• A qualitative analysis of psychological processes mediating quality of life impairments in chronic daily headache

      Tenhunen, K.; Elander, James; University of Derby (2005)
      Quality of life impairments are greater in chronic daily headache (CDH) than in episodic headache conditions like migraine. This qualitative interview study aimed to identify psychological processes associated with quality of life impairments among individuals meeting diagnostic criteria for CDH. Grounded theory analysis showed that perceived loss of control was the central experience mediating the impact of CDH on quality of life. The results provide explanations for previous quantitative findings about quality of life impairments in CDH, and could inform interventions to reduce the impact of CDH. Further research could also examine the roles played by perceived control in the onset and development of CDH, including possible links with pre-emptive analgesic use.
    • A qualitative analysis of psychological processes mediating quality of life impairments in chronic daily headache

      Tenhunen, Katri; Elander, James; University of Derby (SAGE Publications, 2005-05-01)
      Quality of life impairments are greater in chronic daily headache (CDH) than in episodic headache conditions like migraine. This qualitative interview study aimed to identify psychological processes associated with quality of life impairments among individuals meeting diagnostic criteria for CDH. Grounded theory analysis showed that perceived loss of control was the central experience mediating the impact of CDH on quality of life. The results provide explanations for previous quantitative findings about quality of life impairments in CDH and could inform interventions to reduce the impact of CDH. Further research could also examine the roles played by perceived control in the onset and development of CDH, including possible links with pre-emptive analgesic use.
    • A qualitative study of the understanding and use of ‘compassion focused coping strategies’ in people who suffer from serious weight difficulties.

      Gilbert, Jean; Stubbs, James; Gale, Corinne; Gilbert, Paul; Dunk, Laura; Thomson, Louise; Derbyshire Healthcare NHS Trust; Slimming World; University of Derby; University of Nottingham (Biomed Central, 2014-11-11)
      Abstract Background The physical and psychological health problems associated with obesity are now well documented, as is the urgency for addressing them. In addition, associations between quality of life, depression, self-esteem, self-criticism, and obesity are now established indicating a need for a better understanding of the links between self-evaluation, affect-regulation and eating behaviours. Methods Compassion has now been identified as a major source of resilience, helpful self-relating and affect regulation. Thus this study used semi-structured interviews to explore the understanding and experiences of compassion in 2 overweight men and 10 women seeking help for weight problems. The interviews examined people's understandings of compassion, their recall of experiences of compassion in childhood, their current experiences of receiving compassion from others, being compassionate to others, being self-compassionate, and whether they would be compassionate or self-critical for relapses in overeating. Interviews were transcribed and analysed using thematic analysis (Qual Res Psychol, 3: 77-101, 2006). Results Participants saw compassion as related to ‘caring’ and being ‘listened to’. However, their recall of earlier experiences of compassion was of primarily practical help rather than emotional engagement. Typically their response to their own relapse and setbacks were self-criticism, self-disgust and even self-hatred rather than self-caring or understanding. Self-critical/hating responses tend to be associated with poor weight regulation. Conclusions When people with weight problems relapse, or struggle to control their eating, they can become quite self-critical, even self-hating, which may increase difficulties with emotionally coping and maintaining healthy lifestyles and eating habits. Although turning to others for support and compassion, and becoming self-compassionate are antidotes to self-criticism, and are associated with better coping and mental health, many participants did not utilise compassionate strategies – often the opposite. It is possible that interventions that include mindfulness and compassion training could be helpful for these difficulties.
    • Randomized trial of a DVD intervention to improve readiness to self-manage joint pain

      Elander, James; Robinson, Georgina; Morris, John; University of Derby (2011)
      A DVD (digital video disk) intervention to increase readiness to self-manage joint pain secondary to hemophilia was informed by a 2-phase, motivational-volitional model of readiness to self-manage pain, and featured the personal experiences of individuals with hemophilia. The DVD was evaluated in a randomized controlled trial in which 108 men with hemophilia completed measures of readiness to self-manage pain (Pain Stages of Change Questionnaire) before and 6 months after receiving the DVD plus information booklet (n = 57) or just the booklet (n = 51). The effect of the DVD was assessed by comparing changes in Pain Stages of Change Questionnaire scores (precontemplation, contemplation, and action/maintenance) between groups. The impact on pain coping, pain acceptance, and health-related quality of life was tested in secondary analyses. Repeated-measures analysis of variance, including all those with complete baseline and follow-up data regardless of use of the intervention, showed a significant, medium- sized, group time effect on precontemplation, with reductions among the DVD group but not the booklet group. Significant use time effects showed that benefits in terms of contemplation and action/maintenance were restricted to those who used the interventions at least once. The results show that low-intensity interventions in DVD format can improve the motivational impact of written information, and could be used to help prepare people with chronic pain for more intensive self-management interventions. The findings are consistent with a 2-phase, motivational-volitional model of pain self-management, and provide the first insights to our knowledge of readiness to self-manage pain in hemophilia.
    • A randomized-controlled pilot trial of an online compassionate mind training intervention to help people with chronic pain avoid analgesic misuse

      Dhokia, Mayoor; Elander, James; Clements, Keith; Gilbert, Paul; University of Derby (American Psychological Association (APA), 2020-04-09)
      Problematic use of prescribed and over-the-counter analgesics is widespread and increasing among people with chronic pain, but the availability of preventative and treatment services is limited. We evaluated a 21-day online intervention based on compassionate mind training in a prospective, randomized-controlled trial. The participants were 73 adults with concerns about their use of analgesics for chronic pain conditions. Participants completed measures of analgesic use, misuse and dependence, plus self-criticism and self-reassurance (self-inadequacy, self-reassurance and self-hate), cognitive impulsivity (negative urgency, lack of perseverance, lack of premeditation, sensation-seeking and positive urgency) and behavioral impulsivity (delay discounting) at baseline, post-intervention and 1-week post-intervention follow-up. Following baseline assessment, participants were randomized to compassionate mind training (CMT; n=38) or relaxation music (RM; n=35), both delivered online. No adverse events or safety issues were reported and high participant retention and exercise completion rates showed that the intervention was acceptable to participants. Repeated measures analysis of variance showed that by comparison with RM, the CMT group had reduced prescription analgesic use (F=6.123, p=0.015), analgesic dependence (F=14.322, p<.001), self-hate (F=12.218, p<0.001), negative urgency (F=7.323, p=0.006) and lack of perseverance (F=7.453, p=0.001) from baseline to post-intervention, and those improvements were maintained at follow-up. The results show that exercises based on CMT principles and techniques and delivered online can reduce analgesic use, risk of analgesic dependence, and some aspects of self-criticism and impulsivity.
    • Rank perception and self-evaluation in eating disorders

      Cardi, Valentina; Di Matteo, Rosalia; Gilbert, Paul; Treasure, Janet; King's College London; University of Chieti-Pescara; University of Derby; King's College London; Institute of Psychiatry, Psychological Medicine, Section of Eating Disorders; London United Kingdom; Department of Neuroscience and Imaging; University of Chieti-Pescara; Chieti Italy; Mental Health Research Unit; University of Derby; Derby United Kingdom; et al. (Wiley, 2014-02-18)
      ABSTRACT Objectives Heightened sensitivity to social comparison and negative self-evaluation have been implicated in the development and maintenance of eating disorders (EDs). This study used behavioral tasks, as well as self-report measures, to examine processing of social rank-related cues and implicit self-concept in participants with EDs. Method Fifty healthy participants (HCs), 46 people with an ED, and 22 people recovered from an ED (REC) undertook an attentional bias task using social rank-related cues and an implicit self-evaluation task. In addition, they completed self-report measures of social comparison, submissive behavior, and shame. Results People with EDs showed vigilance toward social rank-related stimuli and lower implicit positive self-evaluation than HCs. Self-report data confirmed the behavioral findings and showed that people with EDs had higher levels of unfavorable social comparison, submissive behaviors, and external and internal shame than HCs. People who had recovered from an ED showed an intermediate profile between the two groups. Discussion People with EDs have heightened sensitivity to social rank-related cues and impaired self-evaluation at an automatic level of processing. Some of these biases remain in people who have recovered. Interventions which aim to remediate social threat sensitivity and negative bias about self and others might be of benefit in EDs. © 2014 Wiley Periodicals, Inc. (Int J Eat Disord 2014; 47:543–552)
    • Reading sentences with a late closure ambiguity: does semantic information help?

      Lipka, Sigrid; University of Derby (2002)
      Stowe (1989) reported that semantic information eliminates garden paths in sentences with the direct-object vs. subject ambiguity, such as Even before the police stopped the driver was very frightened. Three experiments are presented which addressed some methodological problems in Stowe's study. Experiment 1, using a word-by-word, self-paced reading task with grammaticality judgements, manipulated animacy of the first subject noun while controlling for the plausibility of the transitive action. The results suggest that initial sentence analysis is not guided by animacy. Experiment 2 and 3, using the self-paced task with grammaticality judgements and eye-tracking, varied the plausibility of the direct-object nouns to test revision effects. Plausibility was found to facilitate revision without fully eliminating garden paths, in line with various revision models. The findings support the view of a sentence processing system relying heavily on syntactic information, with semantic information playing a weaker role both in initial analysis and during revision, thus supporting serial, syntax-first models and ranked-parallel models relying on structural criteria.
    • Recognition of subtle and universal facial expressions in a community-based sample of adults classified with intellectual disability

      Owen, S.; Maratos, Frances A.; University of Derby; Department of Psychology; University of Derby; Derby UK; Department of Psychology; University of Derby; Derby UK (2016-02-09)
      Background Across the USA and UK schemes now exist to aid the successful integration of adults with mild to moderate intellectual disabilities into general society. One factor that may prove important to the success of such schemes is social competence. Here, understanding the facial expressions of others is critical, as emotion recognition is a prerequisite to empathetic responding and an essential factor in social functioning. Yet research in this area is lacking, especially in community-based samples. Method We investigated the performance of 13 adults with mild to moderate intellectual disability (ID), relative to 13 age-matched controls, on three tasks of emotion recognition (emotion categorisation; recognition of valence; recognition of arousal), using a number of ‘basic’ (angry, happy) and more ‘subtle’ (compassionate, critical) emotional expressions, as well as the posers face in a default relaxed (i.e. ‘neutral’) state. Importantly, the sample was drawn from a community-based initiative, and was therefore representative of populations’ government schemes target. Results Across emotion recognition tasks the ID adults, as compared to controls, were significantly impaired when labelling the emotions displayed by the poser as well as recognising the associated ‘feelings’ conveyed by these faces. This was especially true for the neutral, compassionate and angry facial expressions. For example, ID adults demonstrated deficits in categorising neutral and subtle emotional expressions, as well as assessing the valence of such facial expressions. In addition, ID adults also struggled to assess arousal levels; especially those associated with compassionate and angry faces. Conclusion Given both basic and subtle emotions are conveyed in a range of daily situations, errors in interpreting such facial expressions and, relatedly, understanding what potential behaviours such expressions signify could contributing to the social difficulties ID adults face. This is important since current initiatives such as ‘personalisation’ do not appear to have schemes supporting training in this area and understanding the facial expressions of others is, after all, one of our most important non-verbal social communication tools.
    • Recreational 3,4-methylenedioxy-N-methylamphetamine (MDMA) or ‘ecstasy’ and self-focused compassion: Preliminary steps in the development of a therapeutic psychopharmacology of contemplative practices

      Kamboj, Sunjeev K; Kilford, Emma J.; Minchin, Stephanie; Moss, Abigail; Lawn, Will; Das, Ravi K.; Falconer, Caroline J.; Gilbert, Paul; Curran, H Valerie; Freeman, Tom P.; et al. (Sage, 2015-05-18)
      3,4-methylenedioxy-N-methylamphetamine (MDMA) produces diverse pro-social effects. Cognitive training methods rooted in Eastern contemplative practices also produce these effects through the development of a compassionate mindset. Given this similarity, we propose that one potential mechanism of action of MDMA in psychotherapy is through enhancing effects on intrapersonal attitudes (i.e. pro-social attitudes towards the self). We provide a preliminary test of this idea. Recreational MDMA (ecstasy)-users were tested on two occasions, having consumed or not consumed ecstasy. Selfcritical and self-compassionate responses to self-threatening scenarios were assessed before (T1) and after (T2) ecstasyuse (or no use), and then after compassionate imagery (T3). Moderating roles of dispositional self-criticism and avoidant attachment were examined. Separately, compassionate imagery and ecstasy produced similar sociotropic effects as well as increases and reductions in self-compassion and self-criticism respectively. Higher attachment-related avoidance was associated with additive effects of compassionate imagery and ecstasy on self-compassion. Findings were in line with MDMA’s neuropharmacological profile, its phenomenological effects and proposed adjunctive use in psychotherapy. However, although conditions were balanced, the experiment was non-blind and MDMA dose/purity was not determined. Controlled studies with pharmaceutically pure MDMA are still needed to test these effects rigorously.
    • Reflecting the transition from pain management services to chronic pain support group attendance: An interpretative phenomenological analysis

      Finlay, Katherine A.; Elander, James; University of Buckingham and University of Derby; Department of Psychology; School of Science and Postgraduate Medicine; University of Buckingham; UK; Centre for Psychological Research; University of Derby; UK (Wiley, 2016-05-27)
      Objectives. Transitioning from clinical care to community-based self-management represents a significant challenge, throughout which social support can facilitate health adjustment and quality of life. However, community-centred, peer-led support structures are often under-used. This study aimed to investigate the decision-making processes involved in the choice to attend a Chronic Pain Support Group (CPSG) following discharge from a Pain Management Programme. Design. An in-depth, qualitative analysis was undertaken using Interpretative Phenomenological Analysis (IPA), exploring participants’ subjective experiences, decisional making, and rationale for initial CPSG attendance. Methods. Twelve participants (four males, eight females) were recruited from a regional CPSG and completed semi-structured interviews lasting between 45 and 120 minutes. Interviews were transcribed verbatim and analysed idiographically before a cross-case analysis was completed. Results. Analysis of transcripts resulted in three superordinate themes: (1) The thirst for comparative friendship; (2) Conjecture and the imminent choice; (3) Progressive pain management. These themes reflect a desire for empathic, socially comparative friendships and the search for a forum in which to enhance pain self-management strategies, yet also internal conflict over initial CPSG attendance. Conclusion. Social support and associated friendships are attractive to prospective CPSG members and are conceptualised as opportunities to engage in social comparison and nurture self-care. The first visit to the support group presents a significant hurdle, but can be facilitated by managing the transition between therapeutic care and CPSG attendance. Clinicians can challenge preconceptions, foster positive viewpoints regarding the group and support collective decision-making to attend. Following initial attendance, psychosocial wellbeing was enhanced.
    • Reflective self-attention: A more stable predictor of connection to nature than mindful attention.

      Richardson, Miles; Sheffield, David; University of Derby (Mary Ann Liebert, Inc., publishers, 2015-09-28)
      There is much to be gained from understanding the individual differences that predict our connection to nature, as those that are more connected tend to be more caring towards the environment and benefit from better well-being. Study 1 (n=137) found that reflective self-attention and mindful attention significantly predicted connection to nature, while anxious self-attention had a borderline significant negative association. With the introduction of personality measures, study 2 (n=161) found that reflective self-attention and openness had a stronger relationship to nature connection than mindful attention. Study 3 (n=99) found reflective self-attention, rather than mindful attention, to be associated with an increase in connection to nature. A pre-reflective and intentional self-attention account of nature connectedness is proposed with intentional self-reflection being a stronger factor than mindful attention.
    • The relation of entrapment, shame and guilt to depression, in carers of people with dementia.

      Martin, Y.; Gilbert, Paul; McEwan, Kirsten; Irons, Christopher Paul; Kingsway Hospital; University of Derby (Routledge, 2006-01)
      There is increasing research exploring depression in carers of people with dementia. This study explored the relation of entrapment, shame and guilt to depression in a group of 70 carers of those with dementia. As in other studies the experience of entrapment in the role was highly related to depression. Moreover, experiences of shame relating to self-criticism, other people’s expectations and the fear of their criticism were significantly related to depression, entrapment and guilt. Guilt however, as focused on the fears of harming others, letting others down and sense of responsibility, was not associated with depression or entrapment. Depression in carers may relate in part to feeling trapped in a role but also being vulnerable to criticism and feelings of inadequacy in that role. In this study, degree of behavioural disturbance/dependence was not found to be significantly associated with any of the research variables.
    • The relationship between pain beliefs and physical and mental health outcome measures in chronic low back pain: direct and indirect effects

      Baird, Andrew; Sheffield, David; University of Derby (2016-08-19)
      Low back pain remains a major health problem with huge societal cost. Biomedical models fail to explain the disability seen in response to reported back pain and therefore patients’ beliefs, cognitions and related behaviours have become a focus for both research and practice. This study used the Pain Beliefs Questionnaire and had two aims: To examine the extent to which pain beliefs are related to disability, anxiety and depression; and to assess whether those relationships are mediated by pain self-efficacy and locus of control. In a sample of 341 chronic low back pain patients, organic and psychological pain beliefs were related to disability, anxiety and depression. However, organic pain beliefs were more strongly related to disability and depression than psychological pain beliefs. Regression analyses revealed that these relationships were in part independent of pain self-efficacy and locus of control. Further, mediation analyses revealed indirect pathways involving self-efficacy and, to a lesser extent chance locus of control, between organic pain beliefs, on the one hand, and disability, anxiety and depression, on the other. In contrast, psychological pain beliefs were only directly related to disability, anxiety and depression. Although longitudinal data are needed to corroborate our findings, this study illustrates the importance of beliefs about the nature of pain and beliefs in one’s ability to cope with pain in determining both physical and mental health outcomes in chronic low back pain patients.
    • The relationship between self-concealment and disclosure, early experiences, attachement, and social comparison.

      Cruddas, Sarah; Gilbert, Paul; McEwan, Kirsten; University of Derby; Kingsway Hospital (Guildford Press, 2012-03)
      Talking therapies rely on the client being able to reveal their inner feelings and thoughts; however, some people find this type of disclosure very difficult. Given the potential therapeutic disruptive effects of problems in self-disclosure and selfconcealment, this study set out to explore the associations between self-concealment, self-disclosure, early life experiences, attachment style, social comparison, and psychopathology in 92 students. Results show that self-concealment and fear of self-disclosure are related to negative social comparison (feeling inferior), depression, and anxiety. Fear of disclosure is more strongly related to depression, anxiety, and stress than self-concealment. Mediator analysis revealed recalling having to act submissively in childhood is associated with insecure adult attachment and this in turn predicts fear of disclosure. A second mediator analysis revealed that insecure adult attachment is associated with fear of disclosure and this in turn predicts depression.
    • Relationship between VO(2max) and repeated sprint ability using non-motorised treadmill ergometry.

      Brown, Peter I.; Hughes, Michael G.; Tong, Richard J.; University of Derby, Department of Sport and Exercise (2007-06)
      The aim of this study was to investigate the relationship between maximal oxygen uptake (Vo(2max)) and repeated sprint ability (RSA) using non-motorised treadmill ergometry.
    • Remote facilitation of attention focusing with psi-supportive versus psi-unsupportive experimenter suggestions.

      Watt, C.; Baker, Ian S.; University of Edinburgh (Watt, C., & Baker, I. S. (2002). Remote facilitation of attention focusing with psi-supportive versus psi-unsupportive experimenter suggestions. Journal of Parapsychology, 66, 2, 151-168, 2002)
      Eighty individuals took part in a study in which a single experimenter made either psi-supportive or psi-unsupportive suggestions prior to administering questionnaire measures and a psi task. The psi task was remote facilitation of attention focusing, with the dependent variable the participant’s self-reported number of distractions during Help epochs compared with Control epochs while focusing on a lit candle. During Help epochs, a remote individual also focused on a lit candle and maintained the mental intention to help the participant have fewer distractions than during Control epochs. Questionnaire measures were taken of participants’ psi belief, confidence, expected success, perceived success, and quality of focusing. Participants also rated the experimenter’s warmth, professionalism, ability to instil confidence in the task, and belief in psi. No over all remote facilitation of focusing was found, nor was there any difference between positive vs. negative suggestion groups on their psi performance. The groups differed on many of the questionnaire measures, including psi belief, confidence, expected and perceived success, quality of focusing, and experimenter ratings. The results point to an effect of the experimenter’s psi-supportive and psi-unsupportive suggestions on many of the psychological measures taken but no effects of suggestion on the psi task.
    • Representing older and disabled people in virtual user trials: data collection methods

      Gyi, Diane E.; Sims, Ruth; Porter, J. Mark; Marshall, Russell; Case, Keith; Loughborough University (2004)
      A database was developed to support the creation of a computer-based tool which will support design teams in evaluating the usability of a design during early prototyping and indicate which individuals are effectively excluded or designed out. Methods are described for the collection of multivariate data on 100 real individuals covering a range of physical characteristics and capabilities. These data were tested to ensure a breadth of representation of individuals (particularly older and disabled people) in terms of anthropometry, joint constraints, postural capabilities and task behaviours. The concept of the design tool itself is explored by conducting virtual user trials in the computer-aided design environment. The novel approach of the research encourages empathy with individual users and allows generic abilities, such as bending, reaching and lifting to be assessed.
    • Respiratory-related limitations in physically demanding occupations.

      Brown, Peter I.; McConnell, Alison K.; University of Derby, Department of Sport and Exercise (2012-04)
      Respiratory muscle work limits high-intensity exercise tolerance in healthy human beings. Emerging evidence suggests similar limitations exist during submaximal work in some physically demanding occupations. In an occupational setting, heavy loads are routinely carried upon the trunk in the form of body armor, backpacks, and/or compressed air cylinders by military, emergency service, and mountain rescue personnel. This personal and respiratory protective equipment impairs respiratory muscle function and increases respiratory muscle work. More specifically, thoracic load carriage induces a restrictive ventilatory limitation which increases the elastic work of breathing, rendering the respiratory muscles vulnerable to fatigue and inducing a concomitant reduction in exercise tolerance. Similarly, breathing apparatus worn by occupational personnel, including fire fighters and military and commercial divers, increases the inspiratory elastic and expiratory resistive work of breathing, precipitating significant inspiratory and expiratory muscle fatigue and a reduction in exercise tolerance. An argument is presented that the unique respiratory challenges encountered in some occupational settings require further research, since these may affect the operational effectiveness and the health and safety of personnel working in physically demanding occupations.
    • Response.

      Johnson, Michael A.; Mills, Dean E.; Brown, Peter I.; Sharpe, Graham R. (2013-01)
    • A review of evidence about behavioural and psychological aspects of chronic joint pain among people with haemophilia

      Elander, James; University of Derby; University of Derby; Derby UK (2014-03)
      Joint pain related to haemophilia affects large numbers of people and has a significant impact on their quality of life. This article reviews evidence about behavioural and psychological aspects of joint pain in haemophilia, and considers that evidence in the context of research on other chronic pain conditions. The aim is to inform initiatives to improve pain self-management among people with haemophilia. Reduced pain intensity predicts better physical quality of life, so better pain management should lead to improved physical quality of life. Increased pain acceptance predicts better mental quality of life, so acceptance-based approaches to self-management could potentially be adapted for people with haemophilia. Pain self-management interventions could include elements designed to: improve assessment of pain; increase understanding of the difference between acute and chronic pain; improve adherence to clotting factor treatment; improve knowledge and understanding about the benefits and costs of using pain medications; improve judgments about what is excessive use of pain medication; increase motivation to self-manage pain; reduce negative emotional thinking about pain; and increase pain acceptance. The influence of behavioural and psychological factors related to pain are similar in haemophilia and other chronic pain conditions, so there should be scope for self-management approaches and interventions developed for other chronic pain conditions to be adapted for haemophilia, provided that careful account is taken of the need to respond promptly to acute bleeding pain by administering clotting factor.