Background:The mental health consequences of school closure, social isolation, increased financial and emotional stress, and greater exposure to family conflicts are likely to be pronounced for primary school children who are known to be vulnerable. Data from prior to the pandemic are needed to provide robust assessments of the impact of COVID-19 on vulnerable children. Method:The present study capitalises on an ongoing study of primary school children (4-8 years) identified as 'at-risk' for mental health problems by teachers.We collected mental health and socio-economic data prior to the pandemic and reassessed this cohort (n = 142) via researcher-led video calls during the pandemic to evaluate the social and emotional impacts of COVID-19 for these families.Results: Mental health problems, particularly anxiety, increased significantly in these children. Parental mental health difficulties (anxiety and depression) were also prevalent. There were higher reports of financial stress during lockdown amongst low-income families previously identified as living in poverty, prior to the COVID-19 pandemic. Financial strain was found to indirectly predict increases in child mental health problems through parental mental health. Conclusion:These findings show that the pandemic exacerbated mental health problems in already vulnerable children. These negative outcomes were explained by financial stress (e.g., lost employment, loss of income and inability to pay bills), which was negatively linked to parental mental health. K E Y W O R D Sanxiety, child mental health, COVID-19, parent mental health, povertyThis is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

The pupil has been shown to be sensitive to the emotional content of stimuli. We examined this phenomenon by comparing fearful and neutral images carefully matched in the domains of luminance, image contrast, image color, and complexity of content. The pupil was more dilated after viewing affective pictures, and this effect was (a) shown to be independent of the presentation time of the images (from 100–3,000 ms), (b) not diminished by repeated presentations of the images, and (c) not affected by actively naming the emotion of the stimuli in comparison to passive viewing. Our results show that the emotional modulation of the pupil is present over a range of variables that typically vary from study to study (image duration, number of trials, free viewing vs. task), and encourages the use of pupillometry as a measure of emotional processing in populations where alternative techniques may not be appropriate.

Psychopathic individuals show a range of affective processing deficits, typically associated with the interpersonal/affective component of psychopathy. However, previous research has been inconsistent as to whether psychopathy, within both offender and community populations, is associated with deficient autonomic responses to the simple presentation of affective stimuli. Changes in pupil diameter occur in response to emotionally arousing stimuli and can be used as an objective indicator of physiological reactivity to emotion. This study used pupillometry to explore whether psychopathic traits within a community sample were associated with hypo-responsivity to the affective content of stimuli. Pupil activity was recorded for 102 adult (52 female) community participants in response to affective (both negative and positive affect) and affectively neutral stimuli, that included images of scenes, static facial expressions, dynamic facial expressions and sound-clips. Psychopathic traits were measured using the Triarchic Psychopathy Measure. Pupil diameter was larger in response to negative stimuli, but comparable pupil size was demonstrated across pleasant and neutral stimuli. A linear relationship between subjective arousal and pupil diameter was found in response to sound-clips, but was not evident in response to scenes. Contrary to predictions, psychopathy was unrelated to emotional modulation of pupil diameter across all stimuli. The findings were the same when participant gender was considered. This suggests that psychopathy within a community sample is not associated with autonomic hypo-responsivity to affective stimuli, and this effect is discussed in relation to later defensive/appetitive mobilisation deficits.

Psychopathy is a form of personality disorder associated with a deficit in emotional processing. However, there is debate whether this deficit applies to all emotions or exists only for negative emotions. The pupil dilates rapidly in response to emotional stimuli, allowing a time-sensitive index of emotional processing. Across 3 experiments using (a) visual images of real-world scenes, (b) auditory sound clips, and (c) videos of dynamic facial expressions, we measured emotional modulation of the pupil response to both negative and positive stimuli. Participants were 82 male mentally disordered offenders. Psychopathy was measured using the Psychopathy Checklist—Revised to produce factor scores of interpersonal–affective traits (Factor 1) and lifestyle–antisocial traits (Factor 2). Participants with high Factor 1 scores showed reduced emotional modulation of the pupil response to negative images and angry faces but not to any of the positive stimuli. These effects only occurred shortly after the emotion was presented (<2,000 ms), suggesting delayed processing of negative affective stimuli in Factor 1 psychopathy. Factor 2 scores were not associated with any changes in pupil response. There were no effects of psychopathy on the pupil response to the affective sound clips. The results support a specific psychopathic deficit in the processing of negative stimuli related to the interpersonal–affective dimension of psychopathy. We argue that pupillometry is a powerful and noninvasive tool to investigate emotional processing in clinical populations.

Objective The purpose of this study was to (a) examine the structural validity of the International Knee Documentation Committee Subjective Knee Form in light of previously reported dimensionality issues, and (b) examine the relationships between the IKDC and patients’ knee‐related quality of life 2‐9 years after anterior cruciate ligament (ACL) reconstruction. Methods A prospective research design was employed, wherein 319 patients (mean age = 29.07, SD = 9.03) completed the IKDC before surgery, 191 patients (mean age = 29.71, SD = 9.36) completed the IKDC at 6 months post‐surgery, and 132 patients (mean age = 34.34, SD = 7.89) completed the IKDC and the Anterior Cruciate Ligament Quality of Life Survey (ACL‐QOL) at 2‐9 years post‐surgery. Results Bayesian structural equation modeling analysis confirmed the two‐factor structure (symptom & knee articulation and activity level) represented the most accurate conceptualization of perceived knee function across the three time‐points. Moreover, findings revealed that of the two IKDC subscales pre‐operatively, activity level was most strongly associated with long‐term quality of life at 2‐9 years following surgery, whereas 2‐9 years post‐operatively, symptoms and knee articulation was most strongly associated with long‐term quality of life. Conclusions The IKDC provides clinicians with a convenient total score to assess patients’ perceived knee function, but its unidimensional factor structure is a poor representation of its items and fails to detect discrepancies in patients’ post‐operative quality of life, such as the relative importance of perceived knee activity level before reconstructive surgery.