Elaine Fox

• PhD University College Dublin
• Head of Psychology at The University of Adelaide

Background Adolescence is a time of increased emotional volatility, with emotion regulation still developing. Training the cognitive substrate of successful emotion regulation has been shown to benefit adolescents’ mental health. However, cognitive training interventions often have low adherence rates in this age group. The current study therefore...

Background: This paper introduces the UK Biobank (UKB) second mental health questionnaire (MHQ2), describes its design, the respondents and some notable findings. UKB is a large cohort study with over 500,000 volunteer participants aged 40-69 years when recruited in 2006-2010. It is an important resource of extensive health, genetic and biomarker d...

Psychopathic personality traits have been identified as an important predictor of associative learning capacity. Prior work has associated psychopathy with deficits when adapting learned associations in response to novel information. However, findings are inconsistent and are hypothesised to vary as a function of the processing load created by diff...

Psychopathic personality traits have been identified as an important individual predictor of associative learning capacity. Prior work has associated psychopathy with deficits when adapting learned associations in response to novel information. However, findings are inconsistent and are hypothesised to vary as a function of the processing load crea...

The Cognitive Bias (CogBIAS) hypothesis proposes that cognitive biases develop as a function of environmental influences (which determine the valence of biases) and the genetic susceptibility to those influences (which determines the potency of biases). The current study employed a longitudinal, polygenic-by-environment approach to examine the CogB...

A large body of evidence suggests that processing of affective information is typically disrupted in anxiety. It has also been hypothesized that anxious individuals are less able to evaluate contextual cues and to respond in an adaptive way to stress. In the present study, 25 participants (16 females; 9 males) scoring high (scores of 45 or above) a...

During the COVID-19 pandemic, there has been a rise in common mental health problems compared to prepandemic levels, especially in young people. Understanding the factors that place young people at risk is critical to guide the response to increased mental health problems. Here we examine whether age-related differences in mental flexibility and fr...

Progress in psychopathy research has been hampered by ongoing contention about its fundamental cause. The Impaired Integration theory of psychopathy provides an attention-based account of information integration abnormalities. We set out to evaluate the suggested mechanism via an innovative application of the well-established illusory conjunction p...

Individuals vary in their ability to tolerate uncertainty. High intolerance of uncertainty (the tendency to react negatively to uncertain situations) is a known risk factor for mental health problems. In the current study we examined the degree to which intolerance of uncertainty predicted depression and anxiety symptoms and their interrelations ac...

This chapter delivers a concise and comprehensive review of research regarding the associations between interpretational processing biases and psychopathology with a focus on the influence of genetic factors. We introduce cognitive theories relating to the association between cognitive biases and psychopathology before discussing the aetiology of i...

Emerging evidence shows that compared to pre-pandemic norms pregnant women report significant increases in clinical levels of depressive and anxiety symptoms during COVID-19. This pre-registered study examined cognitive and social vulnerability factors for poor mental health in pregnancy during COVID-19. Understanding vulnerability profiles is key...

Emerging evidence shows that compared to pre-pandemic norms pregnant women report significant increases in clinical levels of depressive and anxiety symptoms during COVID-19. This pre-registered study examined cognitive and social vulnerability factors for poor mental health in pregnancy during COVID-19. Understanding vulnerability profiles is key...

Background: Little is understood about the development of cognitive biases, despite their influential role in psychopathology and wellbeing. The Cognitive Bias (CogBIAS) hypothesis proposes that cognitive biases develop as a function of environmental influences (which determine the valence of biases), and the genetic susceptibility to those influen...

Background: During the COVID-19 pandemic there has been a rise in common mental health problems compared to pre-pandemic levels, especially in young people. Understanding the factors that place young people at risk is critical to guide the response to increased mental health problems. Here we examine whether age-related differences in emotion regul...

A large body of evidence suggests that processing of affective information is typically disrupted in anxiety. It has also been hypothesized that anxious individuals are less able to evaluate contextual cues so that they are less able to respond in an adaptive way to stress. In the present study, we use an emotion search task to test whether attenti...

Endometriosis is a chronic condition that affects ~10% of women globally. Its symptoms include chronic pelvic pain, heavy periods and tiredness/fatigue, which have been associated with poorer quality of life and mental health. We aim to explore the impact of the COVID-19 pandemic on pain and fatigue symptoms and their interactions with the impact o...

Progress in psychopathy research has been hampered by ongoing contention about its fundamental cause. The Impaired Integration theory of psychopathy provides an attention-based account of information integration abnormalities. We set out to evaluate the suggested mechanism via an innovative application of the well-established illusory conjunction p...

Belonging is a basic human need, with social isolation signaling a threat to biological fitness. Sensitivity to ostracism varies across individuals and the lifespan, peaking in adolescence. Government-imposed restrictions upon social interactions during COVID-19 may therefore be particularly detrimental to young people and those most sensitive to o...

When experimental tasks require intermittent switching between easy and hard trials, people exhibit switch cost asymmetry. This is a tendency to be slower to switch over from a hard task to an easier task than vice versa. Previously, Gustavson and colleagues (2007) found that people higher on trait-anxiety exhibit a stronger switch cost asymmetry....

The Oxford Achieving Resilience during COVID-19 (ARC) study collected data from adolescents (aged 13–18), and parents of adolescents, from March 2020 to August 2021. Following a baseline survey (1274 completed baseline), participants were invited to 11 follow-up weekly surveys then 9 monthly follow-up surveys, and to an optional cognitive task. Eac...

Background: Adolescence is a sensitive period for the onset of mental health disorders. Effective, easy-to-disseminate, scalable prevention and early interventions are urgently needed. Affective control has been proposed as a potential target mechanism. Training affective control has been shown to reduce mental health symptoms and improve emotion r...

Individuals vary in their ability to tolerate uncertainty. High intolerance of uncertainty is a known risk factor for mental health problems. In the current study we examined the degree to which intolerance of uncertainty predicted depression and anxiety symptoms and their interrelations across the first year of the COVID-19 pandemic. We examined t...

Belonging is a basic human need, with social isolation signaling a threat to biological fitness. Sensitivity to ostracism varies across individuals and the lifespan, peaking in adolescence. Government-imposed restrictions upon social interactions during COVID-19 may therefore be particularly detrimental to young people and those most sensitive to o...

Uncontrolled eating-in the general population-is characterized by overeating, hedonic hunger and being drawn towards palatable foods. Theoretically, it is the result of a strong food reward signal in relation to a poor ability to exert inhibitory control. How food consumption influences inhibitory control and food cue sensitivity, and how this rela...

Endometriosis is a chronic condition affecting ~10% of women globally. Little is known about the impact of the coronavirus disease 2019 (COVID-19) pandemic on their care. This brief report is aimed to explore the impact of COVID-19 on the care of people with endometriosis around the world, their priorities in relation to their clinical care during...

Plain English Summary Binge eating tendencies have become an increasingly common phenomenon in adolescent populations. These behaviours involve consuming large amounts of food in a short period of time, during which one feels out of control and unable to stop. Episodes are often followed by marked emotional distress that can serve to perpetuate and...

Objective To explore the impact of the COVID-19 pandemic on pain and fatigue symptoms and their interactions with the impact on mental health in people with endometriosis. Design Global cross-sectional survey. Setting Online survey. Sample A total of 4717 adults with a surgical or radiological diagnosis of endometriosis. Methods An online global st...

This brief commentary welcomes the UK national goals for mental health research and suggests that the UKRI funded mental health research network approach is a good starting point to achieve these goals.

The combined cognitive bias hypothesis proposes that emotional information-processing biases may conjointly influence mental health. Yet, little is known about the interrelationships amongst cognitive biases, particularly in adolescence. We used data from the CogBIAS longitudinal study (Booth et al., 2017), including 450 adolescents who completed m...

Uncontrolled eating—in the general population—is characterized by overeating, hedonic hunger and being drawn towards palatable foods. Theoretically, it is the result of a strong food reward signal in relation to a poor ability to exert inhibitory control. How food consumption influences inhibitory control and food reward sensitivity, and how this r...

The aim of the present study was to investigate the role of working memory load on the gaze cueing effect in high and low trait-anxious participants, using electroencephalography. Fearful and neutral faces predicted the location of a target, which was a digit that participants were asked to recall from a series encoded in each trial, in a modified...

Deficits in cognitive flexibility have been associated with anxiety and worry, however few studies have assessed cognitive flexibility in the context of emotional stimuli (i.e. affective flexibility). The present study (n = 79) investigated whether individual differences in affective flexibility predict levels of trait anxiety and worry over a peri...

Previous meta-analyses investigating attentional biases towards pain have utilized reaction time measures. Eye-tracking methods have been adopted to more directly and reliably assess biases, but this literature has not been synthesized in relation to pain. This meta-analysis aimed to investigate the nature and time-course of attentional biases to p...

The development of negative cognitive biases, together with symptoms of anxiety and depression, has yet to be investigated longitudinally. Using a three-wave design, the present study examined developmental trajectories of anxiety and depressive symptoms and the co-occurrence of cognitive biases, in a large normative sample of adolescents (N = 504)...

Resilience is a dynamic process depicted by better than expected levels of functioning in response to significant adversity. This can be assessed statistically, by taking the residuals from a model of psychological functioning regressed onto negative life events. We report the first study to investigate multiple cognitive factors in relation to thi...

Worry is common in children and adolescents, yet some youth experience excessive worries that persist over time and cause significant distress. Whilst the literature on worry and generalised anxiety disorder (GAD) in adults is well established, relatively less is known about the cognitive mechanisms underlying child and adolescent worry. An influen...

Attentional bias to threat cues is most adaptive when the dangers they signal can readily be controlled by timely action. This study examined whether heightened trait anxiety is associated with impaired alignment between attentional bias to threat and variation in the controllability of danger, and whether this is moderated by executive functioning...

Background UK Biobank is a well-characterised cohort of over 500 000 participants including genetics, environmental data and imaging. An online mental health questionnaire was designed for UK Biobank participants to expand its potential. Aims Describe the development, implementation and results of this questionnaire. Method An expert working grou...

The objective of this study is to determine whether attention toward fear messages is affected by variation in the controllability of the associated danger. There is no consensus regarding the effectiveness of fear appeals in driving adaptive behaviour, and it may be the case that threat messages fail to capture attention if the associated danger i...

Background: Adolescence is a time of considerable social, cognitive, and physiological development. It reflects a period of heightened risk for the onset of mental health problems, as well as heightened opportunity for flourishing and resilience. The CogBIAS Longitudinal Study (CogBIAS-L-S) aims to investigate psychological development during adol...

Psychological science relies on behavioral measures to assess cognitive processing; however, the field has not yet developed a tradition of routinely examining the reliability of these behavioral measures. Reliable measures are essential to draw robust inferences from statistical analyses, and subpar reliability has severe implications for measures...

In this chapter, we aim to provide an overview of both cognitive and genetic approaches to mental health in order to encourage greater collaboration between those who typically take a cognitive approach to experimental psychopathology and those working in molecular genetics, who typically take a more biological approach. Because of the extensive na...

The Combined Cognitive Bias Hypothesis proposes that emotional information processing biases associate with each other and may interact to conjointly influence mental health. Yet, little is known about the interrelationships amongst cognitive biases, particularly in adolescence. We used data from the CogBIAS longitudinal study (Booth et al. 2017),...

Considerable effort and funding have been spent on developing Attention Bias Modification (ABM) as a treatment for anxiety disorders, theorized to exert therapeutic effects through reduction of a tendency to orient attention toward threat. However, meta-analytical evidence that clinical anxiety is characterized by threat-related attention bias is t...

This paper corrects and updates a paper published in BJPsych Open 2018 Mental Health in UK Biobank (https://doi.org/10.1192/bjo.2018.12) that was voluntarily retracted following the finding of errors in the coding of the variable for alcohol use disorder. Notably, the percentage of participants reaching threshold for alcohol use disorder on the Alc...

Mental health in UK Biobank: development, implementation and results from an online questionnaire completed by 157 366 participants — RETRACTED - Volume 5 Issue 4 - Katrina A. S. Davis, Jonathan R. I. Coleman, Mark Adams, Naomi Allen, Gerome Breen, Breda Cullen, Chris Dickens, Elaine Fox, Nick Graham, Jo Holliday, Louise M. Howard, Ann John, Willia...

Background: Depressive recurrence is highly prevalent and adds significantly to the burden of depressive disorder. Whilst some clinical predictors of recurrence have been clearly demonstrated (e.g. residual symptoms, previous episodes), the cognitive and psychological processes that may contribute to recurrence risk are less well established. In t...

Sensory Processing Sensitivity (SPS) is a common, heritable and evolutionarily conserved trait describing inter-individual differences in sensitivity to both negative and positive environments. Despite societal interest in SPS, scientific knowledge is lagging behind. Here, we critically discuss how SPS relates to other theories, how to measure SPS,...

Eye cues have been shown to stimulate rapid, reflexive, unconscious processing and in many experimental settings to cue increased prosocial and decreased antisocial behaviour. Eye cues are being widely applied in public policy to reduce crime and antisocial behaviour. Recently, failed replication attempts and two meta-analyses examining the eye cue...

Emotions are at the heart of how we understand the human mind and of our relationships within the social world. Yet, there is still no scientific consensus on the fundamental nature of emotion. A central quest within the discipline of affective science is to develop an in-depth understanding of emotions, moods, and feelings and how they are embodie...

Background and objectives: It has been suggested that impaired attentional control (AC) promotes the use of maladaptive emotional regulation strategies, such as rumination, with subsequent increase in risk of depression. Method: This study examined this hypothesis in a healthy community sample. Questionnaire measures of depression, anxiety, rumi...

Sensory Processing Sensitivity (SPS) is a trait describing inter-individual differences in sensitivity to environments, both positive and negative ones. SPS has attracted growing societal interest. However, (neuro)scientific evidence is lagging behind. We critically discuss how to measure SPS, how it relates to other theories of Environmental Sensi...

Mental health in UK Biobank: development, implementation and results from an online questionnaire completed by 157 366 participants – CORRIGENDUM - Volume 4 Issue 5 - Katrina A. S. Davis, Jonathan R. I. Coleman, Mark Adams, Naomi Allen, Gerome Breen, Breda Cullen, Chris Dickens, Elaine Fox, Nick Graham, Jo Holliday, Louise M. Howard, Ann John, Will...

In our food-rich environment we must constantly resist appealing food in order to maintain a healthy lifestyle. Previous studies have found that food-specific inhibition training can produce changes in eating behaviour, such as a reduction in snack consumption. However, the mechanisms that drive the effect of inhibition training on eating behaviour...

Individuals with idiopathic environmental illness with attribution to electromagnetic fields (IEI-EMF) claim they experience adverse symptoms when exposed to electromagnetic fields (EMFs) from mobile telecommunication devices. However, research has consistently reported no relationship between exposure to EMFs and symptoms in IEI-EMF individuals. T...

Background: Considerable effort and funding are spent on developing Attention Bias Modification (ABM) as a treatment for anxiety disorders. ABM is theorized to exert therapeutic effects through reduction of an increased attentional bias towards threat. Yet, the available meta-analytical evidence for the common assertion that clinical anxiety is cha...

Background UK Biobank is a well-characterised cohort of over 500 000 participants that offers unique opportunities to investigate multiple diseases and risk factors. Aims An online mental health questionnaire completed by UK Biobank participants was expected to expand the potential for research into mental disorders. Method An expert working grou...

Mental health in UK Biobank: development, implementation and results from an online questionnaire completed by 157 366 participants – CORRIGENDUM - Volume 4 Issue 3 - Katrina A. S. Davis, Jonathan R. I. Coleman, Mark Adams, Naomi Allen, Gerome Breen, Breda Cullen, Chris Dickens, Elaine Fox, Nick Graham, Jo Holliday, Louise M. Howard, Ann John, Will...

Psychological science relies on behavioural measures to assess cognitive processing; however, the field has not yet developed a tradition of routinely examining the reliability of these behavioural measures. Reliable measures are essential to draw robust inferences from statistical analyses, while subpar reliability has severe implications for the...

Psychological science relies on behavioural measures to assess cognitive processing; however, the field has not yet developed a tradition of routinely examining the reliability of these behavioural measures. Reliable measures are essential to draw robust inferences from statistical analyses, while subpar reliability has severe implications for the...

Authors’ reply - Volume 212 Issue 4 - Ben Grafton, Colin MacLeod, Daniel Rudaizky, Elske Salemink, Elaine Fox, Lies Notebaert

Worry refers to the experience of uncontrollable negative thoughts. Cognitive models suggest that the combination of negative information processing biases along with diminished attentional control contribute to worry. In the current study we investigate whether promoting a) adaptive interpretation bias and b) efficient deployment of attentional co...

Background: Optimal psychological development is dependent upon a complex interplay between individual and situational factors. Investigating the development of these factors in adolescence will help to improve understanding of emotional vulnerability and resilience. The CogBIAS longitudinal study (CogBIAS-L-S) aims to combine cognitive and geneti...

If meta-analysis is to provide valuable answers, then it is critical to ensure clarity about the questions being asked. Here, we distinguish two important questions concerning cognitive bias modification research that are not differentiated in the meta-analysis recently published by Cristea et al (2015) in this journal: (1) do the varying procedure...

The process of worry has been associated with reductions in working memory capacity and availability of resources necessary for efficient attentional control. This, in turn, can lead to escalating worry. Recent investigations into working memory training have shown improvements in attentional control and cognitive performance in high trait-anxious...

Attention bias for pain-related information is theorised to maintain chronic pain, indicating that changing this bias could improve pain-related outcomes. Modifying attention biases in adolescents, when chronic pain often first emerges, may be particularly beneficial. We report here a randomized, placebo-controlled, parallel-group trial of Attentio...

Obesity is a global problem reaching epidemic proportions and can be explained by unhealthy eating and sedentary lifestyles. Understanding the psychological processes underlying unhealthy eating behaviour is crucial for the development of effective obesity prevention programmes. Dual-process models implicate the interplay between impaired cognitive...

Poster presented at the XIII Mind the Brain Symposium (Utrecht, the Netherlands).

Abstract: Resilience is considered to be the process by which individuals demonstrate more positive outcomes than would be expected, given the nature of the adversity experienced. We propose that a cognitive approach has the potential to guide studies investigating the relationships between adversity, stress, and resilience. We outline a preliminar...

Adult chronic pain patients are consistently shown to interpret ambiguous health and bodily information in a pain-related and threatening way. This interpretation bias may play a role in the development and maintenance of pain and disability. However, no studies have yet investigated the role of interpretation bias in adolescent pain patients, desp...

Objective: Cognitive bias modification (CBM) eliminates cognitive biases toward negative information and is efficacious in reducing depression recurrence, but the mechanisms behind the bias elimination are not fully understood. The present study investigated, through computer simulation of neural network models, the neural dynamics underlying the...

Background New indices, calculated on data from the widely used Dot Probe Task, were recently proposed to capture variability in biased attention allocation. We observed that it remains unclear which data pattern is meant to be indicative of dynamic bias and thus to be captured by these indices. Moreover, we hypothesized that the new indices are se...

ABV simulation script. (R)

ABV simulation wrapper script. (R)

TL-BS simulation wrapper script. (R)

Combined plot scripts. (R)

TL-BS simulations—complete outcome tables. (DOCX)

Dot Probe Task–scope of application. (DOCX)

ABV simulations—complete outcome tables. (DOCX)

TL-BS simulation script. (R)

In this presentation I outline our recently accepted paper ”A cognitive model of psychological resilience”. The model aims to draw together the largely disparate research areas of cognitive-experimental or information-processing approaches to emotion dysfunction and resilience resarch.

In this presentation I outline cognitive-experimental and information processing approaches to emotion dysfunction before outlining how these methods can be applied to resilience research. I finish by outlining our recently proposed cognitive model of resilience and the role of applied flexibility in mapping appropriate cognitive processing strateg...

Negative cognitive biases and genetic variation have been associated with risk of psychopathology in largely independent lines of research. Here, we discuss ways in which these dynamic fields of research might be fruitfully combined. We propose that gene by environment (G × E) interactions may be mediated by selective cognitive biases and that cert...

Background: Pain is common and can be debilitating in childhood. Theoretical models propose that attention to pain plays a key role in pain outcomes, however very little research has investigated this in youth. This study examined how anxiety-related variables and attention control interacted to predict children’s attention to pain cues using eye-t...

Resilience is a dynamic process theorized to protect against, or counteract the adverse effects of risk exposure. A wealth of prior research has examined the role of selective processing of negative emotional information as a vulnerability factor in the development of emotion dysfunction. However, less consideration has been given to the possible r...

Resilience is considered to be the process by which individuals demonstrate more positive outcomes than would be expected, given the nature of the adversity experienced. We propose that acognitive approach has the potential to guide studies investigating the relationships between adversity, stress, and resilience. Weoutline a preliminary cognitive...