Publications
13 results found
Powell R, Burmester V, Waddingham E, et al., 2024, A cross-sectional study of the psychosocial and occupational impact of COVID-19 among NHS staff: findings from a Northwest London cohort during the second wave, F1000Research, Vol: 13, ISSN: 2046-1402
Background: Evidence of the deleterious mental health impact of COVID-19 on healthcare workers shows the priority need to support their psychological wellbeing. We assessed the nature, prevalence and factors associated with the psychosocial and occupational impact of COVID-19 among NHS staff during the pandemic.Methods: A cross-sectional online survey was sent to all NHS provider organisations in Northwest London in January 2021.Results: Of 1,065 participants completing the survey, 906 (85%) provided responses to the full survey. Over half (54.1%; n=543) exceeded the cut-off score for probable mental disorders, 31.1% (n=222) for probable burnout, and similarly for PTSD (28.5%; n=210). 28.6% (n=214) had experienced suicidal thoughts. 58% (n=429) scored >5 out of 10 for emotional and physical exhaustion. Over 30% (n=328) of respondents reported using some kind of staff support service.Staff in pay bands 4-6 were more likely to have common mental disorders (CMD) (OR 2.42 [1.20,4.88]) and PTSD symptoms (OR 4.18 [1.44,12.14]) than lower banded staff. Staff working in acute care settings were more likely to experience CMD (OR 1.50 [1.08,2.07]) and PTSD (OR 1.57 [1.03,2.41]) than in non-acute settings. Low social connectedness and perceived delivery of poor-quality care were highly associated with risk of all mental health problems, apart from alcohol misuse (OR range 1.56-18.34).Conclusions: Psychosocial morbidity and adverse occupational impacts on NHS staff in the second wave of the COVID-19 pandemic echoed that reported in the first wave. Social connection and perception of delivering good care were important, potentially modifiable, mitigating factors.
Burmester V, Nicholls D, 2023, Negative interpretation bias in females with bulimia nervosa, Mental Health Science, Vol: 1, Pages: 195-201, ISSN: 2642-3588
<jats:title>Abstract</jats:title><jats:p>Persons with bulimia nervosa (BN) often experience psychosocial difficulties, in particular heightened sensitivity to social rejection and a negative bias toward their social environment. Conversely, social competence and close friendships are protective against mental ill health. The aims of this study were to evaluate the interpretation of ambiguous social scenarios in females with and without BN and to assess the relationship between interpretation biases and clinical characteristics. Females with BN (<jats:italic>n</jats:italic> = 35) and controls (<jats:italic>n</jats:italic> = 35) were recruited via social media. Participants completed the Eating Disorder Examination Questionnaire (EDE‐Q), Adult Rejection Sensitivity Questionnaire, the Depression Anxiety and Stress Scales (DASS), and finished sentence stems depicting ambiguous social scenarios. Completed sentence stems were rated as positive, neutral, or negative by blinded researchers. Females with BN made fewer positive and more negative interpretations of sentence stems than controls. The frequency of negative interpretations correlated positively with clinical symptoms on the EDE‐Q, A‐RSQ, and DASS. A negative interpretation bias was found in females with BN, which aligns with the finding shown by Cardi et al. that females with anorexia nervosa have a negative interpretation bias toward ambiguous social scenarios. This bias was not only associated with eating disorder psychopathology but also with depression, anxiety, and stress, highlighting a potential transdiagnostic role. Interventions that address psychosocial difficulties might prevent the onset, reduce symptoms, and improve prognosis.</jats:p>
Kadirvelu B, Bellido Bel T, Wu X, et al., 2023, Mindcraft, a mobile mental health monitoring platform for children and young people: development and acceptability pilot study, JMIR Formative Research, Vol: 7, Pages: 1-13, ISSN: 2561-326X
BACKGROUND: Children and young people's mental health is a growing public health concern, which is further exacerbated by the COVID-19 pandemic. Mobile health apps, particularly those using passive smartphone sensor data, present an opportunity to address this issue and support mental well-being. OBJECTIVE: This study aimed to develop and evaluate a mobile mental health platform for children and young people, Mindcraft, which integrates passive sensor data monitoring with active self-reported updates through an engaging user interface to monitor their well-being. METHODS: A user-centered design approach was used to develop Mindcraft, incorporating feedback from potential users. User acceptance testing was conducted with a group of 8 young people aged 15-17 years, followed by a pilot test with 39 secondary school students aged 14-18 years, which was conducted for a 2-week period. RESULTS: Mindcraft showed encouraging user engagement and retention. Users reported that they found the app to be a friendly tool helping them to increase their emotional awareness and gain a better understanding of themselves. Over 90% of users (36/39, 92.5%) answered all active data questions on the days they used the app. Passive data collection facilitated the gathering of a broader range of well-being metrics over time, with minimal user intervention. CONCLUSIONS: The Mindcraft app has shown promising results in monitoring mental health symptoms and promoting user engagement among children and young people during its development and initial testing. The app's user-centered design, the focus on privacy and transparency, and a combination of active and passive data collection strategies have all contributed to its efficacy and receptiveness among the target demographic. By continuing to refine and expand the app, the Mindcraft platform has the potential to contribute meaningfully to the field of mental health care for young people.
Brakspear L, Boules D, Nicholls D, et al., 2022, The impact of COVID-19-related living restrictions on eating behaviours in children and adolescents: a systematic review, Nutrients, Vol: 14, Pages: 1-20, ISSN: 2072-6643
The COVID-19 pandemic prompted the imposition of physical and social distancing measures worldwide. Emerging data suggest that younger age groups may be particularly vulnerable to the adverse mental health impacts of the pandemic. Since the start of the COVID-19 pandemic, there has been an unprecedented increase in demand for child and adolescent eating disorder services. The aim of this review was to systematically review and appraise the current literature on the impact of COVID-19-related living restrictions on the eating behaviours of children and adolescents. Searches of eight electronic databases were conducted in March 2021 and December 2021 for published and grey literature on eating behaviours of population samples of children and adolescents (aged 18 months to 18 years old) who were exposed to COVID-19-related living restrictions. Of 3165 retrieved references, sixteen studies were included in this review, comprising data from 125, 286 participants. There was a pattern towards healthier eating behaviours among children and adolescents during the COVID-19 lockdown. However, young people from lower socioeconomic groups showed a tendency towards more unhealthy eating behaviours, and there was an association between mood difficulties and greater changes in eating; this suggests that such groups may be more vulnerable to the adverse health consequences of lockdowns.
Burmester V, Butler GK, Terry P, 2022, Intranasal oxytocin reduces attentional bias to food stimuli, Appetite, Vol: 168, Pages: 1-10, ISSN: 0195-6663
Attentional biases to food-related stimuli have been demonstrated in response to hunger as well as during restrained eating. Such biases are often associated with obesity, but healthy-weight individuals who do not self-report hunger have also demonstrated attentional biases to stimuli signalling food using laboratory-based cognitive tasks. Levels of the anorectic neuropeptide oxytocin are elevated by food intake and, when administered intranasally, oxytocin inhibits food intake in the laboratory. To investigate whether oxytocin can affect appetite via an action on attentional processes, 40 adults (29 women; mean age 24.0 years old) self-administered 24 IU of oxytocin or placebo intranasally. Forty minutes after administration, participants ate a small snack to maintain alertness and ameliorate deprivation-induced hunger before starting a computerized dot-probe attentional bias task that presented 180 trials of paired visual stimuli comprising neutral, food, social and/or romantic images (500 ms presentation time). Reaction times to probe stimuli that appeared after the offset of the visual images indicated a significant attentional bias to food pictures after placebo; this effect was significantly attenuated by oxytocin, p < .001. The effect of oxytocin on attentional bias to the food pictures was not altered by the type of stimulus paired with the food image, and was independent of BMI, age, sex, self-rated eating behaviour, and self-reported parental bonding; however, the effect was modulated by self-reported food cravings and trait stress. The findings support and extend previous work which has suggested that oxytocin can counteract attentional biases to food-related stimuli in a sample with anorexia by demonstrating the same effect for the first time in a cohort who do not have an eating disorder.
Jesuthasan J, Powell R, Burmester V, et al., 2021, “We weren't checked in on, nobody spoke to us”: An exploratory qualitative analysis of two focus groups on the concerns of ethnic minority NHS staff during COVID-19, BMJ Open, Vol: 12, Pages: 1-8, ISSN: 2044-6055
Objective:To gain exploratory insights into the multi-faceted, lived-experience impact of COVID-19 on a small sample of ethnic minority healthcare staff to co-create a module of questions for follow-up online surveys on the wellbeing of healthcare staff during the pandemic. Design:A cross-sectional design using two online focus groups among ethnic minority healthcare workers who worked in care or supportive roles in a hospital, community health or GP surgery setting for at least 12 months.ParticipantsThirteen healthcare workers (11 female) aged 26 to 62 years from diverse ethnic minority backgrounds, eleven working in clinical roles.Results:Five primary thematic domains emerged: 1) viral vulnerability, centring around perceived individual risk and vulnerability perceptions; 2) risk assessment, comprising of pressures to comply, perception of a tick-box exercise, and issues with risk and resource stratification; 3) interpersonal relations in the workplace, highlighting deficient consultation of ethnic minority staff, cultural insensitivity, need for support, and collegiate judgement; 4) lived experience of racial inequality, consisting of job insecurity and the exacerbation of systemic racism and its emotional burden; 5) community attitudes, including public prejudice and judgement, and patient appreciation.Conclusions:Our novel study has shown ethnic minority NHS staff have experienced COVID-19 in a complex, multi-dimensional manner. Future research with a larger sample should further examine the complexity of these experiences and should enumerate the extent to which these varied thematic experiences are shared among ethnic minority NHS workers so that more empathetic and supportive management and related occupational practices can be instituted.
Burmester V, Nicholls D, Buckle A, et al., 2021, Review of eating disorders and oxytocin receptor polymorphisms., Journal of Eating Disorders, Vol: 9, Pages: 1-9, ISSN: 2050-2974
BACKGROUND AND AIMS: Oxytocin, a nine amino acid peptide synthesised in the hypothalamus, has been widely recognised for its role in anxiolysis, bonding, sociality, and appetite. It binds to the oxytocin receptor (OXTR)-a G-protein coupled receptor-that is stimulated by the actions of oestrogen both peripherally and centrally. Studies have implicated OXTR genotypes in conferring either a risk or protective effect in autism, schizophrenia, and eating disorders (ED). There are numerous DNA variations of this receptor, with the most common DNA variation being in the form of the single nucleotide polymorphisms (SNPs). Two OXTR SNPs have been most studied in relation to ED: rs53576 and rs2254298. Each SNP has the same allelic variant that produces genotypes AA, AG, and GG. In this critical review we will evaluate the putative role of rs53576 and rs2254298 SNPs in ED. Additionally, this narrative review will consider the role of gene-environment interactions in the development of ED pathology. FINDINGS: The OXTR SNPs rs53576 and rs2254298 show independent associations between the A allele and restrictive eating behaviours. Conversely, the G allele of the OXTR rs53576 SNP is associated with binging behaviours, findings that were also evident in neuroanatomy. One study found the A allele of both OXTR SNPs to confer risk for more severe ED symptomatology while the G allele conferred some protective effect. An interaction between poor maternal care and rs2254298 AG/AA genotype conferred increased risk for binge eating and purging in women. CONCLUSIONS: Individual OXTR SNP are unlikely in themselves to explain complex eating disorders but may affect the expression of and/or effectiveness of the OXTR. A growing body of G x E work is indicating that rs53576G homozygosity becomes disadvantageous for later mental health under early adverse conditions but further research to extend these findings to eating pathology is needed. The GWAS approach would benefit this area of knowledge.
Burmester V, Graham E, Nicholls D, 2021, Physiological, emotional and neural responses to visual stimuli in eating disorders: a review, Journal of Eating Disorders, Vol: 9, ISSN: 2050-2974
BACKGROUND: Overconcern with food and shape/weight stimuli are central to eating disorder maintenance with attentional biases seen towards these images not present in healthy controls. These stimuli trigger changes in the physiological, emotional, and neural responses in people with eating disorders, and are regularly used in research and clinical practice. However, selection of stimuli for these treatments is frequently based on self-reported emotional ratings alone, and whether self-reports reflect objective responses is unknown. MAIN BODY: This review assessed the associations across emotional self-report, physiological, and neural responses to both food and body-shape/weight stimuli in people with anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED). For food stimuli, either an aversive or lack of physiological effect was generated in people with AN, together with a negative emotional response on neuroimaging, and high subjective anxiety ratings. People with BN showed a positive self-rating, an aversive physiological reaction, and a motivational neural response. In BED, an aversive physiological reaction was found in contrast to motivational/appetitive neural responses, with food images rated as pleasant. The results for shape/weight stimuli showed aversive responses in some physiological modalities, which was reflected in both the emotional and neural responses, but this aversive response was not consistent across physiological studies. CONCLUSIONS: Shape/weight stimuli are more reliable for use in therapy or research than food stimuli as the impact of these images is more consistent across subjective and objective responses. Care should be taken when using food stimuli due to the disconnect reported in this review.
Burmester V, Nicholls D, 2020, Effect of the COVID-19 quarantine on emotional eating in youth, Eating Disorders Research Society (EDRS 2020)
Burmester V, Gibson EL, Butler G, et al., 2019, Oxytocin reduces post-stress sweet snack intake in women without attenuating salivary cortisol, PHYSIOLOGY & BEHAVIOR, Vol: 212, ISSN: 0031-9384
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Burmester V, Terry P, Bailey A, 2019, Intranasal oxytocin reduces hedonic eating in females, British-Pharmacology-Society Meeting (Pharmacology), Publisher: WILEY, Pages: 1642-1643, ISSN: 0306-5251
Burmester V, Higgs S, Terry P, 2018, Rapid-onset anorectic effects of intranasal oxytocin in young men, Appetite, Vol: 130, Pages: 104-109, ISSN: 0195-6663
Although the neuropeptide oxytocin exhibits many of the characteristics that would support its use as an anorectic agent for overeaters, studies of oxytocin's effectiveness at reducing eating in humans remain limited. In a double-blind, placebo-controlled crossover study, under the pretext of examining oxytocin's effects on various aspects of sensory perception, 20 men were given 24 IU of oxytocin and took a taste test of sweet, salty, and neutral snacks 45 min later. Participants self-rated appetite, anxiety, and other mood parameters, and then were left alone for 10 min with the pre-weighed snack food and invited to help themselves. To minimize the influence of hunger-driven eating, lunch had been provided immediately after oxytocin administration. In line with Ott et al. (2013), oxytocin significantly reduced the consumption of sweet foods; however, it also reduced consumption of salty snacks. Self-reported anxiety did not differ across drug conditions. The study is the first to demonstrate an effect of oxytocin on snack eating at 45 min post administration and on salty snacks. The anorectic efficacy of oxytocin after 45 min cannot easily be explained by the same mechanism as the one presumed to underpin its effects in previous studies that adopted much longer intervals between drug administration and testing.
Burmester V, Terry P, 2018, Intranasal oxytocin reduces hedonic eating in satiated males, Appetite, Vol: 123, Pages: 456-456, ISSN: 0195-6663
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