Journal of behavioral medicine
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Randomized Controlled Trial
Impact of psychotherapy on insomnia symptoms in patients with depression and multiple sclerosis.
The purpose of the study was to evaluate the prevalence of insomnia in multiple sclerosis patients with comorbid depression, associations between psychological symptoms, multiple sclerosis symptoms and insomnia, and to test effects of a 16-week protocol-based psychotherapy intervention for depression on insomnia symptoms. Participants with multiple sclerosis and depression (n = 127) were randomized to telephone administered cognitive behavioral therapy and telephone administered supportive emotion-focused therapy. Multiple sclerosis functional limitation was measured at baseline. ⋯ Improvements in insomnia were associated with improvement in depression and anxiety. Participants with residual insomnia were more likely to have major depressive disorder, greater multiple sclerosis severity, elevated anxiety and lower mental components of quality of life. Results demonstrate rates of insomnia in patients with comorbid multiple sclerosis and depression are higher than those reported in the general multiple sclerosis population and additional insomnia treatment is indicated beyond the treatment of comorbid psychological disorders.
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Prior research has found that sex differences in pain are partially due to individual variations in gender roles. In a laboratory study, we tested the hypothesis that the presence of covert gender role cues can also moderate the extent to which women and men experience pain. Specifically, we varied gender role cues by asking male and female participants to write about instances in which they behaved in a stereotypically feminine, masculine, or neutral manner. ⋯ However, no differences existed between the sexes in the masculine or neutral prime conditions. The results indicate that covert gender cues can alter pain reports. Further, at least in some situations, feminine role cues may be more influential on pain reports than masculine role cues.
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In the setting of the new A(H1N1) outbreak, the study was conducted to assess: (1) fear of the A(H1N1) pandemic; (2) risk avoidance behavior; (3) health-protective behavior; and (4) psychosocial impact in the ethnically diverse population of Malaysia. A cross-sectional, computer-assisted telephone interview was conducted between July 11 and September 12, 2009. A total of 1,050 respondents were interviewed. ⋯ Knowledge was a significant predictor for practice of healthprotective behavior across the three ethnic groups. Level of fear was significantly correlated with number of protective and avoidance behaviors. The study highlights the need for provision of accurate information that increases risk avoidance and health protective behaviors, while at the same time decreases fear or panic in the general public.
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Though the positive effect of touch on compliance has been widely reported in the social psychology literature, a new evaluation has been made in a health setting. Six general practitioners were instructed to touch (or not) their patients on the forearm for 1-2 s. Patients who suffered from mild pharyngitis were solicited by the practitioners at the end of the consultation for a verbal promise to take the antibiotic medication as prescribed. ⋯ It was also found that practitioners were perceived to be more concerned about their patients by those in the touch condition. Practitioner competence appeared to be slightly higher in the touch condition. The theoretical implications of this positive effect of tactile contact are discussed and the practical interest for practitioners is highlighted, showing how this nonverbal technique could help them to increase the medication adherence of their patients.
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Recently, an expansion of traditional coping models for chronic pain has been offered. This model specifically includes acceptance of chronic pain, as well as the more general process of psychological flexibility. Psychological flexibility includes qualities of behavior such as acceptance and mindfulness, and the capacity to take committed and values-directed or goals-directed action, among other qualities. ⋯ Exploratory factor analysis indicated the presence of two factors within the items of the BPRI: Flexible Action and Willing Engagement. Subscale and total scores were generally unrelated with patient background variables, although they were related to, and accounted for significant variance in, measures of emotional, physical, and psychosocial functioning. These analyses provide additional support for the relevance of psychological flexibility to the problem of chronic pain, as well as initial evidence for the BPRI as a measure of this process.