Effects of a modified invitation letter to follow-up colonoscopy for bowel cancer detection

OBJECTIVE

To investigate whether modifications made to the current National Health Service (NHS) invitation letter for follow-up colonoscopy examination affect participant state anxiety and behavioural intentions to attend.

METHODS

Five hundred and thirty-eight adults of bowel cancer-eligible screening age (56-74) were randomized to receive the current NHS invitation letter or the modified version of the letter as a hypothetical scenario. Modifications to the letter included fewer uses of the term cancer and awareness of alternative screening options. The history of the colonoscopy invitation, anticipated state anxiety, behavioural intention to attend the nurse appointment, and colonoscopy concerns upon reading the letter were measured.

RESULTS

Behavioural intentions were high in both conditions; however, participants reading the current letter reported significantly higher behavioural intentions compared to the modified letter. There was no main effect of previous invite status or interaction between previous invite status and letter condition on behavioural intentions. However, the effect of the letter on levels of anxiety depended on the participant's invitation history. Those never invited for a colonoscopy were more anxious when reading the modified letter compared to the current letter. Conversely, previous colonoscopy invitees were less anxious following reading the modified letter than those reading the current letter. Those never invited for a colonoscopy were more concerned about embarrassment and test invasiveness. All findings remained the same when controlling for age and education.

CONCLUSION

Modifications to the invitation letter were not beneficial to levels of screening intention or anxiety.

The effects of childhood trauma on stress-related vulnerability factors and indicators of suicide risk: An ecological momentary assessment study

BACKGROUND

Childhood trauma is experienced by approximately one third of young people in the United Kingdom and has been shown to confer an increased risk for mental health difficulties in adulthood. Understanding the associations between these factors before negative health outcomes manifest in adulthood is imperative to help inform the development of interventions. The aims of this study were two-fold; first, to investigate the effects of childhood trauma on daily stress-related vulnerability factors over a period of 7 days and to test whether any observed relationships were moderated by protective or risk factors. Second, to explore the indirect effects of childhood trauma on reasons for living, optimism, daily suicide ideation, defeat and entrapment through the daily stress-related vulnerability factors.

METHODS

212 participants were recruited to an ecological momentary assessment study to complete three diaries per day for a 7-day period. Participants completed daily measures of stress, hassles, executive functioning, impulsivity, sleep quality (stress-related vulnerability factors) as well as measures of reasons for living, optimism, daily thoughts of suicide, defeat and entrapment. The Childhood Trauma Questionnaire was also completed at baseline.

RESULTS

Analyses found that childhood trauma was significantly associated with higher scores on the daily stress-related vulnerability factors and positively related to each of the daily indicators of suicide risk. The study also uncovered key pathways whereby trauma had indirect effects on reasons for living, optimism, daily thoughts of suicide, defeat and entrapment through executive functioning, impulsivity, sleep quality and stress.

LIMITATIONS

The measures of executive function and sleep were self-reported and future research ought to replicate the current findings using more objective methods.

DISCUSSION

The findings from this study highlight the complexity of childhood trauma and its damaging effects on stress-related vulnerability factors and poorer mental health outcomes. Greater understanding of pathways by which trauma may impact later health outcomes is essential for development of interventions.

A registered report survey of open research practices in psychology departments in the UK and Ireland

Open research practices seek to enhance the transparency and reproducibility of research. While there is evidence of increased uptake in these practices, such as study preregistration and open data, facilitated by new infrastructure and policies, little research has assessed general uptake of such practices across psychology university researchers. The current study estimates psychologists' level of engagement in open research practices across universities in the United Kingdom and Ireland, while also assessing possible explanatory factors that may impact their engagement. Data were collected from 602 psychology researchers in the United Kingdom and Ireland on the extent to which they have implemented various practices (e.g., use of preprints, preregistration, open data, open materials). Here we present the summarized descriptive results, as well as considering differences between various categories of researcher (e.g., career stage, subdiscipline, methodology), and examining the relationship between researcher's practices and their self-reported capability, opportunity, and motivation (COM-B) to engage in open research practices. Results show that while there is considerable variability in engagement of open research practices, differences across career stage and subdiscipline of psychology are small by comparison. We observed consistent differences according to respondent's research methodology and based on the presence of institutional support for open research. COM-B dimensions were collectively significant predictors of engagement in open research, with automatic motivation emerging as a consistently strong predictor. We discuss these findings, outline some of the challenges experienced in this study, and offer suggestions and recommendations for future research. Estimating the prevalence of responsible research practices is important to assess sustained behaviour change in research reform, tailor educational training initiatives, and to understand potential factors that might impact engagement.

Effects of a self-affirmation intervention on responses to bowel cancer screening information

OBJECTIVE

To investigate the effect of two brief self-affirmation interventions, immediately prior to reading standard information about bowel cancer screening, on state anxiety, message acceptance and behavioural intention to screen for bowel cancer.

METHODS

242 adults aged 49 were randomised to one of two self-affirmation interventions (health or values) or one of two control conditions, before reading an NHS England bowel cancer screening leaflet. Participant friend and family history of bowel cancer, state anxiety, message acceptance, behavioural intention to screen, trait self-esteem and spontaneous self-affirmation were measured. Data were analysed using between-participants analysis of variance, planned contrasts and moderated regression.

RESULTS

No main effects of experimental condition on levels of state anxiety, message acceptance and behavioural intention were found. However, planned contrasts showed participants who self-affirmed about their health or values (conditions-collapsed) were significantly less anxious and reported significantly higher behavioural intentions compared to participants in the controls (conditions-collapsed). Irrespective of condition, higher levels of spontaneous self-affirmation and trait self-esteem were correlated with lower anxiety, higher intentions, and message acceptance.

CONCLUSION

There was some evidence of the effect of health-based self-affirmation on lowering anxiety; however, further research is needed to explore the effectiveness of different self-affirmation interventions in larger samples.

Social network size moderates the association between loneliness and cardiovascular reactivity to acute stress

Loneliness and objective measures of social isolation (e.g., social network size) have been associated with increased risk of cardiovascular disease (CVD). However, the evidence is mixed and the precise causal mechanisms remain unclear. Cardiovascular reactivity (CVR) to acute stress has been posited as a proposed mechanism. This study aimed to investigate: (i) effects of loneliness and social isolation on CVR to stress and, (ii) whether the loneliness - CVR relationship was moderated by social network size. Two hundred and six participants from the Pittsburgh Cold Study underwent a modified version of the Trier Social Stress Task. Cardiovascular measures of systolic (SBP) and diastolic blood pressure (DBP) and heart rate (HR) were taken throughout the laboratory stress trial. Hierarchical regression analyses found that social network size was positively associated with DBP reactivity (β = 0.19 95 % CI [0.05, 0.29] p = 0.005), while loneliness was not. In addition, social network size moderated the loneliness - DBP reactivity relationship such that a higher number of outer social network ties were beneficial at lower levels of loneliness but not higher. The current study contributes new evidence linking loneliness and social network size to cardiovascular psychophysiology but raises questions about the loneliness - CVD relationship. The findings confirm the importance of social network size and highlight that the characteristics of the networks may be more important than the number of networks.

Effectiveness of stress management interventions to change cortisol levels: a systematic review and meta-analysis

Stress has a damaging impact on our mental and physical health, and as a result, there is an on-going demand for effective stress management interventions. However, there are no reviews or meta-analyses synthesising the evidence base of randomised controlled trials testing the effectiveness of psychological interventions on changing cortisol levels (the stress hormone) in non-patient groups. Therefore, the primary aim of this systematic review and meta-analysis was to address this gap. Six databases (Medline, PsychInfo, Embase, CINAHL, Cochrane and Web of Science) were searched (1171 studies identified) with 58 studies (combined N = 3508) included in the meta-analysis. The interventions were coded into one of four categories; mind body therapies, mindfulness, relaxation or talking therapies. A random effects meta-analysis on cortisol as measured in blood, saliva or hair found that stress management interventions outperformed pooled control conditions with a medium positive effect size (g = 0.282). The studies that utilised cortisol awakening measures (g = 0.644) revealed larger effects of stress management interventions than those that measured diurnal cortisol (g = 0.255). Mindfulness and meditation (g = 0. 345) and relaxation (g = 0. 347) interventions were most effective at changing cortisol levels, while mind body therapies (g = 0. 129) and talking therapies (g = 0.107) were shown to have smaller and non-significant effect sizes. Additionally, studies that utilised an active control group (g = 0. 477) over passive control group (g = 0.129) were found to have stronger effects. Length of the intervention, study quality, risk of bias, age and gender did not influence the effectiveness of interventions and there was no evidence of publication bias. Overall, the current findings confirm that stress management interventions can positively influence cortisol levels. Future research should investigate the longer term implications for health and health outcomes.

Curb the spread: Leveraging intensive longitudinal data to unravel within- and between-person processes in adherence to nonpharmaceutical interventions during COVID-19

OBJECTIVES

Adhering to behavioral recommendations and nonpharmaceutical interventions (NPIs) is a key to control COVID-19 infection rates. However, rates have decreased globally, and potentially modifiable determinants of ongoing adherence and their interaction with social and physical momentary environments are still poorly understood. Here, we comprehensively examine within-person variations and between-person differences in known behavioral determinants (capability and motivation), as well as the moderating role of situational variable environmental factors (opportunity) in predicting adherence to hygiene and social distancing behaviors.

METHOD

Ecological momentary assessment study over 6 months with monthly assessment bouts (4 days each and five daily assessments) in 623 German adults. Repeated daily assessments of capability, opportunity, motivation, and behavior (COM-B) model factors. Bayesian multilevel logistic regression models were estimated to examine main effects of COM-B factors and moderating effects of momentary environmental factors.

RESULTS

Momentary adherence to NPIs was predicted by within-person changes in COM-B factors (motivation: intentions, goal conflict, and control beliefs; opportunities: regulations and norms). Between-person differences in capabilities (habit strength) and motivation (intentions and control beliefs) predicted adherence across situations. Situation-specific environmental factors moderated the motivation-behavior association (regulation measures increased; goal conflict and nonadherent others decreased the association).

CONCLUSIONS

Individual momentary (within-person) and stable (between-person) motivation indicators predicted adherence. However, situational environmental factors such as regulations or norms have strong main effects and moderate the motivation-behavior translation. These findings have policy implications, supporting recent claims to not rely on the narrative of "personal responsibility," but instead combine health education measures to increase individual motivation with consistent regulation. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

COVID Protection Behaviors, Mental Health, Risk Perceptions, and Control Beliefs: A Dynamic Temporal Network Analysis of Daily Diary Data

BACKGROUND

To control infections, behavioral non-pharmaceutical interventions (NPIs) such as social distancing and hygiene measures (masking, hand hygiene) were implemented widely during the COVID-19 pandemic. At the same time, adherence to NPIs has also been implied in an increase in mental health problems. However, the designs of many existing studies are often poorly suited to disentangle complex relationships between NPI adherence, mental health symptoms, and health-related cognitions (risk perceptions, control beliefs).

PURPOSE

To separate between- and temporal within-person associations between mental health, health-related cognitions, and NPI adherence.

METHODS

Six-month ecological momentary assessment (EMA) study with six 4-day assessment bouts in 397 German adults. Daily measurement of adherence, mental health symptoms, and cognitions during bouts. We used dynamic temporal network analysis to estimate between-person, as well as contemporaneous and lagged within-person effects for distancing and hygiene NPIs.

RESULTS

Distinct network clusters of mental health, health cognitions, and adherence emerged. Participants with higher control beliefs and higher susceptibility were also more adherent (between-person perspective). Within-person, similar findings emerged, additionally, distancing and loneliness were associated. Lagged findings suggest that better adherence to NPIs was associated with better mental health on subsequent days, whereas higher loneliness was associated with better subsequent hygiene adherence.

CONCLUSIONS

Findings suggest no negative impact of NPI adherence on mental health or vice versa, but instead suggest that adherence might improve mental health symptoms. Control beliefs and risk perceptions are important covariates of adherence-both on between-person and within-person level.

Social Norms in Cervical Cancer Screening

Cancer screening aims to check the body for cancer before symptoms develop. Social norms theory suggests people falsely perceive the attitudes and/or behaviours of similar others to be different from their own and correcting these perceptions can lead to behaviour change. Across two studies, we tested if women underestimate peer levels of cervical screening behaviour and whether a social norms manipulation increases intention to attend cervical cancer screening. In study 1, participants completed a survey on cervical cancer screening norms. In study 2, participants were randomised to receive no norm information, norm information, or norm information plus statement on value of norms in decision making. In study 1, participant estimates of peer level of cervical screening behaviour were significantly lower than nationally reported levels. In study 2, a social norm plus value statement intervention led to stronger intentions to attend screening. This effect was consistent across demographic factors and screening status. Participants significantly underestimate rates of cervical screening behaviour in their peers. A brief, online social norms plus values manipulation increased intentions to attend cervical cancer screening across all groups.

Effects of COVID-19-related worry and rumination on mental health and loneliness during the pandemic: longitudinal analyses of adults in the UK COVID-19 mental health & wellbeing study

BACKGROUND

The lasting effects of the coronavirus disease 2019 pandemic are likely to be significant.

AIMS

This study tracked worry and rumination levels during the pandemic and investigated whether periods with higher COVID-related worry and rumination were associated with more negative mental health and loneliness.

METHODS

A quota survey design and a sampling frame that permitted recruitment of a national sample were employed. Findings for waves 1 (March 2020) to 6 (November 2020) are reported (N = 1943).

RESULTS

Covid-related worry and rumination levels were highest at the beginning of the first lockdown, then declined but increased when the UK returned to lockdown. Worry levels were higher than rumination levels throughout. High levels of COVID-related worry and rumination were associated with a five- and ten-fold increase in clinically meaningful rates of depression and anxiety (respectively) together with lower well-being and higher loneliness. The effects of COVID-related worry on depression and anxiety levels were most marked and clinically meaningful in individuals living with a pre-existing mental health condition.

CONCLUSIONS

Psychological interventions should include components that specifically target COVID-related worry and rumination. Individuals with pre-existing mental health conditions should be prioritised as we emerge from the current pandemic and in any future public health crises.

Effects of childhood trauma on sleep quality and stress-related variables in adulthood: evidence from two multilevel studies

Childhood trauma has been found to have serious negative consequences for mental and physical health. However, the precise mechanisms through which trauma influences health outcomes are unclear. Childhood trauma-related disruptions to sleep in adulthood represent an important potential mechanism. Two 7-day multilevel studies investigated the effects of childhood trauma on daily sleep outcomes and stress-related variables and whether the effects of trauma on sleep outcomes were mediated through these stress-related variables (or vice versa). Participants completed the Childhood Trauma Questionnaire before a 7-day online daily diary study. Measures of daily stress, perseverative cognition, and sleep were completed daily. Multi-level modelling found that higher levels of childhood neglect were associated with poorer daily sleep quality, shorter sleep duration, longer sleep onset latency, and higher daily stress and rumination levels. Higher childhood abuse was associated with shorter sleep duration, greater morning tiredness, and higher levels of daily stress, rumination, and worry. Childhood trauma was found also to have bidirectional, indirect effects on sleep quality and morning tiredness through daily stress-related variables. The current findings suggest that interventions aimed at mitigating the negative effects of childhood trauma should also incorporate components that target modifiable risk factors, such as sleep, stress, worry, and rumination.

Evaluation of the reboot coaching workshops among urology trainees: A mixed method approach

Background

Urology trainees experience high burnout, and there is an urgent need for acceptable and effective interventions. The current study evaluated Reboot coaching workshops (Reboot-C), a tailored intervention based on cognitive-behavioural principles, with urology trainees.

Objective

Our primary objective was to evaluate the acceptability of Reboot-C among urology trainees. In addition, this study aimed to investigate whether there were changes in confidence, resilience, depression and burnout levels.

Materials and method

A single-arm design was used, including pre- and post-online questionnaires and semi-structured interviews.

Result

Twenty-one urology trainees replied to the survey, attended both Reboot-C workshops and responded to the post-intervention questionnaire. Thirteen of 21 (61%) urology trainees participated in the interview. Participating in Reboot-C was associated with significant improvements in resilience and confidence and a significant reduction in burnout. However, there was no significant reduction in depression. Qualitative data indicated that Reboot was acceptable and helped participants develop useful skills.

Conclusion

These findings pave the way for more conclusive studies on the efficacy of Reboot-C for surgeons.

Childhood Trauma and Suicide

Background: Suicide is a leading cause of death worldwide, and childhood trauma has been found to be an important risk factor. However, the mechanisms linking trauma to suicide risk remain unclear. Aims: The current registered report sought to (1) investigate whether childhood trauma and its subtypes were related to suicide risk in adulthood and (2) explore the potential mechanisms associating childhood trauma with suicide and well-being, especially executive functioning, impulsivity, and stress. Method: A cross-sectional survey of 457 individuals who reported experiencing suicide ideation in the past 12 months. Results: Childhood trauma and its subtypes were associated with an increased risk of reporting recent suicide thoughts, COVID-19-related suicide attempts, and recent suicide attempts. There were also significant indirect effects of childhood trauma on recent suicide ideation and well-being through executive functioning and impulsivity. Conclusion: These findings show that childhood trauma is associated with suicide risk in adulthood and suggest that poorer executive functioning and higher levels of impulsivity contribute to this increased risk. These results have implications for the development of future interventions to reduce suicide vulnerability.

Mental health during the COVID-19 pandemic: exploring the role of psychological flexibility and stress-related variables

OBJECTIVE

Understanding the impact of the COVID-19 pandemic on mental health and the psychological factors associated can help inform subsequent interventions to protect psychological health. In particular, psychological flexibility has been shown to be an important target for intervention. The current study aimed to investigate associations between protective factors (state mindfulness, values and self-compassion) and risk factors (COVID-19 stress, worry and rumination) for mental health during the early stages of the COVID-19 pandemic.

DESIGN

439 participants completed three online surveys during the 1st wave of the pandemic in the UK: Time 1 (April 1-5th 2020), Time 2 (April 15-19th April), Time 3 (May 13-17th 2020).

MAIN OUTCOME MEASURES

Measures of wellbeing, burnout and life satisfaction.

RESULTS

Psychological health outcome measures were found to be lower (worse) than normative comparison data during the early stages of the UK lockdown, while COVID-19 stress and worry reduced over time. Multilevel models found that higher levels of trait and state measures of psychological flexibility and self-compassion were associated with better psychological health across time points. Higher levels of COVID-19 stress, worry and rumination were also associated with poorer psychological health.

CONCLUSION

The results showed that mindfulness, values and self-compassion are potential targets for intervention.

Do British and Chinese adolescents snack for different reasons? A cross-country study using the Theory of Planned Behaviour and eating styles

Snacking is prevalent in adolescents and can have significant health impacts, but there is considerable individual and cross-country variation in determinants on adolescent snacking. The present study examined the role of eating styles (i.e. restrained eating, emotional eating, external eating, mindful eating) and the constructs of an extended Theory of Planned Behaviour (TPB) (i.e. attitudes, subjective norms, perceived behavioural control, habit strength) in predicting adolescent snacking, and the moderating effects of country. A survey was completed by adolescents aged 16-19 years from China (N = 182; mean age = 16.13, SD = 0.87) and England (N = 96; mean age = 17.04, SD = 0.74). Compared to British adolescents, Chinese adolescents showed higher restrained eating (p = .009), lower external eating (p = .004), less positive attitudes (p < .001) and subjective norms (p = .007) to, and less strong habit strength (p = .005) for unhealthy snacking. Mindful eating significantly predicted lower consumption of unhealthy snacks (p = .008) and beverages (p = .001), while restrained eating predicted higher consumption of fruit (p < .001) and vegetables (p < .001), regardless of country. Country showed significant moderating effects of TPB constructs on unhealthy beverages (p = .008) and fruit (p < .001) consumption, and effects on unhealthy snack (p = .023) and vegetable (p = .015) consumption approaching significance. Subjective norms predicted unhealthy snacking frequency regardless of country (p = .001). Habit strength predicted consumption of beverages (p < .001) and fruit (p < .001) only in English adolescents. Mindful eating may be a positive intervention approach to help reduce adolescent unhealthy snacking. TPB-based snacking interventions should carefully consider the country context. Acknowledging country-specific determinants of snacking are recommended.

Open Science in Health Psychology and Behavioral Medicine: A Statement From the Behavioral Medicine Research Council

ABSTRACT

Open Science practices include some combination of registering and publishing study protocols (including hypotheses, primary and secondary outcome variables, and analysis plans) and making available preprints of manuscripts, study materials, de-identified data sets, and analytic codes. This statement from the Behavioral Medicine Research Council (BMRC) provides an overview of these methods, including preregistration; registered reports; preprints; and open research. We focus on rationales for engaging in Open Science and how to address shortcomings and possible objections. Additional resources for researchers are provided. Research on Open Science largely supports positive consequences for the reproducibility and reliability of empirical science. There is no solution that will encompass all Open Science needs in health psychology and behavioral medicine's diverse research products and outlets, but the BMRC supports increased use of Open Science practices where possible.

Open science in health psychology and behavioral medicine: A statement from the Behavioral Medicine Research Council

Open Science practices include some combination of registering and publishing study protocols (including hypotheses, primary and secondary outcome variables, and analysis plans) and making available preprints of manuscripts, study materials, de-identified data sets, and analytic codes. This statement from the Behavioral Medicine Research Council (BMRC) provides an overview of these methods, including preregistration; registered reports; preprints; and open research. We focus on rationales for engaging in Open Science and how to address shortcomings and possible objections. Additional resources for researchers are provided. Research on Open Science largely supports positive consequences for the reproducibility and reliability of empirical science. There is no solution that will encompass all Open Science needs in health psychology and behavioral medicine's diverse research products and outlets, but the BMRC supports increased use of Open Science practices where possible. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Open Science in Health Psychology and Behavioral Medicine: A Statement From the Behavioral Medicine Research Council

Open Science practices include some combination of registering and publishing study protocols (including hypotheses, primary and secondary outcome variables, and analysis plans) and making available preprints of manuscripts, study materials, de-identified data sets, and analytic codes. This statement from the Behavioral Medicine Research Council (BMRC) provides an overview of these methods, including preregistration; registered reports; preprints; and open research. We focus on rationales for engaging in Open Science and how to address shortcomings and possible objections. Additional resources for researchers are provided. Research on Open Science largely supports positive consequences for the reproducibility and reliability of empirical science. There is no solution that will encompass all Open Science needs in health psychology and behavioral medicine's diverse research products and outlets, but the BMRC supports increased use of Open Science practices where possible.

A randomised controlled trial of volitional and motivational interventions to improve cervical cancer screening uptake

OBJECTIVE

Cervical cancer is the fourth most common cancer to occur in women worldwide. In the UK, the NHS cervical screening programme invites eligible individuals to take part in screening every 3-5 years. At present, around 70% of individuals attend screening when invited. The present study aimed to test the effectiveness of a volitional and a motivational intervention alone and in combination on screening uptake at 16-week follow up.

METHODS

14,536 participants were recruited from the list of eligible participants invited for screening in Yorkshire, Humber and the North East regions of England in December 2021. They were randomised to a social norm-based motivational intervention (SNA); implementation intention-based Volitional Help Sheet (VHS); combined intervention (SNA + VHS); or treatment as usual control. The primary outcome was screening uptake measured via patient screening records at 16 weeks.

RESULTS

Of the 14,466 participants with eligible data for analysis, 5793 (40.0%) attended for cervical cancer screening in the 16 weeks after the intervention mailing. Both age and deprivation influenced screening uptake, with lower uptake in the youngest individuals and those from more deprived areas. Compared to control, there was no evidence of any benefit from the VHS implementation intervention alone (Adj.OR = 0.99, 95% CI 0.90 to 1.10), the SNA motivational intervention alone (Adj.OR = 0.89; 95% CI: 0.80 to 0.99), or the combined intervention (Adj.OR = 0.96, 95% CI 0.86 to 1.06).

CONCLUSION

The study did not support any benefit of either VHS or SNA interventions alone or in combination on cervical cancer screening uptake. It did demonstrate alarmingly low levels of screening uptake at 16 weeks which were well below the average rate. Future research needs to urgently investigate and understand the barriers to uptake following on from the COVID-19 pandemic.

Daily stress and eating behaviors in adolescents and young adults: Investigating the role of cortisol reactivity and eating styles

Stress-related eating has been well documented in previous literature. However, there is limited research investigating the role of cortisol reactivity in daily stress-eating associations in samples of adolescents and young adults. 123 participants completed a baseline questionnaire and the Trier Social Stress Test in groups. Four saliva samples were taken at - 10, + 00, + 10 and + 40 min during the stress-induction task. Following this, participants completed an online daily diary each evening for 14 consecutive days to record daily stress and between-meal snack consumption. Multilevel modelling indicated that daily stress was positively associated with daily snack intake, particularly for ego-threatening and work/academic stressors. Emotional and external eating styles were found to moderate the stress-snacking relationship. Cortisol reactivity also moderated stress-eating associations, such that as cortisol reactivity levels increased from lower to higher levels, the impact of stress on eating decreased. The current findings highlight the importance of cortisol reactivity status and eating styles in understanding the complex relationship between daily stress and eating behavior in adolescents and young adults. Future research should continue investigating stress-eating associations in these groups and explore the role of other aspects of hypothalamic-pituitary-adrenal axis functioning.

Burnout and patient safety perceptions among surgeons in the United Kingdom during the early phases of the coronavirus disease 2019 pandemic: A two-wave survey

BACKGROUND

Surgeons in the UK report high burnout levels. Burnout has been found to be associated with adverse patient outcomes but there are few studies that have examined this association in surgeons and even fewer which have examined this relationship over time.

PURPOSE

The main aim was to examine the relationships between surgeon burnout and surgeons' perceptions of patient safety cross-sectionally and longitudinally. The secondary aim was to test whether surgeons' burnout levels varied over the first six months of the coronavirus disease 2019 pandemic.

METHODS

This paper reports data from a two-wave survey (first wave from 5 May and 30 June 2020, the second wave 5 January to 30 February 2021). The dataset was divided into a longitudinal group (for surgeons who responded at both the time points) and two cross-sectional groups (for surgeons who responded at a one-time point, but not the other).

RESULTS

The first key finding was that burnout was associated with patient safety outcomes measured at the same time point (Group 1 = 108, r = 0.309, p < 0.05 and Group 2 = 84, r = 0.238, p < 0.05). Second, burnout predicted poor patients' safety perceptions over time, and poor patient safety predicted burnout over time (Group 3 = 39, p < 0.05). Third, burnout increased between the first and second surveys (t = -4.034, p < 0.05).

CONCLUSION

Burnout in surgeons may have serious implications for patient safety. Interventions to support surgeons should be prioritised, and healthcare organisations, surgeons and psychological specialists should collaborate on their development.

Increased Breast and Colorectal Cancer Risk in Type 2 Diabetes: Awareness Among Adults With and Without Diabetes and Information Provision on Diabetes Websites

BACKGROUND

People with type 2 diabetes mellitus (T2DM) have a higher risk of developing breast and bowel cancers but are less likely to participate in cancer screening.

PURPOSE

Two interlinked studies examined public awareness of the fact that T2DM increases breast and bowel cancer risk, and provision of this information on diabetes websites.

METHODS

Study-1: phase-1 surveyed awareness of T2DM-increased cancer risk in a nationally-representative British sample aged 50-74 (N = 1,458) and compared respondents with and without T2DM (n = 125 vs. n = 1,305); phase-2 surveyed an additional exclusively T2DM sample (N = 319). Study-2: High-ranking diabetes websites (N = 25) were reviewed to determine the rate of inclusion of cancer risk and cancer screening information in evident sections about diabetes-related health conditions.

RESULTS

A low proportion of respondents were aware that T2DM increases risk of breast (13.7%) and bowel (27.6%) cancers, compared to much higher awareness of other diabetes-related conditions such as sight loss (82.2%) and foot problems (81.8%). Respondents with T2DM were significantly more likely than those without T2DM to be aware of all the surveyed diabetes-related health conditions (e.g., sight loss, OR: 3.14, 95%CI: 1.61-6.15; foot problems, OR: 2.58, 95%CI: 1.38-4.81), except breast (OR: 0.82, 95%CI: 0.46-1.45) and bowel (OR: 0.95, 95%CI: 0.63-1.45) cancer, for which awareness was equally low among people with and without T2DM. Few diabetes websites with a section on diabetes-related health conditions included cancer in this section (n = 4/19), and fewer still included cancer screening among any noted cancer-protective behaviors (n = 2/4).

CONCLUSIONS

There is low public awareness that T2DM increases the risk of developing breast and bowel cancers, even among people with T2DM, which may be partly due to limited information provision regarding T2DM-increased cancer risk from diabetes care providers and organizations.

Daily Hassles and Eating Behaviours in Adults: Exploring the Buffering Effects of Daily Uplifts

Existing research has shown that daily hassles are associated with increases in between-meal snacking, often resulting in the increased consumption of high sweet and high fat foods. However, it is currently unclear whether the presence of daily uplifts may buffer the negative effects of daily hassles on unhealthy eating behaviour. Therefore, the current study explored the main and interactive effects of daily hassles and daily uplifts on snacking behaviours in adults. One hundred and sixty participants (M age: 23.69 years) reported their daily hassles, daily uplifts and snacking behaviours over the preceding 24 hour period. Participants' emotional eating style was also measured. Using moderated regression analysis, the daily hassles x daily uplifts interaction was found to be statistically significant for both total snack and unhealthy snack consumption. Simple slopes analyses showed that the relationship between daily hassles and snacking was weaker and non-significant at higher levels of daily uplifts compared to moderate and lower levels. The current study provides novel evidence that daily uplifts may act as a buffer against the negative impact of daily hassles on food consumption.

The role of perseverative cognition in the job strain-health outcome relationship

OBJECTIVE

Job strain has been implicated in a variety of adverse health outcomes, particularly cardiometabolic and inflammatory diseases. However, the mechanisms underlying these effects remain largely unknown. One possibility is that the maladaptive coping response to stress, (perseverative cognition (PC); the cognitive representation of past stressful events (rumination) or feared future events (worry)), either in work or more generally, mediates the relationship between job strain and physical disease. The aim of this study was thus to test the potential role of both general, and work- related PC as a mediating, or potentially moderating, mechanism between job strain and ill- health outcomes.Design & Measures:Using an online cross- sectional design, 650 full- time employees completed measures of job strain, general and work- related PC (rumination & worry) and health outcomes (burnout, somatization, health behaviours & sleep quality).

RESULTS

General and work- related worry and rumination significantly mediated, often independently, the relationship between job strain and burnout, somatization, and sleep quality. No significant mediation effects were observed for health behaviours and no type of PC (general or work- related) moderated job strain- health outcome relations.

CONCLUSION

Both general and work- related worry and rumination are likely to play important, and partly independent, roles in understanding the adverse relationships between job strain and various health outcomes.

Exploring the relationship between suicide vulnerability, impulsivity and executive functioning during COVID-19: A longitudinal analysis

Public health emergencies increase the presence and severity of multiple suicide risk factors and thus may increase suicide vulnerability. Understanding how suicide risk factors interact throughout the course of a global pandemic can inform how to help the most vulnerable groups in society. The aims of the research were to explore the associations between, and changes in, suicide vulnerability, COVID-related stress, worry, rumination, executive functioning and impulsivity across the first 6 weeks of UK lockdown (1st April – May 17, 2020). 418 adults in the UK completed an online survey at three time points during the first lockdown (Time 1 (April 1–5th), Time 2 (April 15–19th April), Time 3 (May 13–17th). Impulsivity and executive functioning remained stable across the first six weeks of UK lockdown. COVID-related stress, worry, and rumination decreased throughout the 6 weeks. Suicide vulnerability was associated with greater impulsivity and poorer executive functioning. Sub-group analysis revealed individuals vulnerable to suicide reported worse COVID-related stress, poorer executive function and greater impulsivity than individuals who reported no suicide vulnerability. Individuals vulnerable to suicide appear to have experienced poorer executive functioning, greater impulsivity and COVID-related stress in the initial phase of the COVID-19 pandemic.

Barriers and facilitators to colonoscopy for cancer detection: patient and practitioner perspectives

OBJECTIVE

To further understand the barriers and facilitators to attending colonoscopy examination following a positive routinely offered stool test result, from the perspective of patients and Specialist Screening Practitioners (SSPs).

METHODS

Qualitative semi-structured interviews were conducted. Participants (N = 32) were patients (n = 20) who, as part of the Bowel Cancer Screening Programme (BCSP) in England, were invited to attend a colonoscopy examination, and SSPs (n = 12), who worked for the BCSP in England. Framework analysis included inductive and deductive coding.

RESULTS

Anxiety was as a key barrier cited by patients and SSPs, arising from the moment the patient received the invitation letter. Notably, procedural-related anxieties centred upon the fear of pain and discomfort and test invasiveness. The role of family, friends and the SSP were recognised by patients and SSPs to facilitate participation. Many patients, yet not SSPs, emphasised an obligation to attend all medical test invitations.

CONCLUSION

Practically orientated strategies suggested by patients and SSPs address the patient barriers identified. These include earlier information to patients on the option of sedation for pain relief, earlier notification of potential financial support for patients unable to fund their own travel costs, and fewer uses of the term cancer within written materials.

Information seeking, mental health and loneliness: Longitudinal analyses of adults in the UK COVID-19 mental health and wellbeing study

Information seeking has generally been seen as an adaptive response to the COVID-19 pandemic. However, it may also result in negative outcomes on mental health. The present study tests whether reporting COVID-related information seeking throughout the pandemic is associated with subsequently poorer mental health outcomes. A quota-based, non-probability-sampling methodology was used to recruit a nationally representative sample. COVID-related information seeking was assessed at six waves along with symptoms of depression, anxiety, mental wellbeing and loneliness (N = 1945). Hierarchical linear modelling was used to assess the relationship between COVID-related information seeking and mental health outcomes. Information seeking was found to reduce over time. Overall, women, older and higher socioeconomic group individuals reported higher levels of information seeking. At waves 1-4 (March-June 2020) the majority of participants reported that they sought information on Covid 1-5 times per day, this decreased to less than once per day in waves 5 and 6 (July-November 2020). Higher levels of information seeking were associated with poorer mental health outcomes, particularly clinically significant levels of anxiety. Use of a non-probability sampling method may have been a study limitation, nevertheless, reducing or managing information seeking behaviour may be one method to reduce anxiety during pandemics and other public health crises.

Do reasoned action approach variables mediate relationships between demographics and cervical cancer screening intentions or behaviour? An online study of women from the UK

OBJECTIVE

In the UK, approximately 3,200 women are diagnosed with cervical cancer each year. Regular screening is one of the best ways to prevent cervical cancer from developing, yet screening rates are declining and vary by sociodemographic variables. The present stratified online study aimed to investigate relationships between sociodemographic factors and screening intentions and past behaviour. Reasoned Action Approach (RAA) variables were assessed as potential mediators.

METHODS

In total, 500 women living in the UK were recruited via an online research recruitment website to an online cross-sectional survey. Participant recruitment was stratified by age, socioeconomic status and ethnicity to ensure adequate representation of each strata. Participants completed measures on RAA variables (affective attitudes, cognitive attitudes, injunctive norms, descriptive norms, capability, autonomy, and intention) as well as screening past behaviour.

RESULTS

Among the demographic variables, age, ethnicity and deprivation were significantly related to screening intention. Younger women, those from less deprived areas, along with white women were more likely to report higher intentions to attend screening. Past behaviour was significantly negatively predicted by deprivation only, indicating that individuals from less deprived areas were more likely to be up to date with their screening. Both intention and past behaviour were significantly positively correlated with all RAA variables. Capability and cognitive attitude partially mediated the relationship between age and intention and fully mediated the relationship between ethnicity and intention. Capability fully mediated the relationships between deprivation and intention and between deprivation and past behaviour.

CONCLUSION

Intentions toward attending cervical cancer screening are related to age, ethnicity, and level of deprivation, with older women and those from areas of greater deprivation and ethnic minority groups reporting lower intentions. Capability (confidence engaging in cervical screening) and cognitive attitudes (how useful/beneficial screening is seen to be) are key variables to target to promote cervical screening attendance and reduce potential inequalities.

Perseverative cognition and health behaviours: exploring the role of intentions and perceived behavioural control

OBJECTIVE

Worry and rumination (Perseverative Cognition, PC) have been associated with health behaviours, but the underlying mechanisms are unknown. Given the role of physiological experiences on perceived behavioural control (PBC) and emotion regulation on intention-health behaviour relationships, we tested whether: PC prospectively predicts poorer health behaviours; PC moderates the relationship(s) between intentions/PBC and health behaviour, as well as whether the relationship between PC and health behaviour is mediated by intentions and PBC.

METHODS AND MEASURES

In a prospective design, 650 participants (mean age = 38.21 years; 49% female) completed baseline measures of intentions, PBC and PC (worry and rumination) and 590 (mean age = 38.68 years; 50% female) completed follow-up (Time 2) measures of health behaviours (physical activity, sleep, sedentary activity, unhealthy snacking) 1-week later.

RESULTS

Worry and rumination (at T1) predicted poorer sleep quality. Worry, but not rumination, moderated PBC-physical activity frequency relations. Consistent with mediation, the indirect paths from both worry and rumination, through PBC, to sleep quality and total sleep time were significant.

CONCLUSION

PC is associated with poorer sleep quality and PBC can play a mediating role in such relationships. Future research should further consider the role that PBC plays in PC-health behaviour relations.

Predicting suicidal ideation in a nationally representative sample of young adults: a 12-month prospective study

BACKGROUND

Evidence-based theoretical models outlining the pathways to the development of suicidal ideation may inform treatment. The current research draws from the Interpersonal Theory of Suicide (IPT) and the Integrated Motivational-Volitional (IMV) Model of suicidal behaviour and aims to test the interaction between perceived burdensomeness and thwarted belongingness as proposed by the IPT model, and the defeat-entrapment pathway as proposed by the IMV model, in the prediction of suicidal ideation at 12-month follow-up.

METHODS

The Scottish Wellbeing Study is a nationally representative prospective study of young people aged 18-34 years (n = 3508) from across Scotland, who completed a baseline interview and a 12-month follow-up (n = 2420). The core factors from both the IPT (perceived burdensomeness and thwarted belongingness) and the IMV model (defeat, internal and external entrapment) were measured alongside demographics, depressive symptoms and suicidal ideation at baseline. At 12-month follow-up, suicidal ideation was assessed again.

RESULTS

In multiple regression analysis perceived burdensomeness and internal entrapment, with baseline suicidal ideation, predicted 12-month suicidal ideation. No support for the interaction between perceived burdensomeness and thwarted belongingness in predicting 12-month suicidal ideation was found. However, there was evidence that internal, but not external, entrapment mediated the relationship between defeat and 12-month suicidal ideation, but no support was found for the moderation of burdensomeness and belongingness on the entrapment to suicidal ideation pathway.

CONCLUSIONS

The current findings highlight the importance of targeting perceived burdensomeness and internal entrapment to reduce the likelihood that suicidal ideation emerges in at risk individuals.

How UK surgeons experience burnout and the link between burnout and patient care: A qualitative investigation

Background and Aims

Poor well-being affects the performance of all kinds of workers, including surgeons. This study aimed to answer two questions: (1) how does burnout affect surgeons personally, and what is their burnout experience like? (2) How does burnout affect the care that surgeons provide in the United Kingdom (UK)?

Method

This study conducted thematic analysis of semi-structured interviews with 14 surgeons recruited from the UK National Health Service (NHS).

Result

The study found three themes in surgeons’ experiences of burnout: first, burnout is common but frequently not recognised nor understood; second, burnout is a personal crisis; and third, burnout creates vulnerability at work. The study also revealed four themes related to burnout's effect on patient care: first, burnout reduces the quality of surgeon-patient relationships; second, burnout affects patient safety; third, burnout impairs staff relationships; and fourth, burnout makes surgeons less motivated to improve.

Conclusion

Burnout is common but not well recognised in surgeons. Improving understanding and treatment of burnout could have benefits for both surgeons themselves and the care they provide to patients.

Feasibility of a multiple-component mindfulness intervention for Chinese adolescents living with overweight: A pilot randomized trial

The prevalence of obesity among Chinese adolescents is rising rapidly, and theoretically informed, scalable weight management interventions are needed. We developed and evaluated the feasibility and preliminary effects of an mHealth nutrition education and mindful snacking intervention for weight loss and improved dietary practices among Chinese adolescents with overweight. We examined whether including implementation intention formation (using if-then plans) improved outcomes. With user consultation, we created a 3-week mindful eating intervention delivered as 10 videos to user smartphones. Participants (n = 55) were randomly assigned to mindful eating or mindful eating + planning. Forty-six (83.6%) participants (age = 16.35 ± 0.48 years; body mass index [BMI] = 25.79 ± 2.05 kg/m² ) completed the intervention. Both groups exhibited significant pre- to post-intervention weight loss (M = 1.42 and 1.79 kg, respectively); decreases in snacking frequencies, emotional eating, external eating, and trait craving; and significant increases in mindful eating and eating self-efficacy. No significant intervention group differences were observed. User experience data (n = 16) indicated acceptability and meaningful behavior change. Findings suggest that a smartphone-delivered mindfulness-based intervention for Chinese adolescents living with overweight is feasible and efficacious.

Interventions to promote physical distancing behaviour during infectious disease pandemics or epidemics: A systematic review

OBJECTIVES

Physical distancing, defined as keeping 1-2m apart when co-located, can prevent cases of droplet or aerosol transmitted infectious diseases such as SARS-CoV2. During the COVID-19 pandemic, distancing was a recommendation or a requirement in many countries. This systematic review aimed to determine which interventions and behavior change techniques (BCTs) are effective in promoting adherence to distancing and through which potential mechanisms of action (MOAs).

METHODS

Six databases were searched. The review included studies that were (a) conducted on humans, (b) reported physical distancing interventions, (c) included any comparator (e.g., pre-intervention versus post-intervention; randomized controlled trial), and (d) reported actual distancing or predictors of distancing behavior. Risk of bias was assessed using the Mixed Methods Appraisal Tool. BCTs and potential MoAs were identified in each intervention.

RESULTS

Six articles (with seven studies and 19 comparisons) indicated that distancing interventions could successfully change MoAs and behavior. Successful BCTs (MoAs) included feedback on behavior (e.g., motivation); information about health consequences, salience of health consequences (e.g., beliefs about consequences), demonstration (e.g., beliefs about capabilities), and restructuring the physical environment (e.g., environmental context and resources). The most promising interventions were proximity buzzers, directional systems, and posters with loss-framed messages that demonstrated the behaviors.

CONCLUSIONS

The evidence indicates several BCTs and potential MoAs that should be targeted in interventions and highlights gaps that should be the focus of future research.

Mental health and well-being during the second wave of COVID-19: longitudinal analyses of the UK COVID-19 Mental Health and Wellbeing study (UK COVID-MH)

BACKGROUND

Waves 1 to 3 (March 2020 to May 2020) of the UK COVID-19 Mental Health and Wellbeing study suggested an improvement in some indicators of mental health across the first 6 weeks of the UK lockdown; however, suicidal ideation increased.

AIMS

To report the prevalence of mental health and well-being of adults in the UK from March/April 2020 to February 2021.

METHOD

Quota sampling was employed at wave 1 (March/April 2020), and online surveys were conducted at seven time points. Primary analyses cover waves 4 (May/June 2020), 5 (July/August 2020), 6 (October 2020) and 7 (February 2021), including a period of increased restrictions in the UK. Mental health indicators were suicidal ideation, self-harm, suicide attempt, depression, anxiety, defeat, entrapment, loneliness and well-being.

RESULTS

A total of 2691 (87.5% of wave 1) individuals participated in at least one survey between waves 4 and 7. Depressive symptoms and loneliness increased from October 2020 to February 2021. Defeat and entrapment increased from July/August 2020 to October 2020, and remained elevated in February 2021. Well-being decreased from July/August 2020 to October 2020. Anxiety symptoms and suicidal ideation did not change. Young adults, women, those who were socially disadvantaged and those with a pre-existing mental health condition reported worse mental health.

CONCLUSIONS

The mental health and well-being of the UK population deteriorated from July/August 2020 to October 2020 and February 2021, which coincided with the second wave of COVID-19. Suicidal thoughts did not decrease significantly, suggesting a need for continued vigilance as we recover from the pandemic.

Investigation of psychometric properties of the Mindful Eating Questionnaire in Chinese adolescents and young adults using mixed methods

Overweight and obesity are major public health challenges in China, and increasingly among young people. Valid measures are needed to examine the relationship between eating styles and weight to advance understanding and intervention. Mindful approaches show promise in weight management. This study aimed to investigate the psychometric properties of a Chinese version of Mindful Eating Questionnaire (C-MEQ). Study 1 used a think aloud methodology to examine Chinese young adults' (n = 7) and adolescents' (n = 10) comprehension of C-MEQ items. Findings informed revision of problematic items before a full validation study (Study 2) of the revised C-MEQ (C-MEQ-R) in a sample of 430 Chinese young adults. In Study 1, both groups misinterpreted ten items as asking about noticing about whether behaviour ever occurred rather than noticing experience, indicating the lack of content validity of the C-MEQ. Ten items were rephrased to emphasise mindful (intentional) noticing in the moment. In Study 2, confirmatory factor analysis revealed an inadequate fit to the original MEQ structure. Exploratory Structural Equation Model of the C-MEQ-R revealed five distinct domains. The C-MEQ-R showed better psychometric properties than the C-MEQ, and significant associations with mindfulness, emotional eating, external eating and BMI in expected directions. However, psychometric limitations including low internal reliability, inadequate coherence of the subscales and limited construct validity were identified. These findings contribute to the progress in the measurement of mindful eating by highlighting the weaknesses of the MEQ. Further research is called to adopt and validate alternative mindful eating measurements to assess mindful eating in Chinese adolescents and young adults.

Burnout in surgeons: A qualitative investigation into contributors and potential solutions

BACKGROUND

Poor wellbeing affects the performance of all types of workers. Surgeons are particularly at risk of suffering from burnout, but minimal qualitative research has examined the causes of burnout and potential solutions in this group. Understanding this could inform the development of future burnout interventions.

PURPOSE

This study aimed to explore the main factors that lead to surgeon burnout and to examine how surgeons cope with burnout at work.

SETTING

Surgical departments in the United Kingdom's National Health Service (NHS).

MATERIALS

Telephone interview and face-to-face interview.

METHODS

This qualitative study was conducted using semi-structured interviews with 14 surgeons from diverse specialisations. The interview consisted of two sections. The first addressed the main reasons for burnout. The second explored how surgeons manage burnout.

RESULTS

A thematic analysis identified several factors that can lead to surgeon burnout, captured in the themes of: rising to the challenge of surgical work; interpersonal conflict at work; greater demands than resources; the challenge of work-life balance; and the devastating impact of errors and poor patient outcomes. The study also revealed various strategies that surgeons employed to cope with burnout, namely: cognitive restructuring; seeking social support; stepping aside or down from the job; and prioritising personal health. Additionally, the study found some surgeons used maladaptive coping.

CONCLUSION

Healthcare organisations, surgeons, and psychological experts should work together to provide more and improved interventions to help surgeons, which might lead to a reduction in the number of surgeons who leave the profession and help improve patient outcomes.

Surgeon burnout, impact on patient safety and professionalism: A systematic review and meta-analysis

BACKGROUND

Previous systematic reviews have found high burnout in healthcare professionals is associated with poorer patient care. However, no review or meta-analysis has investigated this association in surgeons specifically. The present study addressed this gap, by examining the association between surgeon burnout and 1) patient safety and 2) surgical professionalism.

METHODS

A systematic review was performed in accordance with PRISMA guidelines. We included original empirical studies that measured burnout and patient care or professionalism in surgeons. Six databases were searched (PsycINFO, Ovid MEDLINE(R), EMBASE, Cochrane Database, CINAHL, and Web of Science) from inception to February 2021. An adapted version of the Cochrane Risk of Bias tool was used to assess study quality. Meta-analysis and narrative synthesis were utilised to synthesise results.

RESULTS

Fourteen studies were included in the narrative review (including 27,248 participants) and nine studies were included in the meta-analysis. Burnout was associated with a 2.5-fold increased risk of involvement in medical error (OR = 2.51, 95% Cl [1.68-3.72]). The professionalism outcome variables were too diverse for meta-analysis, however, the narrative synthesis indicated a link between high burnout and a higher risk of loss of temper and malpractice suits and lower empathy. No link was found between burnout and patient satisfaction.

CONCLUSION

There is a significant association between higher burnout in surgeons and poorer patient safety. The delivery of interventions to reduce surgeon burnout should be prioritised; such interventions should be evaluated for their potential to produce concomitant improvements in patient safety.

Group-based acceptance and commitment therapy interventions for improving general distress and work-related distress in healthcare professionals: A systematic review and meta-analysis

BACKGROUND

A large proportion of the healthcare workforce reports significant distress and burnout, which can lead to poor patient care. Several psychological interventions, such as Acceptance and Commitment Therapy (ACT), have been applied to improve general distress and work-related distress in healthcare professionals (HCPs). However, the overall efficacy of ACT in this context is unknown. This review and meta-analysis aimed to: 1) test the pooled efficacy of ACT trials for improving general distress and reducing work-related distress in HCPs; 2) evaluate the overall study quality and risk of bias; and 3) investigate potential moderators of intervention effectiveness.

METHOD

Four databases (Ovid MEDLINE, EMBASE, PsycINFO, CINHAL) were searched, with 22 pre-post design and randomised controlled trial (RCTs) studies meeting the inclusion criteria. 10 RCTs studies were included in the meta-analysis.

RESULTS

Two random effects meta-analyses on general distress and work-related distress found that ACT outperformed pooled control conditions with a small effect size for general distress at post-intervention (g = 0.394, CIs [.040; .748]) and for work-related distress (g = 0.301, CIs [.122; .480]) at follow-up. However, ACT was more effective than controls. The number of treatment sessions was a moderator of intervention efficacy for general distress. ACT process measures (psychological flexibility) did not show significantly greater improvements in those who received the intervention.

LIMITATIONS

The methodological quality of studies was poor and needs to be improved.

CONCLUSIONS

Overall, ACT interventions are effective in improving general distress and work-related distress in HCPs. These findings have implications for policymakers, healthcare organisations and clinicians.

A template for preregistration of quantitative research in psychology: Report of the joint psychological societies preregistration task force

Recent years have seen dramatic changes in research practices in psychological science. In particular, preregistration of study plans before conducting a study has been identified as an important tool to help increase the transparency of science and to improve the robustness of psychological research findings. This article presents the Psychological Research Preregistration-Quantitative (PRP-QUANT) Template produced by a Joint Psychological Societies Preregistration Task Force consisting of the American Psychological Association (APA), the British Psychological Society (BPS), and the German Psychological Society (DGPs), supported by the Center for Open Science (COS) and the Leibniz Institute for Psychology (ZPID). The goal of the Task Force was to provide the psychological community with a consensus template for the preregistration of quantitative research in psychology, one with wide coverage and the ability, if necessary, to adapt to specific journals, disciplines, and researcher needs. This article covers the structure and use of the PRP-QUANT template, while outlining and discussing the benefits of its use for researchers, authors, funders, and other relevant stakeholders. We hope that by introducing this template and by demonstrating the support of preregistration by major academic psychological societies, we will facilitate an increase in preregistration practices and also the further advancement of transparency and knowledge-sharing in the psychological sciences. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Financial incentives for bowel cancer screening: Results from a mixed methods study in the United Kingdom

OBJECTIVES

The purpose of bowel cancer screening is to test for signs of cancer before symptoms develop. Financial incentives are one potential method to increase participation rates. Few studies have tested incentives in relation to bowel screening in the United Kingdom (UK). The current research explored reactions to different financial incentives to participate in population-level bowel cancer screening in a UK sample.

DESIGN

An online mixed methods study. Recruitment was via a study recruitment website (https://prolific.ac/).

METHODS

499 participants (aged 60-74 years) completed a survey on invitations for population-level bowel cancer screening using different levels of financial incentives.

RESULT

Respondents were generally positive about the use of financial incentives. A £10 voucher was most frequently selected as the appropriate amount to incentivise screening participation. The current invitation method with no voucher was judged to be most acceptable but suggested to produce the lowest likelihood of others participating. Offering a £10 voucher that the NHS would not be charged for if not used was the second most acceptable invitation method. There were few differences between invitation methods on own perceived likelihood of participation in bowel screening. Offering a £10 voucher was seen as leading to the greatest likelihood of others participating in bowel screening. Findings were largely unaffected by participant demographics.

CONCLUSION

The use of small financial incentives to increase bowel cancer screening uptake was generally well received. Impacts of incentives on actual bowel screening rates in UK samples need to be established in the light of the current findings.

Resilience and vulnerability factors influence the cortisol awakening response in individuals vulnerable to suicide

Suicide is a global health issue. Dysregulated hypothalamic-pituitary-adrenal (HPA) axis activity, as measured by cortisol levels, has been identified as one potential risk factor. Evidence is emerging to suggest that different psychological factors may be associated with increased resilience and vulnerability in this context. The current study investigated whether trait resilience, social support, socially prescribed perfectionism, trait worry and trait impulsivity influenced the cortisol awakening response (CAR) over a 7-day study in individuals vulnerable to suicide. 142 participants with a history of suicidal attempt or ideation (suicide vulnerability group; n = 95) and with no suicide risk history (control group; n = 47) were recruited. Participants completed baseline questionnaires before commencing a 7-day study where they provided cortisol samples immediately upon waking, at 15 min, 30 min and 45 min on 7 consecutive days. Higher worry, socially prescribed perfectionism and impulsivity, lower resilience and social support were found in the suicide vulnerability group compared to the control group. Lower levels of resilience, higher levels of socially prescribed perfectionism, worry and impulsivity were associated with significantly lower total CAR. Suicide group membership was also found to have an indirect effect on total CAR via trait worry. The current findings show for the first time, that these well-known psychological risk factors for suicide are associated with smaller total cortisol awakening responses. Researchers ought to elucidate the precise causal mechanisms linking these traits, CAR and suicide risk in order to develop interventions to help build resilience in vulnerable populations.

Health effects of psychological interventions for worry and rumination: A meta-analysis

OBJECTIVE

Evidence suggests that perseverative cognition (PC), the cognitive representation of past stressful events (rumination) or feared future events (worry), mediates the relationship between stress and physical disease. However, the experimental evidence testing methods to influence PC and the subsequent relationship with health outcomes has not been synthesized. Therefore, the current review addressed these gaps.

METHOD

Studies randomly assigning participants to treatment and control groups, measuring PC and a physical and/or behavioral health outcome after exposure to a nonpharmacological intervention, were included in a systematic review. Key terms were searched in Medline, PsycINFO and CINAHL databases. Of the screened studies (k = 10,703), 36 met the eligibility criteria.

RESULTS

Random-effects meta-analyses revealed the interventions, relative to comparison groups, on average produced medium-sized effects on rumination (g = -.58), small-to-medium sized effects on worry (g = -.41) and health behaviors (g = .31), and small-sized effects on physical health outcomes (g = .23). Effect sizes for PC were negatively associated with effect sizes for health behaviors. (following outlier removal). Effect sizes for PC were significantly larger when interventions were delivered by health care professionals than when delivered via all other methods. No specific intervention type (when directly compared against other types) was associated with larger effect sizes for PC.

CONCLUSIONS

Psychological interventions can influence PC. Medium-sized (negative) effect sizes for PC correspond with small (but positive) health behavior effect sizes. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Exploring the effects of daily hassles and uplifts on eating behaviour in young adults: The role of daily cortisol levels

Existing stress-eating research has shown that daily hassles are associated with increases in food intake and that cortisol reactivity to stress has been found to influence the stress-eating relationship. However, the moderating effects of daily cortisol levels (e.g., the cortisol awakening response, CAR) remain unknown. Moreover, recent evidence has shown that daily uplifts, as well as daily hassles, are important in understanding daily influences on eating behaviour. Therefore, in the same study, the current investigation explored the effects of daily hassles and uplifts on eating behaviour and whether these relationships were moderated by mean daily cortisol levels in young female adults. Forty-nine female participants (M age: 19.13 years) recorded the daily hassles and uplifts that they experienced over a 4-day period, together with the between-meal snacks they consumed each day, using an online daily diary. Cortisol samples were provided daily immediately upon waking, at +30 min and +12 h. Mean CAR and mean cortisol levels were calculated across the 4 days. Using multi-level modeling, daily hassles and uplifts were both significantly associated with greater unhealthy snacking. Daily uplifts, but not daily hassles, were also associated with lower healthy snack intake. Higher levels of mean CAR were associated with lower daily healthy snack intake. Moreover, the effects of daily uplifts on healthy snacking were found to be moderated by mean daily cortisol levels, such that participants with the highest levels of mean cortisol consumed less healthy snacks on days when they experienced uplifts. The current study provides novel evidence that mean daily cortisol levels, as well as daily hassles and uplifts, are implicated in daily snack consumption in young female adults. The role of hypothalamic-pituitary adrenal axis activity should be explored further in the context of the daily hassles/uplifts and eating behaviours relationship, in men and in individuals from lower socio-economic status and minority groups.

Mental health and well-being during the COVID-19 pandemic: longitudinal analyses of adults in the UK COVID-19 Mental Health & Wellbeing study

BACKGROUND

The effects of coronavirus disease 2019 (COVID-19) on the population's mental health and well-being are likely to be profound and long lasting.

AIMS

To investigate the trajectory of mental health and well-being during the first 6 weeks of lockdown in adults in the UK.

METHOD

A quota survey design and a sampling frame that permitted recruitment of a national sample was employed. Findings for waves 1 (31 March to 9 April 2020), 2 (10 April to 27 April 2020) and 3 (28 April to 11 May 2020) are reported here. A range of mental health factors was assessed: pre-existing mental health problems, suicide attempts and self-harm, suicidal ideation, depression, anxiety, defeat, entrapment, mental well-being and loneliness.

RESULTS

A total of 3077 adults in the UK completed the survey at wave 1. Suicidal ideation increased over time. Symptoms of anxiety, and levels of defeat and entrapment decreased across waves whereas levels of depressive symptoms did not change significantly. Positive well-being also increased. Levels of loneliness did not change significantly over waves. Subgroup analyses showed that women, young people (18-29 years), those from more socially disadvantaged backgrounds and those with pre-existing mental health problems have worse mental health outcomes during the pandemic across most factors.

CONCLUSIONS

The mental health and well-being of the UK adult population appears to have been affected in the initial phase of the COVID-19 pandemic. The increasing rates of suicidal thoughts across waves, especially among young adults, are concerning.

Stress and eating behaviours in healthy adults: a systematic review and meta-analysis

Stress leads to detrimental health outcomes through direct biological and indirect behavioural changes. Stress can lead to disruption to normal eating behaviours, although the strength of these associations is unknown. This is the first meta-analysis to determine the strength of the stress-eating relationship in healthy adults and to explore the impact of potential moderators. Studies included had a clearly defined measure of stress (i.e., any noxious event or episode in one's environment with the exclusion of emotional distress) that was linked to non-disordered eating. Key terms were searched in Medline, PsycInfo and Ovid databases (23,104 studies identified). 54 studies (combined N = 119,820) were retained in the meta-analysis. A small, positive effect size was found for the stress-overall food intake relationship (Hedges' g = 0.114). Stress was associated with increased consumption of unhealthy foods (Hedges' g = 0.116) but decreased consumption of healthy foods (Hedges' g = -0.111). Only one significant moderator (restraint on stress-unhealthy eating) was identified. This meta-analysis identified the magnitude of the effect of stress on eating behaviour outcomes. Significant heterogeneity was observed that was not explained by the moderators examined. Further research on moderators of the stress-eating relationship is required and should distinguish effects for healthy versus unhealthy eating.

Wellbeing, burnout, and safe practice among healthcare professionals: predictive influences of mindfulness, values, and self-compassion

Poor wellbeing and burnout are significant issues among health-care professionals (HCPs) and may contribute to unsafe practice. In this exploratory study, we aimed to: provide the first investigation of the combined and unique influences of these psychological factors in predicting safe practice; confirm the role played by mindfulness in relation to wellbeing, burnout and safe practice; and investigate whether values and self-compassion predict additional variability above and beyond mindfulness skills. Ninety-eight NHS staff completed measures of wellbeing, burnout, perceived safety of practice, mindfulness, values and self-compassion. Practitioners with higher perceived safety of practice reported higher levels of mindfulness, but not values or self-compassion, particularly lower experiential avoidance and nonjudgmental attitude toward difficult thoughts. Mindfulness explained significant variability in psychological distress (20%), emotional exhaustion (8%), cognitive weariness (10%), patient safety related to oneself (7%), and related to work (8%). Values (obstruction) added unique variance for psychological distress (12%) and physical fatigue (10%). Moreover, self-compassion explained a small yet significant portion of variability in emotional exhaustion. These preliminary findings suggest that mindfulness processes may be associated with perceived safety of practice. The results also indicate that mindfulness-based interventions for HCPs may benefit from the inclusion of values-based action components and self-compassion practices.

Perfectionism and psychological distress: evidence of the mediating effects of rumination

Three studies investigated the role of ruminative tendencies in mediating the effects of multidimensional perfectionism (Hewitt & Flett, 1991) on psychological distress. Study 1 (Sample 1, N = 279; Sample 2, N = 224) and Study 2 (N = 205) found evidence, cross‐sectionally and prospectively, that brooding ruminative response style either fully or partially mediated the effects of socially prescribed and self‐oriented perfectionism on psychological distress, depression and hopelessness levels. In addition, Study 3 (N = 163) confirmed these mediation effects for socially prescribed perfectionism in relation to depression and hopelessness, 2 months later, after initial levels of distress were controlled. Overall, these findings provide evidence that brooding ruminative response style is an important mechanism that can explain, in part, the relationship between perfectionism and distress. Copyright © 2006 John Wiley & Sons, Ltd.

Research priorities for the COVID-19 pandemic and beyond: A call to action for psychological science

The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) that has caused the coronavirus disease 2019 (COVID-19) pandemic represents the greatest international biopsychosocial emergency the world has faced for a century, and psychological science has an integral role to offer in helping societies recover. The aim of this paper is to set out the shorter- and longer-term priorities for research in psychological science that will (a) frame the breadth and scope of potential contributions from across the discipline; (b) enable researchers to focus their resources on gaps in knowledge; and (c) help funders and policymakers make informed decisions about future research priorities in order to best meet the needs of societies as they emerge from the acute phase of the pandemic. The research priorities were informed by an expert panel convened by the British Psychological Society that reflects the breadth of the discipline; a wider advisory panel with international input; and a survey of 539 psychological scientists conducted early in May 2020. The most pressing need is to research the negative biopsychosocial impacts of the COVID-19 pandemic to facilitate immediate and longer-term recovery, not only in relation to mental health, but also in relation to behaviour change and adherence, work, education, children and families, physical health and the brain, and social cohesion and connectedness. We call on psychological scientists to work collaboratively with other scientists and stakeholders, establish consortia, and develop innovative research methods while maintaining high-quality, open, and rigorous research standards.

Conscientiousness and engagement with national health behaviour guidelines

High conscientiousness is associated with better health and longer life. This relationship is partly accounted for by the performance of health behaviours. The current study aimed to investigate whether conscientiousness was associated with adherence to national health behaviour guidelines as an indicator of healthy lifestyle. A cross-sectional design was used, where participants (N= 886) completed online questionnaires to assess conscientiousness and the facets of conscientiousness (order, virtue, traditionalism, self-control, responsibility, industriousness) and the performance of four health behaviours (fruit and vegetable consumption, alcohol intake, smoking, and physical activity). An index was calculated to combine the health behaviours. Conscientiousness and all its facets significantly predicted the health behaviour guideline index. In comparing high and low conscientious sub-groups, the low conscientious group had lower levels of adherence to all health behaviours guidelines measured. Strikingly, the number of high conscientious participants meeting all health behaviour guidelines was nearly twice the number of low conscientious participants meeting all guidelines. Conscientiousness is associated with adherence to multiple national health behaviour guidelines. Therefore, the positive associations between conscientiousness and health/longevity may be accounted for, in part, by the adoption of a healthy lifestyle across multiple health domains.

Stress and Health: A Review of Psychobiological Processes

The cumulative science linking stress to negative health outcomes is vast. Stress can affect health directly, through autonomic and neuroendocrine responses, but also indirectly, through changes in health behaviors. In this review, we present a brief overview of (a) why we should be interested in stress in the context of health; (b) the stress response and allostatic load; (c) some of the key biological mechanisms through which stress impacts health, such as by influencing hypothalamic-pituitary-adrenal axis regulation and cortisol dynamics, the autonomic nervous system, and gene expression; and (d) evidence of the clinical relevance of stress, exemplified through the risk of infectious diseases. The studies reviewed in this article confirm that stress has an impact on multiple biological systems. Future work ought to consider further the importance of early-life adversity and continue to explore how different biological systems interact in the context of stress and health processes.