"Flashforward" imagery and anxiety in young adults: Risk mechanisms and intervention development

青壮年(16-24岁)是人一生中的关键时期。许多年轻人开始通过教育、工作和人际关系来建立他们的独立性。然而，这也是许多人容易出现心理健康问题的时候。每五个年轻人中就有一个可能会经历心理健康障碍。尤其是焦虑问题，会严重扰乱年轻人的日常生活，降低他们茁壮成长的能力。尽管需要心理健康支持，但由于各种原因，许多年轻人难以获得心理健康支持，包括耻辱、漫长的等待名单、服务分裂(在18岁向成人服务过渡期间)以及地理流动造成的护理中断。我们需要新的方法来预防和早期干预，这些方法也是有效的、可获得的和有吸引力的。这个奖学金探索了一种有前途的新的焦虑问题干预方法，看起来不太像传统的“治疗”，并得到了最近的科学研究的启发。这项研究表明，当人们经历焦虑时，他们也会自发地想象让他们感到焦虑的未来情景。这些图像也被称为“闪回”心理图像，因为它们会迅速地在大脑中将我们投射到未来。想象未来的能力真的很有帮助，例如，它可以帮助我们计划一次旅行或准备面试。然而，反复想象焦虑的场景会让它们看起来更真实，更有可能发生，从而使焦虑更加严重。因此，重要的是我们要找到处理这些图像的方法，以减少它们对情感的影响。新的研究表明，在脑海中保持一个视觉形象的同时，同时做一些特定的活动(比如玩一款叫做俄罗斯方块的流行的适形视频游戏)，脑海中的形象会变得不那么强烈，不那么生动，也不太可能在之后被打扰。这大概是因为同时做两个活动可能很困难，特别是当两者(记住一个图像和玩俄罗斯方块)都使用相似的(视觉)大脑资源时。将有三个独立的项目来更好地理解年轻人的这些“闪回”图像，它们如何加剧焦虑，以及如何改变它们。第一个项目将要求年轻人完成三次在线调查(间隔六个月)。这将帮助我们了解在某个时间点了解闪回图像是否可以帮助我们预测焦虑问题是否会在很长一段时间后(例如六个月到一年后)发展。第二个项目将要求年轻人每天(在两周内)使用智能手机完成对他们时刻体验的多次简短评分，这种方法被称为体验抽样。这将帮助我们了解这些心理图像如何影响他们的焦虑水平和日常生活中的相关问题。第三个项目将开发一种新的(基于俄罗斯方块的)干预措施，并将其提供给一群年轻人。这将帮助我们了解这种新的干预是否可以修改闪回图像，从而降低焦虑水平及其相关问题。如果是这样的话，这种干预可以在未来以更严格的方式进行测试。这三个项目将帮助我们了解这一干预措施是否有潜力成为早期干预和/或预防青少年焦虑问题的有效策略。有焦虑问题生活经历的年轻人将参与该项目从设计到传播的所有阶段。为此目的，将设立一个青年咨询小组，由大约6名青年组成，同时确保多样性(例如在性别、性别认同、族裔和社会经济背景方面)。这一组的一名青年合作者(这一角色可以轮换)还将帮助开展更具体的研究活动，如审查材料、数据收集和随后的分析。

Young adulthood (16-24 years old) is a crucial time in one's life. Many young adults begin to establish their independence through education, work and relationships. However, this is also a time when many people are vulnerable to mental health problems. One in five young adults are likely to experience a mental health disorder. Anxiety problems in particular can significantly disrupt a young adult's daily life and reduce their ability to thrive. Despite the need for mental health support, many young adults struggle with accessing it due to a variety of reasons, including stigma, long waiting lists, splitting of services (in the transition to adult services at age 18), and disruptions to care resulting from geographical mobility. We need new approaches to prevent and intervene early, which are also effective, accessible and appealing.This fellowship explores a promising new intervention for anxiety problems that looks less like traditional "therapy" and is informed by recent scientific research. This research suggests that when people experience anxiety, they also spontaneously visualise future scenarios that are making them anxious. These are also known as "flashforward" mental images, because they rapidly and mentally project us into the future. The ability to imagine the future is really helpful, for example it can help us plan a trip or prepare for an interview. However, repeatedly visualising anxious scenarios can make them seem more real and more likely to happen, making anxiety worse. Therefore, it is important that we find ways to deal with these images to reduce their emotional impact. New research has shown that holding a visual image in mind while also doing certain activities (such as playing a popular shape-fitting videogame called Tetris) makes the mental image less intense, less vivid, and less likely to intrude afterwards. This is presumably because doing two activities at the same time can be difficult, particularly when both (holding an image in mind and playing Tetris) use similar (visual) brain resources.There will be three separate projects to better understand these "flashforward" images in young adults, how they make anxiety worse, and how to change them. The first project will ask young adults to complete an online survey three times (with six-month gaps). This will help us understand if knowing about flashforward images at one time point can help us anticipate if anxiety problems will develop much later on (e.g. in six months to a year). The second project will ask young adults to complete multiple brief ratings per day (for two weeks) using their smartphones of their moment-to-moment experiences, an approach called experience sampling. This will help us understand how these mental images impact on their anxiety levels and associated problems in daily life. The third project will develop a new (Tetris-based) intervention and deliver it to a group of young adults. This will help us understand whether this new intervention can modify flashforward images, resulting in a reduction in anxiety levels and their associated problems. If so, this intervention can be tested in future in an even more rigorous way. Together, the three projects will help us know if this intervention has the potential to be an effective strategy for early intervention and/or prevention for anxiety problems for young people.Young adults with lived experience of anxiety problems will be involved across all stages of the project from design to dissemination. For this purpose, a Youth Advisory Group will be set up with around 6 young adults while ensuring diversity (e.g. in sex, gender identity, ethnicity and socioeconomic background). A youth collaborator from this group (a role which can be rotated) will additionally help with more specific research activities, such as reviewing materials, data collection and subsequent analyses.