Previous meta-analyses investigating attentional biases towards pain have used reaction time meas... more Previous meta-analyses investigating attentional biases towards pain have used reaction time measures. Eye-tracking methods have been adopted to more directly and reliably assess biases, but this literature has not been synthesized in relation to pain. This meta-analysis aimed to investigate the nature and time course of attentional biases to pain-related stimuli in participants of all ages with and without chronic pain using eye-tracking studies and determine the role of task parameters and theoretically relevant moderators. After screening, 24 studies were included with a total sample of 1425 participants. Between-group analyses revealed no significant overall group differences for people with and without chronic pain on biases to pain-related stimuli. Results indicated significant attentional biases towards pain-related words or pictures across both groups on probability of first fixation (k = 21, g = 0.43, 95% confidence interval [CI] 0.15-0.71, P = 0.002), how long participants...
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Jan 2, 2017
Purpose Fear of cancer recurrence (FCR) is prevalent, distressing, and long lasting. This study e... more Purpose Fear of cancer recurrence (FCR) is prevalent, distressing, and long lasting. This study evaluated the impact of a theoretically/empirically based intervention (ConquerFear) on FCR. Methods Eligible survivors had curable breast or colorectal cancer or melanoma, had completed treatment (not including endocrine therapy) 2 months to 5 years previously, were age > 18 years, and had scores above the clinical cutoff on the FCR Inventory (FCRI) severity subscale at screening. Participants were randomly assigned at a one-to-one ratio to either five face-to-face sessions of ConquerFear (attention training, metacognitions, acceptance/mindfulness, screening behavior, and values-based goal setting) or an attention control (Taking-it-Easy relaxation therapy). Participants completed questionnaires at baseline (T0), immediately post-therapy (T1), and 3 (T2) and 6 months (T3) later. The primary outcome was FCRI total score. Results Of 704 potentially eligible survivors from 17 sites and t...
This study aimed to investigate the efficacy of an attention training technique (ATT) on pain rat... more This study aimed to investigate the efficacy of an attention training technique (ATT) on pain ratings, threshold and tolerance during the cold pressor task. One hundred and three undergraduate students were randomly assigned to receive either threat-alleviating or threat-inducing information about the task. Participants were then re-randomized to receive either ATT or progressive muscle relaxation (PMR). Hence, the present study had a 2 (threat expectancy: high vs. low) Â 2 (training: ATT vs. PMR) design. Analyses confirmed that the threat manipulation was effective in increasing the harm associated with the task. ATT resulted in a relative reduction in hypervigilance to sensory pain words compared to PMR. ATT was also associated with a lower degree of focus on internal sensations, but not mindfulness or difficulty disengaging from pain words. Results showed that, relative to relaxation training, those receiving ATT reported pain less quickly than those receiving relaxation, although there were no differences between the training groups for tolerance or pain ratings. These results show that ATT changes the cognitive processes of internal/external focus and hypervigilance towards sensory pain words, but not difficulty disengaging or mindfulness. Although ATT changed threshold, the fact that neither pain ratings nor tolerance was affected suggests that a single, brief session of ATT may not be sufficient to affect broader change. Nonetheless, this study shows that ATT can change cognitive processes thought to be associated with heightened perception of pain and that this changes how quickly pain is registered and is therefore worthy of further investigation.
IntroductionResearch indicates that body image disturbance is associated with poorer psychosocial... more IntroductionResearch indicates that body image disturbance is associated with poorer psychosocial outcomes for individuals with physical health conditions, with poorest body image reported for individuals with visible bodily changes. Using White’s (2000) theoretical model of body image the present paper aimed to examine the nature of these relationships in two distinct groups: individuals with an amputation and individuals with diabetes. It was hypothesized that body image disturbance would be associated with psychosocial outcomes and would mediate the relationships between self-ideal discrepancy and personal investment in psychosocial outcomes.MethodsIndividuals with diabetes (N = 212) and individuals with an amputation (N = 227) provided details regarding their medical condition, and completed measures assessing body image, investment, self-ideal discrepancy, depression, anxiety, and quality of life. Structural equation and invariance modeling were used to test the model paths and...
Although it is well known that anxious adults show selective attention to threatening stimuli, re... more Although it is well known that anxious adults show selective attention to threatening stimuli, research investigating attentional bias in children with anxiety has produced mixed results. The purpose of this paper is to provide a comprehensive analysis of studies investigating attentional bias in children with anxiety. Using a systematic search for articles which included both children with anxiety and reported data suitable for a meta-analysis, 38 articles were identified involving 4221 subjects (anxiety n=2222). We used a random effects metaanalysis with standardized mean difference as our primary outcome to estimate between-and within-group effects of attentional bias towards threat-related information in children with anxiety. Overall, children with anxiety showed a significantly greater bias to threat-related stimuli, compared to controls (d = 0.21). Children with anxiety also showed a significant bias to threat-related stimuli, over neutral stimuli (d = 0.54), which was greater than the bias shown by control children (d = 0.15). Specific variables in attentional bias were also explored, with varying results. The review concluded that anxious children do show a similar bias towards threatening stimuli as has been documented in adults, albeit to a lesser degree and this bias is moderated by age, such that the difference between anxious and control children increases with age. Given the small number of studies in some areas, future research is needed to understand the precise conditions under which anxious children exhibit selective attentional biases to threat-related stimuli.
To provide a review of the literature comparing anxious and depressive symptoms in caregivers of... more To provide a review of the literature comparing anxious and depressive symptoms in caregivers of children with asthma with caregivers of healthy children. METHOD: A systematic search identified 25 studies from 17 articles, reporting outcomes on 4,300 caregivers of children with asthma and 25,064 caregivers of healthy children. RESULTS: Overall, anxious (d = 0.50) and depressive symptoms (d = 0.44) were higher in caregivers of children with asthma compared with caregivers of healthy children. Age, site of recruitment, and whether the asthma diagnosis was medically confirmed were included as potential moderators. The relationship between parental psychopathology and asthma was stronger in those with medically confirmed asthma and participants recruited from clinical settings. Other moderators were not significant. CONCLUSIONS: Caregivers of children with asthma appear to have greater anxious and depressive symptoms than caregivers of healthy children, but the reasons are unclea...
European journal of pain (London, England), Jan 18, 2014
The aim of this study was to investigate the impact of chronic pain on interpretation bias for am... more The aim of this study was to investigate the impact of chronic pain on interpretation bias for ambiguous faces, using a recently developed paradigm with ecologically valid stimuli. Fifty patients with chronic pain and 25 healthy controls were trained to respond to probes following the presentation of happy or painful faces, using an incidental learning task. During a test phase, ambiguous faces were presented. The degree to which participants were faster to respond to probes presented where painful (rather than happy) faces had previously been presented was taken as an indication of the interpretation bias towards painful faces. All participants had learnt the originally presented contingency. As predicted, chronic pain patients showed a greater bias towards interpreting ambiguous faces as painful than control participants. Further, there were correlations between fear of pain and catastrophizing and interpretation bias, indicating that participants with higher fear of pain and high...
Randomised controlled trial. A total of 189 adults with biopsy-confirmed coeliac disease were rec... more Randomised controlled trial. A total of 189 adults with biopsy-confirmed coeliac disease were recruited and randomised to receive the intervention (n = 101) or to a waitlist control condition (n = 88). Post-intervention data was available for 50 intervention and 64 waitlist participants. Three month follow-up data was obtained for 46/50 participants from the intervention group. The primary outcome measure was gluten free diet adherence. Secondary outcomes were gluten free diet knowledge, quality of life, and psychological symptoms. Results: Results were based on intention-to-treat analyses. The intervention group evidenced significantly improved gluten free diet adherence, and gluten free diet knowledge following the treatment period relative to the waitlist control group. The change in knowledge did not contribute to the change in adherence. These improvements were maintained at three-month follow-up. Conclusion: The online program was effective in improving adherence and represents a promising resource for individuals with coeliac disease who are struggling to achieve or maintain adequate gluten free diet adherence.
Objective. The primary aim of this study was to extend previous research on food-related attentio... more Objective. The primary aim of this study was to extend previous research on food-related attentional biases by examining biases toward pictorial vs. word stimuli, and foods of high vs. low calorific value. It was expected that participants would demonstrate greater biases to pictures over words, and to high-calorie over low-calorie foods. A secondary aim was to examine associations between BMI, dietary restraint, external eating and attentional biases. It was expected that high scores on these individual difference variables would be associated with a bias toward high-calorie stimuli. Methods. Undergraduates (N = 99) completed a dot probe task including matched word and pictorial food stimuli in a controlled setting. Questionnaires assessing eating behaviour were administered, and height and weight were measured. Results. Contrary to predictions, there were no main effects for stimuli type (pictures vs. words) or calorific value (high vs. low). There was, however, a significant interaction effect suggesting a bias toward high-calorie pictures, but away from high-calorie words; and a bias toward low-calorie words, but away from low-calorie pictures. No associations between attentional bias and any of the individual difference variables were found. Discussion. The presence of a stimulus type by calorific value interaction demonstrates the importance of stimuli type in the dot probe task, and may help to explain inconsistencies in prior research. Further research is needed to clarify associations between attentional bias and BMI, restraint, and external eating.
About ScienceDirect Remote access Shopping cart Contact and support T erms and conditions Privacy... more About ScienceDirect Remote access Shopping cart Contact and support T erms and conditions Privacy policy Cookies are used by this site. For more information, visit the cookies page.
Research documents high levels of psychopathology among homeless youth. Most research, however, h... more Research documents high levels of psychopathology among homeless youth. Most research, however, has not distinguished between disorders that are present prior to homelessness and those that develop following homelessness. Hence whether psychological disorders are the cause or consequence of homelessness has not been established. The aim of this study is to investigate causal pathways to homelessness amongst currently homeless youth in Australia. The study uses a quasi-qualitative methodology to generate hypotheses for larger-scale research. High rates of psychological disorders were confirmed in the sample 35 homeless youth aged 14-25. The rates of psychological disorders at the point of homelessness were greater than in normative samples, but the rates of clinical disorder increased further once homeless. Further in-depth analyses were conducted to identify the temporal sequence for each individual with a view to establishing a set of causal pathways to homelessness and trajectories following homelessness that characterised the people in the sample. Five pathways to homelessness and five trajectories following homelessness were identified that accounted for the entire sample. Each pathway constituted a series of interactions between different factors similar to that described by Craig and Hodson (1998. Psychological Medicine, 28, 1379-1388) as ''complex subsidiary pathways''. The major findings were that (1) trauma is a common experience amongst homeless youth prior to homelessness and figured in the causal pathways to homelessness for over half of the sample; (2) once homeless, for the majority of youth there is an increase in the number of psychological diagnoses including drug and alcohol diagnoses; and (3) crime did not precede homelessness for all but one youth; however, following homelessness, involvement in criminal activity was common and became a distinguishing factor amongst youth. The implications of these findings for future research and service development are discussed.
Background: In randomised controlled trials, an increasingly used test of the ‘blindness’ of asse... more Background: In randomised controlled trials, an increasingly used test of the ‘blindness’ of assessors is to have them guess the group to which each participant has been allocated. Because assessors are usually aware of the trial hypotheses, we predicted that trial participants who showed the greatest improvement would be assumed by an assessor to have been in the ‘preferred intervention’ group. Methods: Data were derived from a trial in recent-onset rheumatoid arthritis comparing cognitive behavioural therapy plus routine care with routine care alone. Results: Although in this trial assessor blindness was demonstrated, patients ‘guessed’ by the assessor to be in the cognitive therapy group showed significantly greater improvements than those predicted to have received routine care alone in variables predicted to change in the study protocol. Conclusions: These results indicate that even if an assessor’s guesses about patient group allocations are more accurate than expected by chan...
Purpose: Many women who have had adjuvant chemotherapy for early breast cancer judge small benefi... more Purpose: Many women who have had adjuvant chemotherapy for early breast cancer judge small benefits sufficient to make it worthwhile despite significant side effects and inconvenience. The rationality of these preferences has been questioned. We sought to better understand such preferences by assessing associations between preferences and psychosocial factors, and by asking women who judged negligible benefits sufficient to explain why. Methods: We recruited 83 consecutive consenting women who had completed adjuvant chemotherapy for early breast cancer 3-34 months earlier. Preferences were elicited during a structured, scripted interview using four sets of validated, hypothetical trade-off scenarios about the possible benefits of adjuvant chemotherapy on survival times (5 and 15 years) and rates (65 and 85% at 5 years). Women completed questionnaires measuring anxiety, depression, optimism, quality and quantity of social support, and illness perceptions. Results: More than half the women judged benefits of 1 day or 0.1% sufficient to make adjuvant chemotherapy worthwhile. The most important factors in multivariable models were whether the woman had dependants and number of non-specific symptoms attributed to breast cancer and adjuvant chemotherapy since completing treatment. The proportion of variance explained was modest. Preferences were not associated with: scores for anxiety, optimism, and perceived quality and quantity of social support. Explanations for judging negligible benefits sufficient included minimising regret, parenting concerns, doubts about the information provided and feeling that they had no choice. Conclusions: Preferences were highly variable and influenced by women's unique circumstances and attitudes, but not by their anxiety or optimism scores.
This prospective study of acute and sub-acute low back pain (LBP) patients was conducted to asses... more This prospective study of acute and sub-acute low back pain (LBP) patients was conducted to assess whether attentional biases predicted chronic pain status 3 and 6 months later. The attentional biases of 100 LBP patients were assessed within 3 months of developing pain and 6 months later. Participants also completed measures associated with outcome at 3 assessment points: baseline, 3 and 6 months later. Current pain status was assessed at follow-ups. Patients were classified as those that met standard criteria for chronic pain or those who did not (i.e., the comparison group). At baseline, participants demonstrated a bias toward sensory pain words. However, biases toward sensory pain words did not differentiate those who subsequently developed chronic pain and those who did not at either follow-up. The same bias was observed 6 months later, but again it failed to distinguish between the chronic pain and comparison groups. However, subjects who developed chronic pain at both 3 (n = 22) and 6 (n = 21) months demonstrated biases away from affective pain words at baseline but not 6 months later, in comparison to other participants. These results remained significant in multivariate analyses. These findings are consistent with patterns observed in the previous research, and suggest that avoidance of emotionally laden pain-related stimuli (i.e., affective pain words) is associated with negative outcomes for LBP patients in the acute and sub-acute phase. This research suggests that attentional biases in relation to pain-related stimuli are important for the development of chronic pain, but are more complex than initially thought.
The aim of this study was to compare the efficacy of the Neurological Depressive Disorders Invent... more The aim of this study was to compare the efficacy of the Neurological Depressive Disorders Inventory for Epilepsy (NDDI-E) and the depression component of the Hospital Anxiety Depression Scale (HADS-D) for identifying depression and suicide risk in adults with epilepsy. A total of 147 (87 female [59% ]) outpatients attending a tertiary epilepsy center in Sydney Australia completed the NDDI-E and HADS-D. They then completed the depression and suicide sections of the Mini International Neuropsychiatric Inventory (MINI) with a clinician blind to symptom measure scores. Receiver operator characteristic analysis was performed for the clinical cutoff scores for depression on the NDDI-E ≥ 15 and HADS-D ≥ 8 to identify MINI-determined depression and suicidality. The NDDI-E indicated strong sensitivity (84%) and acceptable specificity (78%), whereas the HADS-D had poor sensitivity (42%) but good specificity (97%) for identifying depression. For identifying suicide risk, the NDDI-E indicated strong sensitivity (81%) and reasonable specificity (66%), whereas the HADS-D had poor sensitivity (43%) but acceptable specificity (90%). Area under the curve comparisons for these measures were not significant. In clinical practice, it is essential that screening measures have the highest possible sensitivity values to limit the chances of false-negative results. In accordance with these guidelines, the NDDI-E was a superior screening measure compared with the HADS-D. Our results demonstrate the efficacy of the NDDI-E for identifying both major and minor depression and serious suicide risk. The poor sensitivity of the HADS-D suggests that it should not be used as a screen for depression or suicidality in adults with epilepsy.
Objective: Despite evidence indicating a heightened incidence of psychological symptoms in coelia... more Objective: Despite evidence indicating a heightened incidence of psychological symptoms in coeliac disease (CD), the direct link between psychological factors and quality of life (QOL) has received little attention. The purpose of this paper was to compare the relative impacts of psychological symptoms and coping to the known negative impacts of gastrointestinal symptoms and adherence to the gluten free diet (GFD) on QOL. Methods: In study 1 (N = 390), participants completed measures of QOL, psychological symptoms, coping, several indices of symptom severity, and adherence. Correlations and regression analyses were used to determine the relationships between QOL and the measured variables. Study 2 (N = 189) replicated the findings using a validated measure of current gastrointestinal symptom severity and more a comprehensive measure of coping. Results: Across both studies, poorer QOL was correlated with a higher incidence of psychological and gastrointestinal symptoms, greater reliance on maladaptive coping strategies, and poorer GFD adherence. The relationship between psychological symptoms (particularly depression) and QOL persisted when controlling for past (study 1) and current (study 2) gastrointestinal symptom severity. Psychological symptoms and GFD adherence were more strongly related to reduced QOL than gastrointestinal symptoms. Conclusion: The negative impact of psychological symptoms on QOL and adherence suggests that management in CD should include the provision of psychological coping skills, as well as purely dietetic-based strategies to minimise gastrointestinal symptoms.
Previous meta-analyses investigating attentional biases towards pain have used reaction time meas... more Previous meta-analyses investigating attentional biases towards pain have used reaction time measures. Eye-tracking methods have been adopted to more directly and reliably assess biases, but this literature has not been synthesized in relation to pain. This meta-analysis aimed to investigate the nature and time course of attentional biases to pain-related stimuli in participants of all ages with and without chronic pain using eye-tracking studies and determine the role of task parameters and theoretically relevant moderators. After screening, 24 studies were included with a total sample of 1425 participants. Between-group analyses revealed no significant overall group differences for people with and without chronic pain on biases to pain-related stimuli. Results indicated significant attentional biases towards pain-related words or pictures across both groups on probability of first fixation (k = 21, g = 0.43, 95% confidence interval [CI] 0.15-0.71, P = 0.002), how long participants...
Journal of clinical oncology : official journal of the American Society of Clinical Oncology, Jan 2, 2017
Purpose Fear of cancer recurrence (FCR) is prevalent, distressing, and long lasting. This study e... more Purpose Fear of cancer recurrence (FCR) is prevalent, distressing, and long lasting. This study evaluated the impact of a theoretically/empirically based intervention (ConquerFear) on FCR. Methods Eligible survivors had curable breast or colorectal cancer or melanoma, had completed treatment (not including endocrine therapy) 2 months to 5 years previously, were age > 18 years, and had scores above the clinical cutoff on the FCR Inventory (FCRI) severity subscale at screening. Participants were randomly assigned at a one-to-one ratio to either five face-to-face sessions of ConquerFear (attention training, metacognitions, acceptance/mindfulness, screening behavior, and values-based goal setting) or an attention control (Taking-it-Easy relaxation therapy). Participants completed questionnaires at baseline (T0), immediately post-therapy (T1), and 3 (T2) and 6 months (T3) later. The primary outcome was FCRI total score. Results Of 704 potentially eligible survivors from 17 sites and t...
This study aimed to investigate the efficacy of an attention training technique (ATT) on pain rat... more This study aimed to investigate the efficacy of an attention training technique (ATT) on pain ratings, threshold and tolerance during the cold pressor task. One hundred and three undergraduate students were randomly assigned to receive either threat-alleviating or threat-inducing information about the task. Participants were then re-randomized to receive either ATT or progressive muscle relaxation (PMR). Hence, the present study had a 2 (threat expectancy: high vs. low) Â 2 (training: ATT vs. PMR) design. Analyses confirmed that the threat manipulation was effective in increasing the harm associated with the task. ATT resulted in a relative reduction in hypervigilance to sensory pain words compared to PMR. ATT was also associated with a lower degree of focus on internal sensations, but not mindfulness or difficulty disengaging from pain words. Results showed that, relative to relaxation training, those receiving ATT reported pain less quickly than those receiving relaxation, although there were no differences between the training groups for tolerance or pain ratings. These results show that ATT changes the cognitive processes of internal/external focus and hypervigilance towards sensory pain words, but not difficulty disengaging or mindfulness. Although ATT changed threshold, the fact that neither pain ratings nor tolerance was affected suggests that a single, brief session of ATT may not be sufficient to affect broader change. Nonetheless, this study shows that ATT can change cognitive processes thought to be associated with heightened perception of pain and that this changes how quickly pain is registered and is therefore worthy of further investigation.
IntroductionResearch indicates that body image disturbance is associated with poorer psychosocial... more IntroductionResearch indicates that body image disturbance is associated with poorer psychosocial outcomes for individuals with physical health conditions, with poorest body image reported for individuals with visible bodily changes. Using White’s (2000) theoretical model of body image the present paper aimed to examine the nature of these relationships in two distinct groups: individuals with an amputation and individuals with diabetes. It was hypothesized that body image disturbance would be associated with psychosocial outcomes and would mediate the relationships between self-ideal discrepancy and personal investment in psychosocial outcomes.MethodsIndividuals with diabetes (N = 212) and individuals with an amputation (N = 227) provided details regarding their medical condition, and completed measures assessing body image, investment, self-ideal discrepancy, depression, anxiety, and quality of life. Structural equation and invariance modeling were used to test the model paths and...
Although it is well known that anxious adults show selective attention to threatening stimuli, re... more Although it is well known that anxious adults show selective attention to threatening stimuli, research investigating attentional bias in children with anxiety has produced mixed results. The purpose of this paper is to provide a comprehensive analysis of studies investigating attentional bias in children with anxiety. Using a systematic search for articles which included both children with anxiety and reported data suitable for a meta-analysis, 38 articles were identified involving 4221 subjects (anxiety n=2222). We used a random effects metaanalysis with standardized mean difference as our primary outcome to estimate between-and within-group effects of attentional bias towards threat-related information in children with anxiety. Overall, children with anxiety showed a significantly greater bias to threat-related stimuli, compared to controls (d = 0.21). Children with anxiety also showed a significant bias to threat-related stimuli, over neutral stimuli (d = 0.54), which was greater than the bias shown by control children (d = 0.15). Specific variables in attentional bias were also explored, with varying results. The review concluded that anxious children do show a similar bias towards threatening stimuli as has been documented in adults, albeit to a lesser degree and this bias is moderated by age, such that the difference between anxious and control children increases with age. Given the small number of studies in some areas, future research is needed to understand the precise conditions under which anxious children exhibit selective attentional biases to threat-related stimuli.
To provide a review of the literature comparing anxious and depressive symptoms in caregivers of... more To provide a review of the literature comparing anxious and depressive symptoms in caregivers of children with asthma with caregivers of healthy children. METHOD: A systematic search identified 25 studies from 17 articles, reporting outcomes on 4,300 caregivers of children with asthma and 25,064 caregivers of healthy children. RESULTS: Overall, anxious (d = 0.50) and depressive symptoms (d = 0.44) were higher in caregivers of children with asthma compared with caregivers of healthy children. Age, site of recruitment, and whether the asthma diagnosis was medically confirmed were included as potential moderators. The relationship between parental psychopathology and asthma was stronger in those with medically confirmed asthma and participants recruited from clinical settings. Other moderators were not significant. CONCLUSIONS: Caregivers of children with asthma appear to have greater anxious and depressive symptoms than caregivers of healthy children, but the reasons are unclea...
European journal of pain (London, England), Jan 18, 2014
The aim of this study was to investigate the impact of chronic pain on interpretation bias for am... more The aim of this study was to investigate the impact of chronic pain on interpretation bias for ambiguous faces, using a recently developed paradigm with ecologically valid stimuli. Fifty patients with chronic pain and 25 healthy controls were trained to respond to probes following the presentation of happy or painful faces, using an incidental learning task. During a test phase, ambiguous faces were presented. The degree to which participants were faster to respond to probes presented where painful (rather than happy) faces had previously been presented was taken as an indication of the interpretation bias towards painful faces. All participants had learnt the originally presented contingency. As predicted, chronic pain patients showed a greater bias towards interpreting ambiguous faces as painful than control participants. Further, there were correlations between fear of pain and catastrophizing and interpretation bias, indicating that participants with higher fear of pain and high...
Randomised controlled trial. A total of 189 adults with biopsy-confirmed coeliac disease were rec... more Randomised controlled trial. A total of 189 adults with biopsy-confirmed coeliac disease were recruited and randomised to receive the intervention (n = 101) or to a waitlist control condition (n = 88). Post-intervention data was available for 50 intervention and 64 waitlist participants. Three month follow-up data was obtained for 46/50 participants from the intervention group. The primary outcome measure was gluten free diet adherence. Secondary outcomes were gluten free diet knowledge, quality of life, and psychological symptoms. Results: Results were based on intention-to-treat analyses. The intervention group evidenced significantly improved gluten free diet adherence, and gluten free diet knowledge following the treatment period relative to the waitlist control group. The change in knowledge did not contribute to the change in adherence. These improvements were maintained at three-month follow-up. Conclusion: The online program was effective in improving adherence and represents a promising resource for individuals with coeliac disease who are struggling to achieve or maintain adequate gluten free diet adherence.
Objective. The primary aim of this study was to extend previous research on food-related attentio... more Objective. The primary aim of this study was to extend previous research on food-related attentional biases by examining biases toward pictorial vs. word stimuli, and foods of high vs. low calorific value. It was expected that participants would demonstrate greater biases to pictures over words, and to high-calorie over low-calorie foods. A secondary aim was to examine associations between BMI, dietary restraint, external eating and attentional biases. It was expected that high scores on these individual difference variables would be associated with a bias toward high-calorie stimuli. Methods. Undergraduates (N = 99) completed a dot probe task including matched word and pictorial food stimuli in a controlled setting. Questionnaires assessing eating behaviour were administered, and height and weight were measured. Results. Contrary to predictions, there were no main effects for stimuli type (pictures vs. words) or calorific value (high vs. low). There was, however, a significant interaction effect suggesting a bias toward high-calorie pictures, but away from high-calorie words; and a bias toward low-calorie words, but away from low-calorie pictures. No associations between attentional bias and any of the individual difference variables were found. Discussion. The presence of a stimulus type by calorific value interaction demonstrates the importance of stimuli type in the dot probe task, and may help to explain inconsistencies in prior research. Further research is needed to clarify associations between attentional bias and BMI, restraint, and external eating.
About ScienceDirect Remote access Shopping cart Contact and support T erms and conditions Privacy... more About ScienceDirect Remote access Shopping cart Contact and support T erms and conditions Privacy policy Cookies are used by this site. For more information, visit the cookies page.
Research documents high levels of psychopathology among homeless youth. Most research, however, h... more Research documents high levels of psychopathology among homeless youth. Most research, however, has not distinguished between disorders that are present prior to homelessness and those that develop following homelessness. Hence whether psychological disorders are the cause or consequence of homelessness has not been established. The aim of this study is to investigate causal pathways to homelessness amongst currently homeless youth in Australia. The study uses a quasi-qualitative methodology to generate hypotheses for larger-scale research. High rates of psychological disorders were confirmed in the sample 35 homeless youth aged 14-25. The rates of psychological disorders at the point of homelessness were greater than in normative samples, but the rates of clinical disorder increased further once homeless. Further in-depth analyses were conducted to identify the temporal sequence for each individual with a view to establishing a set of causal pathways to homelessness and trajectories following homelessness that characterised the people in the sample. Five pathways to homelessness and five trajectories following homelessness were identified that accounted for the entire sample. Each pathway constituted a series of interactions between different factors similar to that described by Craig and Hodson (1998. Psychological Medicine, 28, 1379-1388) as ''complex subsidiary pathways''. The major findings were that (1) trauma is a common experience amongst homeless youth prior to homelessness and figured in the causal pathways to homelessness for over half of the sample; (2) once homeless, for the majority of youth there is an increase in the number of psychological diagnoses including drug and alcohol diagnoses; and (3) crime did not precede homelessness for all but one youth; however, following homelessness, involvement in criminal activity was common and became a distinguishing factor amongst youth. The implications of these findings for future research and service development are discussed.
Background: In randomised controlled trials, an increasingly used test of the ‘blindness’ of asse... more Background: In randomised controlled trials, an increasingly used test of the ‘blindness’ of assessors is to have them guess the group to which each participant has been allocated. Because assessors are usually aware of the trial hypotheses, we predicted that trial participants who showed the greatest improvement would be assumed by an assessor to have been in the ‘preferred intervention’ group. Methods: Data were derived from a trial in recent-onset rheumatoid arthritis comparing cognitive behavioural therapy plus routine care with routine care alone. Results: Although in this trial assessor blindness was demonstrated, patients ‘guessed’ by the assessor to be in the cognitive therapy group showed significantly greater improvements than those predicted to have received routine care alone in variables predicted to change in the study protocol. Conclusions: These results indicate that even if an assessor’s guesses about patient group allocations are more accurate than expected by chan...
Purpose: Many women who have had adjuvant chemotherapy for early breast cancer judge small benefi... more Purpose: Many women who have had adjuvant chemotherapy for early breast cancer judge small benefits sufficient to make it worthwhile despite significant side effects and inconvenience. The rationality of these preferences has been questioned. We sought to better understand such preferences by assessing associations between preferences and psychosocial factors, and by asking women who judged negligible benefits sufficient to explain why. Methods: We recruited 83 consecutive consenting women who had completed adjuvant chemotherapy for early breast cancer 3-34 months earlier. Preferences were elicited during a structured, scripted interview using four sets of validated, hypothetical trade-off scenarios about the possible benefits of adjuvant chemotherapy on survival times (5 and 15 years) and rates (65 and 85% at 5 years). Women completed questionnaires measuring anxiety, depression, optimism, quality and quantity of social support, and illness perceptions. Results: More than half the women judged benefits of 1 day or 0.1% sufficient to make adjuvant chemotherapy worthwhile. The most important factors in multivariable models were whether the woman had dependants and number of non-specific symptoms attributed to breast cancer and adjuvant chemotherapy since completing treatment. The proportion of variance explained was modest. Preferences were not associated with: scores for anxiety, optimism, and perceived quality and quantity of social support. Explanations for judging negligible benefits sufficient included minimising regret, parenting concerns, doubts about the information provided and feeling that they had no choice. Conclusions: Preferences were highly variable and influenced by women's unique circumstances and attitudes, but not by their anxiety or optimism scores.
This prospective study of acute and sub-acute low back pain (LBP) patients was conducted to asses... more This prospective study of acute and sub-acute low back pain (LBP) patients was conducted to assess whether attentional biases predicted chronic pain status 3 and 6 months later. The attentional biases of 100 LBP patients were assessed within 3 months of developing pain and 6 months later. Participants also completed measures associated with outcome at 3 assessment points: baseline, 3 and 6 months later. Current pain status was assessed at follow-ups. Patients were classified as those that met standard criteria for chronic pain or those who did not (i.e., the comparison group). At baseline, participants demonstrated a bias toward sensory pain words. However, biases toward sensory pain words did not differentiate those who subsequently developed chronic pain and those who did not at either follow-up. The same bias was observed 6 months later, but again it failed to distinguish between the chronic pain and comparison groups. However, subjects who developed chronic pain at both 3 (n = 22) and 6 (n = 21) months demonstrated biases away from affective pain words at baseline but not 6 months later, in comparison to other participants. These results remained significant in multivariate analyses. These findings are consistent with patterns observed in the previous research, and suggest that avoidance of emotionally laden pain-related stimuli (i.e., affective pain words) is associated with negative outcomes for LBP patients in the acute and sub-acute phase. This research suggests that attentional biases in relation to pain-related stimuli are important for the development of chronic pain, but are more complex than initially thought.
The aim of this study was to compare the efficacy of the Neurological Depressive Disorders Invent... more The aim of this study was to compare the efficacy of the Neurological Depressive Disorders Inventory for Epilepsy (NDDI-E) and the depression component of the Hospital Anxiety Depression Scale (HADS-D) for identifying depression and suicide risk in adults with epilepsy. A total of 147 (87 female [59% ]) outpatients attending a tertiary epilepsy center in Sydney Australia completed the NDDI-E and HADS-D. They then completed the depression and suicide sections of the Mini International Neuropsychiatric Inventory (MINI) with a clinician blind to symptom measure scores. Receiver operator characteristic analysis was performed for the clinical cutoff scores for depression on the NDDI-E ≥ 15 and HADS-D ≥ 8 to identify MINI-determined depression and suicidality. The NDDI-E indicated strong sensitivity (84%) and acceptable specificity (78%), whereas the HADS-D had poor sensitivity (42%) but good specificity (97%) for identifying depression. For identifying suicide risk, the NDDI-E indicated strong sensitivity (81%) and reasonable specificity (66%), whereas the HADS-D had poor sensitivity (43%) but acceptable specificity (90%). Area under the curve comparisons for these measures were not significant. In clinical practice, it is essential that screening measures have the highest possible sensitivity values to limit the chances of false-negative results. In accordance with these guidelines, the NDDI-E was a superior screening measure compared with the HADS-D. Our results demonstrate the efficacy of the NDDI-E for identifying both major and minor depression and serious suicide risk. The poor sensitivity of the HADS-D suggests that it should not be used as a screen for depression or suicidality in adults with epilepsy.
Objective: Despite evidence indicating a heightened incidence of psychological symptoms in coelia... more Objective: Despite evidence indicating a heightened incidence of psychological symptoms in coeliac disease (CD), the direct link between psychological factors and quality of life (QOL) has received little attention. The purpose of this paper was to compare the relative impacts of psychological symptoms and coping to the known negative impacts of gastrointestinal symptoms and adherence to the gluten free diet (GFD) on QOL. Methods: In study 1 (N = 390), participants completed measures of QOL, psychological symptoms, coping, several indices of symptom severity, and adherence. Correlations and regression analyses were used to determine the relationships between QOL and the measured variables. Study 2 (N = 189) replicated the findings using a validated measure of current gastrointestinal symptom severity and more a comprehensive measure of coping. Results: Across both studies, poorer QOL was correlated with a higher incidence of psychological and gastrointestinal symptoms, greater reliance on maladaptive coping strategies, and poorer GFD adherence. The relationship between psychological symptoms (particularly depression) and QOL persisted when controlling for past (study 1) and current (study 2) gastrointestinal symptom severity. Psychological symptoms and GFD adherence were more strongly related to reduced QOL than gastrointestinal symptoms. Conclusion: The negative impact of psychological symptoms on QOL and adherence suggests that management in CD should include the provision of psychological coping skills, as well as purely dietetic-based strategies to minimise gastrointestinal symptoms.
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Papers by Louise Sharpe