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Aim: To determine if consumers and clinicians believe intelligence or health outcomes are more important long‐term outcomes for babies born preterm. Methods: Prospective, online survey of six outcomes ranked using a hierarchy ladder, Likert scale and a hypothetical scenario: education (complete secondary school); longevity (70 years of age or more); money (sufficient for rent and food); normal weight; good health and intelligence. Participants were clinicians taking care of preterm babies, parents of preterm babies, ex‐preterm adults and adult controls. Results: The survey was completed by 145 participants (35 controls, 36 clinicians, 39 parents and 35 ex‐preterm adults). Health was the most frequently top‐ranked variable on the hierarchy ladder (health; 99/145 (68.3%), money; 17/145 (11.7%), longevity; 10/145 (6.9%), education; 8/145 (5.5%), normal weight; 6/145 (4.1%), intelligence; 5/145 (3.4%), P < 0.0001), with no statistical difference between the groups. On a 5‐point Likert scale, participants were most likely to agree that sufficient money, health and finishing secondary school were important for preterm babies to have a good life (mean (SD): money 4.43 (0.81); health 4.39 (0.72); education 4.37 (0.81); normal weight 4.10 (0.81); intelligence 4.03 (0.94); longevity 4.01 (1.07), P < 0.0001). In the scenario, the option of an ex‐preterm adult having a healthy life with low socio‐economic status (SES), was preferred over high SES with an unhealthy life (p < 0.0001). Conclusions: Health was perceived as the most important long‐term outcome for preterm babies. Future research should prioritise good health outcomes for babies born preterm. [ABSTRACT FROM AUTHOR]

Treatment expectations alter the probability of experiencing unpleasant side effects from an intervention, including vaccinations. To date, expectations have mostly been assessed explicitly bearing the risk of bias. This study aims to compare implicit expectations of side effects from COVID-19 and flu vaccinations and to examine their relationships with vaccine attitudes and intentions. N = 248 participants took part in a cross-sectional online survey assessing explicit and implicit expectations, as well as vaccine-related attitudes and personal characteristics. A Single Category Implicit Association Test (SC-IAT) was developed to assess implicit side effect expectations. Explicit side effect expectations were measured with the Treatment Expectation Questionnaire (TEX-Q). Whereas explicit and implicit expectations regarding COVID-19 vaccine were significantly correlated (r = −0.325, p <.001), those correlations could not be found regarding flu vaccine (r = −0.072, p =.32). Explicit measures (COVID-19: β = −0.576, p <.001; flu: β = −0.301, p <.001) predicted the intention to receive further vaccinations more than implicit measures (COVID-19: β = −0.005, p =.93; flu: β = 0.004, p =.96). Explicit measures (COVID-19: OR = 0.360, p <.001; flu: OR = 0.819, p =.03) predicted vaccination status, while implicit measures did not (COVID- 19: OR = 2.643, p =.35; flu: OR = 0.829, p =.61). Expectations to experience side effects from vaccinations can be measured implicitly, in addition to explicit measures. Further investigation needs to determine the relative contribution and additive value of using implicit measures to assess treatment expectations. • An implicit measure assessing expectations of vaccination side effects was developed. • Implicit side effect expectation measures can be used in addition to explicit measures. • Both measures correlated positively for COVID-19, not for flu. • Explicit expectations seem more predictive of vaccination intention and status. [ABSTRACT FROM AUTHOR]

Background: As new targeted oral antineoplastic therapies have emerged in recent years, the development of effective strategies that promote optimal adherence to cancer medication regimens has become an important priority.Methods: We conducted a scoping literature review to search for English language articles published through July 15, 2019, to identify studies that reported the testing and/or evaluation of interventions to improve adherence to oral antineoplastic agents.Results: A total of 56 articles were selected for review. Of the studies evaluated, 14 were randomized trials. All interventions except two targeted adult patients. Thirty-three studies enrolled fewer than 100 patients. Most interventions were education- and counseling-based and centered on provision of information about the drug and strategies to manage side effects. Only eight studies used an mHealth tool and/or text messages to target nonadherence. Among studies with a comparison sample, fewer than one-half (44.7%) reported statistically significant improvements in adherence or persistence associated with the intervention; however, some pharmacist-directed programs, particularly those that integrated monitoring or routine follow-up with a provider, did demonstrate efficacy.Conclusion: Although the development of adherence-promoting interventions for oral antineoplastic therapies has increased recently, few have been rigorously tested. The nascent literature suggests those that are pharmacist directed and use regular monitoring show promise, though additional prospective studies are needed. Study methodology, population selection, and potential challenges that may be encountered in the implementation and dissemination phases should be considered when developing new interventions to address nonadherence to oral antineoplastic treatment. [ABSTRACT FROM AUTHOR]

Placebo effects constitute a major part of treatment success in medical interventions. The nocebo effect also has a major impact, as it accounts for a significant proportion of the reported side effects for many treatments. Historically, clinical trials have aimed to reduce placebo effects; however, currently, there is interest in optimizing placebo effects to improve existing treatments and in examining ways to minimize nocebo effects to improve clinical outcome. To achieve these aims, a better understanding of the psychological and neurobiological mechanisms of the placebo and nocebo response is required. This review discusses the impact of the placebo and nocebo response in health care. We also examine the mechanisms involved in the placebo and nocebo effects, including the central mechanism of expectations. Finally, we examine ways to enhance placebo effects and reduce the impact of the nocebo response in clinical practice and suggest areas for future research. [ABSTRACT FROM AUTHOR]

Background: Previous research has shown a link between low positive affect and mortality, but questions remain about how positive affect is related to mortality and how this differs by gender and age.Purpose: To investigate the relationships between positive affect, negative affect, and mortality in a general population sample, and to examine whether these relationships were related to age, sex, or cause-specific mortality.Methods: We used data from 5,554 Norwegian participants aged 47-49 and 71-74 years who completed the Positive and Negative Affect Schedule (PANAS) and also provided data on demographics, health behaviors, and physical health as part of the Hordaland Health Study. The primary outcome was mortality after an average follow-up period of 16.5 years.Results: Participants in the lowest positive affect tertile had a near twofold increased mortality risk, compared to those in the highest positive affect tertile. This association was driven primarily by the PANAS "active" item and persisted, even after controlling for activity-related confounds and other positive affect items. No significant associations were found between negative affect and mortality. The relationship between positive affect and mortality was not significantly attenuated by age or sex. Although low positive affect was associated with an increased risk of mortality, it was not related to a specific cause of death.Conclusions: Low positive affect was significantly associated with mortality risk. The relationship was driven by the PANAS active item and not associated with cause-specific mortality. Findings suggest future research should examine the association between feeling inactive, sedentary behavior, and subsequent mortality. [ABSTRACT FROM AUTHOR]

Background: Previous studies have proposed that having parents out of work may influence adolescent illness behaviour and school attendance. However, prior research investigating this question has been limited by retrospective reporting and case control studies. In a large epidemiological study we investigated whether parental work absence was associated with symptom complaints and increased school absenteeism in adolescents.Methods: We analysed data from a large epidemiological study of 10,243 Norwegian adolescents aged 16-19. Participants completed survey at school, which included demographic data, parental work absence and current health complaints. An official registry provided school attendance data.Results: Parental work absence was significantly related to the number of adolescent symptom complaints as well as school absenteeism. Having a father out of work was associated with an increased likelihood of being in the highest quartile of symptom reporting by an odds-ratio of 2.2 and mother by 1.6 (compared to the lowest quartile). Similarly, parental work absenteeism was associated with an increased likelihood of being in the highest quartile for school absence by an odds-ratio of 1.9 for a father being out of work and 1.5 for a mother out of work. We found that the number of adolescent symptom complaints mediated the relationship between parental work absenteeism and school absenteeism.Conclusion: We found that parental work absence was significantly associated with the number of adolescent symptom complaints and school absenteeism. The results suggest that parents may play a critical modelling role in the intergenerational transmission of illness and disability behaviour. [ABSTRACT FROM AUTHOR]

Objective: To examine if insomnia before and after childbirth predicts the development of postpartum bodily pain.Methods: This study is part of a longitudinal cohort study, the Akershus Birth Cohort Study, which targeted all women giving birth at Akershus University Hospital in Norway. The current sample is comprised of 1480 women who participated at all three time points, yielding a participation rate of 32% of the 4662 women who originally consented to participate. The Bergen Insomnia Scale (BIS) was used to measure insomnia and a latent profile analysis (LPA) was used to identify subsets of women who shared a similar pattern of responses on the BIS-scale across the three time points. Pain was measured using the bodily pain scale, derived from the Primary Care Evaluation of Mental Disorders (PRIME-MD) and symptoms of depression were measured by the Edinburgh Postnatal Depression Scale (EPDS).Results: Using a latent profile analysis a three class model showed the best fit and identified one major group (55.6%) with a low BIS scores across all three time points, one group with intermediate BIS scores (32.9%), and a smaller group (11.5%) with higher BIS scores across all three times. The chronic high insomnia group had a 2.8-fold increased risk of reporting high levels of bodily pain. The chronic intermediate group was associated with a 2.2-fold increased risk of bodily pain at two years postpartum. Adjusting for demographics and lifestyle behaviors did not reduce any of the associations, while adjusting for depression significantly attenuated the associations. Additional adjustment for pain at eight weeks postpartum further reduced the magnitude of the associations, but both chronic intermediate insomnia and chronic high insomnia remained strongly associated with the onset of bodily pain in the fully adjusted models (RR=1.75, 95% CI: 1.37-2.23) and RR=1.63, 95% CI: 1.15-2.32, respectively).Conclusions: The high prevalence of insomnia among women during and after childbirth, in combination with the strong prospective association with impaired physical health, emphasizes the importance of adequately identifying, preventing and treating insomnia for this population. [ABSTRACT FROM AUTHOR]

Background: A social gradient of sleep problems has been demonstrated in both children and adults, but our knowledge about possible social determinants of adolescent sleep problems remains limited. Methods: A large population-based study in Norway surveyed 10 220 adolescents aged 16-19 years in 2012. Multiple socioeconomic status (SES) indicators and assessment of sleep, including DSM-5 insomnia, sleep duration, weekend-weekdays differences, as well as sleep deficit and delayed sleep phase were included. Results: Insomnia was more frequent among adolescents from families with lower parental education, parents outside the workforce and among adolescents reporting lower perceived family financial circumstances. Adolescents from lower social strata reported a significantly shorter sleep duration, more sleep deficits, later bedtimes and larger weekday-weekend sleep differences. The associations were present across all SES measures. For example, the mean sleep duration was 6:03 (95% CI: 5:55-6:12) among adolescents with mothers with primary school education, compared with sleep duration of 6:24 (95% CI: 6:20-6:27) and 6:35 (95% CI: 6:31-6:38) among adolescent with mothers having a secondary school and university degree, respectively (P < 0.001). The highest rate of insomnia was found in families with worse perceived financial circumstances (32%), when compared with 17-18% in families with better perceived financial circumstances. Depressive symptoms and family cohesion could account for some, but not all of the association. Conclusions: Lower SES was a robust determinant of adolescent sleep patterns and sleep problems, corroborating evidence of a social gradient in sleep from young children and adults. Targeted intervention for adolescents in low SES may be indicated to improve sleep. [ABSTRACT FROM AUTHOR]

The social context in which people take medicines can strongly influence the drug response in both positive and negative ways. We first examine the role of social modeling in influencing treatment outcomes through modifying placebo and nocebo responses, and then explore possible mechanisms for these effects. Viewing another person show improvement after taking a drug can increase the placebo component of the medicine and thus the overall potency of the treatment. Likewise, seeing another person who has taken the same medicine report side effects can substantially increase adverse effects. Such effects can also occur on a wider scale following changes in medicine formulations or from vaccinations programs, when the media transmit adverse effects from these treatments to a wider audience. Females seem to be more susceptible than males to the social modeling of adverse effects of treatments. A greater awareness of the effects of social modeling has potential to improve the effectiveness of medical treatments, minimize side-effect burden, and also lead to more effective management of health scares. [ABSTRACT FROM AUTHOR]

Objective The Internet has expanded the scope for creating health scares and increased the risk of nocebo responding in individuals exposed to misinformation about threats to personal health posed by aspects of modern life, such as exposure to new technologies. It was the aim of this experiment to investigate whether the delivery of positive expectations might reduce or reverse symptoms triggered by negative expectations formed from such misinformation. Method In the context of a study investigating symptoms during exposure to windfarm sound, 64 volunteers assessed their symptomatic experiences during two discrete sessions, throughout which they listened to wind turbine sound containing audible and sub-audible (infrasound) components. Participants were randomly assigned to watch either positive or negative information about the health effects of infrasound prior to their first infrasound exposure session. They were then shown the alternate information and exposed to infrasound during their second session. Results Participants receiving negative expectations were less symptomatic during exposure if they had previously received positive expectations about infrasound. Further, participants given positive expectations after the earlier delivery of negative expectations exhibited a placebo response, reversing the nocebo response exhibited in their first exposure session. Conclusion Results suggest accessing positively framed health information may reverse or dilute the effect of negative expectations formed from exposure to media warnings about health risks posed by new technologies, such as wind turbines. [ABSTRACT FROM AUTHOR]

Background A number of people are reporting an environmental sensitivity to sub-audible windfarm sound (infrasound), characterised by the experience of recurrent non-specific symptoms. A causal link between exposure and symptoms is not indicated by empirical evidence. Research indicates symptoms may be explained by the nocebo response, whereby health concerns and negative expectations, created from social discourse and media reports, trigger symptom reporting. Objective The experimental aim was to test whether providing a nocebo explanation for symptoms, to individuals reporting symptomatic experiences during infrasound exposure, would ameliorate symptoms during further exposure. Method Sixty-six volunteers were randomly assigned to nocebo explanation or biological explanation groups. Participants were concurrently exposed to infrasound and audible windfarm sound, while reporting on current symptoms and mood, during two exposure sessions. Preceding session one, participants watched a presentation integrating media warnings about purported health risks posed by windfarm infrasound. Before session two, nocebo explanation participants viewed material outlining how nocebo responding could explain symptom reporting. Instead biological explanation participants watched material presenting pathophysiological theories for symptoms. Results During session one, participants reported increased symptoms and mood deterioration from baseline assessment. During session two symptom reporting and mood deterioration was maintained by biological explanation participants, while mood and symptoms reported by nocebo explanation participants returned to baseline levels. Conclusion Results indicate that providing an explanation of the nocebo response, followed by exposure to infrasound, has the potential to operate as an intervention to reduce symptomatic experiences in people reporting symptoms attributed to windfarm generated infrasound. [ABSTRACT FROM AUTHOR]

The continued critiques of the PACE trial highlight how differing beliefs about the causes of chronic fatigue syndrome still influence how scientific studies in this area are accepted and evaluated. Causal beliefs about chronic fatigue syndrome and a modern version of Cartesian dualism are important in understanding the reaction to the PACE trial. The continued debate on the PACE trial seems to miss the fact that science is incremental. An unfortunate outcome of the PACE controversy and intimidation of researchers may be less research in the area. It is time to move on from criticism and collect more data on effective treatments. [ABSTRACT FROM AUTHOR]

The article discusses the importance of an efficient communication in relaying adverse drug reaction information to patients with chronic diseases. Topics discussed include the nocebo effect, the potential harm that incompetent information can bring to patients, information that might be too voluminous, with marked variations, and overlaps with commonly experienced symptoms. Suggestions to productively convey information are also presented.

Background: Patients' expectations, as a central mechanism behind placebo and nocebo effects, are an important predictor of health outcomes. Yet, theoretically based generic assessment tools allowing for an integrated understanding of expectations across conditions and treatments are lacking. Based on the preliminary 35-item version, this study reports the development and validation of the Treatment Expectation Questionnaire (TEX-Q), a generic, multidimensional self-report scale measuring patients' expectations of medical and psychological treatments. Methods: The TEX-Q was developed in a validation sample of n = 251 patients undergoing different treatments using exploratory factor analyses and item analyses, as well as analysis of convergent and divergent validity. Confirmatory factor analysis was conducted in an independent sample of n = 303 patients undergoing cancer treatment. Two-weeks test-retest reliability was assessed in n = 28 psychosomatic outpatients. Results: Factor analyses revealed six theoretically founded stable subscales. The TEX-Q assesses expectations of treatment benefit, positive impact, adverse events, negative impact, process and behavioural control with a total of 15 items. Results for the subscales and the sum score indicated good internal consistency (α =.71-.92), moderate to high test-retest reliability (r =.39-.76) as well as good convergent validity with regard to other expectation measures (r =.42-.58) and divergent validity with regard to measures of generalized expectations (r <.32) and psychopathology (r <.28). Conclusions: While further validation is needed, the results suggest that the TEX-Q is a valid and reliable scale for the generic, multidimensional assessment of patients' treatment expectations. The TEX-Q overcomes constraints of ad-hoc and disease-specific scales, while allowing to compare the impact of different expectation constructs across conditions and treatments. [ABSTRACT FROM AUTHOR]

Expectation of treatment side effects is consistently linked with those symptoms being realised. Patient expectations, including those generated by the informed consent process, can have a large influence on the side effects that patients feel after starting a new medical treatment. Such symptoms may be the result of the nocebo effect, whereby the expectation of side effects leads to them being experienced. Side effects may also be due to the misattribution of pre-existing or unrelated symptoms to the new medication. Medical professionals' own negative beliefs about a treatment, especially generic drugs, may further enhance patients' expectations of adverse effects. The news media may also influence expectations, particularly when media attention is directed towards a health or medication scare. This field of research has ethical and clinical implications for both medical professionals and the news media with respect to the level and type of information about treatment side effects that is provided to patients or members of the public. [ABSTRACT FROM AUTHOR]

Patient perceptions influence biosimilar uptake in non-mandatory transitions. Companions (support people) are often actively involved in the patient's medical journey and are likely to have unique perceptions of biosimilars, which may shape patient attitudes. This study explores the congruence between patient and companion perceptions towards biosimilars and their information needs. Patients taking bio-originators for rheumatic diseases (59% for rheumatoid arthritis) and their companions received an explanation about biosimilars. Participants (N = 78) completed questionnaires assessing their familiarity with biosimilars, perceptions, concerns, and benefits of being accompanied. Contingency tables and paired sample t-tests were used to explore differences in familiarity, confidence in knowledge, and perceptions. Intra-class correlation coefficients were calculated to assess the degree of congruence for perceptions towards biosimilars. Companions were significantly less familiar with biosimilars (p = 0.014, Cramer's V = 0.28) and reported lower confidence in their knowledge (p = 0.006, Cohen's d = 0.47) than patients. Companions and patients had moderate to good congruency for perceptions toward confidence in biosimilar use and safety, efficacy, and side-effect expectations (intra-class correlation coefficients ranging from 0.75 to 0.81). Companions and patients were most concerned about safety and effectiveness. Companions also reported concerns about cost savings driving the transition, while patients had concerns about uncertainty and testing. Patients reported the ability for discussion, improved understanding, and validation as benefits of being accompanied. Companions and patients have similar levels of perceptions and expectations towards biosimilars but report some unique information needs. Future educational interventions should involve companions and address their concerns to help improve biosimilar acceptance. [ABSTRACT FROM AUTHOR]

Objective. While effective preventative medication is readily available for asthma, adherence is a major problem due to patients' beliefs about their illness and medication. We investigated whether a text message programme targeted at changing patients' illness and medication beliefs would improve adherence in young adult asthma patients. Methods. Two hundred and sixteen patients aged between 16 and 45 on asthma preventer medication were recruited from pamphlets dispensed with medication and e-mails sent to members of a targeted marketing website. Participants were randomized to receive individually tailored text messages based on their illness and medication beliefs over 18 weeks or no text messages. Illness and medication beliefs were assessed at baseline and at 18 weeks. Adherence rates were assessed by phone calls to participants at 6, 12, and 18 weeks and at 6 and 9 months. Results. At 18 weeks, the intervention group had increased their perceived necessity of preventer medication, increased their belief in the long-term nature of their asthma, and their perceived control over their asthma relative to control group (all p's < .05). The intervention group also significantly improved adherence over the follow-up period compared to the control group with a relative average increase in adherence over the follow-up period of 10% ( p < .001). The percentage taking over 80% of prescribed inhaler doses was 23.9% in the control group compared to 37.7% in the intervention group ( p < .05). Conclusion. A targeted text message programme increases adherence to asthma preventer inhaler and may be useful for other illnesses where adherence is a major issue. [ABSTRACT FROM AUTHOR]

A patient constructs a cognitive representation of his or her illness that guides behavior aimed at managing that illness. Patients’ models of their illness share a common structure made up of beliefs about the cause of an illness, the symptoms that are part of the condition, the consequences of the illness for the patient’s life, how the illness is controlled or cured, and how long the illness will last. Illness perceptions can be measured using questionnaires and also assessed in patients’ drawings, which readily show how an illness is visualized. Illness perceptions change rapidly in response to diagnostic results and have been associated with emotional distress, recovery, and disability, as well as with treatment-related behavior such as adherence. Interventions based around changing inaccurate or unhelpful perceptions of illness are an important emerging area of health psychology. [ABSTRACT FROM PUBLISHER]

The article presents information on a research on how illness perception can be applied to the mental health. A self-regulation theory developed by researcher Howard Leventhal proposes that individuals form common-self beliefs concerning their illness in order to understand and cope with health threats. The five main components of patients' ideas about their illness include personal beliefs as well as causal beliefs about what caused their condition. The research has found psychosocial factors to be the most common cause depression whereas schizophrenia has been stated as the cause for organic disorders such as genetic problem or a brain disorder. Another important dimension of illness perception is the time course of the illness.

The musical group the Beatles had a profound impact on Western culture during their time together between 1960 and 1970. The three songwriters, John Lennon, Paul McCartney, and George Harrison, together and separately evolved in their lyrical styles over time. Using a new generation of computer text analyses, the Beatles' lyrics were analyzed to address how the group changed as a unit over time, how the various members changed in their writing styles, and the overlap in lyrical styles from one composer to the next. Overall, the Beatles' lyrics became darker, more psychologically distant, and less immediate over time. Paul McCartney's lyrical style proved to be more variable and broad ranging than either Lennon or Harrison. Using latent semantic analyses, Harrison's lyrics were more influenced by Lennon than by McCartney. Finally, the lyrics jointly written by Lennon and McCartney were mathematically more similar to Lennon's linguistic styles than McCartney's. [ABSTRACT FROM AUTHOR]

Objectives. Manipulations of the setting and instructions were tested for effects on language use and reported health following expressive writing (EW). Methods. Participants (N = 76) wrote in one of three conditions that differed by setting and the delivery of writing instructions. Results. The results showed that altering the context for EW influences participants' language use and their perceptions of the experience. There was no effect of conditions on self-reported health. Conclusions. Future research should attend to the ways in which manipulations of EW context affect proposed mediators such as language, as well as outcomes of EW. [ABSTRACT FROM AUTHOR]

Abstract: Objective: This study evaluates the Brief Illness Perception Questionnaire (Brief IPQ), a nine-item scale designed to rapidly assess the cognitive and emotional representations of illness. Methods: We assessed the test–retest reliability of the scale in 132 renal outpatients. We assessed concurrent validity by comparing the Brief IPQ with the Illness Perception Questionnaire–Revised (IPQ-R) and other relevant measures in 309 asthma, 132 renal, and 119 diabetes outpatients. Predictive validity was established by examining the relationship of Brief IPQ scores to outcomes in a sample of 103 myocardial infarction (MI) patients. Discriminant validity was examined by comparing scores on the Brief IPQ between five different illness groups. Results: The Brief IPQ showed good test–retest reliability and concurrent validity with relevant measures. The scale also demonstrated good predictive validity in patients recovering from MI with individual items being related to mental and physical functioning at 3 months'' follow-up, cardiac rehabilitation class attendance, and speed of return to work. The discriminant validity of the Brief IPQ was supported by its ability to distinguish between different illnesses. Conclusion: The Brief IPQ provides a rapid assessment of illness perceptions, which could be particularly helpful in ill populations, large-scale studies, and in repeated measures research designs. [Copyright &y& Elsevier]

Abstract: Objective: The objective of this review was to propose a typology for understanding the diversity of psychosocial reactions to environmental incidents. Methodology: The first section provides an introduction and background to the topic; we then attempt to provide a typology of psychosocial responses to environmental incidents. Results: Response to an environmental incident can be usefully considered in terms of the exposure, the response of the individual, the action of professionals, the response of the community, and the influence of the society in which the incident occurs. We reviewed each of these factors. Conclusions: By examining incidents in an ordered framework, we suggest that a more comprehensive understanding is possible. We also suggest some basic ways in which the psychosocial management of such difficult and diverse incidents could be improved. [Copyright &y& Elsevier]

Editorial. Comments on articles on psychological interventions in chronic illness in the March 2005 issue of the "Journal of Health Psychology." Examination of mechanisms of action and improved targeting; Effect of chronic illness on the lives of people affected; Therapeutic techniques used in psychological interventions in chronic illness; Targeting of individual behavior change; Value of expressive writing as a therapeutic tool.

We examined symptom experiences, symptom attributions, and causal attributions reported by patients hospitalized for a first-time myocardial infarction (MI). We also explored the roles of symptoms, negative affect, and risk factors in promoting stress and other causal attributions. Patients (N = 65) completed measures of symptom experiences and attributions, perceived causes of their MI, state and trait negative affect, and risk factors. Patients attributed most of their symptoms to the heart condition, although rates varied from 48% (headaches) to 97% (nausea). The most common causal attribution was stress, followed by high cholesterol, heredity, fat consumption, and hypertension. Stress attributions were positively associated with state anxiety and specific, stress-related symptoms (e.g., fatigue and breathlessness). Anxious mood and stress-related symptoms appear to enhance the plausibility of stress as a cause of MI. Risk factors were moderately correlated with associated causal attributions. For many patients, however, attributions to hypertension, cholesterol, and family history of heart disease were discordant with their clinical data. Causal attributions remained stable over the subsequent 6 months. [ABSTRACT FROM AUTHOR]

This study evaluated whether trait negative affectivity (NA) moderates the effects of an illness perceptions-based education programme on worry, disability and health behaviours following a first-time myocardial infarction (Ml). The intervention targeted problem-focused regulation with minimal attention to emotion-focused regulation. The hospitalized Ml patients (n = 65) completed measures of NA. heart attack worry and exercise, and they were randomized to a three-session intervention condition or standard care condition. Worry was assessed at hospital discharge, and disability, dietary fat intake and exercise were assessed 3 months and 6 months later. Cardiac rehabilitation attendance was recorded by the staff. Regression analyses revealed NA x condition interaction effects indicating that the intervention (relative to standard care) led to: (1) reduced worry only for patients with higher NA levels: (2) higher cardiac rehabilitation attendance and lower disability after three months, but only for patients with lower NA levels; and (3) lower exercise rates and higher dietary fat intake after six months for patients with higher NA levels. This intervention may benefit low NA patients, but it may have negligible or detrimental effects on disability and health behaviours for high NA patients. [ABSTRACT FROM AUTHOR]

Abstract: Objective: The aim of this study was to examine whether myocardial infarction (MI) patients'' drawings of their hearts predict subsequent return to work, exercise, distress about symptoms and perceptions of recovery at 3 months. Methods: Just prior to hospital discharge, 74 consecutive patients aged under 70 admitted with an acute MI drew pictures of their hearts. Patients'' recovery was assessed at 3 months by postal questionnaire. Results: Patients who drew damage on their heart while in the hospital perceived that their heart had recovered less at 3 months (P=.005), that their heart condition would last longer (P=.01) and had lower perceived control over their heart condition (P=.05) than did patients who drew no damage. The amount of damage drawn on the heart was also associated with a slower return to work (r=.37, P<.05). While patients'' peak troponin-T in the hospital was associated with the amount of damage drawn (r=.41, P<.001), it was not associated with the speed of return to work or other 3-month outcomes, apart from perceived duration of heart condition (r=.26, P<.05). Conclusion: Patients drawings of damage on their hearts after a MI predict recovery better than do medical indicators of damage. Drawings offer a simple starting point for doctors to assess patients'' ideas when discussing their heart condition and an opportunity to counter illness negative beliefs. [Copyright &y& Elsevier]

Investigates the association of trait negative affect and perceived sensitivity to medicines on symptoms reported following vaccination of patients. Vaccinations received by participants of the study; Percentage of reported symptoms following vaccination and of symptoms attributed to vaccination.

Objective. This study tested whether CFS patients have an attentional information processing bias for illness-related information and a tendency to interpret ambiguous information in a somatic fashion. Design. 25 patients meeting research criteria for a diagnosis of CFS were compared to 24 healthy matched controls on a modified Stroop task and an ambiguous cues task. Method. In the modified Stroop task, participants colour named a series of somatic, depressed and neutral words in order to ascertain whether the somatic words were more distracting to the CFS patients than the depressed and neutral words when compared to controls. In the ambiguous cues task, participants were presented with a tape-recorded list of 30 words including 15 ambiguous illness words (e.g., vein/vain) and 15 unambiguous words. For each word, they were asked to write down the first word that came into their head. A somatic bias score was obtained for each subject by summing the number of somatic responses to the ambiguous word cues. Results. Although CFS patients were significantly slower in colour naming all of the Stroop word categories than controls, there was no evidence for illness or depressed words creating greater interference than neutral words. However, on the ambiguous cues task, CFS patients made significantly more somatic interpretations than controls and this bias was significantly associated with the extent to which they currently reported symptoms. Conclusion. CFS patients have an interpretive bias for somatic information which may play a part in the maintenance of the disorder by heightening patients' experience of physical symptoms and helping to maintain their negative illness schemas. Although patients did not show an attentional... [ABSTRACT FROM AUTHOR]

The accuracy of healthy women's perceptions of how breast-cancer patients cope with treatment was assessed in this study. Standardized questionnaires measuring distress, coping, and illness perceptions were completed by 78 women undergoing postsurgical treatment for primary breast cancer. The patients' responses were then compared with assessments made by a matched community sample. The results showed a marked incongruity between healthy women's perceptions and actual patients' experiences of the disease and its treatment. Community women overestimated patients' distress, perceived the consequences of breast cancer to be more severe, and were more likely to believe that patients used denial and disengagement strategies. The discrepancy in findings has implications for the appropriateness of the support offered to patients by healthy women. [ABSTRACT FROM AUTHOR]

Objectives To gain a clearer conceptual understanding of medical students’ disease and its impact on students, by separating the process of thinking that one may have a particular illness under study from the emotional distress that may accompany these thoughts. Method In a questionnaire survey, the responses of 92 first-year and 85 third-year medical students were compared with those of 82 law students, with regard to medical students’ disease perception, medical students’ disease distress, hypochondriacal beliefs, concerns about health, the value placed on health, and recent visits to doctors in the past 12 months. Setting The University of Auckland, New Zealand. Results Both groups of medical students scored higher on medical students’ disease perception than law students. First-year students scored higher on medical students’ disease distress and hypochondriacal concerns than both law and third-year medical students. While medical students place a higher value on health, there were no differences with regard to health visits in the past year. Conclusions The results support the separation of medical students’ disease into perceptual and emotional components. This conceptualization of medical students’ disease as a normal process rather than a form of hypochondriasis may be used to brief medical students when they enter medical school, in order to reduce the distress associated with the condition. Medical students’ disease can also be used as a personally relevant example in teaching about how patients make sense of symptoms. [ABSTRACT FROM AUTHOR]

Individuals often suppress emotional thoughts, particularly thoughts that arouse negative emotions, as a way of regulating mood and reducing distress. However, recent work has highlighted the complexities and unexpected cognitive and physiological effects of thought suppression. In a study designed to examine the short-term immunological effects of thought suppression, participants wrote about either emotional or nonemotional topics with or without thought suppression. Blood was drawn before and after each experimental session on 3 consecutive days. Results showed a significant increase in circulating total lymphocytes and CD4 (helper) T lymphocyte levels in the emotional writing groups. Thought suppression resulted in a significant decrease in CD3 T lymphocyte levels. The implications of the results for the role of the expression and suppression of emotion in health are discussed. [ABSTRACT FROM AUTHOR]

Presents information on a study on the influence of patients' attitude to their myocardial infarction illness on return to work decisions. Category of illness perceptions; Importance of personal models of illness to recovery after myocardial infarction; Measurement of anxiety and psychological distress.

Investigates whether expressing emotions of traumatic experiences through writing about stressful or emotional topics would influence the immunological response to a hepatitis B vaccination program. Details of a study in this regard.

Evaluates the symptoms of fatigue among international pilots in New Zealand. Use of Vitality Scale in assessing the fatigue of pilots; List of cognitive behavior related with fatigue; Coping strategy for fatigue.

Objective To investigate whether providing information about normal findings before a diagnostic test improves patients' reassurance and reduces anxiety about symptoms. Design Randomised controlled trial. Setting Outpatient cardiology clinic. Participants 92 patients with chest pain referred for a diagnostic exercise stress test. Intervention Before undergoing testing patients were randomised to receive standard information (n=28; control group), a pamphlet explaining the function of the test and the meaning of normal test results (n=30; pamphlet group), or the pamphlet and a brief discussion about the meaning of normal test results (n=34; discussion group). Main outcome measures The primary outcome was patients' reported reassurance on a 5 item scale immediately after the test and at one month. Secondary outcomes were the proportion of patients still with chest pain and still taking cardiac drugs at one month. Results The mean levels of reassurance after testing and feedback from the doctor were significantly higher in the discussion group (42.0, 95% confidence interval 39.7 to 44.2) than in the pamphlet (39.2, 36.1 to 42.3) and control groups (35.8, 31.6 to 39.9). This difference was maintained at one month. The proportion of patients still reporting chest pain at one month decreased significantly in the discussion group (to 17%) and pamphlet group (to 28%) but not in the control group (to 36%). A trend was for fewer patients in the discussion group to be taking cardiac drugs at one month. Conclusion Providing patients with information about normal test results before testing can improve rates of reassurance and reduce the likelihood of future reports of chest pain. [ABSTRACT FROM AUTHOR]

The efficacy of the timely administration of thrombolytic treatment in the clinical management of acute myocardial infarction (MI) is well established. Large scale clinical trials have conclusively shown that the earlier the administration of such treatment, the greater the morbidity and mortality advantage. The failure of sociodemographic and clinical factors to be consistently related to pre-hospital delay has recently focused attention on how patients make sense of their symptoms and determine whether they need urgent medical help.

Presents a survey of medical students at the Auckland University School of Medicine in New Zealand on altruistic wishes and money oriented wishes in later years of medical course than students in earlier years. Breakdown of the students that participated in the research; What are the most popular categories; Rate of altruistic wishes; Differences in the wishes of men and women.

Background Side-effect concerns are a major barrier to vaccination against COVID-19 and other diseases. Identifying cost- and time-efficient interventions to improve vaccine experience and reduce vaccine hesitancy—without withholding information about side effects—is critical. Purpose Determine whether a brief symptom as positive signals mindset intervention can improve vaccine experience and reduce vaccine hesitancy after the COVID-19 vaccination. Methods English-speaking adults (18+) were recruited during the 15-min wait period after receiving their second dose of the Pfizer COVID-19 vaccination and were randomly allocated to the symptom as positive signals mindset condition or the treatment as usual control. Participants in the mindset intervention viewed a 3:43-min video explaining how the body responds to vaccinations and how common side effects such as fatigue, sore arm, and fever are signs that the vaccination is helping the body boost immunity. The control group received standard vaccination center information. Results Mindset participants (N = 260) versus controls (N = 268) reported significantly less worry about symptoms at day 3 [ t (506)=2.60, p =.01, d =0.23], fewer symptoms immediately following the vaccine [ t (484)=2.75, p =.006, d =0.24], and increased intentions to vaccinate against viruses like COVID-19 in the future [ t (514)=−2.57, p =.01, d =0.22]. No significant differences for side-effect frequency at day 3, coping, or impact. Conclusions This study supports the use of a brief video aimed at reframing symptoms as positive signals to reduce worry and increase future vaccine intentions. Clinical Trial information Australian New Zealand Clinical Trials Registry: ACTRN12621000722897p. [ABSTRACT FROM AUTHOR]

Objective: The use of health apps is increasing worldwide, with a common feature being daily symptom tracking. However, symptom tracking has been shown to increase symptom reporting. This study investigated whether using a menstrual-monitoring app with a symptom-tracking feature increases symptom reporting compared to an app without this feature or no app at all.Design: Experimental study.Methods: Ninety-one participants were randomly allocated to use either a menstrual-monitoring app with a symptom tracker or a simple calendar app, or to a no app control group. The number of period-related symptoms as well as general symptom reporting was assessed at baseline prior to group allocation and then 1 and 4 months later. The change in the proportion of people classified as high symptom reporters was also examined.Results: We found that the symptom-tracking app group reported significantly more period-related symptoms at 4 months than the calendar app group (mean difference = 1.16 symptoms, p = .010). At the 4-month time point, significantly more participants in the symptom-tracking group were now classified as high period symptom reporters (baseline 50%, 4 months 70%, p = .031), while the other two groups did not change from baseline. There were no differences in general symptom reporting across the three groups.Conclusion: A period-monitoring app with a symptom tracker may increase the reporting of period symptoms. This effect does not appear to generalize to broader symptom reporting. Further research is needed to support these findings and to examine the impact of symptom-tracking apps on daily functioning and health anxiety. Statement of contribution What is already known on this subject? The experience of transient symptoms is common in day-to-day life. These symptoms often do not have an underlying cause or are a sign of illness. Actively tracking symptoms has been shown to result in greater symptom reporting, symptom severity, and slower recovery from injury. The use of health apps is increasing, with a common feature being symptom tracking. Menstrual-monitoring apps, in particular, frequently require users to track symptoms. What does this study add? Using a menstrual-monitoring app with a symptom tracker for 4 months increases the number of period-specific symptoms reported compared a basic calendar app. A greater proportion of people were now classified as high period symptom reporters after using the symptom-tracking app. These effects do not seem to generalize to broader non-specific symptom reporting. [ABSTRACT FROM AUTHOR]

Objective: To explore how the addition of a medical illustration and its style affected information comprehension, perception of educational material and illness beliefs.Methods: 204 people recruited in a supermarket were randomised to read one of the four leaflets about gout and fill out a questionnaire. Three leaflets had a picture showing gout in the form of a cartoon, an anatomical drawing or a computed tomography scan (CT). The control leaflet did not contain images.Results: Seeing an illustrated leaflet helped correctly identify treatment for gout X2(1, N = 204) = 5.51, p=0.019. Out of the three images, only the cartoon was better than text in conveying information about treatment X2(1, n = 102) = 8.84, p=0.018. Participants perceived illustrated leaflets as more visually appealing t(70) = 3.09, p = 0.003, and the anatomical image was seen as more helpful for understanding of the illness than the cartoon. Pictures did not significantly influence lay illness perceptions about gout.Conclusion: Pictures aid the understanding of health information and increase the visual appeal of materials. While simpler illustrations convey information more effectively, people prefer more detailed anatomical images; CT scans offer no benefits over simpler images.Practice Implications: The results can help guide the use of images in gout education material. [ABSTRACT FROM AUTHOR]