Background The COVID-19 pandemic highlighted the critical role of population behaviour in controlling the devastating impact of a health emergency. The absence of a standardised, cross-national survey that monitors preparedness behaviours and their determinants limit timely, evidence-informed public health preparedness and policy development. This study introduces and validates the Pandemic and Emergency Preparedness Behaviour (PEPB) monitor, a theory-informed survey designed to assess behavioural preparedness for future pandemics and emergencies. Methods Data were collected in March 2024 among adults aged ≥ 18 years in four European countries (the Netherlands, Spain, Ireland, and Slovenia; total N = 4,636). The PEPB monitor includes validated and new constructs covering preparedness and health behaviours, psychosocial determinants, preparedness perceptions, and self-reported health, theoretically supported by the COM-B model. Psychometric properties were examined using multigroup structural equation modelling, including tests of validity, internal reliability, and cross-national measurement invariance. Cross-national comparisons of preparedness-related behaviours and determinants were conducted, and illustrative regression analyses were performed to demonstrate policy-relevant use cases. Results Most multi-item constructs demonstrated good internal reliability and adequate structural validity across countries. Metric invariance was supported for all scales, indicating that associations between constructs can be meaningfully compared cross-nationally. Scalar invariance was supported for all constructs, except for mental health, perceived likelihood of disaster occurrence, and perceived severity of disaster consequences. Substantial cross-national differences were observed in hygiene behaviours, household preparedness, institutional trust, health literacy, and conspiracy beliefs. Regression analyses illustrate how the PEPB monitor can be used to identify behavioural, social, and institutional determinants of key preparedness-relevant outcomes. Conclusions By testing the survey’s psychometric properties in diverse national settings, the PEPB monitor provides an empirical baseline reference for observing societal behavioural changes during future pandemic and health emergency threats. Substantial cross-national variation in preparedness-related behaviours and institutional trust indicates that behavioural readiness during non-crisis phases cannot be assumed. Continued implementation of the PEPB monitor over time across countries can support evidence-informed preparedness policy and strengthen societal resilience to future public health emergencies. Clinical trial number: not applicable.’

Societal shocks such as extreme weather events, pandemics, large-scale conflict, or disasters test the resilience of individuals, communities, and broader societal systems. In response, governments and organizations worldwide are investing in improving preparedness and strengthening societal resilience. Despite widespread endorsement, a major challenge lies in the absence of a shared conceptualization that captures the behaviour of the various actors involved in the multi-level, dynamic, and time-dependent nature of preparedness.Using a pandemic as central illustrative example of an emergency, this paper fills the gap by merging the emergency management cycle with the socio-ecological model and offering a behavioural framework that captures the complex temporal and social dimensions of preparedness. We delineate how actions of individuals, communities, organizations, and governments - across phases of the emergency management cycle, from “cold” (preparation) to “hot” (crisis) phases - jointly shape preparedness, i.e. the capability to prevent, respond to, and recover from emergencies. The framework highlights both horizontal interdependencies, where early actions enable or constrain later responses; and vertical interdependencies, reflecting feedback and influence among actors at different societal levels.By mapping these dynamic interconnections, the framework provides practical guidance for designing policies and protocols. It offers an analytical frame for deciding who must act, when, and how; emphasizes coordination and feedback across levels; and identifies behavioral and systemic determinants of preparedness.

OBJECTIVE:Although the COVID-19 pandemic has affected mental health, understanding who has been affected most and why is incomplete. We sought to understand changes in mental health in the context of transmission numbers and pandemic (social) restrictions and whether changes in mental health varied among population groups.METHODS:We analyzed data from 92 062 people (aged ≥16 years and able to read Dutch) who participated in the Corona Behavioral Unit cohort study at the National Institute for Public Health and the Environment, the Netherlands, from April 17, 2020, through January 25, 2022. Participants self-reported mental well-being through multiple rounds of surveys. We used a multivariable linear mixed-effects model to analyze loneliness, general mental health, and life satisfaction.RESULTS:As strictness of pandemic prevention measures and social restrictions increased, people's feelings of loneliness increased and mental health and life satisfaction decreased. As restrictions were relaxed, loneliness decreased and general mental health improved. Younger people (aged 16-24 y) versus older people (aged ≥40 y), people with low (vs high) education levels, and people living alone (vs living together) were more likely to have negative well-being outcomes. We observed that trajectories over time differed considerably only by age, with participants aged 16-24 years affected substantially more than participants aged ≥40 years by pandemic social restrictions. These patterns were consistent across multiple waves of SARS-CoV-2 infection.CONCLUSIONS:Our findings suggest that the social restrictions imposed by the Dutch government during the study period were associated with reduced mental well-being, especially among younger people. However, people appeared resilient as they recovered during periods when restrictions were relaxed. Monitoring and supporting well-being, in particular to reduce loneliness, may help younger people during periods of intense social restrictions.

This 'cohort profile' aims to provide a description of the study design, methodology, and baseline characteristics of the participants in the Corona Behavioral Unit cohort. This cohort was established in response to the COVID-19 pandemic by the Dutch National Institute for Public Health and the Environment (RIVM) and the regional public health services. The aim was to investigate adherence of and support for COVID-19 prevention measures, psychosocial determinants of COVID-19 behaviors, well-being, COVID-19 vaccination, and media use. The cohort also examined specific motivations and beliefs, such as for vaccination, which were collected through either closed-ended items or open text responses. In April 2020, 89,943 participants aged 16 years and older were recruited from existing nation-wide panels. Between May 2020 and September 2022, 99,676 additional participants were recruited through online social media platforms and mailing lists of higher education organizations. Participants who consented were initially invited every three weeks (5 rounds), then every six weeks (13 rounds), and since the summer of 2022 every 12 weeks (3 rounds). To date, 66% of participants were female, 30% were 39 years and younger, and 54% completed two or more questionnaires, with an average of 9.2 (SD = 5.7) questionnaires. The Corona Behavioral Unit COVID-19 cohort has published detailed insights into longitudinal patterns of COVID-19 related behaviors, support of COVID-19 preventive measures, as well as peoples' mental wellbeing in relation to the stringency of these measures. The results have informed COVID-19 policy making and pandemic communication in the Netherlands throughout the COVID-19 pandemic. The cohort data will continuously be used to examine COVID-19 related outcomes for scientific analyses, as well as to inform future pandemic preparedness plans.

Introduction: Research suggests that the COVID-19 pandemic has affected mental health, however understanding of who has been affected most and why is incomplete. We aimed to understand how changes in mental health varied in the dynamic context of transmission numbers and pandemic (social) restrictions, and whether trends varied between population groups. Methods: We analyzed longitudinal data from 92,062 individuals who participated in the cohort of the Corona Behavioral Unit (National Institute of Public Health and the Environment, Netherlands) between April 2020 and January 2022 using multivariable linear mixed models. The main outcomes were general mental health, life satisfaction and loneliness. Findings: As the number of COVID-19 related hospital admissions and the strictness of pandemic policies increased, people’s feelings of loneliness increased while mental health and satisfaction deteriorated. Vice versa, as restrictions were relaxed, loneliness decreased and mental health improved. Younger people, those with lower educational levels and living alone were more likely to have negative outcomes. Only for age did trajectories over time differentiate considerably: younger participants were impacted substantially more by pandemic restrictions than older participants. These patterns were consistent across multiple pandemic waves. Discussion: The findings suggest that COVID-19 burden on health care and the pandemic restrictions – rather than the physical threat of COVID-19 – reduced mental health and satisfaction with life for younger people in particular. However, people appeared resilient as they recovered during periods when restrictions were relaxed. The present study highlights the importance of monitoring and supporting well-being during a pandemic, in particular to reduce loneliness during periods of intensive social restrictions amongst younger people. Funding Information: The Corona Behavioral Unit initiative has been made possible by funding from ZonMW, the Dutch Ministry of Health, Welfare and Sport and the National Institute for Public Health and the Environment (RIVM). Declaration of Interests: We declare no competing interests. Ethics Approval Statement: The cohort study does not meet the requirement as laid down in the Law for Research Involving Human Subjects (WMO) and was therefore exempted by the Centre for Clinical Expertise at RIVM from formal ethical review (Study number G&M-561).

Vaccination of youth could be key to preventing future outbreaks of SARS-CoV-2. Given the limited direct health benefit for young people, it is important to understand how youth themselves perceive obtaining a vaccination. This survey study in a representative sample of Dutch youth aged 12-18 showed that 73% were willing to get vaccinated against COVID-19. In regression analyses, vaccination willingness was strongly related to age, perceived personal (protect own health) and societal benefits (to get rid of restrictive policies), and their peers' and parents' vaccination uptake. Negative associations with vaccination willingness were perceived side-effects and potential unknown long term consequences. On-going and transparent communication with up-to-date information about safety and risks, delivered by independent and trusted experts (as perceived by the recipients) seems important for addressing questions and concerns. Local information sessions for youth and parents where a vaccination can be obtained without appointment could have merit in addition to mass media communication.

In response to the COVID-19 pandemic in the Netherlands, the National Institute of Public Health and the Environment (RIVM) established a longitudinal collaborative cohort study to examine adherence to COVID-19 behaviours, its psychosocial determinants, participant well-being, trust in the Dutch government, with additional attention for COVID-19 test and vaccination uptake. The cohort profile gives a comprehensive description of the cohort’s recruitment and its mixed-method design.

Background Primary aim of the current randomized controlled trial was to test the effectiveness of the parenting intervention ‘Video-feedback to promote Positive Parenting and Sensitive Discipline’ (VIPP-SD) in a sample of parents of preschool-aged twins, as well as differential susceptibility to intervention efforts, that is, whether more temperamentally reactive parents would profit more from the VIPP-SD than parents with lower reactivity. Methods The sample consisted of 202 families with same-sex twins [N = 404 children, mean age 45 months (SD = 6.81)]. Randomization was done at the family level in a 2:3 ratio, with 83 families (41%) randomized to the VIPP-SD group, and 119 families (59%) to the control group. After two pre-tests in year 1 and year 2 of the study, the VIPP-SD was implemented in the third year, with a post-test assessment 1 month after the five intervention sessions. Parental sensitivity was observed during structured play in which parent and child copied a drawing together in a computerized Etch-A-Sketch paradigm. Parental limit-setting was observed in a ‘don’t touch’ task in which the parent required from the child to abstain from playing with attractive toys. Parents interacted with each of their twins in separate sessions. Results The VIPP-SD intervention had a positive impact on the level of parents’ positive limit-setting in interaction with their preschool twins, and this positive effect was most pronounced when the parents completed at least five intervention sessions. However, the intervention did not enhance parental sensitivity during structured play. Parents with higher reactivity were not more open to the impact of the intervention, thus for this temperamental marker differential susceptibility in adults was not supported. Conclusions The current study is unique in targeting families with twin preschoolers, providing proof of principle that coaching parents with video-feedback promotes parental sensitive limit-setting to both children. It remains to be seen whether this finding can be replicated in families with non-twin siblings, or other parental susceptibility markers. Trial registration Trial NL5172 (NTR5312), 2015-07-20.

To date, behavioral genetic studies investigated either sleep or cortisol levels in middle childhood, but not both simultaneously. Therefore, a pertinent question is the degree to which genetic factors and environmental factor contribute to the correlation between sleep and cortisol levels. To address this question, we employed the classical twin design. We measured sleep in 6-9-year-old twins (N = 436 twin pairs, "Together Unique" study) over four consecutive nights using actigraphy, and we measured morning cortisol on two consecutive days. Sleep duration, sleep efficiency, and wake episodes were used as indicators of sleep. Morning cortisol level was used as cortisol indicator. A structural equation model was fitted to estimate the contribution of additive genetic effects (A), shared (common) environmental effects, (C) and unique environmental effects (E) to phenotypic variances and covariances. Age, cohort, and sex were included as covariates. The heritability of sleep duration, sleep efficiency, and wake episodes were 52%, 45%, and 55%, respectively. Common environmental factors played no significant role. High genetic correlations between sleep duration and sleep efficiency and high genetic correlations between sleep efficiency and wake episodes were found. Shared environmental (29%) and unique environmental factors (53%) explained the variance in morning cortisol levels. Because the sleep and cortisol measures were found to be uncorrelated, we did not consider genetic and environmental contributions to the association between the sleep and cortisol measures. Our findings indicate that sleep duration, sleep efficiency, and wake episodes in children are mostly impacted by genetic factors and by unique environmental factors (including measurement error).

BACKGROUND:Although there is a large body of literature highlighting the behavioral effects of parenting interventions, studies on the neurocognitive mechanisms involved in such intervention effects remain scarce.PURPOSE:The aim of the current study was to test whether changes in neural face processing (as reflected in N170 amplitudes) would act as a mediator in the association between the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) and maternal sensitivity.METHODS:A total of 66 mothers of whom a random 33% received the VIPP-SD and the others a "dummy" intervention participated in pre- and postintervention assessments. We recorded mothers' electroencephalographic (EEG) activity in response to photographs of children's neutral, happy, and angry facial expressions. Maternal sensitivity was observed while mothers interacted with their offspring in a semi-structured play situation.RESULTS:In contrast with our expectations, we did not find evidence for mediation of intervention effects on maternal sensitivity by the N170.CONCLUSION:We discuss that parenting support programs may yield different effects on neurocognitive processes depending on the population and provide recommendations for future research. Our study underscores the importance of reporting null findings and preregistering studies in the field of neurocognitive research.

The transition period between early childhood and late adolescence is characterized by pronounced changes in social competence, or the capacity for flexible social adaptation. Here, we propose that two processes, self-control and prosociality, are crucial for social adaptation following social evaluation. We present a neurobehavioral model showing commonalities in neural responses to experiences of social acceptance and rejection, and multiple pathways for responding to social context. The Leiden Consortium on Individual Development (L-CID) provides a comprehensive approach towards understanding the longitudinal developmental pathways of, and social enrichment effects on, social competence, taking into account potential differential effects of such enrichment. Using Neurosynth based brain maps we point towards the medial prefrontal cortex as an important region integrating social cognition, self-referential processing and self-control for learning to respond flexibly to changing social contexts. Based on their role in social evaluation processing, we suggest to examine medial prefrontal cortex connections with lateral prefrontal cortex and the ventral striatum as potential neural differential susceptibility markers, in addition to previously established markers of differential susceptibility.

To thrive as an individual and within society, children need to develop the ability to control their behavior. Using a twin design, we estimated the relative influence of genetic, shared, and unique environmental factors on hot and cool effortful control (EC). Furthermore, we investigated whether parental sensitivity in a play, task, or discipline context when the children were on average 3.78 years old, was differentially related to children's hot and cool EC 1 year later (Mage 4.77 years). We included 476 children from 238 twin pairs (48% boys, 58% monozygotic) and their primary parent. Hot EC (delay of gratification) was measured with the marshmallow test and cool EC (response inhibition) was measured with a stop-signal task. The behavioral genetics analyses showed that individual differences in hot and cool EC were mostly explained by unique environmental factors, whereas their association was mostly explained by shared environmental factors. Controlling for sensitivity in the other contexts, task sensitivity contributed to the prediction of cool EC, and sensitive discipline contributed to both cool and hot EC. Play sensitivity did not contribute to the prediction of hot or cool EC over and above parental sensitivity in the other contexts. Our study contributes to a better understanding of the unique and shared antecedents of hot and cool EC, suggesting parental sensitive discipline as a focus for preventive interventions targeting both hot and cool EC. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

This report evaluated sex-specific differences in the association between brain aging and body mass index (BMI) in young adults using the publicly available data from the Human Connectome Project (HCP).Participants of HCP with available structural imaging and BMI data were included [n = 1112; mean age = 28.80 (SD = 3.70); mean BMI = 26.53 (SD = 5.20); males n = 507, females n = 605]. Predicted brain age was generated using raw T1-weighted MRI scan and a Gaussian Processes regression model. The difference (Δ aging) between brain age predicted by structural imaging and chronological age was computed. A linear regression model was used with Δ aging as the dependent variable, and sex, BMI, and BMI-by-sex interaction as independent variables of interest, and race, ethnicity, income, and education as covariates.There was a significant BMI-by-sex interaction for Δ aging (p = 0.041). Higher BMI was associated with greater brain aging in both sexes. However, this association was substantially stronger in males (β = 0.215; SE = 0.050; p < 0.0001) than in females (β = 0.122; SE = 0.035; p = 0.0005).We found evidence suggesting that higher BMI is associated with greater brain aging in adults. Furthermore, the association between higher BMI and greater brain aging was stronger in males than in females. Future studies are needed to explore the mechanistic pathways that link higher BMI to greater brain aging and whether weight-loss interventions, such as exercise, can reverse higher BMI-associated greater brain aging.

We examined the relative contribution of genetic, shared environmental and non-shared environmental factors to the covariance between parental sensitivity and limit-setting observed twice in a longitudinal study using a child-based twin design. Parental sensitivity and parental limit-setting were observed in 236 parents with each of their same-sex toddler twin children (M-age = 3.8 years; 58% monozygotic). Bivariate behavioral genetic models indicated substantial effects of similar shared environmental factors on parental sensitivity and limit-setting and on the overlap within sensitivity and limit-setting across 1 year. Moderate child-driven genetic effects were found for parental limit-setting in year 1 and across 1 year. Genetic child factors contributing to explaining the variance in limit-setting over time were the same, whereas shared environmental factors showed some overlap.

Young children's behavioral control predicts a broad range of developmental outcomes in child-and adulthood. It is therefore important to study how individual differences in behavioral control arise. Previous studies suggest that there are both genetic and environmental influences, which were estimated in the current study using a sample of mono-and dizygotic same-sex twins. Furthermore, we examined the associations between indicators of a stressful family environment like household chaos, parenting daily hassles, and parental depressive symptoms and children's behavioral control in 2 samples. Children of the same twin pair were randomly divided over 2 samples; a test (N = 201, 48.3% boys, M age 46.53 months) and replication sample (N = 201, 49.8% boys, M age 46.06 months). Both parents reported on their children's effortful control via the Child Behavior Questionnaire and children's cheating behavior was observed during a throwing game. We found that AE models fitted the data for effortful control (A = 31%, E = 69%) and cheating (A = 16%, E = 84%) best. Path analyses revealed that children of parents experiencing more parenting daily hassles and depressive symptoms had lower levels of effortful control in the test sample. Furthermore, we found that children growing up in more chaotic households (parent report) had an increased risk of being in the cheating group versus the possible intention to cheat group in the test sample. These results were partially replicated. We suggest that the role of stressful family environments in the development of behavioral control should be considered when setting up prevention and intervention programs targeting children's behavioral control.

Early in their lives young children are confronted with social judgments by peers. Previous studies have shown that in adults negative social judgments are associated with more aggressive behavior. However, little is known about the relation between social judgments and aggressive behavior, or the underlying neurocognitive mechanisms, in early childhood. We developed the Social Network Aggression Task - Early Childhood (SNAT-EC) to examine the mediating role of frontal EEG asymmetry in the relation between social judgment and aggressive behavior in 4-6 year old children. To replicate our findings, we included three samples: a pilot sample, test sample 1 and test sample 2 (total N = 78). In the SNAT-EC, children receive positive, negative and neutral social judgments about their chosen cuddly animal by same-aged unfamiliar peers. EEG was acquired to measure frontal asymmetry during the processing of social judgments. Aggressive behavior was measured as the duration of a button press with which children could destroy balloons of the judging peer, thus reducing the number of remaining balloons for that peer. We used a within-subject mediation model to test whether frontal asymmetry mediated the effect of social judgment (negative vs. positive) on aggressive behavior. Results show that the SNAT-EC robustly elicits more aggressive behavior in response to negative social judgments about the cuddly animal compared to positive judgments. Meta-analysis revealed a large combined effect size (r = .42) for the relation between negative (vs. positive) social judgments and aggressive behavior. However, frontal asymmetry in response to the social judgments did not mediate the relation between social judgment and aggressive behavior. Future studies should search for other neural mediators to bridge the brain-behavior gap between social judgments and aggressive behavior, in particular in early childhood.

Being accepted or rejected by peers is highly salient for developing social relations in childhood. We investigated the behavioral and neural correlates of social feedback and subsequent aggression in 7-10-year-old children, using the Social Network Aggression Task (SNAT). Participants viewed pictures of peers that gave positive, neutral or negative feedback to the participant's profile. Next, participants could blast aloud noise towards the peer, as an index of aggression. We included three groups (N = 19, N = 28 and N = 27) and combined the results meta-analytically. Negative social feedback resulted in the most behavioral aggression, with large combined effect-sizes. Whole brain condition effects for each separate sample failed to show robust effects, possibly due to the small samples. Exploratory analyses over the combined test and replication samples confirmed heightened activation in the medial prefrontal cortex (mPFC) after negative social feedback. Moreover, meta-analyses of activity in predefined regions of interest showed that negative social feedback resulted in more neural activation in the amygdala, anterior insula and the mPFC/anterior cingulate cortex. Together, the results show that social motivation is already highly salient in middle childhood, and indicate that the SNAT is a valid paradigm for assessing the neural and behavioral correlates of social evaluation in children. (C) 2017 The Authors. Published by Elsevier Ltd.

The Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline (VIPP-SD) has proven effective in increasing parental sensitivity. However, the mechanisms involved are largely unknown. In a randomized controlled trial we examine parental neurocognitive factors that may mediate the intervention effects on parenting behavior. Our aims are to (1) examine whether the intervention influences parents’ neural processing of children’s emotional expressions and the neural precursors of response inhibition and to (2) test whether neural changes mediate intervention effects on parenting behavior.

Intervention programs with the aim of enhancing parenting quality have been found to be differentially effective in decreasing negative child outcomes such as externalizing behavioral problems, resulting in modest overall effect sizes. Here we present the protocol for a randomized controlled trial to examine the efficacy of the Video-feedback Intervention to promote Positive Parenting and Sensitive Discipline for Twin Families (VIPP-Twins) on parenting quality and children’s behavioral control and social competence. In addition, we aim to test the differential susceptibility theory; we examine differential efficacy of the intervention based on genetic make-up or temperament for both parents and children. Lastly, we explore neurobiological mechanisms underlying intervention effects on children’s developmental outcomes.