J. Mark G. Williams’s research while affiliated with University of Oxford and other places

People exhibit marked individual variation in their ability to exercise cognitive control in affectively charged situations. Affective control is typically assessed in laboratory settings by comparing performance in carefully constructed executive tasks performed in both affectively neutral and affectively charged contexts. There is some evidence that affective control undergoes significant improvement throughout adolescence, though it is unclear how adolescents deemed at risk of developing depression exercise affective control despite poor affective control being identified as a contributing factor to ongoing mental ill health in adulthood. The present study therefore investigated affective control in a large (n = 425) sample of adolescents (aged 11–18 years) collected from 2016 to 2018. A simultaneous visuospatial search and written storage working memory (WM) capacity task was carried out to examine affective control, using affectively neutral and affectively negative social images as the task-irrelevant distractors. Overall, WM capacity increased as a function of age across both affective conditions. Moreover, we report a significant difference between affective conditions, with WM capacity slightly lower during trials with affectively negative social scenes, relative to neutral. Performance in each condition and the performance “cost” for completing the task in negative relative to neutral conditions was not modulated by depressive symptoms. Furthermore, age did not predict performance cost, irrespective of depressive symptoms. These findings suggest that WM capacity is relatively robust against socioaffective contexts and mood in adolescents.

Objective: Adolescence is a key developmental window that may determine long-term mental health. As schools may influence students’ mental health, we examined the association of school-level characteristics with students’ mental health over time. Method: We analysed longitudinal data from a cluster randomised controlled trial on 8,376 students (55% female; aged 11-14 years at baseline) across 84 schools in the United Kingdom. Data collection started in the academic years 2016/2017 (Cohort 1) and 2017/2018 (Cohort 2), with follow-up at 1, 1.5, and 2 years. We explored students’ mental health (risk for depression (Center for Epidemiologic Studies-Depression Scale), social-emotional-behavioural difficulties (Strength and Difficulties Questionnaire)) and well-being (Warwick-Edinburgh Mental Well-Being Scale), and their relationship with student- and school-level characteristics, using multilevel regression models. Results: Mental health difficulties and poorer well-being increased over time, particularly in girls. Differences among schools represented a small but statistically significant proportion of variation (95% CI) in students’ mental health at each timepoint: depression: 1.7% (0.9%-2.5%) to 2.5% (1.6%-3.4%), social-emotional-behavioural difficulties: 1.9% (1.1%-2.7%) to 2.8% (2.1%-3.5%), and well-being: 1.8% (0.9%-2.7%) to 2.2% (1.4%-3.0%). Better student-rated school climate analysed as time-varying at the student- and school-level was associated with lower risk of depression (regression coefficient (95%CI) student-level: -4.25 (-4.48,-4.01), school-level: -4.28 (-5.81,-2.75)), fewer social-emotional-behavioural difficulties (student-level: -2.46 (-2.57,-2.35), school-level: -2.36 (-3.08,-1.63)), and higher well-being (student-level: 3.88 (3.70,4.05); school-level: 4.28 (3.17,5.38)), which was a stable relationship. Conclusion: Student-rated school climate predicted mental health in early adolescence. Policy and system interventions that focus on school climate may promote students’ mental health.

Background Depression is characterized by different forms of overgeneralization that are all assumed to play a causal role in the development and course of depression. Methods We examined, in a community sample of over 625 individuals, whether these different forms of overgeneralization are correlated and whether they are prospective predictors of depression at 6-month follow-up. Results Negative overgeneralization to the self and across situations—two types of overgeneralized thinking processes—were significantly but weakly related, but neither of them was related to overgeneral memory—a memory-based form of overgeneralization. Overgeneralization to the self and overgeneral memory both predicted depression symptoms at follow-up. Further, two and three-way interactions indicated that higher levels of overgeneralization processes interact to predict depressive symptoms. Overgeneralization to the self and overgeneral memory both independently predicted probable recurrence of a major depressive episode during the follow-up period in individuals that formerly experienced depression. Conclusions Findings suggest that overgeneralization in depression is not a unitary construct and that different overgeneralization processes play independent and interacting roles in the course of depression.

Objective: We explored what predicts secondary school students' mindfulness practice and responsiveness to universal school-based mindfulness training (SBMT), and how students experience SBMT. Method: A mixed-methods design was used. Participants were 4,232 students (aged 11-13) in 43 UK secondary schools, who received universal SBMT (i.e., '.b' program), within the MYRIAD trial (ISRCTN86619085). Following previous research, student, teacher, school, and implementation factors were evaluated as potential predictors of students' out-of-school mindfulness practice and responsiveness (i.e., interest in and attitudes towards SBMT), using mixed effects linear regression. We explored pupils' SBMT experiences using thematic content analysis of their answers to two free response questions, one focused on positive experiences and one on difficulties/challenges. Results: Students reported practicing out-of-school mindfulness exercises on average 'once' during the intervention (M (SD)=1.16 (1.07), range 0-5). Students' average ratings of responsiveness were intermediate (M (SD)=4.72 (2.88), range 0-10). Girls reported more responsiveness. High-risk of mental health problems was associated with lower responsiveness. Asian ethnicity and higher school-level economic deprivation were related to greater responsiveness. More SBMT sessions and better quality of delivery were associated with both greater mindfulness practice and responsiveness. In terms of students' experiences of SBMT, the most frequent themes (60% of the minimally elaborated responses) were an increased awareness of bodily feelings/sensations and increased ability to regulate emotions. Conclusion: Most students did not engage with mindfulness practice. While responsiveness to the SMBT was intermediate on average, there was substantial variation with some youth rating it negatively and others rating it positively. Future SBMT developers should consider codesign curricula with students, carefully assessing the student characteristics, aspects of the school environment, and implementation factors associated with mindfulness practice and responsiveness. SBMT teacher training is key, as more observed proficiency in SBMT teaching is associated with greater students' mindfulness practice and responsiveness to SBMT.

Mindfulness training programmes have shown to encourage prosocial behaviours and reduce antisocial tendencies in adolescents. However, less is known about whether training affects susceptibility to prosocial and antisocial influence. The current study investigated the effect of mindfulness training (compared with an active control) on self‐reported prosocial and antisocial tendencies and susceptibility to prosocial and antisocial influence. 465 adolescents aged 11–16 years were randomly allocated to one of two training programmes. Pre‐ and post‐training, participants completed a social influence task. Self‐reported likelihood of engaging in prosocial and antisocial behaviours did not change post‐training, and regardless of training group, participants showed a higher propensity for prosocial influence than for antisocial influence. Finally, participants were less influenced by antisocial ratings following both training programmes.

Objectives The effectiveness of mindfulness-based programs (MBPs) has been established in many randomized controlled trials. However, effect sizes are often modest, and there remains ample scope to improve their effectiveness. One approach to this challenge is to offer a “follow-on” course to people who have completed an MBP and are interested in further skill development. We developed and tested a new 8-week course for this purpose based on awareness of feeling tone (vedanā), an understudied aspect of mindfulness in many current MBPs, incorporating new developments in neuroscience and trauma sensitivity. We examined its effectiveness and the frequency and severity of unpleasant experience and harm. Methods In an open trial, 83 participants, 78 of whom had previously taken part in an MBP (majority MBSR or MBCT), completed the program in nine groups. Participants completed questionnaires before and after and gave qualitative written feedback at completion. Results Participants reported significantly reduced depression (d = 0.56), stress (d = 0.36), and anxiety (d = 0.53) and increased well-being (d = 0.54) and mindfulness (d = 0.65) with 38% meeting criteria for reliable change on anxiety and depression. As expected, about three-quarters of participants reported some unpleasant experiences associated with mindfulness practice during the course, but none reported harm. Five participants showed “reliable deterioration” (an increase) in either depression or anxiety, but four of these five also gave anonymous qualitative feedback describing benefits of the course. Conclusions Findings support the added value of a follow-on course based on the exploration of feeling tone for participants who have a range of previous mindfulness experience.

Background Systematic reviews suggest school-based mindfulness training (SBMT) shows promise in promoting student mental health. Objective The My Resilience in Adolescence (MYRIAD) Trial evaluated the effectiveness and cost-effectiveness of SBMT compared with teaching-as-usual (TAU). Methods MYRIAD was a parallel group, cluster-randomised controlled trial. Eighty-five eligible schools consented and were randomised 1:1 to TAU (43 schools, 4232 students) or SBMT (42 schools, 4144 students), stratified by school size, quality, type, deprivation and region. Schools and students (mean (SD); age range=12.2 (0.6); 11–14 years) were broadly UK population-representative. Forty-three schools (n=3678 pupils; 86.9%) delivering SBMT, and 41 schools (n=3572; 86.2%) delivering TAU, provided primary end-point data. SBMT comprised 10 lessons of psychoeducation and mindfulness practices. TAU comprised standard social-emotional teaching. Participant-level risk for depression, social-emotional-behavioural functioning and well-being at 1 year follow-up were the co-primary outcomes. Secondary and economic outcomes were included. Findings Analysis of 84 schools (n=8376 participants) found no evidence that SBMT was superior to TAU at 1 year. Standardised mean differences (intervention minus control) were: 0.005 (95% CI −0.05 to 0.06) for risk for depression; 0.02 (−0.02 to 0.07) for social-emotional-behavioural functioning; and 0.02 (−0.03 to 0.07) for well-being. SBMT had a high probability of cost-effectiveness (83%) at a willingness-to-pay threshold of £20 000 per quality-adjusted life year. No intervention-related adverse events were observed. Conclusions Findings do not support the superiority of SBMT over TAU in promoting mental health in adolescence. Clinical implications There is need to ask what works, for whom and how, as well as considering key contextual and implementation factors. Trial registration Current controlled trials ISRCTN86619085 . This research was funded by the Wellcome Trust (WT104908/Z/14/Z and WT107496/Z/15/Z).

Background Education is broader than academic teaching. It includes teaching students social–emotional skills both directly and indirectly through a positive school climate. Objective To evaluate if a universal school-based mindfulness training (SBMT) enhances teacher mental health and school climate. Methods The My Resilience in Adolescence parallel group, cluster randomised controlled trial (registration: ISRCTN86619085 ; funding: Wellcome Trust (WT104908/Z/14/Z, WT107496/Z/15/Z)) recruited 85 schools (679 teachers) delivering social and emotional teaching across the UK. Schools (clusters) were randomised 1:1 to either continue this provision (teaching as usual (TAU)) or include universal SBMT. Data on teacher mental health and school climate were collected at prerandomisation, postpersonal mindfulness and SBMT teacher training, after delivering SBMT to students, and at 1-year follow-up. Finding Schools were recruited in academic years 2016/2017 and 2017/2018. Primary analysis (SBMT: 43 schools/362 teachers; TAU: 41 schools/310 teachers) showed that after delivering SBMT to students, SBMT versus TAU enhanced teachers’ mental health (burnout) and school climate. Adjusted standardised mean differences (SBMT minus TAU) were: exhaustion (−0.22; 95% CI −0.38 to −0.05); personal accomplishment (−0.21; −0.41, −0.02); school leadership (0.24; 0.04, 0.44); and respectful climate (0.26; 0.06, 0.47). Effects on burnout were not significant at 1-year follow-up. Effects on school climate were maintained only for respectful climate. No SBMT-related serious adverse events were reported. Conclusions SBMT supports short-term changes in teacher burnout and school climate. Further work is required to explore how best to sustain improvements. Clinical implications SBMT has limited effects on teachers’ mental and school climate. Innovative approaches to support and preserve teachers’ mental health and school climate are needed.

Background Previous research suggests that mindfulness training (MT) appears effective at improving mental health in young people. MT is proposed to work through improving executive control in affectively laden contexts. However, it is unclear whether MT improves such control in young people. MT appears to mitigate mental health difficulties during periods of stress, but any mitigating effects against COVID-related difficulties remain unexamined. Objective To evaluate whether MT (intervention) versus psychoeducation (Psy-Ed; control), implemented in after-school classes: (1) Improves affective executive control; and/or (2) Mitigates negative mental health impacts from the COVID-19 pandemic. Methods A parallel randomised controlled trial (RCT) was conducted (Registration: https://osf.io/d6y9q/ ; Funding: Wellcome (WT104908/Z/14/Z, WT107496/Z/15/Z)). 460 students aged 11-16 years were recruited and randomised 1:1 to either MT (N=235) or Psy-Ed (N=225) and assessed preintervention and postintervention on experimental tasks and self-report inventories of affective executive control. The RCT was then extended to evaluate protective functions of MT on mental health assessed after the first UK COVID-19 lockdown. Findings Results provided no evidence that the version of MT used here improved affective executive control after training or mitigated negative consequences on mental health of the COVID-19 pandemic relative to Psy-Ed. No adverse events were reported. Conclusions There is no evidence that MT improves affective control or downstream mental health of young people during stressful periods. Clinical implications We need to identify interventions that can enhance affective control and thereby young people’s mental health.