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

青年期（16-24岁）是人生的关键时期。许多年轻人开始通过教育、工作和人际关系建立自己的独立性。然而，这也是许多人容易受到心理健康问题影响的时期。五分之一的年轻人可能患有精神疾病。焦虑问题尤其会严重扰乱年轻人的日常生活，降低他们的成长能力。尽管需要心理健康支持，但由于各种原因，包括耻辱、漫长的等待名单、服务分散（在18岁时向成人服务过渡）以及由于地理流动而导致的护理中断，许多年轻人难以获得心理健康支持。我们需要新的预防和早期干预方法，这些方法也是有效的、可获得的和有吸引力的。这项研究探索了一种有希望的焦虑问题的新干预方法，这种方法看起来不太像传统的“治疗”，并得到了最近科学研究的支持。这项研究表明，当人们感到焦虑时，他们也会自发地想象让他们焦虑的未来情景。这些也被称为“闪前”的心理图像，因为它们迅速地在心理上将我们投射到未来。想象未来的能力真的很有用，例如，它可以帮助我们计划旅行或准备面试。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，让焦虑更严重。因此，我们找到处理这些图像的方法来减少它们对情绪的影响是很重要的。新的研究表明，在做某些活动（比如玩一款名为“俄罗斯方块”的流行塑形电子游戏）的同时，在脑海中保留一幅视觉图像，会使脑海中的图像不那么强烈、不那么生动，之后也不太可能侵入。这可能是因为同时进行两项活动很困难，特别是当两者（在脑海中保持图像和玩俄罗斯方块）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，它们是如何使焦虑恶化的，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）。这将帮助我们理解，了解某个时间点的闪过图像是否可以帮助我们预测焦虑问题是否会在更晚的时候出现（例如，六个月到一年）。第二个项目将要求年轻人每天（持续两周）用他们的智能手机对他们当下的经历进行多次简短的评分，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改变闪进图像，从而减少焦虑水平及其相关问题。如果是这样，这种干预可以在未来以更严格的方式进行测试。总之，这三个项目将帮助我们了解这种干预是否有潜力成为早期干预和/或预防年轻人焦虑问题的有效策略。有焦虑问题生活经验的年轻人将参与项目从设计到传播的所有阶段。为此，我们将成立一个由大约6名年轻人组成的青年咨询小组，同时确保多样性（例如性别、性别认同、种族和社会经济背景）。该小组的一名青年合作者（可轮流担任这一角色）还将协助开展更具体的研究活动，例如审查材料、收集数据和随后的分析。

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.