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Journal of Geriatric Physical Therapy...In light of the fear avoidance model, kinesiophobia and fear avoidance (FA) can lead to physical inactivity and disability. Previous studies regarding kinesiophobia and...
BACKGROUND AND PURPOSE
In light of the fear avoidance model, kinesiophobia and fear avoidance (FA) can lead to physical inactivity and disability. Previous studies regarding kinesiophobia and FA in older adults have reported conflicting results. The purpose of this review was to identify the reported constructs and assessment instruments used in published studies on kinesiophobia and FA in older adults and to verify the alignment between the instruments used and the constructs under study.
METHODS
Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses 2020 statement (PRISMA-2020), 4 databases were searched from January 2005 to March 2020. All study types, except qualitative, were eligible for inclusion. The participants were 65 years and older. Studies were excluded in the absence of sufficient data on participant age. Study characteristics, constructs related to kinesiophobia, fear and/or avoidance, and instruments used were extracted independently by 2 reviewers.
RESULTS
Fourteen articles were selected for inclusion in the study, in which 7 constructs were identified. The most reported constructs were "fear avoidance beliefs" (FAB) (50%; n = 7), "kinesiophobia" (35.7%; n = 5), and "fear of falling" (14.3%; n = 2). The remaining constructs were only approached, each in 7.1% (n = 1) of the included studies. Seven instruments were used to assess the constructs. The Fear Avoidance Beliefs Questionnaire (FABQ) was the most used instrument (n = 3) to evaluate "FAB," and the Tampa Scale for Kinesiophobia-11 (TSK-11) was the most reported (n = 3) to assess "kinesiophobia."
CONCLUSION
This review identified a large diversity in the constructs and instruments used to study kinesiophobia and FA among older adults. Some constructs are used interchangeably although they do not share the same conceptual definition. There is poor standardization in the use of assessment tools in accordance with the construct under study. Clinical evaluation and study results can be biased owing to this ambiguity.
Topics: Humans; Aged; Psychometrics; Reproducibility of Results; Low Back Pain; Fear; Surveys and Questionnaires
PubMed: 35939664
DOI: 10.1519/JPT.0000000000000354 -
Archives of Suicide Research : Official... 2020This study aimed to systemically review the literature regarding self-harm, emotion regulation, and experiential avoidance. Articles were identified through systematic...
This study aimed to systemically review the literature regarding self-harm, emotion regulation, and experiential avoidance. Articles were identified through systematic searches of several databases using combinations of the phrases "emotion regulation" AND "experiential avoidance" AND "self-harm," or "self-injury," and "BPD" or "Borderline Personality Disorder." Additional searches were conducted inclusive of terms related to experiential avoidance and emotion regulation, as well as other disorders related to self-harm. 17 articles were identified and reviewed. Results tentatively support the role of experiential avoidance in self-harm; some studies described phenomena similar to experiential avoidance without using the term. Poor emotion regulation was often cited as a reason for engagement in self-harm. Several gaps in the literature were identified and discussed.
Topics: Avoidance Learning; Borderline Personality Disorder; Emotional Regulation; Humans; Self-Injurious Behavior
PubMed: 30636566
DOI: 10.1080/13811118.2018.1563575 -
Epilepsy & Behavior : E&B Jun 2019Avoidance is the active process of trying to escape from or not experience situations, places, thoughts, or feelings. This can be done through behavioral or cognitive... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Avoidance is the active process of trying to escape from or not experience situations, places, thoughts, or feelings. This can be done through behavioral or cognitive strategies, or more broadly, a combination of both, utilized in an attempt to disengage from private experiences referred to as experiential avoidance (EA). Avoidance is considered important in the development and maintenance of nonepileptic attack disorder (NEAD). This review aimed to understand avoidance in NEAD and evaluate its role as a contributory factor.
METHODS
Fourteen articles were identified by searching Cumulative Index to Nursing and Allied Health (CINAHL), MEDLINE Complete, PsycINFO, and EMBASE and were combined in a narrative synthesis. Six of these articles were included in a meta-analysis comparing levels of EA for individuals with NEAD and healthy controls (HC), and four were included in a meta-analysis comparing EA in NEAD to epilepsy comparisons (EC).
CONCLUSIONS
Experiential avoidance appears to be a strategy that is used by a high proportion of the population with NEAD. The group with NEAD utilized significantly more avoidance compared with both the HC and EC. However, further research is needed to understand the extent and types of avoidance that are relevant.
Topics: Avoidance Learning; Humans; Seizures; Somatoform Disorders
PubMed: 31030077
DOI: 10.1016/j.yebeh.2019.03.004 -
European Eating Disorders Review : the... May 2018This review sought to systematically review and quantify the evidence related to body checking and body avoidance in eating disorders (EDs) to gauge the size of effects,... (Meta-Analysis)
Meta-Analysis
This review sought to systematically review and quantify the evidence related to body checking and body avoidance in eating disorders (EDs) to gauge the size of effects, as well as examine potential differences between clinical and nonclinical populations, and between different ED subtypes. PsycINFO, PsycARTICLES, PsycEXTRA, Cochrane Library, and MEDLINE databases were searched for academic literature published until October 2017. A grey literature search was also conducted. Fifty-two studies were identified for the systematic review, of which 34 were eligible for meta-analysis. Only female samples were included in the meta-analysis. ED cases experienced significantly higher body checking (d = 1.26, p < .001) and body avoidance (d = 1.88, p < .001) overall relative to healthy controls, but neither behaviour varied by ED subtype. In nonclinical samples, body checking (r = .60) and body avoidance (r = .56) were significantly correlated with ED pathology (p < .001). These findings support transdiagnostic theoretical models and approaches to ED treatment and early intervention programmes.
Topics: Body Image; Feeding and Eating Disorders; Female; Humans
PubMed: 29528168
DOI: 10.1002/erv.2585 -
Journal of Psychiatric Research Jun 2021The associations between the distinct types of obsessive-compulsive and related disorders and experiential avoidance have received mixed evidence. We, thus, undertook... (Meta-Analysis)
Meta-Analysis Review
The associations between the distinct types of obsessive-compulsive and related disorders and experiential avoidance have received mixed evidence. We, thus, undertook this meta-analysis to i) re-examine the association between obsessive-compulsive disorder and experiential avoidance, ii) extend this association to hoarding disorder, trichotillomania, and body dysmorphic disorder, and iii) identify potential variables affecting these associations. Five databases, including Medline, Embase, PsychINFO, Web of Science and CINAHL, were searched until March 15th, 2021. Meta-analyses based on random-effect models were performed. Heterogeneity and publication bias tests were applied using the I statistic and the Egger's test. Meta-regression analyses were performed to identify potential moderators affecting the strength of these associations. Thirty-six unique studies based on n = 11,859 participants were identified. The association between obsessive-compulsive disorder and experiential avoidance was moderate (SMD = 0.75, 95% CI = 0.57-0.92), whereas the associations between individual obsessive-compulsive symptoms, including obsessions, responsibility for harm, ordering, checking, washing and neutralizing, and experiential avoidance ranged from low to strong (SMD ranged between 0.41 and 1.06, 95% CI = 0.25 to 1.40). The associations between hoarding disorder (SMD = 0.93, 95% CI = 0.46-1.40), trichotillomania (SMD = 0.56, 95% CI = 0.48-0.63), body dysmorphic disorder (SMD = 1.55, 95% CI = 0.72-2.37) and experiential avoidance were moderate to strong. Meta-regression analyses demonstrated that studies using the AAQ/AAQ-II scales for measuring experiential avoidance, and/or self-report scales for assessing OCRDs contributed smaller effect sizes. These findings suggest that reducing experiential avoidance may be a viable way of complementing exposure strategies in alleviating obsessive-compulsive and related symptoms.
Topics: Body Dysmorphic Disorders; Hoarding Disorder; Humans; Obsessive-Compulsive Disorder; Self Report; Trichotillomania
PubMed: 33866051
DOI: 10.1016/j.jpsychires.2021.03.062 -
BMJ Open Dec 2019To accumulate evidence that obstacle avoidance training alone is effective in improving the locomotor ability of individuals with stroke. (Meta-Analysis)
Meta-Analysis
OBJECTIVES
To accumulate evidence that obstacle avoidance training alone is effective in improving the locomotor ability of individuals with stroke.
DESIGN
Systematic review and meta-analysis.
SETTING
MEDLINE, EMBASE, CENTRAL, ICTRP and PEDro were searched for related information until December 2018. Two independent reviewers extracted data. Outcome measurement data were subjected to meta-analyses using random-effects models. Data syntheses were conducted using RevMan V.5.3, and the certainty of evidence was determined using the Grading of Recommendations Assessment, Development, and Evaluation approach.
PARTICIPANTS
Participants with various types and phases of stroke were included.
INTERVENTION
The usual gait training including obstacle avoidance training (interventions of any type, intensity, duration and frequency).
PRIMARY AND SECONDARY OUTCOME MEASURES
Primary outcomes were gait speed, composite gait ability and objective balance ability. Secondary outcomes were subjective balance ability, gait endurance and fall incidence.
RESULTS
Two randomised controlled trials with a total of 49 participants were used as data sources for this study. The obstacle avoidance training (training) group had lower gait speed than the control group (mean difference (MD) 0.03, 95% CI -0.11 to 0.16, p=0.51). Further, the certainty of evidence was very low. The subjective balance ability (Activities-specific Balance Confidence scale) was not significantly different between the training and control groups (MD 6.65, 95% CI -7.59 to 20.89, p=0.36), and it showed very low certainty of evidence.
CONCLUSIONS
Obstacle avoidance training may have little or no effect on individuals with stroke. The failure to find the effectiveness of obstacle avoidance training alone is possibly attributable to the insufficient amount of training in the intervention and the lack of well-designed studies that measured relevant outcomes.
PROSPERO REGISTRATION NUMBER
CRD42017060691.
Topics: Accidental Falls; Humans; Randomized Controlled Trials as Topic; Reaction Time; Stroke; Stroke Rehabilitation; Walking; Walking Speed
PubMed: 31848159
DOI: 10.1136/bmjopen-2018-028873 -
Revista Paulista de Pediatria : Orgao... 2020To identify the factors associated with food neophobia in children through a systematic review.
OBJECTIVE
To identify the factors associated with food neophobia in children through a systematic review.
DATA SOURCES
This research was based on the recommendations of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. The research was carried out in the PubMed, Science Direct, and Scientific Electronic Library Online databases, with the combination of health descriptors in English and Portuguese: ("Food Neophobia" OR "Feeding Behavior" OR "Food Preferences" OR "Food Selectivity") AND Child, from 2000 to 2019. Studies that evaluated factors associated with food neophobia in children were included. The quality of the studies was assessed using the Effective Public Health Practice Project: Quality Assessment Tool for Quantitative Studies (QATQS).
DATA SYNTHESIS
19 studies were included in the systematic review. The prevalence of food neophobia ranged from 12.8 to 100%. The studies used three different scales to measure the level of food neophobia. The main factors associated with food neophobia were: parental influence on children's eating habits, children's innate preference for sweet and savory flavors, influence of the sensory aspect of the food, parents' pressure for the child to eat, parents' lack of encouragement and/or affection at mealtime, childhood anxiety, and diets with low variety and low nutritional quality.
CONCLUSIONS
The factors associated with food neophobia permeate several areas of the child's life, thus, interprofessional follow-up becomes essential in the intervention process.
Topics: Adolescent; Anxiety; Avoidant Restrictive Food Intake Disorder; Child; Child, Preschool; Feeding Behavior; Female; Food Preferences; Humans; Male; Parent-Child Relations; Parenting; Risk Factors; Severity of Illness Index
PubMed: 33175005
DOI: 10.1590/1984-0462/2021/39/2020089 -
Cancer Nursing 2013The emotion of disgust appears to promote psychological and behavioral avoidance, a dynamic that has significant implications in physical and psychological outcomes in... (Review)
Review
BACKGROUND
The emotion of disgust appears to promote psychological and behavioral avoidance, a dynamic that has significant implications in physical and psychological outcomes in colorectal cancer (CRC). Patients, caregivers, and health professionals alike are all potentially susceptible to responding with disgust and the associated avoidance.
OBJECTIVE
This article aimed to review the early-stage literature related to disgust and CRC, consider the clinical implications, and suggest an appropriate research agenda.
METHODS
Given limited research in this area, a systematic review of the literature was broadened to include disgust and all cancers. MEDLINE, Web of Science, SCOPUS, and ProQuest Dissertations and Theses databases were searched, with additional works sourced by reviewing citation lists and/or by contacting the lead authors.
RESULTS
Nine studies were identified relating to disgust and cancer screening, and 6 related to disgust and cancer treatment. Two broad findings emerged: (1) disgust appears to be promoting aversion to (and avoidance of) CRC screening, and (2) several known elicitors of disgust are widely apparent in CRC contexts.
CONCLUSIONS
Disgust likely represents a key emotional substrate for avoidance among CRC patients, caregivers, and health professionals. Further research is required to identify disgust's elicitors and effects in CRC contexts, informing interventions that target early identification of persons at risk of maladaptive outcomes. Exposure therapies and mindfulness training may be well suited to treating disgust-generated avoidance.
IMPLICATIONS FOR PRACTICE
Disgust has significant implications in CRC contexts. Oncology nurses are uniquely positioned to guide clinical interventions and ultimately improve outcomes in this area.
Topics: Caregivers; Colorectal Neoplasms; Early Detection of Cancer; Fear; Health Knowledge, Attitudes, Practice; Humans; Nurse-Patient Relations; Nursing Research; Oncology Nursing; Phobic Disorders
PubMed: 23047793
DOI: 10.1097/NCC.0b013e31826a4b1b -
Obesity Reviews : An Official Journal... Aug 2016Studies demonstrate an association between personality traits and obesity as well as their prognostic influence on weight course. In contrast, only few studies have... (Review)
Review
BACKGROUND
Studies demonstrate an association between personality traits and obesity as well as their prognostic influence on weight course. In contrast, only few studies have investigated the association between personality disorders (PDs) and obesity.
OBJECTIVE
The present review summarizes through a comprehensive and critical evaluation the results of 68 studies identified by database research (PubMed and PsycINFO) covering the last 35 years that investigated the association between PDs, overweight and obesity as well as the predictive value of PDs for the development of obesity and the effectiveness of weight reduction treatments.
RESULTS
Adults with any PD have a higher risk of obesity. In the female general population, there is an association between avoidant or antisocial PD and severe obesity. Further, women with paranoid or schizotypal PD have a higher risk of obesity. Clinical studies including foremost female participants showed a higher comorbidity of PDs, especially borderline PD and avoidant PD, in binge-eating disorder. Regarding both genders, patients with PD show less treatment success in conservative weight-loss treatment programmes for obesity than patients without PD.
CONCLUSIONS
In prevention and conservative weight-loss treatment strategies, more care should be taken to address the special needs of patients with comorbid PDs.
Topics: Binge-Eating Disorder; Comorbidity; Humans; Meta-Analysis as Topic; Obesity; Overweight; Personality Disorders; Prevalence; Randomized Controlled Trials as Topic
PubMed: 27230851
DOI: 10.1111/obr.12415 -
Journal of Behavioral Medicine Dec 2014The avoidance model in patients with knee and hip osteoarthritis (OA) hypothesizes that pain and psychological distress lead to avoidance of activities, and thereby to... (Review)
Review
The avoidance model in patients with knee and hip osteoarthritis (OA) hypothesizes that pain and psychological distress lead to avoidance of activities, and thereby to muscle weakness and activity limitations. This paper systematically reviews the scientific evidence for the validity of this avoidance model. A qualitative data synthesis was used to identify levels of evidence. Sixty studies were included. In knee OA, strong evidence was found that avoidance of activities is associated with activity limitations via muscle weakness (mediation by muscle weakness), strong evidence was found for an association between muscle weakness and activity limitations, and weak evidence was found that pain and psychological distress are associated with muscle weakness via avoidance of activities (mediation by avoidance). In hip OA, weak evidence was found for mediation by muscle weakness; and strong evidence was found for an association between muscle weakness and activity limitations. More research is needed on the consecutive associations between pain or psychological distress, avoidance of activities and muscle weakness, and to confirm causal relationships.
Topics: Avoidance Learning; Humans; Models, Psychological; Motor Activity; Muscle Weakness; Osteoarthritis, Hip; Osteoarthritis, Knee; Pain; Stress, Psychological
PubMed: 24841177
DOI: 10.1007/s10865-014-9571-8