Recent Submissions

  • The mental health needs of child and adolescent refugees and asylum seekers entering Europe.

    Sapthiang, s; Van Gordon, W; Shonin, E; Griffiths, M; University of Derby; University of Essex.; Awake to Wisdom Centre for Meditation and Mindfulness Research, Ragusa, Italy; Nottingham Trent University. (2019-02-01)
    Children and adolescents constitute more than half of the global refugee population, and almost one‑third of first‑time asylum seekers in the European Union (EU) during 2015 were under 18 years of age. Syria, in particular, accounts for a substantial proportion of young refugees and asylum seekers because the ongoing civil war has led to almost 5 million Syrians fleeing their country and becoming refugees during the past 7 years. Being a child or adolescent refugee or asylum seeker carries an increased risk of developing mental illness, and such displaced young people are known to experience problems in accessing health‑care support. The present article draws on examples from Syria in order to (i) Highlight mental health issues that typically arise in children and adolescent refugees and asylum seekers entering Europe and (ii) discuss how changes to health systems and policies in European countries receiving refugees and asylum seekers can be better aligned with global efforts to improve the mental health of young displaced immigrants. In general, research findings indicate that there is a need for better awareness, intra‑agency collaboration, and cultural sensitivity toward the mental health needs of this immigrant population. Furthermore, there is also a need for EU countries to better respond to posttraumatic stress disorder and other typical refugee and asylum seeker mental health problems by more closely aligning national policies with global initiatives to improve the mental health of young displaced immigrants.
  • Mindfulness in schools: a health promotion approach to improving adolescent mental health.

    Sapthiang, Supakyada; Van Gordon, William; Shonin, Edo; University of Derby (Springer., 2018-10-16)
    Between 10 and 20% of adolescents worldwide experience a mental health problem within a given 12-month period. Mental health problems impact on an adolescent’s potential to live a fulfilling and productive life and lead to challenges such as stigma, isolation and discrimination. To address this need, in recent years, there has been growing interest into broad-based school-integrated health promotion interventions that seek to build resilience and augment protective factors in adolescents. Mindfulness-based interventions (MBIs) reflect one such approach that have been administered to adolescent populations in both resilience building and treatment contexts. This paper discusses the utility of school-based MBIs as an adolescent health promotion approach and makes recommendations for intervention design, delivery and evaluation. Emerging evidence indicates that school-integrated MBIs may be a cost-effective means of not only meeting government objectives relating to adolescent mental health, but also for improving the wellbeing of teachers and parents. Furthermore, there is growing evidence indicating that mindfulness can elicit improvements in student learning performance and general classroom behaviour. However, notwithstanding these beneficial properties, there remains a need to conduct large-scale empirical investigations that seek to evaluate the effectiveness of school-integrated MBIs at a regional or national level. A further challenge is the need to ensure that mindfulness instructors are able to impart to adolescents an experiential understanding of this ancient contemplative technique.
  • Exploring emptiness and its effects on non-attachment, mystical experiences, and psycho-spiritual wellbeing: a quantitative and qualitative study of advanced meditators.

    Van Gordon, William; Shonin, Edo; Dunn, Thomas J.; Sapthiang, Supakyada; Kotera, Yasuhiro; Garcia-Campayo, Javier; Sheffield, David; University of Derby; Bishop Grosseteste University; University of Essex; University of Zaragoza; Awake to Wisdom Centre for Meditation and Mindfulness Research (Elsevier, 2018-12-28)
    Wisdom-based Buddhist-derived practices (BDPs) are concerned with transmuting suffering by cultivating insight into the ultimate nature of both the self and reality. Arguably the most important wisdom-based BDP is emptiness (Sanskrit: śūnyatā) that implies that although phenomena are perceptible to the human mind, they do not intrinsically exist. Despite its significance in Buddhism, emptiness has received little empirical attention. Advancing scientific understanding of emptiness is important as it may yield novel insights not only into the nature of mind and reality, but also in terms of helping human beings realise more of their capacity for wisdom and wellbeing. This study recruited 25 advanced Buddhist meditators and compared emptiness meditation against a mindfulness meditation control condition within the same group of participants. Qualitative analytical techniques were also employed to investigate meditators’ experiences of emptiness. Compared to the mindfulness control condition, emptiness meditation resulted in significantly greater improvements in non-attachment to self and environment, mystical experiences, compassion, positive affect, and negative affect. No significant relationship was observed between duration of emptiness meditation and any of the aforementioned outcome measures. Qualitative outcomes demonstrated that participants (i) combined concentrative and investigative meditation techniques to induce emptiness, (ii) elicited spiritually meaningful insights both during and following the meditation on emptiness, and (iii) retained volitional control over the content and duration of the emptiness meditation. Cultivating emptiness appears to be a means of reconnecting advanced Buddhist meditators to what they deem to be the innermost nature of their minds and phenomena.
  • Self-criticism and self-reassurance as mediators between mental health attitudes and symptoms: Attitudes towards mental health problems in Japanese workers.

    Kotera, Yasuhiro; Gilbert, Paul; Asano, Kenichi; Ishimura, Ikuo; Sheffield, David; University of Derby (Wiley, 2018-12-13)
    Japanese workers suffer high rates of mental health symptoms, recognised recently by the Japanese government, which has enacted workplace well-being initiatives. One reason for poor mental health concerns negative attitudes about mental health problems such as shame, which may be mediated by self-reassurance and self-criticism. This study aimed to evaluate shame-based attitudes towards mental health problems, and explore the relationship between mental health attitudes, self-criticism, self-reassurance and mental health symptoms. Japanese workers (n=131) completed three measures; attitudes towards mental health problems, mental health symptoms, and self-criticism/reassurance. A high proportion of workers reported negative attitudes about mental health problems. There were strong relationships between mental health attitudes, mental health symptoms, self-criticism, and self-reassurance. Path analyses revealed that the total and indirect effects (through self-criticism and self- reassurance) of mental health attitudes on mental health were larger than the direct effect alone. Hated-self and family-reflected shame were identified as predictors for mental health symptoms. The findings suggest the importance of self-criticism and self-reassurance in mental health and mental health attitudes. Implications for help-seeking behaviours are also discussed. Interventions aimed at reducing self-criticism and enhancing self-reassurance are recommended to improve mental health attitudes and increase help-seeking in Japanese workers.
  • The lived experiences of experienced Vipassana Mahasi meditators: an interpretative phenomenological analysis.

    Ekici, Cimen; Garip, Gulcan; Van Gordon, William; University of Derby (Springer, 2018-11-27)
    Research into the effects and mechanisms of mindfulness training draws predominantly on quantitative research. There is a lack of understanding about the subjective experiences of experienced mindfulness meditators, which may provide additional insights into the effects, processes and context of mindfulness training. This qualitative study explored the lived experiences of a novel group of experienced mindfulness meditators who practise Vipassana Mahasi (VM) meditation. The study aimed to understand how experienced VM practitioners make sense of the effects of practice and what processes they ascribe to it. Participants attended semistructured interviews, and their responses were analysed using interpretative phenomenological analysis. Results yielded overarching themes including (a) improvements in hedonic and eudaimonic well-being; (b) insights into self, others and perception of reality; (c) attaining equanimity; and (d) physical and interpersonal difficulties. Participants perceived VM as a ‘cleansing’ process whereby maladaptive responses were eliminated through mindfulness, other supportive mental qualities, decentering and nonattachment. The findings revealed a complex and dynamic set of interdependent outcomes and processes, which are reinforced by Buddhist teachings and ethical practices. This study highlights the need for additional interdisciplinary research into topics such as insight generation and supportive mental qualities cultivated during VM, novel states of well-being informed by Buddhist constructs and interpersonal difficulties related to long-term practice. Findings also suggest that incorporating Buddhist teachings and ethics into mindfulness-based interventions may enhance practitioner understanding and implementation of meditation techniques.
  • Ethical judgement in UK business students: relationship with motivation, self-compassion and mental health.

    Kotera, Yasuhiro; Conway, Elaine; Van Gordon, William; University of Derby (Springer, 2018-11-30)
    There is growing awareness of mental health problems among UK business students, which appears to be exacerbated by students’ attitudes of shame toward mental health. This study recruited 138 UK business students and examined the relationship between mental health and shame, and mental health and potential protective factors such as self-compassion and motivation. A significant correlation between each of the constructs was observed and self-compassion was identified as an explanatory variable for mental health. Shame moderated the relationship between self-compassion and mental health. Integrating self-compassion training into business study programs may help to improve the mental health of this student group.
  • Further development of the Children’s Mathematics Anxiety Scale UK (CMAS-UK) for ages 4–7 years

    Petronzi, Dominic; Staples, Paul; Sheffield, David; Hunt, Thomas E.; Fitton-Wilde, Sandra; University of Derby (Springer, 2018-10-31)
    There are currently many mathematics anxiety rating scales designed typically for adult and older children populations, yet there remains a lack of assessment tools for younger children (< 7 years of age) despite a recent focus on this age range. Following previous testing and validation, the 26-item iteration of the Children’s Mathematics Anxiety Scale UK (CMAS-UK) for ages 4–7 years was further validated with 163 children (4–7 years) across two schools in the UK to test the validity and reliability of the items through subsequent exploratory and confirmatory factor analysis. The predictive validity of the scale was also tested by comparing scale scores against mathematics performance on a mathematics task to determine the relationship between scale and mathematics task scores. Exploratory factor analysis and associated parallel analysis indicated a 19-item scale solution with appropriate item loadings (> 0.45) and high internal consistency (α = 0.88). A single factor model of Online Mathematics Anxiety was related to the experience of an entire mathematics lesson, from first entering the classroom to completing a task. A significant negative correlation was observed between the CMAS-UK and mathematics performance scores, suggesting that children who score high for mathematics anxiety tend to score to perform less well on a mathematics task. Subsequent confirmatory factor analysis was conducted to test a range of module structures; the shortened 19-item CMAS-UK was found to have similar model indices as the 26-item model, resulting in the maintenance of the revised scale. To conclude, the 19-item CMAS-UK provides a reliable assessment of children’s mathematics anxiety and has been shown to predict mathematics performance. This research points towards the origins of mathematics anxiety occurring when number is first encountered and supports the utility of the CMAS-UK. Subsequent research in the area should consider and appropriately define an affective component that may underlie mathematics anxiety at older ages. Mathematics anxiety relates to more complex procedures that elude the experiences of younger children and may instead be the result of number-based experiences in the early years of education.
  • The applications of neuro-linguistic programming in organizational settings: A systematic review of psychological outcomes.

    Kotera, Yasuhiro; Sheffield, David; Van Gordon, William; University of Derby; Centre for Psychological Research; University of Derby; Derby UK; Centre for Psychological Research; University of Derby; Derby UK; Centre for Psychological Research; University of Derby; Derby UK (Wiley, 2018-11-15)
    Neuro‐linguistic programming (NLP) is an approach to communication and personal development focusing on how individuals organize their thinking, feelings, and language. While a growing number of academic articles highlight the application of NLP in organizational settings, a systematic review synthesizing and evaluating the quality of this evidence has not been conducted to date. The aim of this article was to follow the preferred reporting items for systematic reviews and meta‐analysis (PRISMA) guidelines and conduct a systematic review of empirical studies evaluating the application of NLP in organizational settings. Targeted outcomes included self‐esteem, trustworthiness, organizational commitment, and occupational stress. Academic research databases used to identify articles included ProQuest, PsycINFO, Science Direct, Google Scholar, and a specific NLP database. The literature search yielded 952 titles from which seven studies met all of the inclusion criteria. Findings indicate that NLP can be effective for improving a wide range of work‐related psychological outcomes including self‐esteem and occupational stress. However, there were concerns regarding methodological rigor. In general, the benefits of NLP were both overpromised and undersupported. Implications for future NLP application and research, with a focus on the relevance to current issues in the field of human resource (HR) development, are discussed.
  • Mental health attitudes, self-criticism, compassion and role identity among UK social work students.

    Kotera, Yasuhiro; Green, Pauline Catherine; Sheffield, David; University of Derby (Oxford Academic, 2018-08-10)
    Although many social work students suffer from mental health symptoms, the majority of them do not seek help, because of shame. Accordingly, the purposes of this study were to evaluate social work students' attitudes for mental health problems, and explore relationships among shame, mental health symptoms, self-criticism, self-compassion, and role identity. Firstly, 84 UK female undergraduate social work students completed a measure of attitudes toward mental health problems, and were compared with 94 UK female undergraduate students in other subjects. UK female undergraduate social work students had a higher level of negative perception in their community’s attitudes toward mental health problems. Secondly, 87 UK social work students, completed the attitudes, mental health, self-criticism, self-compassion, and role identity measures. Self-criticism, self-compassion, and role identity were significantly related to mental health symptoms, and identified as significant, independent predictors of mental health symptoms. This study confirmed that social work students consider that their community perceives mental health problems negatively, and that their self-criticism, self-compassion, and role identity relate to their poor mental health. The findings may help social work students, educators, and researchers deepen the understanding of their mental health symptoms and identify better solutions.
  • The psychosocial impact of caregiving in dementia and quality of life: a systematic review and meta-synthesis of qualitative research.

    Cross, Ainslea; Garip, Gulcan; Sheffield, David; University of Derby (Taylor and Francis, 2018-09-27)
    A systematic meta-synthesis of qualitative studies was conducted to interpret and synthesise findings from studies investigating the experiences, quality of life, and psychosocial impact of caregiving on adult informal caregivers of people with dementia.
  • Effects of mindfulness training on sleep problems in patients with fibromyalgia.

    Amutio, Alberto; Franco, Clemente; Sánchez-Sánchez, Laura C.; Pérez-Fuentes, María del C.; Gázquez-Linares, José J.; Van Gordon, William; Molero-Jurado, María del M.; University of Derby; Universidad Autónoma de Chile; University of Almería; University of the Basque Country (Frontiers, 2018-08-03)
    Fibromyalgia syndrome (FMS) is a complex psychosomatic pain condition. In addition to generalized pain and various cognitive difficulties, new FMS diagnostic criteria acknowledge fatigue and sleep problems as core aspects of this condition. Indeed, poor sleep quality has been found to be a significant predictor of pain, fatigue, and maladaptive social functioning in this patient group. While there is promising evidence supporting the role of mindfulness as a treatment for FMS, to date, mindfulness intervention studies have principally focused on dimensions of pain as the primary outcome with sleep problems either not being assessed or included as a secondary consideration. Given the role of sleep problems in the pathogenesis of FMS, and given that mindfulness has been shown to improve sleep problems in other clinical conditions, the present study explored the effects of a mindfulness-based intervention known as Flow Meditation (Meditación-Fluir) on a range of sleep-related outcomes (subjective insomnia, sleep quality, sleepiness, and sleep impairment) in individuals with FMS. Adult women with FMS (n = 39) were randomly assigned to the 7 weeks mindfulness treatment or a waiting list control group. Results showed that compared to the control group, individuals in the mindfulness group demonstrated significant improvements across all outcome measures and that the intervention effects were maintained at a 3 month follow-up assessment. The Meditación-Fluir program shows promise for alleviating sleep problems relating to FMS and may thus have a role in the treatment of FMS as well as other pain disorders in which sleep impairment is a central feature of the condition.
  • Mental wellbeing of caring profession students: relationship with caregiver identity, self-compassion, and intrinsic motivation.

    Kotera, Yasuhiro; Green, Pauline; Van Gordon, William; University of Derby (Elsevier, 2018)
    Aims To assess mental well-being in a sample of UK caring profession students and explore the relationship between mental well-being, psychological distress, caregiver role identity, self-compassion, and motivation. Background Students of caring profession subjects in UK universities typically follow a demanding educational and clinical training curriculum. Consequently, compared to other UK student groups, levels of psychological distress and mental illness are high. Design A cross-sectional observational study was conducted during the 2016-2017 academic year. Methods UK caring profession students (n=116) completed measures assessing mental well-being, psychological distress, caregiver role identity, self-compassion, and motivation. Significant correlations and independent predictors of mental well-being and psychological distress were identified. Results/Findings The current sample of UK caring profession students had low levels of mental well-being and two-thirds were deemed to have severe levels of psychological distress. Mental well-being and psychological distress were negatively associated with role identity, and positively associated with self-compassion and intrinsic motivation. Role identity, self-compassion and intrinsic motivation were significant independent predictors of mental well-being and psychological distress. Conclusion This study accords with other studies reporting that levels of psychological distress and mental illness are high amongst UK caring profession students. Findings suggest role identity, self-compassion, and intrinsic motivation are key factors that influence the mental well-being of this student group. Further research is warranted to determine whether adjusting the training curriculum to change how students identify with their caregiver role, as well as improve student levels of self-compassion and intrinsic motivation, leads to improvements in mental well-being and academic completion.
  • Mental health of UK university business students: Relationship with shame, motivation and self-compassion

    Kotera, Yasuhiro; Conway, Elaine; Van Gordon, William; University of Derby; Centre for Psychological Research, University of Derby, Derby, UK;; Derby Business School, University of Derby, Derby, UK; Centre for Psychological Research, University of Derby, Derby, UK; (2018-09-20)
    There is growing awareness of mental health problems among UK business students, which appears to be exacerbated by students’ attitudes of shame toward mental health. This study recruited 138 UK business students and examined the relationship between mental health and shame, and mental health and potential protective factors such as self-compassion and motivation. A significant correlation between each of the constructs was observed and self-compassion was identified as an explanatory variable for mental health. Shame moderated the relationship between self-compassion and mental health. Integrating self-compassion training into business study programs may help to improve the mental health of this student group.
  • Development and validation of the inspirational leaders survey.

    Pates, John; Kotera, Yasuhiro; Clancy, David; University of Derby; Hartpury College; University of Huddersfield (Inderscience Publishers, 2018-04-20)
    Purpose The Inspirational Leaders Survey (ILS) was developed to identify the behaviours and characteristics of inspirational leaders. The main aim of the ILS is to help businesses identify and recruit inspirational leaders into their workforce. Design/methodology/approach After a literature review 75 inspiring behaviours were identified. The items were examined through the exploratory factor analysis of responses from a sample of 212 adults; and a confirmatory factor analysis from a sample of 248 adults employed in various organisations with management systems. Findings Two factors with nine items emerged as the best approximation of the population covariance matrix of the three models tested from the results. The factors were called 'Individual Behaviours (five items: desire to achieve success, determined to achieve goals, passionate about work, committed to achieve success, and hardworking)' and 'Relationship Behaviours (four items: ability to instil confidence in people, inspire others, offer hope to others, and offer stability and direction to others)'. Originality/value The characteristics of inspirational leaders have received only limited empirical assessment, and an instrument to measure these characteristics has not been widely available. Such an instrument could provide a useful tool to identify inspirational leaders in our social and work- related groups. The present study describes the development of the ILS, which would help human resources in organisations identify and recruit inspirational leaders into their workforce.
  • Caregiving in multiple sclerosis and quality of life: A meta-synthesis of qualitative research.

    Topcu, Gogem; Buchanan, Heather; Aubeeluck, Aimee; Garip, Gulcan; University of Nottingham; Eastern Mediterranean University (Taylor and Francis, 2016-02-09)
    OBJECTIVE: The lack of adequate conceptualisation and operationalisation of quality of life (QoL) limits the ability to have a consistent body of evidence to improve QoL research and practice in informal caregiving for people with multiple sclerosis (MS). Thus, we conducted a meta-synthesis of qualitative research to improve the conceptual understanding of the experiences of MS carers and to identify factors that affect carers' QoL. DESIGN: Systematic searches of five electronic databases yielded 17 qualitative studies which were synthesised using the principles of meta-ethnography. RESULTS: The synthesis resulted in nine inter-linking themes: Changes and losses; challenges revolving around MS; caregiving demands; burden of care; future concerns; external stressors; experiences of support; strategies used in managing the caregiving role; and motivating factors. Our findings suggest that MS carers can have both positive and negative experiences which may bring challenges and rewards to the carers. CONCLUSION: We present a proposed QoL model for MS caregiving which can be used to inform the development of interventions for MS carers to improve their QoL. However, further empirical research is needed to examine the utility of this model and to explore the concept of QoL in MS carers in more detail.
  • Decisional and emotional forgiveness scales: Psychometric validity and correlates with personality and vengeance.

    Cavalcanti, Thiago Medeiros; de Holanda Coelho, Gabriel Lins; Rezende, Alessandro Teixeira; Vione, Katia Correa; Gouveia, Valdiney Veloso; Federal University of Paraiba; Cardiff University; University of Derby (Springer, 2018-07-22)
    Forgiveness is an internal process to overcome negative aspects (e.g., anger, bitterness, resentment) towards an offender, being associated to a range of variables (e.g., well-being, quality of loving relationships, resilience). Forgiveness can happen through two different types: (1) decisional, which is a behavioural modification to reduce direct hostility; and (2) emotional, which is a transformation of negative emotions into positive. The current research aimed to gather psychometric evidences for the Decisional Forgiveness Scale (DFS) and the Emotional Forgiveness Scale (EFS), using a Brazilian sample. Two studies were conducted. In Study 1 (n = 181), the bifactorial structures were replicated, also providing satisfactory reliability levels. Through Item Response Theory, results indicated good discrimination, difficulty levels, and considerable information to all the items from both measures. In Study 2 (n = 220), confirmatory factor analyses confirmed their structure, presenting good model fit. The measures were also invariant regarding participants’ gender. Finally, the measures presented significant results when correlated to personality and vengeance. In sum, the instruments demonstrated satisfactory psychometric properties, evidencing the possibility of their use in the respective context.
  • Ontological addiction theory: Attachment to me, mine, and I.

    Van Gordon, William; Shonin, Edo; Diouri, Sofiane; Garcia-Campayo, Javier; Kotera, Yasuhiro; Griffiths, Mark D.; University of Derby; Centre for Psychological Research, University of Derby, Derby, UK; Awake to Wisdom Centre for Meditation and Mindfulness Research, Ragusa, Italy; Awake to Wisdom Centre for Meditation and Mindfulness Research, Ragusa, Italy; Miguel Servet University Hospital, University of Zaragoza, Zaragoza, Spain; Centre for Psychological Research, University of Derby, Derby, UK; Department of Psychology, Nottingham Trent University, Nottinghamshire, UK (Akadémiai Kiadó, 2018-06-07)
    Background: Ontological addiction theory (OAT) is a novel metaphysical model of psychopathology and posits that human beings are prone to forming implausible beliefs concerning the way they think they exist, and that these beliefs can become addictive leading to functional impairments and mental illness. The theoretical underpinnings of OAT derive from the Buddhist philosophical perspective that all phenomena, including the self, do not manifest inherently or independently. Aims and methods: This paper outlines the theoretical foundations of OAT along with indicative supportive empirical evidence from studies evaluating meditation awareness training as well as studies investigating non-attachment, emptiness, compassion, and loving-kindness. Results: OAT provides a novel perspective on addiction, the factors that underlie mental illness, and how beliefs concerning selfhood are shaped and reified. Conclusion: In addition to continuing to test the underlying assumptions of OAT, future empirical research needs to determine how ontological addiction fits with extant theories of self, reality, and suffering, as well with more established models of addiction.
  • Cross-cultural differences and similarities in human value instantiation.

    Hanel, Paul H. P.; Maio, Gregory R.; Soares, Ana K. S.; Vione, Katia C.; de Holanda Coelho, Gabriel L.; Gouveia, Valdiney V.; Patil, Appasaheb C.; Kamble, Shanmukh V.; Manstead, Antony S. R.; Cardiff University; University of Bath; Universidade Federal de Mato Grosso do Sul; University of Derby; Universidade Federal da Paraíba; Karnatak University (Frontiers, 2018-05-29)
    Previous research found that the within-country variability of human values (e.g., equality and helpfulness) clearly outweighs between-country variability. Across three countries (Brazil, India, and the United Kingdom), the present research tested in student samples whether between-nation differences reside more in the behaviors used to concretely instantiate (i.e., exemplify or understand) values than in their importance as abstract ideals. In Study 1 (N = 630), we found several meaningful between-country differences in the behaviors that were used to concretely instantiate values, alongside high within-country variability. In Study 2 (N = 677), we found that participants were able to match instantiations back to the values from which they were derived, even if the behavior instantiations were spontaneously produced only by participants from another country or were created by us. Together, these results support the hypothesis that people in different nations can differ in the behaviors that are seen as typical as instantiations of values, while holding similar ideas about the abstract meaning of the values and their importance.
  • Laughter and humour interventions for well-being in older adults: A systematic review and intervention classification.

    Gonot-Schoupinsky, Freda N.; Garip, Gulcan; University of Derby (Elsevier, 2018-05-01)
    Objectives To assess the potential of laughter and humour interventions to increase well-being in a general population of adults aged 60 plus; and to develop a classification to compare approaches and potential benefits of different intervention types. Design A systematic search of Web of Science, PubMed/MEDLINE, PsychInfo, AMED, and PsychArticles used inclusive terms relating to laughter and humour interventions. A realist synthesis approach enabled heterogeneous interventions to be compared pragmatically. Setting Five laughter interventions, and one humour intervention, using one or more outcome related to well-being, were considered for inclusion after screening 178 primary research papers. The five laughter interventions, representing a sample of 369 participants, were retained. Main outcome measures Well-being related outcome measures reported in each intervention informed efficacy; Joanna Briggs Institute tools appraised design; and a realist approach enabled heterogeneous interventions to be measured on their overall potential to provide an evidence base. Results Well-being related measures demonstrated at least one significant positive effect in all interventions. Confounding factors inherent in the intervention types were observed. Individual participant laughter was not reported. Conclusions Laughter and humour interventions appear to enhance well-being. There is insufficient evidence for the potential of laughter itself to increase well-being as interventions contained a range of confounding factors and did not measure participant laughter. Interventions that isolate, track, and measure the parameters of individual laughter are recommended to build evidence for these potentially attractive and low-risk interventions. The classification proposed may guide the development of both evidence-oriented and population-appropriate intervention designs.
  • A brain-based pain facilitation mechanism contributes to painful diabetic polyneuropathy.

    Segerdahl, Andrew R.; Themistocleous, Andreas C.; Fido, Dean; Bennett, David L.; Tracey, Irene; University of Oxford; Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, FMRIB, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK (Oxford Academic, 2018-01-15)
    The descending pain modulatory system represents one of the oldest and most fundamentally important neurophysiological mechanisms relevant to pain. Extensive work in animals and humans has shown how a functional imbalance between the facilitatory and inhibitory components is linked to exacerbation and maintenance of persistent pain states. Forward translation of these findings into clinical populations is needed to verify the relevance of this imbalance. Diabetic polyneuropathy is one of the most common causes of chronic neuropathic pain; however, the reason why ∼25–30% of patients with diabetes develop pain is not known. The current study used a multimodal clinical neuroimaging approach to interrogate whether the sensory phenotype of painful diabetic polyneuropathy involves altered function of the ventrolateral periaqueductal grey—a key node of the descending pain modulatory system. We found that ventrolateral periaqueductal grey functional connectivity is altered in patients suffering from painful diabetic polyneuropathy; the magnitude of which is correlated to their spontaneous and allodynic pain as well as the magnitude of the cortical response elicited by an experimental tonic heat paradigm. We posit that ventrolateral periaqueductal grey-mediated descending pain modulatory system dysfunction may reflect a brain-based pain facilitation mechanism contributing to painful diabetic polyneuropathy.

View more