Person, persona, and personality modification : An in-depth qualitative exploration of quantitative findings

Peer reviewedPostprin

Assessing treatments used to reduce rumination and/or worry : a systematic review

Peer reviewedPostprin

Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy for psychological health and wellbeing in non-clinical samples: A systematic review and meta-analysis.

Much of the burden associated with poor mental health is associated with symptom experience in the general population. We conducted a systematic review and meta-analysis of studies conducted in non-clinical samples, evaluating Mindfulness-Based Programs (MBPs) for outcomes related to psychological health and well-being. We focussed on Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) because they have the strongest evidence base. We searched MEDLINE, PsycINFO, EMBASE and CINAHL (2006 – February, 2019) for published peer-reviewed journals articles of intervention studies evaluating MBCT or MBSR for psychological health and well-being in non-clinical samples. Data were pooled using a random-effects model and effect estimates were reported as Hedges’ g. We included 49 studies conducted in non-clinical samples (n=4733). When compared to a passive control, MBPs significantly reduced symptoms of rumination/worry (g=-1.13, [-2.17, -0.08]), stress/psychological distress (g=-0.52 [-0.68, -0.36]), depression [g=-0.45 [-0.64, -0.26]), and anxiety (g=-0.44 [-0.65, -0.23]); and significantly improved quality of life/well-being (g=0.32 [0.10, 0.54]). In general, MBCT generated larger effect sizes than MBSR for all outcomes. This study provides evidence that in non-clinical samples, MBPs are associated with benefits to health and well-being. These findings add to the growing evidence-base suggesting that MBSR and MBCT may be effective approaches for sub-clinical levels of mental ill-health and could form part of the public mental health agenda

Is Work-Related Rumination Associated with Deficits in Executive Functioning?

Work-related rumination, that is, perseverative thinking about work during leisure time, has been associated with a range of negative health and wellbeing issues. The present paper examined the association between work-related rumination and cognitive processes centred around the theoretical construct of executive functioning. Executive functioning is an umbrella term for high level cognitive processes such as planning, working memory, inhibition, mental flexibility; and it underlies how people manage and regulate their goal directed behaviour. Three studies are reported. Study I, reports the results of a cross-sectional study of 240 employees, and demonstrates significant correlations between work-related rumination and three proxy measures of executive functioning: cognitive failures (.33), cognitive flexibility (-.24) and situational awareness at work (-.28). Study II (n = 939), expands on the findings from study 1 and demonstrates that workers reporting medium and high work-related rumination were 2.8 and 5 times, respectively, more likely to report cognitive failures relative to low ruminators. High ruminators also demonstrated greater difficulties with ‘lapses of attention’ (OR = 4.8), ‘lack of focus of attention’ (OR = 3.4), and ‘absent mindedness’ (OR = 4.3). The final study, examined the association between work-related rumination and executive functioning using interview data from 2460 full time workers. Workers were divided into tertiles low, medium and high. The findings showed that high work-related rumination was associated with deficits in starting (OR = 2.3) and finishing projects (OR = 2.4), fidgeting (OR = 1.9), memory (OR = 2.2), pursuing tasks in order (OR = 1.8), and feeling compelled to do things (OR = 2.0). It was argued that work-related rumination may not be related to work demands per se, but appears to be an executive functioning/control issue. Such findings are important for the design and delivery of intervention programmes aimed at helping people to switch off and unwind from wor

Improving fatigue risk management in healthcare: A systematic scoping review of sleep-related/fatigue-management interventions for nurses and midwives.

Background. Nurses and midwives make up almost 50% of the global healthcare shift working workforce. Shift work interferes with sleep and causes fatigue with adverse effects for nurses’ and midwives’ health, as well as on patient safety and care. Where other safety-critical sectors have developed Fatigue Risk Management Systems, healthcare is behind the curve; with published literature only focussing on the evaluation of discreet sleep-related/fatigue-management interventions. Little is known, however, about which interventions have been evaluated for nurses and midwives. Our review is a critical first step to building the evidence-base for healthcare organisations seeking to address this important operational issue. Objectives. We address two questions: 1) What sleep-related/fatigue-management interventions have been assessed in nurses and midwives and what is their evidence-base? and 2) What measures are used by researchers to assess intervention effectiveness? Design & data sources. The following databases were searched in November, 2018 with no limit on publication dates: MEDLINE, PsychINFO and CINAHL. Review methods. We included: 1. studies conducted in adult samples of nurses and/or midwives that had evaluated a sleep-related/fatigue-management intervention; and 2. studies that reported intervention effects on fatigue, sleep, or performance at work, and on measures of attention or cognitive performance (as they relate to the impact of shift working on patient safety/care). Results. The search identified 798 potentially relevant articles, out of which 32 met our inclusion criteria. There were 8619 participants across the included studies and all were nurses (88.6% female). We did not find any studies conducted in midwives nor any studies conducted in the UK, with most studies conducted in the US, Italy and Taiwan. There was heterogeneity both in terms of the interventions evaluated and the measures used to assess effectiveness. Napping could be beneficial but there was wide variation regarding nap duration and timing, and we need to understand more about barriers to implementation. Longer shifts, shift patterns including nights, and inadequate recovery time between shifts (quick returns) were associated with poorer sleep, increased sleepiness and increased levels of fatigue. Light exposure and/or light attenuation interventions showed promise but the literature was dominated by small, potentially unrepresentative samples. Conclusions. The literature related to sleep-related/fatigue-management interventions for nurses and midwives is fragmented and lacks cohesion. Further empirical work is warranted with a view to developing comprehensive Fatigue Risk Management Systems to protect against fatigue in nurses, midwives, and other shift working healthcare staff

Relaxation and related therapies for people with multiple sclerosis (MS): A systematic review

Objective: To establish the effectiveness of relaxation and related therapies in treating Multiple Sclerosis related symptoms and sequelae. Data Sources: PsycINFO, PubMed, Embase, CINAHL, ProQuest Dissertations and Theses Global databases were searched. Methods: We included studies from database inception until 31 December 2021 involving adult participants diagnosed with multiple sclerosis or disseminated sclerosis, which featured quantitative data regarding the impact of relaxation interventions on multiple sclerosis-related symptoms and sequelae. Studies which examined multi-modal therapies - relaxation delivered in combination with non-relaxation interventions - were excluded. Risk of bias was assessed using the Revised Risk of Bias tool for randomised trials – ROB2, Risk of Bias in Non-Randomised Studies of Interventions ROBINS-I), and within and between-group effects were calculated (Hedges’ g). Results: Twenty-eight studies met inclusion criteria. Twenty-three of these were randomised controlled trials, with 1246 total participants. This review reports on this data, with non-randomised study data reported in supplemental material. Post –intervention relaxation was associated with medium to large effect-size improvement for depression, anxiety, stress and fatigue. The effects of relaxation were superior to wait-list or no treatment control conditions; however, comparisons with established psychological or physical therapies were mixed. Individual studies reported sustained effects (≤ 6 months) with relaxation for stress, pain and quality of life. Most studies were rated as having a high/serious risk of bias. Conclusion: There is emerging evidence that relaxation therapies can improve outcomes for persons with multiple sclerosis. Given the high risk of bias found for included studies, stronger conclusions cannot be drawn

Recovery From Work: The Link Between Work-Related Rumination, Fatigue and Sleep.

The occupational health literature suggests that perseverative cognitions about work in non-work time are damaging for health and wellbeing; however, there is also research suggesting that some thinking about work outside of work may be adaptive. This thesis addressed a current gap in the literature by assessing the impact of two forms of work-related rumination (affective rumination and problem-solving pondering) on recovery processes. Four studies were carried out. In study 1, a systematic review of the clinical/health literature showed that Cognitive Behaviour Therapy (CBT)-based and mindfulness-based interventions, delivered in both face-to-face and online formats, may prove effective in the reduction of perseverative cognitions. In study 2, results from a quasi-experimental longitudinal study showed that participants who attended a one-day CBT-based intervention (conducted in the workplace; N=102) reported significantly lower levels of affective rumination, problem-solving pondering and chronic fatigue at follow-up (6 months postintervention) when compared with participants in the control group (N=125). In study 3, results from a randomised waitlist control study showed that participants who completed a 4-week online mindfulness course (N=60) reported lower levels of affective rumination, problem-solving pondering, acute (end-of-day) fatigue and chronic fatigue, and improved sleep quality, when compared with participants in the control group (N=58). In study 4, a longitudinal cross-lagged panel structural equation model was tested, in which questionnaire data was collected from participants (N=218) at two time points - 6 months apart - showed that affective rumination and problem-solving pondering were both implicated in causing chronic fatigue. In summary, the results from this thesis suggest that work-related rumination is detrimental to recovery from work because it appears to cause work-related fatigue. However, further work is warranted to properly conceptualise (and measure) different forms of work-related perseverative thinking. Both types of interventions appear worthy of future empirical work; however, delivering mindfulness online would probably provide the greatest return on investment for organisational occupational health programmes

Recovery From Work: The Link Between Work-Related Rumination, Fatigue and Sleep.

The occupational health literature suggests that perseverative cognitions about work in non-work time are damaging for health and wellbeing; however, there is also research suggesting that some thinking about work outside of work may be adaptive. This thesis addressed a current gap in the literature by assessing the impact of two forms of work-related rumination (affective rumination and problem-solving pondering) on recovery processes. Four studies were carried out. In study 1, a systematic review of the clinical/health literature showed that Cognitive Behaviour Therapy (CBT)-based and mindfulness-based interventions, delivered in both face-to-face and online formats, may prove effective in the reduction of perseverative cognitions. In study 2, results from a quasi-experimental longitudinal study showed that participants who attended a one-day CBT-based intervention (conducted in the workplace; N=102) reported significantly lower levels of affective rumination, problem-solving pondering and chronic fatigue at follow-up (6 months postintervention) when compared with participants in the control group (N=125). In study 3, results from a randomised waitlist control study showed that participants who completed a 4-week online mindfulness course (N=60) reported lower levels of affective rumination, problem-solving pondering, acute (end-of-day) fatigue and chronic fatigue, and improved sleep quality, when compared with participants in the control group (N=58). In study 4, a longitudinal cross-lagged panel structural equation model was tested, in which questionnaire data was collected from participants (N=218) at two time points - 6 months apart - showed that affective rumination and problem-solving pondering were both implicated in causing chronic fatigue. In summary, the results from this thesis suggest that work-related rumination is detrimental to recovery from work because it appears to cause work-related fatigue. However, further work is warranted to properly conceptualise (and measure) different forms of work-related perseverative thinking. Both types of interventions appear worthy of future empirical work; however, delivering mindfulness online would probably provide the greatest return on investment for organisational occupational health programmes