Ian S. Penton-Voak’s research while affiliated with University of Bristol and other places

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Publications (207)


A qualitative study exploring how secondary school PE uniform policies influence body image, and PE engagement among adolescent girls
  • Preprint
  • File available

December 2024

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62 Reads

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Elin Cawley

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Laura Chapman

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Background: Many adolescent girls experience body dissatisfaction and have low levels of physical activity. Secondary school Physical Education (PE) offers opportunities for girls to build self-confidence and stay active; however, PE uniforms can be a barrier to participation. Objectives: To explore how secondary school PE uniform policies influence body image and PE engagement (participation and enjoyment) among adolescent girls, and how these policies could be co-developed in future. Design: A qualitative study involving focus groups and interviews. Participants and setting: Forty-four 13-14-year-old girls and six PE staff members from six mixed-sex secondary schools in England. Data collection and analysis: Using topic guides and participatory activities to aid discussions, we explored PE uniform preferences and the influence on body image and PE engagement with adolescent girls, as well as the PE uniform policy development process with PE staff. Data were analysed using reflexive thematic analysis, supported by NVivo 14. Results: Three themes were generated. Theme 1, Striking the right balance between choice, comfort and uniformity, describes the challenges of developing PE uniform policies that offer pupils choice to maximise comfort, whilst maintaining uniformity to ensure smartness, and to reduce social comparison. Theme 2, PE uniforms are made for boys, reflects that current policies can often provide unisex uniforms that do not fit the female body, or gendered options that limit girls choices over style and fit. Theme 3, Self-confidence influences comfort in wearing PE uniform, and in turn PE engagement, suggests girls with high self-confidence may be less concerned about others opinions and how they look, leading to greater PE enjoyment, whereas girls with lower self-confidence described feeling self-conscious, especially in communal changing rooms, which could impact their comfort and PE engagement. Conclusions: Our findings suggest that developing PE uniform policies, which allow pupils to choose their own bottoms, wear additional layers, and wear PE uniform all day may improve comfort and inclusivity among girls, facilitating better PE engagement.

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A Feasibility Study of a Preventative, Transdiagnostic Intervention for Mental Health Problems in Adolescence: Building Resilience Through Socioemotional Training (ReSET)

September 2024

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70 Reads

Background: Adolescence is a developmental period during which an estimated 75% of mental health problems emerge (Solmi et al., 2022). This paper reports a feasibility study of a novel indicated, preventative, transdiagnostic, school-based intervention: Building Resilience Through Socioemotional Training (ReSET). The intervention addresses two domains thought to be causally related to mental health problems during adolescence: social relationships and emotion processing. Social relationships were targeted using principles from interpersonal psychotherapy, while emotion processing was targeted using cognitive-emotional training focused on three areas of emotion processing: Emotion perception, emotion regulation and interoception. The aims of this feasibility study were to i) assess the acceptability of integrating group-based psychotherapy with individual cognitive-emotional training, ii) evaluate the feasibility of our recruitment measures, and iii) assess the feasibility of delivering our research measures.Methods: The feasibility study involved 41 adolescents, aged 12-14, who were randomly assigned to receive the ReSET intervention or their school’s usual mental health and wellbeing provision. Results: Qualitative data from intervention participants suggested the programme was experienced as a cohesive intervention, with participants able to draw on a combination of skills. Further, the cognitive-training tasks were received positively (with the exception of the interoception training task). The recruitment and research measures were successfully delivered in the school-based setting, with 97.5% retention of participants from baseline to post-intervention assessment. Qualitative data was overwhelmingly positive regarding the benefits to participants who had completed the intervention. Moreover, there was only limited data missingness. Conclusions: We conclude that a trial of the ReSET intervention in a school setting is feasible. We discuss the implications of the feasibility study with regard to optimising school-based interventions and adaptations made in preparation for a full-scale randomised controlled trial, now underway.


Testing The Effectiveness Of A Gamified Emotional Cognitive Bias Modification Task As An Intervention For Low Mood: Randomised Controlled Trial (Preprint)

August 2024

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8 Reads

BACKGROUND Emotion recognition bias in depression is well documented and is proposed to play a causal role in depression. A Cognitive Bias Modification (CBM) intervention targeting the bias in emotional expression perception was developed, but despite robust training effects on emotion perception, the effect on mood was unreliable and weak. We propose a new gamified version of CBM (GCBM) to address potential limitations that may attenuate therapeutic effects. OBJECTIVE This study aims to test the effectiveness of GCBM in altering the perception of emotional facial expressions and improving the immediate mood of healthy participants. Study 1 aimed to investigate the effectiveness of a single session of GCBM on emotion perception and to assess whether the gamified version of the task would produce the same robust training effects on the interpretation of emotional expressions as the original CBM. Study 2 aimed to compare the effectiveness of a single session of CBM training, CBM (no training) control, and GCBM training on immediate mood. METHODS We reported two between-subjects online experimental studies that recruited participants from the general population. Study 1 (N = 58) tested the effectiveness of GCBM in changing participants' responses to ambiguous facial expressions. The primary outcome was emotion recognition bias, measured by increased identification of happy faces. Study 2 (N = 916) compared the effects of a single session of GCBM training, CBM training and CBM control conditions on immediate mood. The primary outcome was immediate mood after the training, measured by the Immediate Mood Scaler (IMS). RESULTS Study 1 showed that participants in the intervention condition classified more ambiguous faces as 'happy' after the training compared to controls, indicating an increased perception of happiness in ambiguous faces. (B = 1.73, P < .001). Study 2 provided evidence that GCBM training produced more positive changes in immediate mood compared to the CBM control condition (B = -3.64, P = .003) and compared to the CBM training condition (B = 1.73, P = .044). CONCLUSIONS These studies showed that GCBM may change participants' emotion recognition bias to ambiguous facial expressions and enhance mood compared to both CBM and control conditions. These results suggest that GCBM might be an effective intervention for addressing mood-related cognitive biases. Further exploration of GCBM's long-term effects on mood and its clinical application is needed.


Relationship between low mood and micro-expression processing: evidence of negative bias in interpreting fleeting facial expressions

July 2024

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40 Reads

Depression affects the recognition of emotion in facial expressions by reducing the detection accuracy and adding a bias towards negativity. However, no study has examined associations between depression and the recognition of microfacial expressions (fleeting facial cues of emotions in people’s faces). Thus, we investigated associations between low mood and micro-expression processing using video stimuli of micro-expressions. We examined whether (i) individuals with low mood had trouble recognizing emotions, (ii) were more likely to perceive happy facial expressions as neutral and neutral facial expressions as sad, and (iii) recognized sad emotional expressions better than control subjects (n = 349). We found that participants with low mood showed poorer performance when judging emotions in faces (p = 0.03). Furthermore, there was a specific deficit among them in recognizing happiness. Lastly, participants with low moods were more likely to perceive neutral faces as sad (p = 0.042). However, no evidence was found that individuals with low moods confused happy faces as neutral or were better than the control group at recognizing sad faces. Our results show that mood affects the perception of emotions in facial expressions, which has the potential to negatively affect interpersonal interactions and ultimately quality of life.


Fig. 1. Study session overview.
Assessing the effectiveness of multi-session online emotion recognition training in autistic adults

July 2024

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28 Reads

Purpose: Difficulties with emotion recognition can occur in neurodevelopmental conditions, including in autistic individuals. Providing interventions to support this would therefore be beneficial, particularly in terms of downstream effects on wellbeing, social relationships and education. Methods: In this online experimental study, we examined the effect of a recently developed facial emotion recognition training task versus a sham/control task in an adult population identifying as autistic over four sessions in a 2-week period, with a fifth follow-up session (N=184). Results: Our main analyses showed that facial emotion recognition accuracy was greater in Session 4 in the active group, with an estimated improvement of 14% (equivalent to approximately 7 additional correct responses), compared to 2% (equivalent to approximately 1 additional correct responses) in the sham group. Additional analyses suggested training effects were generalisable to facial stimuli that participants had not been trained on and were still present, although attenuated, two weeks later. We also observed some self-reported improvements in social interactions post-training. Conclusion: Overall, this study demonstrated improved emotion recognition in an adult autistic sample with this training task. Future work is needed to investigate the effect of this emotion recognition training on emotion recognition accuracy in autistic children, where support could be most beneficial.


Example body stimuli depicting the same identity at varying degrees of apparent body mass index (BMI). (a) The low BMI version of the identity (i.e. the smallest transformed morph level), (b) the average BMI version of the identity (i.e. the unmanipulated morph level), and (c) the high BMI version of the identity (i.e. the largest transformed morph level).
Example visual search trials. (a) An example training/pre-training target visual search trial for participants trained to attend to high body mass index (BMI) body stimuli. In this example, the target bar is the horizontal bar at the top centre of the array. The target bar is paired adjacent to a high BMI body stimulus and the remaining body stimuli are average BMI. (b) An example training/pre-training target visual search trial for participants trained to attend to low BMI body stimuli. In this example, the target bar is the vertical bar at the bottom centre of the array. The target bar is paired adjacent to a low BMI body stimulus and the remaining body stimuli are average BMI. (c) An example pre-training neutral visual search trial. The target bar is vertical at the bottom centre of the array and all body stimuli are average BMI.
A bar chart depicting the effect of the attention training on the participants' attentional bias score (N = 142). For participants trained to attend to high (low) BMI body stimuli, a positive attentional bias score meant that participants demonstrated an attentional bias to high (low) BMI body stimuli, relative to average BMI body stimuli. Note: error bars indicate 95% confidence intervals.
A bar chart depicting the effect of the attention training on the participants’ PSN score (N = 142). A higher (lower) PSN score indicated the participant perceived bodies higher (lower) in BMI to be ‘normal’ in size. Note: error bars indicate 95% confidence intervals. ***p < 0.001.
A bar chart depicting the effect of the attention training on the participants' body dissatisfaction score (N = 142). A higher body dissatisfaction score indicated greater body dissatisfaction. Note: error bars indicate 95% confidence intervals.
The effect of an odd-one-out visual search task on attentional bias, body size adaptation, and body dissatisfaction

July 2024

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75 Reads

Body image disturbance is a both a risk factor for, and a symptom of, many eating disorders and refers to the misperception of and dissatisfaction with one's own body. Women with high body dissatisfaction have been shown to direct more attention to low body mass index (BMI) bodies, which results in the overestimation of body size via body size adaptation. Therefore, attention may have a causal role in body image disturbance. We conducted a novel training visual search task with 142 young adult women who we trained to attend to either high or low BMI bodies. We assessed the effects of this training on attention to bodies of different sizes, body size adaptation, and body dissatisfaction. Women trained to attend to low BMI bodies decreased their perceptions of a ‘normal’ body size via adaptation from pre- to post-training (p < 0.001); however, women trained to attend to high BMI bodies showed no change in their perception of a ‘normal’ body size. We found no lasting effects of the training on attention to body size or body dissatisfaction; however, our visual search task showed poor internal consistency as a measure of attention. These findings indicate that attention to low BMI bodies may exacerbate body image disturbance in women. However, more reliable measures of attentional are required to confirm this finding.


Figure 1 Study design. Details of assessments carried out during the main study session using a four-parallel group design. CBM, cognitive bias modification. on July 3, 2024 by guest. Protected by copyright.
Figure 3 Main and interaction effects on measures of learning. (A) Bar chart showing participants were better able to shift their emotional perception of faces in the synchronous compared with asynchronous condition. (B) Line graph showing this effect split out by chronotype group where both chronotype groups perform better in the synchronous condition (morning for early chronotypes and evening for late chronotypes). (C) Line graph showing evidence that late chronotypes had a higher effective learning rate and (D) a higher post-training balance point in the synchronous (green lines) compared with asynchronous (purple lines) condition. Estimated values are adjusted for covariates.
Baseline characteristics
Chronotype and emotion processing: a pilot study testing timing of online cognitive bias modification training

July 2024

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46 Reads

BMJ Mental Health

Background Circadian rhythms influence cognitive performance which peaks in the morning for early chronotypes and evening for late chronotypes. It is unknown whether cognitive interventions are susceptible to such synchrony effects and could be optimised at certain times-of-day. Objective A pilot study testing whether the effectiveness of cognitive bias modification (CBM) for facial emotion processing was improved when delivered at a time-of-day that was synchronised to chronotype. Methods 173 healthy young adults (aged 18–25) with an early or late chronotype completed one online session of CBM training in either the morning (06:00 hours to 10:00 hours) or evening (18:00 hours to 22:00 hours). Findings Moderate evidence that participants learnt better (higher post-training balance point) when they completed CBM training in the synchronous (evening for late chronotypes, morning for early chronotypes) compared with asynchronous (morning for late chronotypes, evening for early chronotypes) condition, controlling for pre-training balance point, sleep quality and negative affect. There was also a group×condition interaction where late chronotypes learnt faster and more effectively in synchronous versus asynchronous conditions. Conclusions Preliminary evidence that synchrony effects apply to this psychological intervention. Tailoring the delivery timing of CBM training to chronotype may optimise its effectiveness. This may be particularly important for late chronotypes who were less able to adapt to non-optimal times-of-day, possibly because they experience more social jetlag. Clinical implications To consider delivery timing of CBM training when administering to early and late chronotypes. This may generalise to other psychological interventions and be relevant for online interventions where the timing can be flexible.


META-ANALYSIS OF STUDIES TESTING COGNITIVE BIAS MODIFICATION (CBM) INTERVENTION FOR EMOTION RECOGNITION BIAS

June 2024

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12 Reads

Background There is a growing need for cost-effective interventions for depression. Cognitive Bias Modification (CBM) techniques have been proposed as economical and scalable interventions, that aim to change cognitive biases present in depression, with potential therapeutic effects. Penton-Voak et al., (2012) developed and tested a novel CBM intervention that focuses on retraining negative biases in emotion perception which, over a series of studies, has shown generally positive but unreliable and weak associations between CBM training and mood improvements. Objectives: The aim of this study is to meta-analyse the effectiveness of an emotional bias CBM task on mood. Additionally, this study aims to examine the mediating effect of emotion processing, the proposed therapeutic target of the intervention, on the relationship between CBM and mood outcomes.Methods . We performed mediation analyses on 8 CBM studies separately (with a total of 1,250 participants) to determine whether the relationship between CBM and mood is mediated by emotion processing. Following this, we conducted a meta-analysis on the direct, indirect, and total effects from the mediation analyses.Results The meta-analysis results suggest that there is no reliable positive total effect of CBM training on mood improvement. However, we found a mediation effect in which mood improvements are mediated by changes in emotion processing. Conclusions These findings are promising, suggesting that modified training targeting emotional processing may offer therapeutic benefits.


Exploring How Virtual Reality Could Be Used to Treat Eating Disorders: Qualitative Study of People With Eating Disorders and Clinicians Who Treat Them

May 2024

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35 Reads

Background Immersive virtual reality (VR) interventions are being developed and trialed for use in the treatment of eating disorders. However, little work has explored the opinions of people with eating disorders, or the clinicians who treat them, on the possible use of VR in this context. Objective This study aims to use qualitative methodology to explore the views of people with eating disorders, and clinicians who treat them, on the possible use of VR in the treatment of eating disorders. Methods We conducted a series of focus groups and interviews with people with lived experience of eating disorders and clinicians on their views about VR and how it could potentially be used in the treatment of eating disorders. People with lived experience of eating disorders were recruited between October and December 2020, with focus groups held online between November 2020 and February 2021; clinicians were recruited in September 2021 and interviewed between September and October 2021. We took a thematic approach to analyzing the resulting qualitative data. Results We conducted 3 focus groups with 10 individuals with a current or previous eating disorder, 2 focus groups with 4 participants, and 1 with 2 participants. We held individual interviews with 4 clinicians experienced in treating people with eating disorders. Clinicians were all interviewed one-to-one because of difficulties in scheduling mutually convenient groups. We describe themes around representing the body in VR, potential therapeutic uses for VR, the strengths and limitations of VR in this context, and the practicalities of delivering VR therapy. Suggested therapeutic uses were to practice challenging situations around food-related and weight/appearance-related scenarios and interactions, to retrain attention, the representation of the body, to represent the eating disorder, for psychoeducation, and to enable therapeutic conversations with oneself. There was a substantial agreement between the groups on these themes. Conclusions People with lived experience of eating disorders and clinicians with experience in treating eating disorders generated many ideas as to how VR could be used as a part of eating disorders treatment. They were also aware of potential limitations and expressed the need for caution around how bodies are represented in a VR setting.


Investigating the impact of lived experience stories on self-harm, mood, and help-seeking intentions: an experimental study

April 2024

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74 Reads

Objective To investigate the psychological impact of variations in help-seeking messages contained in lived experience stories about self-harm. Method In an online experiment, individuals with a recent history of self-harm, were randomised to read stories that either mentioned: i) self-help strategies, ii) seeking help from informal and formal sources, or iii) did not mention help-seeking. Help-seeking intentions, mood, entrapment, and expectations of future self-harm was measured, and participants provided feedback on the stories. Results There was limited evidence for an effect of story type on future help-seeking intentions and stronger evidence for an effect of story type on negative affect. Participants in the “Self-help” condition reported lower negative affect after reading the stories compared to participants in the “No help” condition (Mean difference = -3.97, 95% CI -7.72 to -0.22, p = .04) and the “Informal/formal” help condition (Mean difference = -3.70, 95% CI -7.55 to 0.14, p =.06). A key criticism of the stories was that they were unrelatable, but this sentiment was less prevalent among those in the “No help” condition. Key positives were that the stories included a realistic but hopeful outlook of recovery (less prevalent in the “Informal/formal help” condition) and were supportive (less prevalent in the “No help” condition). Conclusion While the inclusion of self-help strategies in a lived experience story reduced its impact on negative affect, the inclusion of self-help strategies or seeking help from others did not encourage future help-seeking intentions. Making stories relatable, authentic, and providing multiple strategies for support might be key to encourage help-seeking, but more research is needed.


Citations (49)


... Increased EI is also directly related to improved health and subjective well-being (Fern andez-Mart ınez et al., 2019). A significant number of studies derive as a main conclusion the statement that a high ability of emotional perception is related to improving managers' performance (Wezowski and Penton-Voak, 2023;Gottfredson and Becker, 2023;Xue et al., 2023). Borrajo et al. (2023) point to the appropriate cognition, identification, and regulation of emotions as effective mechanisms not only in occupational fulfilment but also in various other contexts: problematic Internet use, cyberbullying, or burnout, as well as in various mental disorders such as eating disorders, anxiety, depression and suicidal behaviour. ...

Reference:

Examining emotional intelligence evolution with age: insights from Bulgarian digital entrepreneurs of different generations
Associations between workplace emotional intelligence and micro expression recognition
  • Citing Article
  • October 2023

Acta Psychologica

... Effectiveness of a computer based-ER training task on emotion recognition accuracy in the general adult population has previously been demonstrated and it has been shown that the effects of this training transfer to facial stimuli other than those individuals were trained on (Reed et al., 2023). This task presents facial emotional expressions, of varying intensities, and asks the individual to select the emotion they believe was presented. ...

Assessing the effectiveness of online emotion recognition training in healthy volunteers

... Studies that did assess attentional bias typically did so using reaction times on an assessment version of the dot probe task. However, the assessment version of the dot probe task has notably poor reliability [50][51][52][53][54] and, unlike eye-tracking measures, does not reliably detect positive associations between body dissatisfaction and attentional bias [21]. Therefore, the assessment dot probe task may not be an appropriate method of evaluating the effectiveness of attention training tasks. ...

The relationship between body dissatisfaction and attentional bias to thin bodies in Malaysian Chinese and White Australian women: a dot probe study

... Research on affective disturbances and cognitive impairment following stroke continues to face challenges, including small sample sizes, unclear differentiation between stroke types and locations, insufficient inclusion of relevant variables, and inconsistent assessment methods, resulting in numerous contradictory conclusions [17]. Furthermore, there is a noticeable lack of studies on predictive models for affective disturbances and cognitive impairment following ICH, particularly for patients with supratentorial ICH and small hematomas. ...

Cognitive functioning in anxiety and depression: results from the ALSPAC cohort

... Signi cant empirical literature has sought to explore the impact of such engagement [5,6], especially in adolescents and young people [7], reporting both associated harms and bene ts. While individuals may receive encouragement to self-harm, obtain information about high lethality or novel suicide methods, and join suicide pacts online [8,9], they may also derive hope and support from recovery content and peer communities, or obtain online help [10][11][12]. Crucially, research has revealed online content cannot easily be de ned as either helpful or harmful since impact varies across and within individuals over time, depending on mental wellness [13,14]. ...

How do people who self-harm evaluate online lived experience stories? A focus group study

JMIR Mental Health

... The present study echoes these findings and suggest that an attentional bias towards idealised bodies can lead to reductions in body satisfaction, and changes in body satisfaction levels between the pre-and post-experiment intervals seem to confirm this was indeed the case in the present sample, supporting H 2 . Attentional bias towards idealised body images has also been associated with eating disorder symptomology, eating disorders and body dissatisfaction (House et al., 2023); studies have also shown a greater immediate impact of exposure to thin-ideal media on drive for thinness, body dissatisfaction and problematic eating attitudes on women in Hong Kong compared to China (Rochelle and Wu, 2017). The present findings provide support for the positive association between body dissatisfaction and attentional bias to idealised bodies in both women and men in a Chinese context. ...

Is body dissatisfaction related to an attentional bias towards low weight bodies in non-clinical samples of women? A systematic review and meta-analysis

Body Image

... Differences in emotional functioning are an integral part of ED. Emotion regulation difficulties have been identified as a transdiagnostic feature of eating psychopathology [15][16][17][18], as has alexithymia, a difficulty identifying and describing one's emotions [19][20][21]; moreover, there is evidence that such difficulties precede and contribute to the development and maintenance of ED [22][23][24]. People with ED also report difficulties using adaptive emotion regulation strategies like cognitive reappraisal [15,25,26] and instead report more use of suppression as a way of regulating their emotions. ...

Emotional dysregulation in childhood and disordered eating and self‐harm in adolescence: prospective associations and mediating pathways

... The incorporation of eye-tracking to research on emotion recognition in children and adolescents with CU is providing valuable results, as it allows specifically evaluating the attention they pay to emotional stimuli, particularly to the eye area (Billeci et al., 2019;Carter Leno et al., 2023;Centifanti et al., 2021;Dawel et al., 2012;Demetriou & Fanti, 2022). However, not all studies are drawing the same conclusions. ...

Associations between emotion recognition and autistic and callous‐unemotional traits: differential effects of cueing to the eyes

... Aerobic activities include walking, swimming, and cycling; resistance training activities include weightlifting or bodyweight exercises; while mind-body activities include yoga, tai chi, and qigong. As people with depression are characterized by strong affective responses [15], clinicians should encourage patients to select enjoyable activities, leading to greater adherence and long-term success [3]. ...

Associations of negative affective biases and depressive symptoms in a community-based sample

Psychological Medicine

... Under the cost-benefit framework, motivation refers to the process that facilitates overcoming costs to achieve desired outcomes (Soutschek & Tobler, 2018). Previous studies have reported that anhedonia is associated with less willingness to overcome effort costs for rewards (Ang et al., 2022;Barch et al., 2014;Slaney et al., 2022;Treadway et al., 2009) and inefficient effort allocation in pursuit of rewards (McCarthy et al., 2015;Wen et al., 2024). Our finding extends these studies by demonstrating that anhedonia is susceptible to time costs in pursuit of rewards. ...

Objective measures of reward sensitivity and motivation in people with high v. low anhedonia

Psychological Medicine