Search

Individuals frequently update their beliefs and behaviours based on observation of others' experience. While often adaptive, social learning can contribute to the development of negative health expectations, leading to worsened health outcomes, a phenomenon known as the nocebo effect. This systematic review and meta-analysis examined: whether social learning is sufficient to induce the nocebo effect, how it compares to other forms of induction (classical conditioning and explicit instruction), and factors that influence these effects. The meta-analysis included twenty studies (n = 1388). Social learning showed a medium-large effect size (Hedges' g =.74) relative to no treatment and a to small-medium effect (g =.42) when compared to neutral modelling. The effect of social learning was similar in magnitude to classical conditioning but greater than explicit instruction with a small-medium effect (g =.46). Face-to-face social modelling, longer exposure, higher proportions of female participants and models, and greater observer empathy led to stronger socially-induced nocebo effects. However, further research is essential as only a minority of studies measured important constructs like negative expectancies and state anxiety. Nonetheless, the study highlights social learning as a key pathway for nocebo effects, suggesting it as a target for interventions to reduce the substantial personal and societal burden caused by nocebo effects. [ABSTRACT FROM AUTHOR]

AbstractFrom a Terror Management perspective, the pursuit of thinness that characterizes eating disorders (EDs) is arguably a culturally endorsed way to mitigate death anxiety. In the present studies, we used the mortality salience (MS) paradigm to examine whether priming death increases ED symptoms. We recruited two samples of women from undergraduate (Study 1, N = 120), and clinically relevant (Study 2, N = 154) populations. After priming, participants completed measures of potential confounds (e.g., neuroticism, affect). Next, we assessed ED attitudes and behavior using a portion size estimation task, and measures of body dissatisfaction and eating intention. Study 1 findings were inconsistent with the claimed role of death anxiety in ED related behavior. However, in Study 2, MS priming led to increased dissatisfaction with current thinness and smaller portion sizes for high-fat compared to low-fat food. Overall, the results suggest that death anxiety may, at least partially, drive ED symptoms. [ABSTRACT FROM AUTHOR]

Despite the theoretical prominence of expectancy and anxiety as potential mechanisms of the nocebo effect, not all studies measure expectancy and/or anxiety, and there are inconsistent findings among those that do. The present study sought to systematically review and meta-analyse available data to evaluate the relationship between expectancy, anxiety and the nocebo effect. The two key questions were: (1) whether nocebo manipulations influence expectancy and anxiety; and (2) whether expectancy and anxiety are associated with the subsequent nocebo effect. Fifty-nine independent studies (n = 3129) were identified via database searches to 1st August 2021. Nocebo manipulations reliably increased negative expectancy with a large effect (g = .837) and state anxiety with a small effect (g = .312). Changes in expectancy and state anxiety due to the nocebo manipulation were associated with larger nocebo effects (r = .376 and .234, respectively). However, there was no significant association between dispositional anxiety and the nocebo effect. These findings support theories that rely on situationally-induced expectancy and anxiety, but not dispositional anxiety, to explain nocebo effects. Importantly, being malleable, these findings suggest that interventions that target maladaptive negative expectancies and state anxiety could be beneficial for reducing the harm nocebo effects cause across health settings. Recommendations for future research are discussed. [ABSTRACT FROM AUTHOR]

Fear of cancer recurrence (FCR) is the most common psychosocial issue amongst cancer survivors. However, fear of progression (FoP) has rarely been studied outside of the cancer context. This review aimed to: (1) meta-synthesise qualitative studies of FoP in illnesses other than cancer; and (2) quantify the relationship between FoP and anxiety, depression, and quality of life (QoL) in non-cancer chronic illnesses. We identified 25 qualitative and 11 quantitative studies in a range of chronic illnesses. Participants described fears of progression and recurrence of their illness, including fears of dying, and fears of becoming a burden to family. Fears were often triggered by downward comparison (i.e., seeing people worse off than themselves). Participants coped in different ways, including by accepting the illness or seeking knowledge. Those for whom these fears caused distress reported hypervigilance to physical symptoms and avoidance. Distress, and seeking information, were associated with adherence. In quantitative analyses, FoP was moderately associated with QoL, and strongly associated with anxiety and depression. These results suggest that FoP in illnesses other than cancer is similar to FCR. FoP appears to be an important transdiagnostic construct associated with distress. Evidence-based FCR interventions could be adapted to better manage FoP in other illnesses. [ABSTRACT FROM AUTHOR]

A body of research has demonstrated high rates of comorbidity among individuals with obsessive-compulsive disorder (OCD). Further, recent empirical evidence has demonstrated the relevance of death anxiety in OCD. Given that the trajectory towards OCD remains unclear, the current study aimed to examine which disorders individuals typically experience prior to the onset of this disorder. Further, the study aimed to explore the role of death anxiety in the developmental pathways to the disorder. The present study involved administering a measure of death anxiety and conducting structured diagnostic interviews among a treatment-seeking sample of 98 individuals with OCD. First, the findings revealed a number of anxiety-related disorders commonly experienced prior to the development of OCD, the most frequent of which were separation anxiety disorder, specific phobias, and generalised anxiety disorder. Second, consistent with hypotheses, individuals with higher death anxiety experienced more disorders prior to the onset of OCD. Conversely, those with lower fears of death were significantly more likely to develop OCD as their first disorder. These findings support the argument that death anxiety may influence the trajectory towards OCD, and the comorbidity among anxiety-related disorders. However, further research is needed to clarify whether death anxiety plays a causal role in this trajectory. [ABSTRACT FROM AUTHOR]

Studies investigating attentional biases towards pain information vary widely in both design and results. The aim of this meta-analysis was to determine the degree to which attentional biases towards pain occur when measured with the dot-probe task. A total of 2168 references were screened, resulting in a final sample of 4466 participants from 52 articles. Participants were grouped according to pain experience: chronic pain, acute pain, anticipating experimental/procedural pain, social concern for pain, or healthy people. In general, results revealed a significant, but small bias towards pain words (d =  0.136), and pain pictures (d =  0.110) in chronic pain patients, but not in those with acute pain, those anticipating pain, or healthy people. Follow-up analyses revealed an attentional bias towards sensory pain words in the chronic pain group (d =  0.198), and the acute pain group (d =  0.303), but not other groups. In contrast, attentional biases towards affective pain stimuli were not significant for any pain groups. This meta-analysis found support for attentional biases towards sensory pain stimuli in patients with chronic pain in comparison to healthy individuals across a range of common parameters. Future researchers need to consider task design when seeking to optimally measure pain-relevant attentional biases. [ABSTRACT FROM AUTHOR]

Background: Treatment decision-making in bipolar II disorder (BPII) is challenging, yet the decision support needs of patients and family remain unknown. Aim: To explore patient and family perspectives of treatment decision-making in BPII. Method: Semistructured, qualitative interviews were conducted with 28 patients with BPII-diagnosis and 13 family members with experience in treatment decision-making in the outpatient setting. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Participant demographics, clinical characteristics and preferences for patient decision-making involvement were assessed. Results: Four inter-related themes emerged: (1)Attitudes and response to diagnosis and treatment; (2)Influences on decision-making;(3)The nature and flow of decision-making; (4)Decision support and challenges. Views differed according to patient involvement preferences, time since diagnosis and patients’ current mood symptoms. Conclusions: This is the first known study to provide in-depth patient and family insights into the key factors influencing BPII treatment decision-making, and potential improvements and challenges to this process. Findings will inform the development of BPII treatment decision-making resources that better meet the informational and decision-support priorities of end users. Declaration of interest: This research was partly funded by a Postgraduate Research Grant awarded to the first author by the University of Sydney. No conflicts of interest declared. [ABSTRACT FROM AUTHOR]

Objective: Treatment decision‐making in bipolar II disorder is complex due to limited evidence on treatment efficacy and potentially burdensome side‐effects of options. Thus, involving patients and negotiating treatment options with them is necessary to ensure that final treatment decisions balance both clinician and patient preferences. This study qualitatively explored clinician views on (a) effective treatment decision‐making, unmet patient needs for (b) decision‐support and (c) information. Method: Qualitative semi‐structured interviews with 20 practising clinicians (n = 10 clinical psychologists, n = 6 general practitioners, n = 4 psychiatrists) with experience treating adult outpatients with bipolar II disorder were conducted. Interviews were audiotaped, transcribed verbatim and analysed thematically using framework methods. Self‐report professional experience, and clinician preferences for patient decision‐making involvement were also assessed. Results: Qualitative analyses yielded two inter‐related themes: (a) challenges and barriers to decision‐making and (b) facilitators of clinician decision‐making. Symptom severity, negative family attitudes, system‐based factors, and information gaps were thought to pose challenges to decision‐making. By contrast, decision‐making was supported by patient information, family involvement and patient‐centredness, and a strong therapeutic relationship. Clinician views varied depending on their professional background (medical vs clinical psychologist), patient involvement preferences, and whether the clinician was a bipolar specialist. Conclusions: Whilst clinicians uniformly recognise the importance of involving patients in informed treatment decision‐making, active patient participation is hampered by unmet informational and decision‐support needs. Current findings inform a number of bipolar II disorder‐specific, clinician‐endorsed strategies for facilitating patient decision‐making, which can inform the development of targeted patient decision‐support resources for use in this setting. [ABSTRACT FROM AUTHOR]

The present study investigated the presence and possible predictors of complicated grief symptoms in perinatally bereaved mothers (N = 121) up to 5 years postbereavement. The presence of complicated grief scores in the clinical range was 12.4%, which is higher than in many other bereaved populations, and the presence of other living children may protect against the development of complicated grief symptoms. The majority of the women were able to negotiate a perinatal loss without developing complicated grief; however, there remains an important group of women who up to 5 years later score in the clinical range for complicated grief symptoms. [ABSTRACT FROM PUBLISHER]

The current aim was to examine the effectiveness of behaviour change techniques (BCTs), theory and other characteristics in increasing the effectiveness of computer-delivered interventions (CDIs) to reduce alcohol consumption. Included were randomised studies with a primary aim of reducing alcohol consumption, which compared self-directed CDIs to assessment-only control groups. CDIs were coded for the use of 42 BCTs from an alcohol-specific taxonomy, the use of theory according to a theory coding scheme and general characteristics such as length of the CDI. Effectiveness of CDIs was assessed using random-effects meta-analysis and the association between the moderators and effect size was assessed using univariate and multivariate meta-regression. Ninety-three CDIs were included in at least one analysis and produced small, significant effects on five outcomes (d+ = 0.07–0.15). Larger effects occurred with some personal contact, provision of normative information or feedback on performance, prompting commitment or goal review, the social norms approach and in samples with more women. Smaller effects occurred when information on the consequences of alcohol consumption was provided. These findings can be used to inform both intervention- and theory-development. Intervention developers should focus on, including specific, effective techniques, rather than many techniques or more-elaborate approaches. [ABSTRACT FROM PUBLISHER]

Objective:To determine whether changes in theory of planned behaviour (TPB) constructs could predict intention and gluten-free diet (GFD) adherence following participation in an online theory-based intervention designed to improve adherence in coeliac disease. Design:Theory-based process evaluation of the mechanisms of change over the course of a six-week online intervention. Measures of GFD adherence and TPB variables were administered at baseline and follow-up (immediate post-intervention:n = 74; three-month:n = 68; six-month:n = 65). Hierarchical regression analyses using residualised change scores were conducted at each time point (dependent variables: intention and adherence). Results:Baseline intention and GFD adherence were the strongest predictors of follow-up intention and adherence, respectively. Change in attitude accounted for significant variance in intention. Change in intention accounted for significant variance in GFD adherence immediately post-intervention; by the six-month follow-up change in perceived behavioural control was the stronger predictor. Conclusions:Partial support for the hypotheses suggests that, for certain behaviours, the TPB may be relevant in explaining the mechanism of action responsible for changes in intention and behaviour following participation in a behaviour change intervention. Additional predictive pathways are also likely to exist and, in the area of GFD adherence, may include habit strength and actual behavioural control. [ABSTRACT FROM PUBLISHER]

This study compared a 9-week individualised Cognitive Behaviour Therapy (CBT) programme for people with epilepsy (PWE), with a wait-list control. Fifty-nine PWE were randomised and 45 (75%) completed post-treatment outcomes. People with lower quality of life (QoL), particularly for cognitive functioning, were more likely to drop out. Analyses based on treatment completers demonstrated significant improvements on the Neurological Depressive Disorders Inventory for Epilepsy (p = .045) and Hospital Anxiety Depression Scale-Depression subscale (p = .048). Importantly, CBT significantly reduced the likelihood of clinical depressive symptoms (p = .014) and suicidal ideation (p = .005). Improvements were not observed for anxiety, QoL or maintained overtime for depression. Results suggest that CBT was effective, however, and could be improved to increase patient retention and long-term outcomes. [ABSTRACT FROM AUTHOR]

Young people with chronic illnesses including type 1 diabetes mellitus (T1DM) are at increased risk of developing psychological problems during adolescence. The aim of the present study was to explore whether a relationship exists between developmental challenges of adolescence (eating attitudes, family support and fear of negative evaluation) and psychopathology in adolescents with T1DM, and the nature of such a relationship. Sixty-one adolescents with T1DM completed a series of questionnaires assessing illness beliefs, eating attitudes, family support, Fear of Negative Evaluation (FNE) and psychopathology. The study was of a correlational design, and also included a seven-day diabetes management diary in order to collect blood glucose levels over this time. Results demonstrated the relevance of all three developmental challenges. In multiple regression analyses, FNE and eating attitudes independently predicted current levels of depressive symptomatology. Current levels of anxiety were predicted by FNE and family support, but not eating attitudes. The results support the relevance of all three developmental challenges of adolescence to psychopathology in young people with diabetes. These results suggest that in working with adolescents who are having difficulty coping with diabetes; it may be beneficial to focus on the developmental issues that commonly face adolescents. [ABSTRACT FROM AUTHOR]

The aim of the present study was to test Turk and Okifuji's (2002) model of chronic pain and in particular the moderating role of self-efficacy. We assessed 207 consecutive chronic pain patients (53.1% female) on a range of relevant measures and tested the model using structured equation modelling. The model was supported. These results support Turk and Okifuji's model of chronic pain and suggest that it can account for the relationships between variables in chronic pain patients. In particular, the results support the central role of fear-based avoidance and self-efficacy in chronic pain. Future research should be aimed at testing the alternative contemporary models of chronic pain at different stages of the development and maintenance of chronic pain and over time. [ABSTRACT FROM AUTHOR]

The phenomenological similarities between gambling and substance dependence have led to the conceptualization of pathological gambling as an addictive disorder. Tolerance and withdrawal are important features of both disorders, suggesting commonalities in the neurobiological processes associated with neuroadaptational underpinnings. However, there are few empirical studies supporting the presence of tolerance and withdrawal reported in the gambling literature. Moreover, there are no studies comparing the equivalence of tolerance and withdrawal between gambling and alcohol dependence. This study compared tolerance and withdrawal features in samples of gamblers, alcoholics and gamblers who also met criteria for alcohol dependence. In contrast to the addiction model, findings indicate that, while a majority of participants increased bet size, the motivation to do so was not for excitement or to maintain arousal levels as indicated by the DSM-IV-TR but because of cognitive factors related to winning. Results supported the notion that pathological gamblers experienced similar levels of withdrawal symptom severity as alcohol-dependent participants. Further research is needed to evaluate whether those symptoms result from the inability to gamble or from the loss of an avoidant stress coping strategy. [ABSTRACT FROM AUTHOR]

This study evaluated the impact of three specific modifications to the structural design of electronic gaming machines proposed by the New South Wales Liquor Administration Board, on player satisfaction. These modifications: reduction in reel spin speed, maximum bet limited to A$1.00 and removal of high denomination bill acceptors; were recommended as putative harm minimisation strategies within a larger government responsible gaming policy framework. Participants were a total of 363 patrons attending either a club or hotel venue in Sydney. Gambling behaviour and responses to a brief satisfaction questionnaire were obtained under conditions of play on modified and unmodified electronic gaming devices. Responses to satisfaction measures varied between hotel and club patrons and recreational and problem gamblers. Problem gamblers consistently reported less satisfaction and enjoyment playing machines. Overall, little effect on satisfaction or enjoyment was found for either social or problem gamblers in respect to concurrent modifications limiting maximum bet size and reducing high denomination bill acceptors. Slower machines were rated as less satisfying to play, but effects were small and did not appear to influence player's stated intentions. It is yet to be determined if changes to structural characteristics of electronic gaming machines are associated with harm reduction. [ABSTRACT FROM AUTHOR]

The article informs that chronic pain has been removed from the new Somatic Symptom and Related Disorders section of the Diagnostic and Statitical Manual of Mental Disorders, Fifth Edition (DSM-V). Topics discussed include patients needing to experience one or more somatic symptoms for the diagnosis of chronic pain. Also mentioned is the likely rare labeling of chronic pain as a psychiatric illness as this may be counter-therapeutic.