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Clinical Psychology Review Aug 2021Repetitive negative thinking (RNT) and executive functioning (EF) deficits are each characteristic of many forms of youth psychopathology. Extensive work has examined... (Review)
Review
Repetitive negative thinking (RNT) and executive functioning (EF) deficits are each characteristic of many forms of youth psychopathology. Extensive work has examined the relationship between rumination, a form of RNT, and EF in adults. However, less is known about the relationship between RNT more broadly and EF in youth, for whom these constructs are developing and emerging. Here, we systematically and qualitatively reviewed 27 studies on the associations between EF (e.g., shifting, inhibition, working memory) and RNT (e.g., rumination, worry, obsessions) in youth. All forms of RNT were more commonly positively associated with questionnaire-reported EF problems in daily life, most frequently in the domain of shifting. Task-based assessments of EF were less consistently associated with RNT in youth, with no strong pattern of presence vs. absence of associations. Further, limited longitudinal work has been conducted on this topic to date. This review integrates initial work with regard to RNT and EF deficits in a still-developing population, and discusses clear future need for longitudinal, multi-method assessments of the relationship between RNT and EF subtypes in youth.
Topics: Adolescent; Adult; Anxiety; Anxiety Disorders; Executive Function; Humans; Memory, Short-Term; Pessimism
PubMed: 34144296
DOI: 10.1016/j.cpr.2021.102050 -
Clinical Psychology & Psychotherapy May 2021It has been proposed that repetitive negative thinking (worry and rumination) may be more common among adults who have been exposed to childhood adverse experiences,... (Review)
Review
BACKGROUND
It has been proposed that repetitive negative thinking (worry and rumination) may be more common among adults who have been exposed to childhood adverse experiences, leading to emotional disorders and other adverse outcomes. The current study aims to present a comprehensive evaluation of the literature examining the relationship between the exposure to childhood adversities, repetitive negative thinking and clinical outcomes in adulthood.
METHODS
In accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, a search was conducted on PubMed and Ebsco. A manual search of reference lists was also run. Search terms were 'childhood adversity/childhood abuse/childhood neglect/early loss event AND worry or rumination'.
RESULTS
A total of 18 studies met the inclusion criteria. In both non-clinical and clinical populations, worry and rumination seem to be common among adults exposed to childhood abuse or childhood neglect. Among adults who have been exposed to childhood adversities, rumination seems to be associated with worse clinical outcomes such as severe psychiatric symptoms, depression, dysphoria, suicidal ideation, cognitive complaints, post-traumatic stress symptoms and aggression.
CONCLUSION
Early experiences of abuse and neglect may be associated with a tendency to engage in repetitive negative thinking, such as worry and rumination, in adulthood. Among adults, with a history of childhood adversities, tailored treatment to reduce repetitive negative thinking should be considered.
Topics: Adult; Adverse Childhood Experiences; Anxiety; Child; Depressive Disorder, Major; Humans; Pessimism; Suicidal Ideation
PubMed: 33861493
DOI: 10.1002/cpp.2590 -
Sleep Medicine Reviews Feb 2021Repetitive negative thinking (RNT), i.e., worry, rumination, and transdiagnostic repetitive thinking, is thought to exacerbate and perpetuate insomnia in cognitive... (Meta-Analysis)
Meta-Analysis Review
Repetitive negative thinking (RNT), i.e., worry, rumination, and transdiagnostic repetitive thinking, is thought to exacerbate and perpetuate insomnia in cognitive models. Moreover, RNT is a longitudinal precursor of depression and anxiety, which are often co-present alongside insomnia. Whilst accumulating evidence supports the efficacy of cognitive behavioural therapy for insomnia (CBT-I) in reducing depression and anxiety symptoms, the literature on the effects of CBT-I on RNT has never been systematically appraised. Importantly, preliminary evidence suggests that reduction of RNT following CBT-I may be associated with reduction of depression and anxiety. Therefore, we aimed to conduct a systematic review and meta-analysis on the effects of CBT-I on RNT. Seven databases were searched, and 15 randomised controlled trials were included. Results showed moderate-to-large effects of CBT-I on worry (Hedge's g range: -0.41 to g = -0.71) but small and non-reliable effects on rumination (g = -0.13). No clear evidence was found for an association between post-treatment reduction in RNT and post-treatment reduction in depression and anxiety. Although the literature is small and still developing, CBT-I seems to have a stronger impact on sleep-related versus general measures of RNT. We discuss a research agenda aimed at advancing the study of RNT in CBT-I trials.
Topics: Anxiety; Cognitive Behavioral Therapy; Humans; Pessimism; Sleep; Sleep Initiation and Maintenance Disorders
PubMed: 32992228
DOI: 10.1016/j.smrv.2020.101378 -
Neuroscience and Biobehavioral Reviews Nov 2020Just as happy people see the proverbial glass as half-full, 'optimistic' or 'pessimistic' responses to ambiguity might also reflect affective states in animals.... (Meta-Analysis)
Meta-Analysis Review
Just as happy people see the proverbial glass as half-full, 'optimistic' or 'pessimistic' responses to ambiguity might also reflect affective states in animals. Judgement bias tests, designed to measure these responses, are an increasingly popular way of assessing animal affect and there is now a substantial, but heterogeneous, literature on their use across different species, affect manipulations, and study designs. By conducting a systematic review and meta-analysis of 459 effect sizes from 71 studies of non-pharmacological affect manipulations on 22 non-human species, we show that animals in relatively better conditions, assumed to generate more positive affect, show more 'optimistic' judgements of ambiguity than those in relatively worse conditions. Overall effects are small when considering responses to all cues, but become more pronounced when non-ambiguous training cues are excluded from analyses or when focusing only on the most divergent responses between treatment groups. Task type (go/no-go; go/go active choice), training cue reinforcement (reward-punishment; reward-null; reward-reward) and sex of animals emerge as potential moderators of effect sizes in judgement bias tests.
Topics: Animals; Behavior, Animal; Cognition; Cues; Judgment; Optimism; Pessimism
PubMed: 32682742
DOI: 10.1016/j.neubiorev.2020.07.012 -
The American Journal of Sports Medicine May 2020An athlete's preexisting psychological factors may influence the incidence and/or severity of sports-related concussions (SRCs).
BACKGROUND
An athlete's preexisting psychological factors may influence the incidence and/or severity of sports-related concussions (SRCs).
PURPOSE
To determine if emotional states, personality traits, temperament, life stressors, and explanatory styles (optimism vs pessimism) influence the incidence and severity of SRCs in athletes.
STUDY DESIGN
Systematic review.
METHODS
A systematic literature search of multiple major medical reference databases was performed following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Studies were included that evaluated the effect of preexisting psychological factors on the incidence and severity of SRCs in male and female athletes participating in all sports.
RESULTS
The initial search identified 1195 articles. Ten studies met our inclusion criteria and were included in our analysis. Factors such as meanness, aggression, and psychoticism were associated with an increased incidence of SRCs. Baseline traits of irritability, sadness, nervousness, and depressive symptoms were associated with worse symptomatology after SRCs. In young athletes, preexisting psychiatric illnesses, family history of psychiatric illness, and significant life stressors were associated with an increased risk of developing postconcussion syndrome after SRCs.
CONCLUSION
This systematic review demonstrated a potential relationship between an athlete's preexisting psychological factors and the incidence and severity of SRCs. These associations are not entirely clear owing to the heterogeneity across included studies and the low-to-moderate certainty of evidence. Future studies should attempt to evaluate men and women independently, use well-validated psychological questionnaires, and limit the usage of self-reported SRCs, when possible. Furthermore, the potential efficacy of baseline psychological factor and/or symptom reports on the prevention and management of SRCs should be explored.
Topics: Athletes; Athletic Injuries; Brain Concussion; Female; Humans; Incidence; Male; Sports
PubMed: 31702943
DOI: 10.1177/0363546519882626 -
JAMA Network Open Sep 2019Optimism and pessimism can be easily measured and are potentially modifiable mindsets that may be associated with cardiovascular risk and all-cause mortality. (Meta-Analysis)
Meta-Analysis
IMPORTANCE
Optimism and pessimism can be easily measured and are potentially modifiable mindsets that may be associated with cardiovascular risk and all-cause mortality.
OBJECTIVE
To conduct a meta-analysis and systematic review of the association between optimism and risk for future cardiovascular events and all-cause mortality.
DATA SOURCES AND STUDY SELECTION
PubMed, Scopus, and PsycINFO electronic databases were systematically searched from inception through July 2, 2019, to identify all cohort studies investigating the association between optimism and pessimism and cardiovascular events and/or all-cause mortality by using the following Medical Subject Heading terms: optimism, optimistic explanatory style, pessimism, outcomes, endpoint, mortality, death, cardiovascular events, stroke, coronary artery disease, coronary heart disease, ischemic heart disease, and cardiovascular disease.
DATA EXTRACTION AND SYNTHESIS
Data were screened and extracted independently by 2 investigators (A.R. and C.B.). Adjusted effect estimates were used, and pooled analysis was performed using the Hartung-Knapp-Sidik-Jonkman random-effects model. Sensitivity and subgroup analyses were performed to assess the robustness of the findings. The Meta-analysis of Observational Studies in Epidemiology (MOOSE) reporting guideline was followed.
MAIN OUTCOMES AND MEASURES
Cardiovascular events included a composite of fatal cardiovascular mortality, nonfatal myocardial infarction, stroke, and/or new-onset angina. All-cause mortality was assessed as a separate outcome.
RESULTS
The search yielded 15 studies comprising 229 391 participants of which 10 studies reported data on cardiovascular events and 9 studies reported data on all-cause mortality. The mean follow-up period was 13.8 years (range, 2-40 years). On pooled analysis, optimism was significantly associated with a decreased risk of cardiovascular events (relative risk, 0.65; 95% CI, 0.51-0.78; P < .001), with high heterogeneity in the analysis (I2 = 87.4%). Similarly, optimism was significantly associated with a lower risk of all-cause mortality (relative risk, 0.86; 95% CI, 0.80-0.92; P < .001), with moderate heterogeneity (I2 = 73.2%). Subgroup analyses by methods for assessment, follow-up duration, sex, and adjustment for depression and other potential confounders yielded similar results.
CONCLUSIONS AND RELEVANCE
The findings suggest that optimism is associated with a lower risk of cardiovascular events and all-cause mortality. Future studies should seek to better define the biobehavioral mechanisms underlying this association and evaluate the potential benefit of interventions designed to promote optimism or reduce pessimism.
Topics: Cause of Death; Coronary Artery Disease; Humans; Myocardial Infarction; Optimism; Stroke
PubMed: 31560385
DOI: 10.1001/jamanetworkopen.2019.12200 -
Social Science & Medicine (1982) May 2019The criminological "broken windows" theory (BWT) has inspired public health researchers to test the impact of neighborhood disorder on an array of resident health... (Meta-Analysis)
Meta-Analysis
The criminological "broken windows" theory (BWT) has inspired public health researchers to test the impact of neighborhood disorder on an array of resident health behaviors and outcomes. This paper identifies and meta-analyzes the evidence for three mechanisms (pathways) by which neighborhood disorder is argued to impact health, accounting for methodological inconsistencies across studies. A search identified 198 studies (152 with sufficient data for meta-analysis) testing any of the three pathways or downstream, general health outcomes. The meta-analysis found that perceived disorder was consistently associated with mental health outcomes, as well as substance abuse, and measures of overall health. This supported the psychosocial model of disadvantage, in which stressful contexts impact mental health and related sequelae. There was no consistent evidence for disorder's impact on physical health or risky behavior. Further examination revealed that support for BWT-related hypotheses has been overstated owing to data censoring and the failure to consistently include critical covariates, like socioeconomic status and collective efficacy. Even where there is evidence that BWT impacts outcomes, it is driven by studies that measured disorder as the perceptions of the focal individual, potentially conflating pessimism about the neighborhood with mental health.
Topics: Crime; Health Behavior; Humans; Mental Disorders; Outcome Assessment, Health Care; Residence Characteristics; Self Report; Socioeconomic Factors; Substance-Related Disorders
PubMed: 30885673
DOI: 10.1016/j.socscimed.2018.11.015 -
Human Reproduction (Oxford, England) Apr 2019How much statistical power do randomised controlled trials (RCTs) and meta-analyses have to investigate the effectiveness of interventions in reproductive medicine? (Meta-Analysis)
Meta-Analysis
STUDY QUESTION
How much statistical power do randomised controlled trials (RCTs) and meta-analyses have to investigate the effectiveness of interventions in reproductive medicine?
SUMMARY ANSWER
The largest trials in reproductive medicine are unlikely to detect plausible improvements in live birth rate (LBR), and meta-analyses do not make up for this shortcoming.
WHAT IS KNOWN ALREADY
Effectiveness of interventions is best evaluated using RCTs. In order to be informative, these trials should be designed to have sufficient power to detect the smallest clinically relevant effect. Similar trials can subsequently be pooled in meta-analyses to more precisely estimate treatment effects.
STUDY DESIGN, SIZE, DURATION
A review of power and precision in 199 RCTs and meta-analyses from 107 Cochrane Reviews was conducted.
PARTICIPANTS/MATERIALS, SETTING, METHODS
Systematic reviews published by Cochrane Gynaecology and Fertility with the primary outcome live birth were identified. For each live birth (or ongoing pregnancy) meta-analysis and for the largest RCT in each, we calculated the power to detect absolute improvements in LBR of varying sizes. Additionally, the 95% CIs of estimated treatment effects from each meta-analysis and RCT were recorded, as these indicate the precision of the result.
MAIN RESULTS AND THE ROLE OF CHANCE
Median (interquartile range) power to detect an improvement in LBR of 5 percentage points (pp) (e.g. 25-30%) was 13% (8-21%) for RCTs and 16% (9-33%) for meta-analyses. No RCTs and only 2% of meta-analyses achieved 80% power to detect an improvement of 5 pp. Median power was high (85% for trials and 93% for meta-analyses) only in relation to 20 pp absolute LBR improvement, although substantial numbers of trials and meta-analyses did not achieve 80% power even for this improbably large effect size. Median width of 95% CIs was 25 pp and 21 pp for RCTs and meta-analyses, respectively. We found that 28% of Cochrane Reviews with LBR as the primary outcome contain no live birth (or ongoing pregnancy) data.
LARGE-SCALE DATA
The data used in this study may be accessed at https://osf.io/852tn/?view_only=90f1579ce72747ccbe572992573197bd.
LIMITATIONS, REASONS FOR CAUTION
The design and analysis decisions used in this study are predicted to overestimate the power of trials and meta-analyses, and the size of the problem is therefore likely understated. For some interventions, it is possible that larger trials not reporting live birth or ongoing pregnancy have been conducted, which were not included in our sample. In relation to meta-analyses, we calculated power as though all participants were included in a single trial. This ignores heterogeneity between trials in a meta-analysis, and will cause us to overestimate power.
WIDER IMPLICATIONS OF THE FINDINGS
Trials capable of detecting realistic improvements in LBR are lacking in reproductive medicine, and meta-analyses are not large enough to overcome this deficiency. This situation will lead to unwarranted pessimism as well as unjustified enthusiasm regarding reproductive interventions, neither of which are consistent with the practice of evidence-based medicine or the idea of informed patient choice. However, RCTs and meta-analyses remain vital to establish the effectiveness of fertility interventions. We discuss strategies to improve the evidence base and call for collaborative studies focusing on the most important research questions.
STUDY FUNDING/COMPETING INTEREST(S)
There was no specific funding for this study. KS and SL declare no conflict of interest. AV consults for the Human Fertilisation and Embryology Authority (HFEA): all fees are paid directly to AV's employer. JW declares that publishing research benefits his career. SR is a Statistical Editor for Human Reproduction. JW and AV are Statistical Editors for Cochrane Gynaecology and Fertility. DRB is funded by the NHS as Scientific Director of a clinical IVF service.
PROSPERO REGISTRATION NUMBER
None.
Topics: Birth Rate; Female; Humans; Infertility; Live Birth; Pregnancy; Randomized Controlled Trials as Topic; Reproductive Medicine; Treatment Outcome
PubMed: 30838395
DOI: 10.1093/humrep/dez017 -
Acta Psychiatrica Scandinavica May 2018To provide an update on the evidence base for the nature of the relationship between negative symptoms and depressive features in people with schizophrenia, and propose...
OBJECTIVE
To provide an update on the evidence base for the nature of the relationship between negative symptoms and depressive features in people with schizophrenia, and propose new models that reflect their complex relationship.
METHOD
A systematic review following PRISMA guidelines. A total of 2210 articles were identified from EMBASE, PsychInfo and MEDLINE, and further two articles were hand-searched from references. Twenty-seven met inclusion criteria and were included in the review.
RESULTS
In schizophrenia, primary evidence suggests symptoms of low mood, suicidal ideation and pessimism have more specificity for depression whereas alogia and blunted affect may have more specificity as negative symptoms. Anhedonia, anergia and avolition may be common to both.
CONCLUSION
It may be possible to further distinguish depressive features from negative symptoms in schizophrenia when detailed phenomenology is considered. However, in a proposed dimensional model, these two domains continue to share certain phenomena, highlighting their close relationship.
Topics: Comorbidity; Depressive Disorder; Humans; Schizophrenia
PubMed: 29532909
DOI: 10.1111/acps.12873 -
Psycho-oncology Apr 2018A growing number of children and adolescents are experiencing and surviving cancer. This review aims to identify the demographic, medical, and psychosocial correlates of... (Meta-Analysis)
Meta-Analysis
OBJECTIVE
A growing number of children and adolescents are experiencing and surviving cancer. This review aims to identify the demographic, medical, and psychosocial correlates of perceived post-traumatic growth in individuals of any age who were affected by paediatric cancer. Findings will highlight protective factors that may facilitate post-traumatic growth, allowing for directed social support, intervention, and follow-up care.
METHODS
A systematic search based on the key concepts "post-traumatic growth," "neoplasms," and "paediatric" retrieved 905 records from online databases: Embase, Ovid MEDLINE, PILOTS: Published International Literature on Traumatic Stress, PsycINFO, and Web of Science. Eligible studies were appraised as excellent quality with a high level of interrater reliability. The results of 18 studies were synthesised.
RESULTS
After the removal of outliers, post-traumatic growth shared small, negative associations with time since diagnosis (r = -0.14) and time since treatment completion (r = -0.19), and small, positive associations with age at diagnosis (r = 0.20), age at survey (r = 0.17), post-traumatic stress symptoms (r = 0.11), and social support (r = 0.25). Post-traumatic growth was positively and moderately associated with optimism (r = 0.31).
CONCLUSIONS
Several findings were consistent with a comparable meta-analysis in adult oncology populations. Targeted social support, clinical intervention, and education may facilitate post-traumatic growth. Longitudinal research in individuals affected by childhood and adolescent cancer would allow an examination of the effects of predictive variables on post-traumatic growth over time.
Topics: Adaptation, Psychological; Adolescent; Adult; Age of Onset; Cancer Survivors; Child; Correlation of Data; Humans; Male; Optimism; Pessimism; Posttraumatic Growth, Psychological; Reproducibility of Results; Social Support; Stress Disorders, Post-Traumatic; Surveys and Questionnaires; Young Adult
PubMed: 29096418
DOI: 10.1002/pon.4577