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Journal of Clinical Medicine Feb 2022Anger has been associated with increased pain perception, but its specific connection with Fibromyalgia Syndrome (FMS) has not yet been established in an integrated... (Review)
Review
Anger has been associated with increased pain perception, but its specific connection with Fibromyalgia Syndrome (FMS) has not yet been established in an integrated approach. Therefore, the present systematic review focuses on exploring this connection, and based on this connection, delimiting possible gaps in the research, altogether aimed at improving FMS clinical intervention and guiding future research lines. Anger is considered a basic negative emotion that can be divided into two dimensions: anger-in (the tendency to repress anger when it is experienced) and anger-out (the leaning to express anger through verbal or physical means). The current systematic review was performed based on the guidelines of the PRISMA and Cochrane Collaborations. The Prospective Register of Systematic Reviews (PROSPERO) international database was forehand used to register the review protocol. The quality of chosen articles was assessed and the main limitations and research gaps resulting from each scientific article were discussed. The search included PubMed, Scopus, and Web of Science databases. The literature search identified 13 studies eligible for the systematic review. Levels of anger-in have been shown to be higher in FMS patients compared to healthy participants, as well as patients suffering from other pain conditions (e.g., rheumatoid arthritis). FMS patients had also showed higher levels of state and trait anxiety, worry and angry rumination than other chronic pain patients. Anger seems to amplify pain especially in women regardless FMS condition but with a particularly greater health-related quality of life´s impact in FMS patients. In spite of the relevance of emotions in the treatment of chronic pain, including FMS, only two studies have proposed intervention programs focus on anger treatment. These two studies have observed a positive reduction in anger levels through mindfulness and a strength training program. In conclusion, anger might be a meaningful therapeutic target in the attenuation of pain sensitivity, and the improvement of the general treatment effects and health-related quality of life in FMS patients. More intervention programs directed to reduce anger and contribute to improve well-being in FMS patients are needed.
PubMed: 35160295
DOI: 10.3390/jcm11030844 -
Journal of Clinical Psychology Dec 2019Difficulties in emotion regulation may contribute to the development of mania. This review aimed to assess how emotion regulation strategies reported by individuals at... (Review)
Review
OBJECTIVES
Difficulties in emotion regulation may contribute to the development of mania. This review aimed to assess how emotion regulation strategies reported by individuals at risk of mania compare with clinical and nonclinical controls.
METHODS
Search terms relating to mania risk and emotion regulation were entered into three databases. Sixteen studies were included.
RESULTS
Mania risk was typically associated with overall endorsement of emotion regulation strategies, particularly dampening, and positive and negative rumination.
CONCLUSIONS
Findings were limited by overall lack of evidence for individual strategies, lack of consideration of key mediating factors and reliance upon self-report designs.
Topics: Bipolar Disorder; Emotional Regulation; Humans; Male; Personality Inventory; Risk; Rumination, Cognitive
PubMed: 31385293
DOI: 10.1002/jclp.22841 -
Frontiers in Psychiatry 2022Previous theoretical models and reviews have documented a strong connection between emotion dysregulation eating disorder (ED) psychopathology among the general and...
BACKGROUND
Previous theoretical models and reviews have documented a strong connection between emotion dysregulation eating disorder (ED) psychopathology among the general and clinical populations. The aim of this review was to build on this previous work by conducting a network meta-analysis to explore associations between adaptive and maladaptive emotion regulation strategies and ED psychopathology trans-diagnostically across the ED spectrum to identify areas of emotion dysregulation that have the strongest association with symptomatology.
METHODOLOGY
A total of 104 studies were included in the meta-analysis and correlation coefficient representing the associations between specific emotion regulation strategies and ED symptomatology were extracted. We ran a Bayesian random effects network meta-analysis and the initial network was well-connected with each emotion regulation strategy being linked to at least one other strategy. We also conducted a network meta-regression to explore whether between-study differences in body mass index (BMI), age, and whether the sample consisted of solely female participants explained any possible network inconsistency.
RESULTS
The network meta-analysis revealed that ruminations and non-acceptance of emotions were most closely associated with ED psychopathology. There was no significant network inconsistency but two comparisons approached significance and thus meta-regressions were conducted. The meta-regressions revealed a significant effect of BMI such that the associations between different emotion regulation strategies and ED symptomatology were weaker among those with low BMI.
DISCUSSION
The present findings build on previous work and highlight the role of rumination and difficulties with accepting emotions as key emotion regulation difficulties in EDs. Additionally, the finding that the associations were weaker among ED patients with low BMI may point toward a complex relationship between ED behaviors and emotion regulation. Taken together, our findings call for interventions that target emotion regulation, specifically rumination and difficulties accepting emotions, in the treatment of EDs.
SYSTEMATIC REVIEW REGISTRATION
https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021249996, PROSPERO, identifier: CRD42021249996.
PubMed: 35280172
DOI: 10.3389/fpsyt.2022.793094 -
Journal of Clinical and Experimental... Nov 2023Rumination, defined as intrusive and repetitive thoughts in response to negative emotions, uncertainty, and inconsistency between goal and current situation, is a...
INTRODUCTION
Rumination, defined as intrusive and repetitive thoughts in response to negative emotions, uncertainty, and inconsistency between goal and current situation, is a significant risk factor for depressive disorders. The rumination literature presents diverse findings on functional connectivity and shows heterogeneity in research methods. This systematic review seeks to integrate these findings and provide readers diverse perspectives.
METHOD
For this purpose, the literature on functional connectivity in rumination was reviewed according to the PRISMA guidelines. Regional connectivity and network connectivity results were scrutinized according to the presence of depression, research methods, and type of rumination. After screening 492 articles, a total of 36 studies were included.
RESULTS
The results showed that increased connectivity of the default mode network (DMN) was consistently reported. Other important findings include alterations in the connectivity between the DMN and the frontoparietal network and the salience network (SN) and impaired regulatory function of the SN. Region-level connectivity studies consistently show that increased connectivity between the posterior cingulate cortex and the prefrontal cortex is associated with rumination, which may cause the loss of control of the frontoparietal network over self-referential processes. We have seen that the number of studies examining brooding and reflective rumination as separate dimensions are relatively limited. Although there are overlaps between the connectivity patterns of the two types of rumination in these studies, it can be thought that reflective rumination is more associated with more increased functional connectivity of the prefrontal cortex.
CONCLUSIONS
Although there are many consistent functional connectivity outcomes associated with trait rumination, less is known about connectivity changes during state rumination. Relatively few studies have taken into account the subjective aspect of this thinking style. In order to better explain the relationship between rumination and depression, rumination induction studies during episode and remission periods of depression are needed.
Topics: Humans; Brain; Brain Mapping; Magnetic Resonance Imaging; Prefrontal Cortex; Rumination, Cognitive
PubMed: 38346167
DOI: 10.1080/13803395.2024.2315312 -
Journal of Eating Disorders Apr 2023Feeding and eating disorders are associated with significant illness burden and costs, yet access to evidence-based care is limited. Low intensity psychological... (Review)
Review
BACKGROUND
Feeding and eating disorders are associated with significant illness burden and costs, yet access to evidence-based care is limited. Low intensity psychological interventions have the potential to increase such access.
METHODS
A systematic review and meta-analysis were conducted on the use of low intensity psychological interventions for the treatment of feeding and eating disorders. Studies comparing low intensity psychological interventions against high intensity therapies and non-eating disorder specific psychological interventions were included, as well as those with waiting list control arms. There were three primary outcomes: eating disorder psychopathology, diagnostic and statistical manual of mental disorders (DSM) severity specifier-related outcomes and rates of remission/recovery.
RESULTS
Thirty-three studies met the inclusion criteria, comprising 3665 participants, and 30 studies were included in the meta-analysis. Compared to high intensity therapies, low intensity psychological interventions were equivalent on reducing eating disorder psychopathology (g = - 0.13), more effective at improving DSM severity specifier-related outcomes (g = - 0.15), but less likely to achieve remission/recovery (risk ratio (RR) = 0.70). Low intensity psychological interventions were superior to non-eating disorder specific psychological interventions and waiting list controls across all three primary outcomes.
CONCLUSION
Overall, findings suggest that low intensity psychological interventions can successfully treat eating disorder symptoms. Few potential moderators had a statistically significant effect on outcome. The number of studies for many comparisons was low and the methodological quality of the studies was poor, therefore results should be interpreted with caution. More research is needed to establish the effectiveness of low intensity psychological interventions for children and young people, as well as for individuals with anorexia nervosa, avoidant/restrictive food intake disorder, pica and rumination disorder.
PubMed: 37016447
DOI: 10.1186/s40337-023-00775-2 -
Journal of Psychosomatic Research Dec 2023Cognitive behavioural therapy (CBT) is increasingly used to manage Disorders of Gut-Brain Interaction (DGBIs). This systematic review aimed to review the evidence for... (Review)
Review
OBJECTIVE
Cognitive behavioural therapy (CBT) is increasingly used to manage Disorders of Gut-Brain Interaction (DGBIs). This systematic review aimed to review the evidence for the effectiveness of CBT-based interventions for patients with gastroduodenal DGBIs.
METHODS
Medline, Embase, PubMed, Cochrane Central, and Scopus were searched in July 2022. Studies were included if they investigated the effects of a CBT-based intervention on gastrointestinal symptoms and/or psychological outcomes pre- and post-intervention in patients with gastroduodenal DGBIs. Case studies, studies not in English, and studies with patients under 18 years were excluded. Results were synthesised narratively, and standardised effect sizes were calculated where possible.
RESULTS
Nine studies (seven RCTs and two pre/post studies) were identified, with data reported in 10 articles (total N = 602). The studies investigated patients with functional dyspepsia (n = 7), rumination syndrome (n = 1), and supragastric belching (n = 1). The studies had heterogeneous interventions, methodologies, and outcomes, precluding meta-analysis, as well as a moderate-high risk of bias and high drop-outs rates. Findings demonstrated decreased gastrointestinal symptoms and improved anxiety, depression, and quality of life, from pre- to post-intervention, with medium to large effect sizes for symptoms and small to large effect sizes for psychological outcomes. Efficacy was maintained at follow-up, up to one year later.
CONCLUSIONS
This review suggests promising evidence that CBT effectively improves gastrointestinal symptoms and psychological outcomes in patients with gastroduodenal DGBIs. However, heterogeneity, risk of bias, and lack of statistical reporting were noted, indicating the need for more robust research and standardisation.
Topics: Adolescent; Humans; Anxiety Disorders; Brain; Cognitive Behavioral Therapy; Psychotherapy; Quality of Life
PubMed: 37832277
DOI: 10.1016/j.jpsychores.2023.111516 -
Journal of Child and Adolescent... Aug 2022This systematic review aims to examine, from an interdisciplinary perspective, the relationship between posttraumatic stress disorder (PTSD), posttraumatic growth (PTG),...
PURPOSE
This systematic review aims to examine, from an interdisciplinary perspective, the relationship between posttraumatic stress disorder (PTSD), posttraumatic growth (PTG), and rumination in adolescents after an earthquake. The aim of the review is to provide high-quality, evidence-based recommendations that contribute to the roles of psychiatric nurses and the development of psychosocial support systems.
DESIGN AND METHODS
This study has been conducted in line with the Centres for Reviews and Dissemination (CRD) guideline which guides preparation for transparent reporting of meta-analysis and systematic reviews.
FINDINGS
Despite the limited evidence, it was concluded that it is important to identify the psychological processes that lead to PTG and reduce the incidence of PTSD in earthquake-affected adolescents.
PRACTICAL IMPLICATIONS
This evidence shows how important it is to raise the awareness of healthcare providers in different disciplines, including psychiatric nurses, around the need for psychosocial support interventions following a natural disaster.
Topics: Adolescent; Earthquakes; Humans; Posttraumatic Growth, Psychological; Stress Disorders, Post-Traumatic; Survivors
PubMed: 35267222
DOI: 10.1111/jcap.12374 -
Frontiers in Psychiatry 2023Depression is a mental health disorder characterized by affective, somatic, and cognitive symptoms. Attention bias modification (ABM) has been widely used to treat...
BACKGROUND
Depression is a mental health disorder characterized by affective, somatic, and cognitive symptoms. Attention bias modification (ABM) has been widely used to treat depression. However, the results seem inconsistent. We conducted a systematic review and meta-analysis to investigate the efficacy of ABM for depression and to explore the optimal protocol of ABM.
METHODS
Seven databases were systematically searched from their inceptions to 5 October 2022 to include randomized controlled trials (RCTs) of ABM for depression. Two independent reviewers selected the eligible articles, extracted data, and evaluated the risk of bias using version 2 of the Cochrane risk-of-bias tool (ROB 2.0) for randomized trials. The primary outcome was the evaluation of depressive symptoms using widely accepted and validated scales. The secondary outcomes included rumination and attentional control. Meta-analysis was conducted by using RevMan (version 5.4) and Stata (version 12.0). Subgroup analyses and meta-regressions were performed to identify the source of heterogeneity. The certainty of the evidence was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE).
RESULTS
A total of 19 trials involving 20 datasets (1,262 participants) were included. The overall risk of bias in one study was rated as low risk of bias, three studies were considered as high, and the remaining studies were some concerns. Compared with attention control training (ACT), ABM had a greater effect in the improvement of depression (SMD = -0.48, 95% CI -0.80 to -0.17, = 82%) and rumination (MD = -3.46, 95% CI -6.06 to -0.87, = 0%). No significant differences were observed in the attentional control outcome between ABM and ACT (MD = 3.07, 95% CI -0.52 to 6.65, = 0%). Subgroup analysis demonstrated that adults exhibited a greater decrease in depression scores than adolescents. ABM using the dot-probe task, training target stimulus presented by face, and training directions by left-right were associated with better antidepressant effects. ABM training delivered in the laboratory tended to yield a better effect than those conducted at home. Sensitivity analysis indicated that the results were robust. The certainty of the evidence for all outcomes was low or very low, and publication bias may exist.
CONCLUSION
Due to high heterogeneity and limited studies, not enough current evidence supported that ABM could be an effective intervention to relieve depressive symptoms. More rigorous RCTs are required to verify the benefits and to explore the optimal protocol of ABM training for depression. [PROSPERO], identifier [No. CRD42021279163].
PubMed: 36970284
DOI: 10.3389/fpsyt.2023.1098610 -
Trauma, Violence & Abuse Oct 2023Firefighters are repeatedly exposed to work-related potential traumatic events and have an increased risk of developing post-traumatic stress disorder (PTSD). However,... (Review)
Review
Firefighters are repeatedly exposed to work-related potential traumatic events and have an increased risk of developing post-traumatic stress disorder (PTSD). However, the mechanisms implicated in this relationship are not clear. The aim of this study was to analyse the risk and protective factors related to the development of PTSD in firefighters. According to PRISMA, a systematic review of scientific literature was conducted in Web of Science, PsycINFO, Scopus, PubMed and the Cochrane Central Register of Controlled Trials. Quality in Prognosis Studies (QUIPS) was used as the methodological quality indicator of the selected articles (PROSPERO reference CRD42020213009). Prognostic studies involving active firefighters with presence of post-traumatic symptomatology, presenting original findings, and written in Spanish or English were included. A total of 1768 potentially eligible articles were identified. According to the inclusion criteria, 87 articles were selected to evaluate the full text. Finally, 19 articles were included, comprising 12,298 active firefighters. There is high heterogeneity in the variables evaluated in the different studies. Taking the data for which this review has found more evidence (moderate support), operational stress, job duration, burnout, expressive suppression and rumination could be risk factors of PTSD, and belongingness and dispositional mindfulness could be protective factors. Other variables with weak support (e.g. resilience) were analysed. This review analyses the available literature, highlighting its scarcity for future research on the subject. Due to repeated trauma exposure, it is important to continue investigations and bear these variables in mind for the prevention of PTSD in firefighters.
Topics: Humans; Stress Disorders, Post-Traumatic; Firefighters; Resilience, Psychological; Stress, Psychological
PubMed: 35521996
DOI: 10.1177/15248380221082944 -
Journal of Anxiety Disorders Mar 2024Pre-event and post-event rumination have been consistently identified by cognitive models as important maintaining factors in Social Anxiety Disorder (SAD). This... (Meta-Analysis)
Meta-Analysis Review
Pre-event and post-event rumination have been consistently identified by cognitive models as important maintaining factors in Social Anxiety Disorder (SAD). This systematic review and meta-analysis aimed to investigate the effectiveness of psychological treatment in reducing pre-event and post-event rumination in adults with social anxiety. A comprehensive literature search identified 26 eligible studies, with 1524 total participants. Psychological treatments demonstrated large significant within-group effect sizes (from pre- to post-treatment) in reducing pre-event rumination (g = 0.86) and post-event rumination (g = 0.83). Subgroups analysed showed CBT to have large significant effect sizes in reducing pre-event rumination (g = 0.97) and post-event rumination (g = 0.85). Interventions that specifically addressed rumination were found to be significantly more effective in reducing pre-event rumination than those that did not (p = .006). Both individual and group treatment formats were equally effective in reducing pre-event rumination and post-event rumination. Meta-regressions revealed that pre-event rumination treatment effects were significantly larger in individuals with higher baseline social anxiety, meanwhile post-event rumination treatment effects were larger for those with higher baseline depression. Overall findings show that pre-event and post-event rumination are effectively reduced through psychological treatment, and clinical implications for the enhancement of evidence-based treatment protocols are discussed.
Topics: Adult; Humans; Psychosocial Intervention; Phobia, Social; Anxiety
PubMed: 38142483
DOI: 10.1016/j.janxdis.2023.102823