containing neutral (i.e., potentially ambiguous) faces. Here, we report two temporal attentional blink experiments with high trait anxious (HTA) and low trait anxious (LTA) children. In an emotive experiment, we manipulated the valence of the second target (T2: threatening/positive/neutral). Results revealed that HTA, relative to LTA, children demonstrated better performance on neutral trials. Additionally, HTA children demonstrated a threat-superiority effect whereas LTA children demonstrated an emotion-superiority effect. In a non-emotive control, no differences between HTA and LTA children were observed. Results suggest trait anxiety is associated with an attentional bias for threat in children. Additionally, the neutral face finding suggests HTA children bias attention towards ambiguity. These findings could have important implications for current anxiety disorder research and treatments.
    • Attentional biases towards familiar and unfamiliar foods in children. The role of food neophobia

      Maratos, Frances A.; Staples, Paul; University of Derby (2015-04-08)
      Familiarity of food stimuli is one factor that has been proposed to explain food preferences and food neophobia in children, with some research suggesting that food neophobia (and familiarity) is at first a predominant of the visual domain. Considering visual attentional biases are a key factor implicated in a majority of fear-related phobias/anxieties, the purpose of this research was to investigate attentional biases to familiar and unfamiliar fruit and vegetables in 8 to 11 year old children with differing levels of food neophobia. To this end, 70 primary aged children completed a visual-probe task measuring attentional biases towards familiar and unfamiliar fruit/vegetables, as well as the food neophobia, general neophobia and willingness to try self-report measures. Results revealed that as an undifferentiated population all children appeared to demonstrate an attentional bias toward the unfamiliar fruit and vegetable stimuli. However, when considering food neophobia, this bias was significantly exaggerated for children self-reporting high food neophobia and negligible for children self-reporting low food neophobia. In addition, willingness to try the food stimuli was inversely correlated with attentional bias toward the unfamiliar fruits/vegetables. Our results demonstrate that visual aspects of food stimuli (e.g. familiarity) play an important role in childhood food neophobia. This study provides the first empirical test of recent theory/models of food neophobia (e.g. Brown & Harris, 2012). Findings are discussed in light of these models and related anxiety models, along with implications concerning the treatment of childhood food neophobia.
    • Brief compassion-focused imagery dampens physiological pain responses

      Maratos, Frances A.; Sheffield, David; University of Derby (Springer Science and Business Media LLC, 2020-09-03)
      Affiliative processes are postulated to improve pain coping. Comparatively, compassion-focused imagery (CFI) also stimulates affiliate affect systems with a burgeoning behavioural, cognitive and physiological evidence base. Thus, the purpose of the present research was to investigate if engaging in brief CFI could improve pain coping. Utilising a randomised repeated measures crossover design, 37 participants were subjected to experimental pain (cold pressor) following counter-balanced engagement with CFI or control imagery, 1 week apart. Salivary alpha-amylase (sAA) and questionnaire measures of emotional responding were taken: at baseline, following introduction to the imagery condition (anticipation), and immediately after the cold pressor pain task (actual). Participants exhibited increases in sAA levels in response to pain following control imagery but, no such changes were observed following CFI (i.e. there was a significant time-by-condition interaction). Pain tolerance (the length of time participants immersed their hands in the cold pressor) did not differ by imagery condition. However, sAA responses to actual pain predicted decreased pain tolerance in the CFI condition. Additionally, anticipatory sAA response predicted increased pain tolerance across both conditions. None of the emotional measures of well-being differed by imagery condition, nor by condition over time. These data demonstrate that using CFI can curtail a physiological stress response to pain, as indicated by increases in sAA in the control imagery condition only, following pain; pain tolerance was not influenced by CFI. Compassion-based approaches may therefore help people cope with the stress associated with pain.
    • Can compassion, happiness and sympathetic concern be differentiated on the basis of facial expression?

      Condliffe, Otto; Maratos, Frances A.; University of Shanghai; University of Derby (Taylor and Francis, 2020-04-11)
      Recent research has demonstrated the importance of positive emotions, and especially compassion, for well-being. Via two investigations, we set out to determine if facial expressions of happiness, “kind” compassion and sympathetic concern can be distinguished, given limitations of previous research. In investigation one, prototypes of the three expressions were analysed for similarities and differences using the facial action coding system (FACS) by two certified independent coders. Results established that each expression comprised distinct FACS units. Thus, in investigation 2, a new photographic stimulus set was developed using a gender/racially balanced group of actors to pose these expressions of “kind” compassion, happiness, sympathetic concern, and the face in a relaxed/neutral pose. 75 participants were then asked to name the FACS generated expressions using not only forced categorical quantitative ratings but, importantly, free response. Results revealed that kind compassionate facial expressions: (i) engendered words associated with contented and affiliative emotions (although, interestingly, not the word “kind”); (ii) were labelled as compassionate significantly more often than any of the other emotional expressions; but (iii) in common with happiness expressions, engendered happiness word groupings and ratings. Findings have implications for understandings of positive emotions, including specificity of expressions and their veridicality.
    • Development and validation of a short-form Pain Medication Attitudes Questionnaire (PMAQ-14)

      Elander, James; Said, Omimah; Maratos, Frances A.; Dys, Ada; Collins, Hannah; Schofield, Malcolm B.; University of Derby (International Association for the Study of Pain, 2017-03-01)
      Attitudes to pain medication are important aspects of adjustment to chronic pain. They are measured by the 47-item Pain Medication Attitudes Questionnaire (PMAQ). To measure those attitudes more quickly and easily, we developed and evaluated a 14-item PMAQ using data from three separate surveys of people with pain in the general population. In survey 1, participants (n=295) completed the 47-item PMAQ and measures of pain, analgesic use, analgesic dependence and attitudes to self-medication. For each of the seven PMAQ scales, the two items that best preserved the content of the parent scales were identified using correlation and regression. The 2-item and parent scales had very similar relationships with other measures, indicating validity had been maintained. The resulting 14-item PMAQ was then completed by participants in survey 2 (n=241) and survey 3 (n=147), along with the same other measures as in survey 1. Confirmatory factor analysis showed that the 14-item PMAQ retained the 7-factor structure of the 47-item version, and correlations with other measures showed it retained the validity of the 47-item version. The PMAQ scale Need was the most significant independent predictor of analgesic dependence in each of four separate multiple regression analyses. This short form of the PMAQ allows attitudes to pain medications to be measured in a valid and more efficient way.
    • Development of a compassion-based training for cancer (CforC) curriculum for female breast cancer patients in stages I-III and cancer survivors. Origins, rationale and initial observations.

      Wahl, Julia; Sheffield, David; Maratos, Frances A.; Archer, Stephanie; University of Derby; Imperial College London (Elsevier, 2018-07-20)
      Compassion is an intrinsic trait and is linked to psychological and physiological well-being. It can be trained and improved through a systematic contemplative training programme. The purpose of this paper is to present a new training programme for cancer patients and survivors (CforC) that was designed and tested in a pilot study. We review the potential benefits of CforC which include attention regulation, self-regulation, mental awareness, and acceptance of physical sensations (including pain experiences). We also consider limitations. Results of the pilot suggest that the current intervention is feasible and provides potential psychological benefits for female breast cancer patients/survivors. Future research may benefit from examining other potential effects of the CforC programme, including emotional and physical outcomes in cancer patients and survivors, and the application of the intervention to other populations of chronically ill patients.
    • Development of the critical thinking toolkit (CriTT): A measure of student attitudes and beliefs about critical thinking

      Stupple, Edward J. N.; Maratos, Frances A.; Elander, James; Hunt, Thomas E.; Cheung, Kevin Yet Fong; Aubeeluck, Aimee; University of Derby (Elsevier, 2016-11-24)
      Critical thinking is an important focus in higher education and is essential for good academic achievement. We report the development of a tool to measure critical thinking for three purposes: (i) to evaluate student perceptions and attitudes about critical thinking, (ii) to identify students in need of support to develop their critical thinking, and (iii) to predict academic performance. Seventy-seven items were generated from focus groups, interviews and the critical thinking literature. Data were collected from 133 psychology students. Factor Analysis revealed three latent factors based on a reduced set of 27 items. These factors were characterised as: Confidence in Critical Thinking; Valuing Critical Thinking; and Misconceptions. Reliability analysis demonstrated that the sub-scales were reliable. Convergent validity with measures of grade point average and argumentation skill was shown, with significant correlations between subscales and validation measures. Most notably, in multiple regression analysis, the three sub-scales from the new questionnaire substantially increased the variance in grade point average accounted for by measures of reflective thinking and argumentation. To sum, the resultant scale offers a measure that is simple to administer, can be used as a diagnostic tool to identify students who need support in developing their critical thinking skills, and can also predict academic performance.
    • Do cardiovascular responses to active and passive coping tasks predict future blood pressure 10 months later?

      Yuenyongchaiwat, Kornanong; Baker, Ian S.; Maratos, Frances A.; Sheffield, David; University of Derby (2016-03-14)
      The study examined whether cardiovascular responses to active or passive coping tasks and single or multiple tasks predicted changes in resting blood pressure (BP) over a ten-month period. Heart rate (HR), BP, cardiac output (CO), and total peripheral resistance (TPR) were measured at rest, and during mental stress tests (mental arithmetic, speech, and cold pressor tasks). A total of 104 eligible participants participated in the initial study, and 77 (74.04%) normotensive adult participants’ resting BP were re-evaluated at ten-month follow-up. Regression analyses indicated that after adjustment for baseline BP, initial age, gender, body mass index, family history of cardiovascular disease, and current cigarette smoking, heightened systolic blood pressure (SBP) and HR responses to an active coping task (mental arithmetic) were associated with increased future SBP (R2 = .060, R2 =.045, respectively). Further, when aggregated, SBP responsivity (over the three tasks) resulted in a significant, but smaller increase in R2 accounting for .040 of the variance of follow-up SBP. These findings suggest that cardiovascular responses to active coping tasks predict future SBP. Furtherthe findings revealed that SBP responses to the tasks when aggregated were less predictive compared to an individual task (i.e., mental arithmetic). Of importance, hemodynamic reactivity (namely CO and TPR) did not predict future BP; suggesting that more general psychophysiological processes (e.g., inflammation, platelet aggregation) may be implicated, or that BP, but not hemodynamic reactivity may be a marker of hypertension.
    • Do therapeutic imagery practices affect physiological and emotional indicators of threat in high self-critics?

      Duarte, Joana; McEwan, Kirsten; Barnes, Christopher; Gilbert, Paul; Maratos, Frances A.; University of Coimbra; University of Derby; Cardiff University; Cognitive and Behavioural Centre for Research and Intervention; University of Coimbra; Portugal; Institute of Primary Care and Population Health; School of Medicine; Cardiff University; Wales UK; et al. (Wiley, 2015-09)
      Objectives: Imagery is known to be a powerful means of stimulating various physiological processes and is increasingly used within standard psychological therapies. Compassion-focused imagery (CFI) has been used to stimulate affiliative emotion in people with mental health problems. However, evidence suggests that self-critical individuals may have particular difficulties in this domain with single trials. The aim of the present study was to further investigate the role of self-criticism in responsiveness to CFI by specifically pre-selecting participants based on trait self-criticism. Design: Using the Forms of Self-Criticism/Self-Reassuring Scale, 29 individuals from a total sample of 139 were pre-selected to determine how self-criticism impacts upon an initial instance of imagery. Methods: All participants took part in three activities: a control imagery intervention (useable data N = 25), a standard CFI intervention (useable data N = 25), and a non-intervention control (useable data N = 24). Physiological measurements (alpha amylase) as well as questionnaire measures of emotional responding (i.e., the Positive and Negative Affect Schedule, the Types of Positive Affect Scale, and the State Adult Attachment Scale) were taken before and after the different interventions. Results: Following both imagery interventions, repeated measures analyses revealed that alpha amylase increased significantly for high self-critics compared with low self-critics. High self-critics (HSC) also reported greater insecurity on entering the imagery session and more negative CFI experiences compared with low self-critics. Practitioner Points: Data demonstrate that HSC respond negatively to imagery interventions in a single trial. This highlights that imagery focused therapies (e.g., CFI) need interventions that manage fears, blocks, and resistances to the techniques, particularly in HSC. An initial instance of imagery (e.g., CFI) can be frightening for people who have a tendency to be self-critical. This research provides examples of physiological and emotional responses to imagery type therapies in high and low self-critics, and associated clinical implications. Therapists may find it helpful to be mindful that when introducing imagery based therapies, highly self-critical patients need interventions that manage fears, blocks, and resistances to the techniques.
    • Early gamma-band activity as a function of threat processing in the extrastriate visual cortex

      Maratos, Frances A.; Senior, Carl; Mogg, Karin; Bradley, Brendan P.; Rippon, Gina (2012)
    • The effects of anxiety on temporal attention for emotive and neutral faces in children

      Kelly, Lauren; Maratos, Frances A.; Lipka, Sigrid; University of Derby (Stress and Anxiety Research Society (STAR), 2014-07)
      OBJECTIVES: Cognitive theories suggest that the aetiology and maintenance of anxiety are associated with biases of attention for threatening information. However, findings relating to studies in child populations are inconsistent and the majority of such research has focused on spatial attentional biases. Consequently, the aim here was to investigate the effects of anxiety on temporal biases of attention for emotive stimuli in children. METHODS: A total of 53 children, aged eight to eleven, were preselected for levels of trait anxiety to participate in an attentional blink task. On each trial, two target stimuli (i.e., a neutral face and either a happy or angry face) appeared in a stream of consecutively presented distracters (i.e., scrambled face stimuli). Participants were required to report which face(s) they had seen. RESULTS: A mixed analysis of variance revealed a significant interaction between anxiety and trial type, such that high trait anxiety was associated with facilitated engagement towards angry, compared with happy and neutral, faces. In addition, high trait, relative to low trait, anxious participants displayed facilitated engagement towards neutral faces. CONCLUSIONS: Findings offer support for cognitive theories, which purport that attentional bias for threat is an innate phenomenon and moderated according to anxiety level. The neutral face finding may further suggest that maladaptive assumptions/beliefs, particularly concerning ambiguous situations, play a role in the aetiology and/or maintenance of anxiety disorders. This research offers important clinical implications in relation to attention retraining that has been used to successfully attenuate such biases in anxious adults.
    • Emotion based attentional priority for storage in visual short-term memory

      Simione, Luca; Calabrese, Lucia; Belardinelli, Marta Olivetti; MARUCCI, Francesco Saverio; RAFFONE, Antonino; Maratos, Frances A.; University of Derby (PLOS, 2014-05-01)
      A plethora of research demonstrates that the processing of emotional faces is prioritised over non-emotive stimuli when cognitive resources are limited (this is known as ‘emotional superiority’). However, there is debate as to whether competition for processing resources results in emotional superiority per se, or more specifically, threat superiority. Therefore, to investigate prioritisation of emotional stimuli for storage in visual short-term memory (VSTM), we devised an original VSTM report procedure using schematic (angry, happy, neutral) faces in which processing competition was manipulated. In Experiment 1, display exposure time was manipulated to create competition between stimuli. Participants (n = 20) had to recall a probed stimulus from a set size of four under high (150 ms array exposure duration) and low (400 ms array exposure duration) perceptual processing competition. For the high competition condition (i.e. 150 ms exposure), results revealed an emotional superiority effect per se. In Experiment 2 (n = 20), we increased competition by manipulating set size (three versus five stimuli), whilst maintaining a constrained array exposure duration of 150 ms. Here, for the five-stimulus set size (i.e. maximal competition) only threat superiority emerged. These findings demonstrate attentional prioritisation for storage in VSTM for emotional faces. We argue that task demands modulated the availability of processing resources and consequently the relative magnitude of the emotional/threat superiority effect, with only threatening stimuli prioritised for storage in VSTM under more demanding processing conditions. Our results are discussed in light of models and theories of visual selection, and not only combine the two strands of research (i.e. visual selection and emotion), but highlight a critical factor in the processing of emotional stimuli is availability of processing resources, which is further constrained by task demands.
    • Emotional faces, visuo-spatial working memory and anxiety

      Maratos, Frances A.; Simione, Luca; Raffone, Antonino; University of Derby; Italian National Research Council; “Sapienza” University of Rome (ECronicon, 2020-03-30)
      Recent research has demonstrated competition for limited cognitive resources, via emotional prioritization, occurs not only during attentional capture, but also extends to visuo-spatial working memory (VSWM). However, to what extent VSWM biases are influenced by individual differences such as anxiety has received limited attention. Here, we investigated this using a novel change detection paradigm with memory arrays containing 3, 4 or 5 emotional faces (angry, happy and neutral) and participants (n=41), preselected to be high or low trait anxious. The task of participants was to detect if a probe face, presented in the location of one of the original memory array faces, was the ‘same’ or ‘different’. On ‘no change’ trials results revealed that high anxious participants demonstrated poorer performance for larger set sizes than low anxious participants per se. Additionally, high anxious participants demonstrated a threat bias, whereas low anxious participants trended toward emotion superiority. On ‘change’ trials, change detection altered as a function of expression change; change detection was typically greatest when either the memory or probe face was angry. Results reveal VSWM capacity is modulated by trait anxiety and stimulus threat value, as well as highlight the importance of actively investigating (or controlling for) individual differences.
    • Exploring the international utility of progressing compassionate mind training in school settings: a comparison of implementation effectiveness of the same curricula in the UK and Portugal

      Maratos, Frances A.; Matos, Marcela; Alberquerque, Isabel; Wood, Wendy; Palmeira, Lara; Cuna, Marina; Lima, Margarida; Gilbert, Paul; University of Derby; University of Coimbra (British Psychological Society, 2020-09-01)
      Given current retention and well-being crises within the teaching profession worldwide, this research sought to explore implementation efficacy of a Compassion Mind Training (CMT) programme in cross-cultural school-settings. A 6-module CMT curriculum was implemented in teaching staff of two primary schools in the UK (N=76) and one primary school in Portugal (N=41). Results revealed that high-quality implementation was achieved across the UK and Portuguese cohorts, with the majority of staff providing extremely positive ratings regarding all aspects of module content, delivery, and interest/relevance. Moreover, recommendation of the CMT to others was the modal response across cohorts. These findings indicate that CMT in school settings has international appeal and utility in helping educators manage educational-based stresses.
    • Facial expressions depicting compassionate and critical emotions: the development and validation of a new emotional face stimulus set

      McEwan, Kirsten; Gilbert, Paul; Dandeneau, Stephane; Lipka, Sigrid; Maratos, Frances A.; Paterson, Kevin B.; Baldwin, Mark; University of Derby (2014-02-19)
      Attachment with altruistic others requires the ability to appropriately process affiliative and kind facial cues. Yet there is no stimulus set available to investigate such processes. Here, we developed a stimulus set depicting compassionate and critical facial expressions, and validated its effectiveness using well-established visual-probe methodology. In Study 1, 62 participants rated photographs of actors displaying compassionate/kind and critical faces on strength of emotion type. This produced a new stimulus set based on N = 31 actors, whose facial expressions were reliably distinguished as compassionate, critical and neutral. In Study 2, 70 participants completed a visual-probe task measuring attentional orientation to critical and compassionate/kind faces. This revealed that participants lower in self-criticism demonstrated enhanced attention to compassionate/kind faces whereas those higher in self-criticism showed no bias. To sum, the new stimulus set produced interpretable findings using visual-probe methodology and is the first to include higher order, complex positive affect displays.
    • Identification of angry faces in the attentional blink

      Maratos, Frances A.; Mogg, Karin; Bradley, Brendan P. (2008)
    • In search of critical thinking in psychology: an exploration of student and lecturer understandings in higher education

      Duro, Elaine; Elander, James; Maratos, Frances A.; Stupple, Edward J. N.; Aubeeluck, Aimee; University of Derby (Sage Publications, 2013-12)
      This qualitative study of understandings of critical thinking in higher education aimed to identify themes that could help to demystify critical thinking and inform its more explicit incorporation in the psychology curriculum. Data collected from focus groups with 26 undergraduate psychology students and individual semi-structured interviews with 4 psychology lecturers were examined using thematic analysis. The same key themes were identified from both student and lecturer data: ‘vague beginnings’, ‘conceptualizations’, ‘development and transitions’, and ‘learning strategies’. Both students and lecturers described critical thinking as implicit knowledge that develops through social interactions. The findings indicate the importance of explicit discussion about critical thinking, and could be used to inform the design and delivery of instructional methods to promote critical thinking
    • An international study of analgesic dependence among people with pain in the general population

      Omimah, Said; Elander, James; Maratos, Frances A.; University of Derby (Taylor and Francis, 2019-03-26)
      Overuse of and dependence on analgesics (including opioids and other pain medications) are major international public health problems. To identify influences on analgesic dependence among analgesic users in the general populations of different countries. Online surveys of 1,283 people with pain in the UK, USA, Australia, Germany, Egypt and China/Macau/Hong Kong. Levels of analgesic overuse and dependence were highest in Egypt and lowest in China/Macau/Hong Kong. In every country except Egypt, frequency of pain and frequency of analgesic use were correlated with analgesic dependence, and scores on the Need subscale of the Pain Medication Attitudes Questionnaire (PMAQ; McCracken et al., 2006) independently predicted analgesic dependence. In the UK, USA, Australia and Germany, frequency of analgesic use mediated the effects of pain frequency or intensity, and Need scores mediated the effects of frequency of analgesic use. In Egypt, more recent pain, analgesic overuse, and the Emotion and Solicitude subscales of the Survey of Pain Attitudes (SOPA) independently predicted analgesic dependence. Across multiple countries, the impact of pain on analgesic dependence was mediated by frequency of analgesic use rather than overuse or abuse, and self-reported need for analgesics was the strongest independent predictor of dependence. Asking people directly about their feelings of needing analgesics could therefore identify those who could be helped to use analgesics less frequently, which should reduce their risk of dependence.
    • Investigating the relationship between consultation length and patient experience: a cross-sectional study in primary care

      Elmore, Natasha; Burt, Jenni; Abel, Gary; Maratos, Frances A.; Montague, Jane; Campbell, John; Roland, Martin; University of Derby (Royal College of General Practitioners, 2016-11-24)
      Background Longer consultations in primary care have been linked with better quality of care and improved health-related outcomes. However, there is little evidence of any potential association between consultation length and patient experience. Aim To examine the relationship between consultation length and patient-reported communication, trust and confidence in the doctor, and overall satisfaction. Design and setting Analysis of 440 videorecorded consultations and associated patient experience questionnaires from 13 primary care practices in England. Method Patients attending a face-to-face consultation with participating GPs consented to having their consultations videoed and completed a questionnaire. Consultation length was calculated from the videorecording. Linear regression (adjusting for patient and doctor demographics) was used to investigate associations between patient experience (overall communication, trust and confidence, and overall satisfaction) and consultation length. Results There was no evidence that consultation length was associated with any of the three measures of patient experience (P >0.3 for all). Adjusted changes on a 0–100 scale per additional minute of consultation were: communication score 0.02 (95% confidence interval [CI] = −0.20 to 0.25), trust and confidence in the doctor 0.07 (95% CI = −0.27 to 0.41), and satisfaction −0.14 (95% CI = −0.46 to 0.18). Conclusion The authors found no association between patient experience measures of communication and consultation length, and patients may sometimes report good experiences from very short consultations. However, longer consultations may be required to achieve clinical effectiveness and patient safety: aspects also important for achieving high quality of care. Future research should continue to study the benefits of longer consultations, particularly for patients with complex multiple conditions.
    • Joy and calm: how an evolutionary functional model of affect regulation informs positive emotions in nature

      Richardson, Miles; McEwan, Kirsten; Maratos, Frances A.; Sheffield, David; University of Derby (Springer, 2016-08-23)
      Key theories of the human need for nature take an evolutionary perspective, and many of the mental well-being benefits of nature relate to positive affect. As affect has a physiological basis, it is important to consider these benefits alongside regulatory processes. However, research into nature and positive affect tends not to consider affect regulation and the neurophysiology of emotion. This brief systematic review and meta-analysis presents evidence to support the use of an existing evolutionary functional model of affect regulation (the three circle model of emotion) that provides a tripartite framework in which to consider the mental well-being benefits of nature and to guide nature-based well-being interventions. The model outlines drive, contentment and threat dimensions of affect regulation based on a review of the emotion regulation literature. The model has been used previously for understanding mental well-being, delivering successful mental health-care interventions and providing directions for future research. Finally, the three circle model is easily understood in the context of our everyday lives, providing an accessible physiological-based narrative to help explain the benefits of nature.