"Je ne regret rien?" : the value of adding anticipated regret to the theory of planned behaviour

Regret is fundamentally motivational, where there is a desire to be able to undo what has or has not been done; anticipating regret, therefore, seems a useful way of avoiding this negative experience and has been found to be a powerful mechanism for changing behaviour in areas such as economics and litigation (e.g. Larrick & Boles, 1995). Recent research has also been conducted into incorporating this explicitly affective component into the utilitarian-bound Theory of Planned Behaviour (Ajzen, 1985, 1988, 1991). A meta-analysis conducted in this thesis on all previous relevant research established that anticipated affective reactions, including regret, did make a significant contribution to the model in terms of increasing the variance in intentions. The remit of this PhD was to specifically consider anticipated regret’s predictive value to a broader variety of behaviours in a completely novel way. Study 1 differentiated between two particular behaviour types, Immediate Hedonic and Distal Benefit Behaviours, which mapped on to action and inaction regret respectively. A selection of these behaviours was used in Studies 2, 3 and 4, with Study 4 using an intervention designed to explicitly increase regret salience. Studies 5 and 6 set out to replicate the results from previous research into exercise behaviour by Abraham and Sheeran (2003; 2004), whilst Study 7 used an objective measure of exercise behaviour. The studies were either traditional pen-and-paper or web studies. The results provide overwhelming evidence that anticipated regret (unambiguously defined) adds significantly and independently to the predictive validity of the TPB in terms of intentions over and above the traditional TPB variables, even when controlling for past behaviour, experiential and instrumental attitudes. Replication of Abraham and Sheeran’s (2003; 2004) results (i.e. moderation by anticipated regret on the intention-behaviour relationship, mediated by intention stability) failed in pen-and-paper Study 5, although success was evident in web Study 6. Finally, although Study 7 explicitly established the disparate value of anticipated regret to the predictive validity of intention, there was a failure to detect any moderation or mediation effects: rather the most important predictor of exercise behaviour by Sports Centre members was past behaviour. Issues regarding multi-item versus single-item scales, web versus pen-and-paper designs, student versus ‘other’ populations, and observational designs are discussed with recommendations for further research

The impact of asking intention or self-prediction questions on subsequent behavior: a meta-analysis

The current meta-analysis estimated the magnitude of the impact of asking intention and self-prediction questions on rates of subsequent behavior, and examined mediators and moderators of this question–behavior effect (QBE). Random-effects meta-analysis on 116 published tests of the effect indicated that intention/prediction questions have a small positive effect on behavior (d+ = 0.24). Little support was observed for attitude accessibility, cognitive dissonance, behavioral simulation, or processing fluency explanations of the QBE. Multivariate analyses indicated significant effects of social desirability of behavior/behavior domain (larger effects for more desirable and less risky behaviors), difficulty of behavior (larger effects for easy-to-perform behaviors), and sample type (larger effects among student samples). Although this review controls for co-occurrence of moderators in multivariate analyses, future primary research should systematically vary moderators in fully factorial designs. Further primary research is also needed to unravel the mechanisms underlying different variants of the QBE

The question-behaviour effect: a theoretical and methodological review and meta-analysis

Research has demonstrated that asking people questions about a behaviour can lead to behaviour change. Despite many, varied studies in different domains, it is only recently that this phenomenon has been studied under the umbrella term of the question-behaviour effect (QBE) and moderators of the effect have been investigated. With a particular focus on our own contributions, this article: (1) provides an overview of QBE research; (2) reviews and offers new evidence concerning three theoretical accounts of the QBE (behavioural simulation and processing fluency; attitude accessibility; cognitive dissonance); (3) reports a new meta-analysis of QBE studies (k = 66, reporting 94 tests) focusing on methodological moderators. The findings of this meta-analysis support a small significant effect of the QBE (g = 0.14, 95% CI = 0.11, 0.18, p < .001) with smaller effect sizes observed in more carefully controlled studies that exhibit less risk of bias and (4) also considers directions for future research on the QBE, especially studies that use designs with low risk of bias and consider desirable and undesirable behaviour separately

Fibromyalgia and neuropathic pain - differences and similarities. A comparison of 3057 patients with diabetic painful neuropathy and fibromyalgia

<p>Abstract</p> <p>Background</p> <p>Patients with diabetic neuropathy (DPN) and fibromyalgia differ substantially in pathogenetic factors and the spatial distribution of the perceived pain. We questioned whether, despite these obvious differences, similar abnormal sensory complaints and pain qualities exist in both entities. We hypothesized that similar sensory symptoms might be associated with similar mechanisms of pain generation. The aims were (1) to compare epidemiological features and co-morbidities and (2) to identify similarities and differences of sensory symptoms in both entities.</p> <p>Methods</p> <p>The present multi-center study compares epidemiological data and sensory symptoms of a large cohort of 1434 fibromyalgia patients and 1623 patients with painful diabetic neuropathy. Data acquisition included standard demographic questions and self-report questionnaires (MOS sleep scale, PHQ-9, Pain<it>DETECT</it>). To identify subgroups of patients with characteristic combinations of symptoms (sensory profiles) a cluster analysis was performed using all patients in both cohorts.</p> <p>Results</p> <p>Significant differences in co-morbidities (depression, sleep disturbance) were found between both disorders. Patients of both aetiologies chose very similar descriptors to characterize their sensory perceptions. Burning pain, prickling and touch-evoked allodynia were present in the same frequency. Five subgroups with distinct symptom profiles could be detected. Two of the subgroups were characteristic for fibromyalgia whereas one profile occurred predominantly in DPN patients. Two profiles were found frequently in patients of both entities (20-35%).</p> <p>Conclusions</p> <p>DPN and fibromyalgia patients experience very similar sensory phenomena. The combination of sensory symptoms - the sensory profile - is in most cases distinct and almost unique for each one of the two entities indicating aetiology-specific mechanisms of symptom generation. Beside the unique aetiology-specific sensory profiles an overlap of sensory profiles can be found in 20-35% of patients of both aetiologies.</p

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]

Evidence synthesis to inform model-based cost-effectiveness evaluations of diagnostic tests: a methodological systematic review of health technology assessments

Background: Evaluations of diagnostic tests are challenging because of the indirect nature of their impact on patient outcomes. Model-based health economic evaluations of tests allow different types of evidence from various sources to be incorporated and enable cost-effectiveness estimates to be made beyond the duration of available study data. To parameterize a health-economic model fully, all the ways a test impacts on patient health must be quantified, including but not limited to diagnostic test accuracy. Methods: We assessed all UK NIHR HTA reports published May 2009-July 2015. Reports were included if they evaluated a diagnostic test, included a model-based health economic evaluation and included a systematic review and meta-analysis of test accuracy. From each eligible report we extracted information on the following topics: 1) what evidence aside from test accuracy was searched for and synthesised, 2) which methods were used to synthesise test accuracy evidence and how did the results inform the economic model, 3) how/whether threshold effects were explored, 4) how the potential dependency between multiple tests in a pathway was accounted for, and 5) for evaluations of tests targeted at the primary care setting, how evidence from differing healthcare settings was incorporated. Results: The bivariate or HSROC model was implemented in 20/22 reports that met all inclusion criteria. Test accuracy data for health economic modelling was obtained from meta-analyses completely in four reports, partially in fourteen reports and not at all in four reports. Only 2/7 reports that used a quantitative test gave clear threshold recommendations. All 22 reports explored the effect of uncertainty in accuracy parameters but most of those that used multiple tests did not allow for dependence between test results. 7/22 tests were potentially suitable for primary care but the majority found limited evidence on test accuracy in primary care settings. Conclusions: The uptake of appropriate meta-analysis methods for synthesising evidence on diagnostic test accuracy in UK NIHR HTAs has improved in recent years. Future research should focus on other evidence requirements for cost-effectiveness assessment, threshold effects for quantitative tests and the impact of multiple diagnostic tests

Erratum to: Methods for evaluating medical tests and biomarkers

[This corrects the article DOI: 10.1186/s41512-016-0001-y.]