In Conversation… Prof Elaine Fox

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Professor Elaine Fox, Professor of Psychology & Affective Science, University of Oxford, and UKRI Mental Health Networks Impact & Engagement Coordinator talks to freelance journalist Jo Carlowe.

Professor Fox discusses the risk and preventative factors around mental health including the role of resilience, cognitive and affective flexibility, memory bias and negative bias. Also covered is her role in UKRI’s Mental Health Research Matters network aiming to use multi-disciplinary approaches and encourage a national conversation on mental health.

Follow Elaine on Twitter @profelainefox

You can listen to this podcast directly on our website or on the following platforms; SoundCloudiTunesSpotifyCastBox, DeezerGoogle Podcasts and Radio.com (not available in the EU).

I am interested in the nature of human emotions and why people differ so much from each other in how they react to similar environmental situations. A current research focus is cognitive and affective flexibility and how these fundamental mechanisms affect psychological health and wellbeing.

In a recently completed programme of research funded by a European Research Council Advanced Investigator Award – The CogBIAS project – we investigated the cognitive and genetic mechanisms underpinning why some people flourish and others struggle. In a longitudinal study with over 500 Oxfordshire adolescents we have found that certain combinations of subtle cognitive biases are linked to emotional vulnerability on the one hand, and resilience and mental wellbeing on the other. We have also found that certain ‘polygenic risk scores’ can affect the sensitivity with which people pick up emotional cues from the environment. We now have a rich data set from this project which will keep us busy for years to come.

I have recently been appointed as the national Mental Health Networks Impact and Public Engagement Coordinator by the UK Department of Research and Innovation (UKRI).This role supports one-third of my time to work with eight mental health networks all around the UK to truly change the mental health research landscape. With a coordination team from the McPin Foundation, Mental Elf, and Sixth Sense Media we are working with the networks to do all we can to ensure that mental health research includes truly multidisciplinary teams, including people with expertise from lived experience of mental health problems, to help generate a new mental health science that genuinely makes a difference to people’s lives. (Bio via The University of Oxford)

Transcript

Interviewer: Hello, welcome to the ‘In Conversation’ podcast series for the Association for Child and Adolescent mental health or ACAMH for short. I’m Jo Carlow a freelance journalist for the specialism in Psychology today. I’m interviewing Elaine Fox Professor of Psychology and Affective Neuroscience at the University of Oxford. Elaine, welcome, thanks for joining me. Can you start with an introduction of who you are and what you do?

Professor Elaine Fox: Well first of all, thanks very much for inviting me, it’s nice to be here. And when I said, I’m at the Psychology at Oxford University, so I have a small research team and my work really involves looking at risk and protective factors around mental well-being. And more recently, I’ve become quite interested in adolescent mental health.

Interviewer: You’re interested in the nature of human emotions why people differ so much from each other and how they react to similar environmental situations what got you interested?

Professor Elaine Fox: I think I initially got into it actually back when I was doing my PhD and I was actually working in a psychopharmacology unit. So we were looking at the effects of sedative drugs so anti anxiety drugs and particularly with people going in for minor surgical procedures. So we were looking at the amnesic effect and one of the things we needed to test prior to the study was whether people were actually becoming sedated on auto relaxed before the surgery.

And after we had a placebo-controlled conditions are some people got a dummy pill, some got the real pill. Everyone did get a drug before they actually went in for the procedure, but it’s just a different time scale and we were trained how to measure levels of sedation, Using a kind of anesthetic scale really. And one of the measures is called ptosis, which is the drooping of the eye how quickly the eyes droop and it’s something we shouldn’t have done. But of course the students we always try to guess who are the placebo and who didn’t and of course it’s not good scientific practice.

But the thing I was absolutely astounded when finally we did break the code afterwards, to find that some of the people who showed really deep physical science of sedation including this ptosis measure, actually had been on placebo and I became really kind of fascinated by that. And not only that kind of fascinated me about the placebo effect generally, but just looking at the differences of how people to responded to something as physical if you like a drug so, you know, and I drugs where we know the mechanism of action pretty well, but actually some people are really sensitive and responded by strongly others didn’t respond at all.

Throughout my career that I kind of moved away from psychopharmacology, but really maintains that interest in how we kind of differ in terms of both. I suppose very bad things happening. So in adversity know how people differ in terms of how well they cope but also when really good things happen. So if you win the lottery not that I’ve studied many people winning the lottery, but you know, really good things. We all know people who absolutely get overly excited and you know with other people they kind of just take it in their stride ready. So I’ve just really been always fascinated by those are those kind of systemic individual differences.

Interviewer: And what kinds of differences do you see between people in terms of their let’s say their resilience on the one hand and their emotional vulnerability on the other?

Professor Elaine Fox: Well, it’s really interesting that I think one of the findings in the research and more recently actually is is just how many people are really resilient and I think we hear in the media a lot about emotional vulnerability and anxiety and depression which quite understandably these are major problems and I’m not anyway underestimating them. But actually even after quite major problems and major setbacks and most people are actually quite resilient.

And but one of the things that we the research is really found is that there are a lot of different Pathways to resilience. So it’s not that you know, there are some people who are simply resilient regardless and others were vulnerable. It’s very much different find different pathways through and there’s lots of different coping strategies that will help and in terms of you know who becomes more resilient and who becomes less resilient.

Interviewer: And this is part of some of your current research, I believe so the focus is cognitive and effective re flexibility and how these mechanisms effect psychological health and well-being? Can you elaborate a bit more on your work?

Professor Elaine Fox: Maybe if I backtrack a little bit. So a lot of my early research was looking at negative cognitive biases. So the idea that people might have biases in attention, so the brain Tunes in instantly to more negative material. Or they interpret socially ambiguous information in a more negative rather than positive way. Or say memory biases when people selectively remember and more negative of than one more positive or neutral material. Now, all of those things are really important. We know they are predictive of particular anxiety and depression.

So my research is very much focused on the negativity if you like of the biases, but more recently, I think what myself and several other people and have begun to realize is that maybe is not the negativity so much as just the kind of inflexibility of those biases. So in other words anxious people tend to have a very strong negative bias, but they have that negative bias, even in face safe situations. Whereas all of us if we’re in a slightly threatening situation, you know, imagine you wake up in the night and you hear a noise or something or if you’re in a particular area of town where it’s dark and you’re on your own and it is actually threatening.

Well, then it makes absolute sense to have a negative bias and be hyper-vigilant, you know, if that’s absolutely appropriate and that’s why we have those kind of bias as they’re very protective. But the problem is it’s people are more resilient and have a lot of flexibility so they’ll have those biases in the right context.

But actually when you are in a safe environment and you know, actually you won’t be particularly hyper-vigilant and so I’m beginning to kind of realize or hypothesize really that maybe that’s actually one of the big problems with anxiety, that is not so much the negativity on its own but rather that the bias is really inflexible. People get stuck into these very rigid ways of not only processing information, but also rigid ways of trying to cope, you know, we all know we will all do it.

We all kind of keep trying to do the same thing, even though it’s clearly not working. Whereas, people who are prone to anxiety and depression often particularly get into that frame rigid style of trying out the same thing over and over again rather than kind of stepping back and just trying to be more flexible.

Interviewer: And how does that apply to children and young people at what age do these patterns start to?

Professor Elaine Fox: We’ve just started doing a lot of work around this now and then and there isn’t there hasn’t actually been too much imperical research on this so so we don’t really know too much about these mechanisms in younger children, but I suspect they do start to kind of relatively early. Although I think generally we know definitely that between the age of seven and eleven condo flexibility and actually does increase flexibility dramatically.

So a seven or a six-year-old will be pretty inflexible. If they tried us are upon they’ll just keep trying to do the same thing and then you know as they progress up to about 11 or 12, then they’ll just develop a lot more cognitive flexibility. But in terms of if you like applying that to emotional situations, We don’t really know too much about that. And we’ve been looking at a large cohort of people who we followed over about a four-year period and we started at the age of 12 so they weren’t very young but they started in secondary school really and we followed them until they were about 16 or 17 and we’ve looked at some kind of measures of flexibility in that in that cohort and we have another big study on going at the moment which is funded by the ESRC and that specifically looking at cognitive flexibility in a teenage again. We’re primarily looking around 13, 14 years of age.

Interviewer: And any interim findings that you can share?

Professor Elaine Fox: We haven’t really got too many results coming out with the Adolescent population but we have done some interesting studies with a first-year student population. So again, it’ll be around 18, 19 years of age. And I had a master student a couple of years ago Eve Trivy, who did a very interesting study where she followed just over 80 people for an eight-week period.

So we measured their and their condo flexibility on a what we call a task switching tasks. So this is simply where people look at images on a computer screen and there’s two judgments they have to make, so on some trials they simply have to decide is that a negative or positive seen so it might be highly positive or negative. In other situations, they have to say whether there’s more or less than two people in the scene. And so what we look at the switch cost.

That’s what it’s called when you have to switch from one task to the other. So on one trial you might have to say there’s more than two people and then the very next trial, you have to make an emotional judgment. And what you look as, is there a difference in terms of how easily people can switch depending on the emotionality of the scene? And to be honest what we had expected what we’ve hypothesized was that people who are more prone to worry and anxiety over time would be much more likely to have difficulty switching away from negative material because I have been a number of studies that have found that.

And even though we found a trend for that, actually it wasn’t particularly significant in this study. But what was really significant was that those people who are much more likely to be worried and anxious over the eight weeks, were actually showed a really strong inflexibility in shifting towards positive material, which I thought was really interesting. It wasn’t so much that that there was a trend in that they tend to get stuck on the negative and you took a bit longer to pull our attention away, but actually the real action seemed to be in terms of switching towards positivity which you know that it was really interesting.

And those people were also much more affected by kind of everyday hassles. So we gave people a measurement called the hassles and uplifts scale which is pretty self-explanatory so it measures every day as you have any hassles or everyday things like missing a bus or you know minor kind of things and likewise uplifts as well. But your again minor things like bumping into a friend or having a nice bar of chocolate or something and what we found was that people who were less flexible in terms of switching towards positive material were much more prone to worry.

And also we’re much more affected by these kind of daily hassles and weren’t as predicted by the daily uplifts which other was kind of really interesting. So we’re running another study now and with another Clinical Psychology student, Holly Banfield and Holly is basically trying to replicate that finding. But also trying to follow people over a much longer period so we’re actually following people up to 12 months.

Interviewer:  Tell me about the cog bias project?

Professor Elaine Fox: So I was lucky enough in 2013, I got European research Council Advanced investigator award is what it’s called. And this is quite a big program grant over a five-year period and we actually got a one-year extension. So just finished last October so we added for six years and it was called the called the Cog Bias project and the aim of the project really was to bring together two literature’s.

So my own background has been very much looking at the role of these cognitive biases particularly in relation to anxiety and depression. So we know for example the negative biases that we say it in both memory interpretation and attention can really, you know have an adverse effect on the development of anxiety. And then I kind of discovered a number of years ago.

I got interested in literature looking at particular genetic variance, that also seem to you know increase risk for depression and anxiety. It’s becoming very controversial literature. But at the time there’s a lot of excitement about this literature and that you know, these genes were really seem to predict. And what I realized was that both of these literature’s were really asking exactly the same questions was one with looking at cognitive biases. The other was looking at genetic variance. But actually there was hardly any overlap between them at all. Yeah, they didn’t cite each other.

They didn’t really, people didn’t know about the other literature. So the aim of this project was really to try and bring these two things together and really say that you know, well, is it the case that if you have a particular say group of, let’s say you have, we’re now actually calling them sensitivity genes rather than risk genes. So genes that if you like kind of make you a little bit more sensitive to the environment.

If you have those genes the hypothesis is that that might actually could facilitate the development of negative biases. So if you’re in a negative environment, for example, you might develop a negative bias much more rapidly, if you have these particular sensitivity genes and that that in turn then will lead into more anxiety and depression. So that was really the aim of the project and we ended up with about five different projects quite complex really. But one of the big projects within there was this longitudinal study of just been mentioned, which was following, we followed 504 12 year olds until they’re about 16 or 17.

And we finished in wave we tested them on three occasions over that period roughly a year apart a little bit more than a year apart. And we finally we had 411 I think was the number that finished in Wave 3 which is just a 19 percent Dropout, which is actually pretty good. So I think the the team did really well. I think in you know in actually making sure that we didn’t get to bigger drop out. And I think that’s a really unique study because it’s we took lots of self-report measures.

We obviously took DNA samples. We have full genome information for all of the children involved. But I think what makes it unique is we also have a wide range of behavioral measures of biases. So we measured – as in attention in memory and interpretation, we also looked at approach avoidance for food-related stimuli.

In relation to say binge eating so we’d have subjective measures of binge eating and other eating behaviors. So it’s a very rich data set and I think will keep us going for years to come. We’ve obviously analyzed a bit of the data, but even though the project is formally finished. We’ll absolutely be working on it for a long time in terms of the the data set.

Interviewer: And in terms of findings, what are the highlights?

Professor Elaine Fox: I think that highlights what does a couple of things em, first of all, I suppose I thought I’d kind of mentioned maybe there’s three kind of key projects that I could possibly mention which we’ve kind of analyzed pretty well. So during the project there were three people who actually do their PhDs or Dphil as they are called an Oxford. So, one was called Sam Parsons and so he did a very nice  study looking at well-being and so, psychological well-being really in this in this group of people. And he used a measure and called the mental health continuum, which basically measures from kind of languishing at one end to flourishing at the other end.

And what we find is that most people are kind of somewhere in the middle. Some people are kind of just getting by but they’re not particularly flourishing. But what Sam did was very interesting. He applied this statistical technique called network analysis, which really tries to look at the connections among different factors, whether there are bias measures or things like self-esteem or social factors lots of different factors.

And what we found was quite expected in terms of the people who were languishing. So these were the people with relatively poor mental health, so relatively poor, so high worry rumination. And they had really really tight and rich connections between the different biases.

So they tended to have a strong negative bias in how they interpret it and they use information for example. And that’ll be very tightly linked to a bias in memory for example, and so the idea was that if one of those buyers is gets activated the whole network can become activated very quickly. Whereas when we looked at people much higher in on that kind of scale. So those who are more of the flourishing end actually, the connections were much, much looser.

So just you could even see it’s a very visual diagram you can see the diagram just looks like it has less connections. And so that was kind of really fascinating is we thought yes, we really thought wow, that’s really interesting and you know, it really seems to indicate or it is a little bit speculative. But what was speculating is that so those because the connections are just strong that might actually give a lot more flexibility.

So going back to what we were saying about the flexibility that if you don’t have that tightly connected, especially negative biases. It may give a lot more flexibility in reacting to different situations. So those kind of results party were what sparked our new study with the ESRC by were specifically looking at a flexibility.

So that’s the kind of really interesting study that Sam has written up and it’s just it’s under revision at the moment with a journal so and we’re hoping that will be accepted obviously. And then another so Annabel Songco am also did her PhD and is now working as a postdoc in my group and she looks specifically at worry and anxiety in this cohort. And again, we found some really interesting results.

And so again what she did was in the literature and most of the research actually looks at biases fairly independently from each other. So you tend to find a lot of studies looking at just attention bias, other studies looking just at memory bias, others looking to interpretation bias whereas, we really brought them together really. And the hypothesis was that the biases, that the multiple biases, would actually be more predictive of anxiety than just a single bias. And that’s effectively what we found.

So in Annabelle’s analysis, she found that would you did a thing called a principal components analysis or PCA analysis where you basically see what kind of fits together better,what she found was that biases in memory and biases in interpretation really linked together very closely. The attention measures we found and weren’t particularly reliable unfortunately throughout all our studies.

So that tends to drop out of this statistical analysis now a lot. But what Annabelle found was that the what we’re calling the polybius score. So the combined bias score was much more predictive of anxiety and depression than the single bias on its own. So I think that was really kind of quite interesting and you know, and the other thing I suppose I could just look up so we’ve just done a kind of analysis looking at course time of year what happens with things like anxiety and depression and rumination.

First of all, I should say it in this cohort, so this is a normative sample of school children.  10 different schools around the Oxfordshire area and about 20 percent of those children actually had levels of anxiety depression that reach kind of clinical cut off. So we didn’t this isn’t a clinical diagnosis but using the kind of standardized scales the cut-offs are generally seen as getting close to clinical levels with about 20% which is about typical. It’s about what you find nationally and in big National surveys.

And what we found instincts are over that period of time from the age of 12 or 13 to the edge of that 16, 17, we found no particular change in anxiety, but we did find a pretty significant increase in depression. The depression increased and there was almost a hint in there of anxiety seem to turn into depression as children a little bit older, Which I think this has been found before as well. So that the very anxious 12 year olds often the anxiety wouldn’t really change much but their level of depression will increase.

Also, we measured some of these so called transdiagnostic measures and which I think are particularly Instinct. So things like worry and rumination. Which is probably the same process it’s just rumination looks back really worry looks forward. So worries about ruminating about what might go wrong in the future, whereas rumination tends to be more associated with depression, but it’s thinking about all the bad things that happened in the past and failures in the past. And both of those really increased doing this quite dramatically during this period.   which was a little bit of a worry.

Self-esteem actually decreased. So while the 12 year olds are pretty high in self-esteem it gradually decreased as we went over that kind of age group. And so basically there was a worsening mood across that period from 12, 13, 16, 17, which is a bit of a concern. But as I said is was quite interesting to see that in in this kind of cohort.

So another Charlotte Booth who’s another PhD student in my group who again and then went on to work on a post doc with us, and she’s now actually an Imperial College in London. So she did a very our study on this longitudinal study looking at resilience. So particularly looking at, you know, one of the factors that predicted more resilient children? And what she did was she used a quite a new measure which I’ve done.

It hasn’t been used too much at all, especially in adolescence. And so it’s a measure of rather than giving a questionnaire,  you know, as I said before the idea that resilience is somehow personality trait. I think it’s been fairly debunked now really.

And so what you did was, we had quite a good measure of all of the different kind of good and bad things that happened to these children. So in the previous year they, again it was assessed on questionnaires. And what we what Charlotte did was found using a thing called the residuals method, looking at who’s doing better than expected relative to what had happened to them and who’s doing worse than expected.

So the ideas that resillient people aren’t necessarily doing really well. You if they’ve been in really like if you are a Syrian refugee for example, you know if you actually kind of pretty okay a little bit depressed or anxious. You’re probably actually extremely resilient. So it’s you know, you have to look at what people have been through.

Interviewer: This sounds much more accurate.

Professor Elaine Fox: Exactly is a much more accurate measure. Yeah. So so we took on the real events that people have happened and then looked at the regression lines if you like so who’s doing better and who’s doing worse? And this is I think this is the first time this has been done where we also took on the biases into account as well, which I think was quite interesting.

And basically what Charlotte found was that, the kind of things that we predicted increased resilience were certainly self-esteem, so higher self-esteem as you might expect was definitely linked to to high resilience. And lower levels of rumination and worry, which as I said, we know are these kind of trans diagnostic factors that we know can be quite toxic in terms of resilience.  But instantly also memory bias and interpretation bias, so the more the negative bias, The less resilient basically people were.

And that was particularly the case with memory bias. So memory bias was a unique predictor of the zillions across this age group, which is really kind of quite interesting. And another couple of the protective factors was being male. So I should say our outcome measure here was internalizing problems. So that’s anxiety and depression symptoms.

So we do know that anxiety depression is much more common in females generally, so that’s probably not overly surprising. So as we found especially across development, the girls tend to show more anxiety and depression symptoms than the boys. And so that came out as a factor within this residual analysis where we found that actually being male was actually protective factor and higher socioeconomic status. Likewise was a protective factor. So again, that’s just been submitted for publication as well. So we’re obviously, so as a lot of this analysis is still ongoing, So I think it will keep us going for quite a while.

Interviewer: There’s masses in the pipeline.

Professor Elaine Fox: There is yeah.

Interviewer: I wanted to ask you about polygenic risk scores, is that the same as a polybius score?

Professor Elaine Fox:  So the biases are just looking at the cognitive biases. So the polygenic risk scores are really looking at a whole range of genes that we know might be linked. So there are usually genes around the serotonin system and the dopamine system. And so the method we’ve been using is to look at the big there’s a big studies called gwa studies, which is genome-wide Association studies.

So these usually have twenty, thirty, forty thousand people so, you know, you need really big studies. For example, the latest depression polygenic risk score, I think it has been tested on about 300,000 people worldwide in a big consortium. So what they’ve done is they’ve picked out about 20 genes or so that in particular variants are linked to depression in this big study. So it’s almost like a kind of a psychometric scale if you like, so you can work out the variance along these 20 or so different genes.

So what we’re doing is we’re taking the latest polygenic risk score from the big GWA studies and then applying that in our data and saying well does this polygenic score actually explain, you know, a variance in our study? And what we found so far is that it definitely is linked again to our measures of anxiety and depression.

We’re just now looking at binge eating and eating behaviors. So we haven’t really gotten results there yet. But what’s really interesting is what we’re finding is that some of the link between the polygenic risk scores and say depression are completely moderated by interpretation biases. So in other words of people have say a highly sensitive genetic risk score, we know that generally links with increased depression, but that’s only the case if they have a face strong negative interpretation bias.

If they don’t have a strong negative interpretation buyers that relationship really decreases, so we’re just writing that up in the moment and we’re actually trying to, because this whole area has become quite controversial. We’re trying to make sure we replicate this in another sample.

And the difficulties we can’t actually run that data ourselves because it’s also another big five-year study. And a lot of the big studies around don’t have measures of biases which is a problem. But there is one study. That’s Jenny Hudson and her team in Macquarie University in Sydney have done a study where they started just a year before us actually, So we kind of collaborated on certain measures. So we made sure that we had some overlap with our measures and so we’re hoping that we’ll be able to replicate some of our findings on her data set.

Where I think she’s testing about 1,500 children in the Sydney school system. And so hopefully if we replicate the same findings, I think they would be really quite exciting findings.

Interviewer: And do you know other polygenic risk scores being used in clinical practice or is it too early?

It’s again. It is quite early, but there is  a lot of really interesting research. So again Professor Thalia Eley and King’s College here in London. She’s doing some very interesting work looking at reaction to psychological therapies using the same type of polygenic risk scores.

And so the idea is that again, if your very sensitive if you have a lot of these sensitivity genes, for example, that made might make you quite vulnerable in a very negative situation, but it also might mean that you might benefit more from things like psychological therapy.

So she’s already done some really interesting work indicating that you know, there is some support for that notion. And they have a really big study going on at the moment where they’re really trying to get a much much bigger data set and including genetics to really see is that the case you’ll do is there a difference?

So you can see ,I think it’s still kind of a long way off, but the idea would be that it is using the genetic information might be a way of developing much more personalized treatments and personalized medicine, personalized psychology, if you like. Which I think would be a good be a real benefit in the future.

Interviewer: Yes, very interesting. You’ve recently been appointed as the National Mental Health Network Impact on Public Engagement Coordinator by the UK Department of Research and Innovation. What will you be doing in this role?

Professor Elaine Fox: Yeah. it’s a little bit of a mouthful but it’s a really interesting role. Actually. I’m really excited about and getting involved with this. So UKRI, I about I think about a year and a half ago or so and fund it eight different mental health networks around the country.

These are Mental health research networks. And four of them are actually particularly focused on on young people’s mental health and mental well-being and the idea behind the initiative really is it’s quite a big investment from the UK Department of a certain Innovation the and the idea really is to try and genuinely change the landscape of mental health research by bringing in a much much more interdisciplinary approach.

And particularly bringing people with lived experience of mental health problems Into the Heart of the research process. So basically UKRI funded these eight networks, each of them were awarded roughly around a million pounds. So it’s a big investment and what UKRI are really keen to ensure is that these networks actually will collaborate with each other as much as possible.

And really just raise the profile of mental health research generally both among researchers, but also among the general public and other charities and other funders. So, they were a little bit concerned that this may not happen kind of organically. So they advertise for this role as a coordinator. So I put together a small team of people and applied for that. So the team I got together was a guy called and Andre Tomlin who is probably better known in the medical field of mental health. You may if you if you’re on Twitter, he’s The Mental Elf. And so he’s done a great job. I think on presenting evidence-based information around mental health.

And then Vanessa Pinfold from the McPin Foundation. And so they are a charity who are focused on mental health research and their particular expertise is on making sure that people with lived experience are involved in mental health research. So they are very much involved in the team.

And then the third person is woman called Sally Ann Kaiser who have known for a number of years and she runs a TV production company called Sixth Sense Media.

And the idea there is she’s done a lot of work around and young people’s mental health and well-being and really good TV programs around that. So the idea is that we’ve got two kind of remits if you like. The first part of the job and my role really is to try and first of all make sure that we can try and facilitate the Network’s to work together as much as possible where that makes sense, you know, so really looking into see are there particular areas where two or three or four networks might be able to work together quite productively.

And then another big part of the role is to really start to kind of what we’re calling A national conversation. so we didn’t try and do a little bit of of awareness raising if you like around mental health research. Because it’s been a lot of really fantastic media coverage in the last couple of years around mental health generally and I think stigmas are decreasing. I think there’s been a lot of really interesting stuff going on. But actually research has been missed out a little bit in that that hasn’t really been much about research and we know you know, there’s another charity works in the UK.

And MQ who are specifically linked with mental health research as well. And you know, they’ve pointed out that actually the amount of research funding that goes into mental health is Tiny compared to say cancer or heart disease or other other physical diseases and more physical health issues.

So I think that’s part of our remit is to try and really raise awareness and to really raise the importance of of the research process that to really provide better treatments and as we were saying with the genetics with more personalized treatments in order to do that, We need a lot more fundamental research. Of course, it is a very exciting time because the Welcome Trust for example are already there for they’ve had a long investment in mental health research, but recently they’ve really put if a large investment in and again, you know, Miranda Waldport has just taken over there as leading on the mental health and side of the welcome trust agenda.

So it is a very exciting time I think to be in and we just really want to try, and so our role is to try and make sure that all of these different groups work together as much as possible and try and have a coherent message.

Interviewer: And why is it so important to have this highly collaborative research at this time?

Professor Elaine Fox: Well, I think what’s I think a real problem has been people really working in silos if you like. So that you know, it’s been a lot of fantastic research going on. It is really good research, but particularly because people with lived experience, so people are really on the ground are having difficulties or families who have people who are having mental health difficulties because traditionally they haven’t really been so involved in the research process.

A lot of that research is a little bit divorced from people’s everyday lives. So when you look at the research that we’ve learned a huge amount, if you look at say and your assigns research, genetics research lots of different types of research and cognitive stuff that I’m involved in and it’s already interesting and I think we’ve learned a lot about how the brain works and how people react to different situations.

But that still hasn’t really got translated into therapies and into interventions that can help to prevent mental health problems. So I think the idea is that really involving people who are actively you know have mental health problems involving them in the research process. When I think to keep those things to the forefront of people’s minds, but also I think generally because I think what we all kind of acknowledge now is that mental health isn’t one of these problems that has a single cause or even a small group of causes.

There’s you know, you can end up being extremely say depressed or anxious for a wide variety of different reasons. It may because of social deprivation. It may be because of some hormonal imbalance. It may be a biological reason and you know, there’s multiple reasons but often you end up at the same type of symptoms.

So I think what happened is a lot of the search has been in these silos looking at individual causes but not taking in the complexity of it. So the idea really is to say well, let’s actually take that on board. Let’s look at this as a much more complex human problem that involves Society at large as well as biological factors and social factors and lots of other factors. And I think by getting everyone together the hope is that actually will end up with much more realistic Mental Health Science.

Interviewer: And what more can be done to raise the public profile and quality of mental health research in the UK?

Professor Elaine Fox: I think really just getting that message out there that research Is really important and that at that actually there is a lot of research going on. Because I think the really has been a gap in awareness there. As I said, there’s been a lot of fantastic campaigns by heads together and lots of others, But the focus has been very much on services and what services. And again quite rightly because that’s something that definitely needs to be improved and but really there’s been very little about the actual research.

Professor Elaine Fox:  And what kind of research is needed. So I think just really getting that on on the agenda and as part of my role with UKRI in the mental health networks. That’s very much what we’re hoping to do with this kind of we don’t call it a campaign but a kind of a national conversation really around how can we improve research? How can we really get lots of people involved in research and particularly facilitating Pathways for younger people to get involved in research.

And hopefully just you know, trying to normalize the whole situation and that in turn would hopefully decrease stigma around mental health problems. And for example, a lot of the some of the networks are very involved with them with young people and they have very good youth advisory panels, for example, which are led and it gives a very different perspective when you’ve got a group of say 14 or 15 year olds are actually advising on how research should be conducted.

Interviewer: Elaine, what else is in the pipeline that you’d like to mention?

Professor Elaine Fox: Big project for me on a personal level is I’ve just agreed to write a  it was actually a second and popular science book, so I wrote a book a couple years ago the Cold Rainy Brain Sunny brain, which is really about my own research on genetics and cognitive biases in relation to anxiety and depression. And really enjoyed that whole process of engaging the public with the science.

And I think there was a great appetite among the public for and science particularly around young people’s mental health and mental well-being and so actually as part of my ERC Grant I was supposed to spend about 30% of my time for writing a popular book and an accessible book on this.

did make a start and stop the started a bit. But it really it was just such a big team that you can imagine, I just got kind of overloaded. So I’m really now focused on that. So I’m working on a book and it’s called switchcraft, Which I have to thank my husband for the title, which I think is quite a nice title. And is really looking at an about looking at mental flexibility and the importance of flexibility, especially in relation to resilience.

So really kind of going through the literature and obviously in a very accessible way to really say well, actually what is the evidence that that inflexibility is linked to a wide range of mental health problems. And if we do become more flexible in terms of how we cope with situations, does that actually enhance our resilience? and you know, and then are there ways we can actually develop our flexibility. So so I’m really kind of primarily in my spare time trying to write that but really that’s going to be a big Focus over the next year or so.

Interviewer: And who’s the target readership to be?

Professor Elaine Fox: It’s the general public. Sorry, but I mean everybody hopefully the it’s very much aimed at a very general and group of people, but certainly hopefully the teenagers themselves and but probably primarily parents and people who enjoy and popular science and the idea is it will just make the science behind this whole area very accessible.

And just in terms of you know, anybody who needs to know a bit more about how you can cope with setbacks and cope with life in general and I suppose part of the idea behind the book is that, you know, we live in a really volatile world in a quite a precarious type of world and particularly recently with Brexit here. And with the Trump Administration in the states, there’s a lot of precariousness and the coronavirus and everything all of that going on and I think a lot of people really feel very vulnerable in those kind of a changeable situations. So it’s really looking at how people can develop and their flexibility in those very changeable situations.

Interviewer: Elaine, Finally. What is your takeaway message for those listening to our conversation?

Professor Elaine Fox: I think my main takeaway would be for people to really think about can they get involved in mental health research and in some way and I think that’s certainly what this world with UKRI and with the mental health networks. What we’re really hoping to do is really provide opportunities for people.

All sorts of people, very young people, you know people who don’t necessarily have any academic qualifications. but people who feel they have something to contribute in to research in some way. So I’d really encourage people to try and have a look at the Network’s web sites, you know, try and see is there a way they could get involved?

Because I think and again just in terms of generally trying to decrease stigma around mental health particularly in young people. I think even now even though the stigma has decreased a lot. I think a lot of people are still very nervous about acknowledging mental health problems. And so I think really just trying to if you’re an employer or if you’re a parent or a school teacher just trying to provide a kind of a place you like where people can really feel free, feel they will be judged harshly if they admit and that they have mental health problems.

And I know for example in my own University in Oxford, but I think probably most universities. There’s a lot of people in lab groups who are really nervous about admitting they have mental health problems because they just really feel that will reflect badly on them. And you know, so I think it’s just a general culture change. We really need to change the culture and around mental health generally.

Interviewer: And for people who want to get involved. Do you have the website address?

Professor Elaine Fox: That name is mentalhealthresearchmatters.org.uk

Interviewer: Elaine. Thank you ever so much that’s really fascinating for more details on Professor Elaine Fox. Please visit the ACAMH website www.acamh.org and Twitter @acamh.

 

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