A pilot randomised controlled trial of an Internet-based cognitive behavioural therapy self-management programme (MS Invigor8) for multiple sclerosis fatigue

The majority of people affected by Multiple Sclerosis (paMS) experience severe and disabling fatigue. A recent randomised controlled trial (RCT) showed that cognitive behaviour therapy with a clinical psychologist was an effective treatment for MS fatigue. An Internet-based version of this intervention, MS Invigor8, was developed for the current study using agile design and input from paMS. MS Invigor8 includes eight tailored, interactive sessions. The aim was to test the feasibility and potential efficacy and cost-effectiveness of the programme in a pilot RCT. 40 patients were randomised to MS Invigor8 (n=23) or standard care (n=17). The MS Invigor8 group accessed sessions over 8-10 weeks and received up to three 30-60min telephone support sessions. Participants completed online standardised questionnaires assessing fatigue, mood, quality of life and service use at baseline and 10 weeks follow-up. Large between group treatment effects were found for the primary outcomes of fatigue severity (d=1.19) and impact (d=1.02). The MS Invigor8 group also reported significantly greater improvements in anxiety, depression and quality-adjusted life years. These data suggest that Internet-based CBT may be a clinically and cost-effective treatment for MS fatigue. A larger RCT with longer term follow-up is warranted.     

Behaviorally inhibited temperament is associated with severity of post-traumatic stress disorder symptoms and faster eyeblink conditioning in veterans

Prior studies have sometimes demonstrated facilitated acquisition of classically conditioned responses and/or resistance to extinction in post-traumatic stress disorder (PTSD). However, it is unclear whether these behaviors are acquired as a result of PTSD or exposure to trauma, or reflect preexisting risk factors that confer vulnerability for PTSD. Here, we examined classical eyeblink conditioning and extinction in veterans self-assessed for current PTSD symptoms, exposure to combat, and the personality trait of behavioral inhibition (BI), a risk factor for PTSD. A total of 128 veterans were recruited (mean age 51.2 years; 13.3% female); 126 completed self-assessment, with 25.4% reporting a history of exposure to combat and 30.9% reporting current, severe PTSD symptoms (PTSS). The severity of PTSS was correlated with current BI (R(2) = 0.497) and PTSS status could be predicted based on current BI and combat history (80.2% correct classification). A subset of the veterans (n = 87) also completed the eyeblink conditioning study. Among veterans without PTSS, childhood BI was associated with faster acquisition; veterans with PTSS showed delayed extinction, under some conditions. These data demonstrate a relationship between current BI and PTSS, and indicate that the facilitated conditioning sometimes observed in patients with PTSD may partially reflect personality traits such as childhood BI that pre-date and contribute to vulnerability for PTSD.     

The 5C’s Model of Successful Partnerships in Elite Beach Volleyball Dyads

An athlete–athlete partnership is a form of athletic dyad in which both members equally share power and responsibility. Although research on the coach–athlete relationship is prevalent, research on the unique interpersonal dynamics of athlete–athlete partnerships in elite sport is sparse, particularly in beach volleyball. The purpose of the present study was to explore the interpersonal components of successful, elite athlete–athlete beach volleyball partnerships through the lens of interdependence theory and Jowett and colleagues’ 3?+?1C’s theory of coach–athlete relationships. Interpretative Phenomenological Analysis was applied to semistructured interviews with four Olympic-level beach volleyball players (3 male, 1 female). Results revealed 5 higher order themes: (a) compatibility, (b) commitment, (c) complementarity, (d) coorientation, and (e) closeness, which became the key constructs in the proposed 5C’s model of the successful athlete–athlete partnership. Interpersonal awareness, interpersonal maturation, and context were identified as 3 overarching meta-themes, whereas interdependence connected all interpersonal components. For example, in consultation, increasing athlete individual and interpersonal awareness (e.g., in the areas of personal and dyadic philosophy, personal and shared values, and individual and dyadic coping) requires careful contextualization and thoughtful implementation. Future studies need to examine diverse samples of athlete–athlete dyads to advance interpersonal theory in sport and add to emerging theories of performance behavior and expertise in sport.

Lay Summary: Successful beach volleyball partnerships share a philosophy and commitment to their sport. Desired partners are supportive and adaptive, are compatible, depend on one another, and continually appraise and reflect on their relationship to grow as individuals and as teammates.     

Psychological impact of colorectal cancer screening.

This article examines the psychological impact of participating in sigmoidoscopy screening for colorectal cancer prevention. The 1st study examined psychological well-being at 3 months, in relation to screening outcome, in 4,153 individuals. The 2nd study used longitudinal data to examine changes in psychological functioning from before to after screening in relation both to screening outcome and baseline indicators of vulnerability. There were few psychological differences between those who had received negative results or had polyps detected. These findings were confirmed in the longitudinal study, which also found no evidence for vulnerability to adverse effects among those who were initially most anxious or who perceived their risk of cancer to be higher. The longitudinal data suggested that screening might produce transient positive effects.     

Nonresident Suicides in England: A National Study

Little is known about the numbers and characteristics of people who travel away from home before dying by suicide. Therefore, this studied attempts to identify the sociodemographic characteristics, location, and method of suicide in people who died distant from home, in a national sample. Data were collected on all English suicides and a patient population; nonresident suicides resided in one Health Authority but died in a different one. Twelve percent of suicides were nonresident and features of these included: young age, social adversity, and severe mental illness. In conclusion, both individual‐ and area‐based factors are likely to contribute to suicide away from home.     

The processing of affectively valenced stimuli: The role of surprise

Two experiments tested the hypothesis that the surprise mechanism activates a threat detection system that prioritises the processing of threat-related stimuli. In Experiment 1, participants responded to a dot that appeared during the presentation of two words. In the critical trial, one of the two words was either pleasant or unpleasant. In Experiment 2, depending on the condition, the participants had to decide whether at least one of two simultaneously presented pictures depicted either a pleasant or an unpleasant stimulus. In the critical trial, both a pleasant and an unpleasant picture appeared. In both experiments, the stimuli in the critical trial were presented either during routine behaviour or in the context of a surprising event. The results showed that during routine behaviour unpleasant stimuli received more attentive resources than pleasant stimuli only if the affective valence of the stimuli was action-relevant (Experiment 2). In contrast, in the context of surprise, unpleasant words engaged more attentive resources than pleasant words although they were action-irrelevant (Experiment 1). In addition, in the context of surprise, the decision time increase was more pronounced in the pleasant than in the unpleasant experimental group. This finding was interpreted as evidence that the threat detection system of the surprise mechanism initially searches for a threat-related stimulus.     

Method of Suicide in the Mentally Ill: A National Clinical Survey

Comparisons of psychiatric patients who die by suicide using different methods are scarce. We aimed to establish the methods of suicide used by those who are currently or have recently been in contact with mental health services in England and Wales (N = 6,203), and describe the social and clinical characteristics of suicides by different methods. We found that hanging, self‐poisoning, and jumping (from a height or in front of a moving vehicle) were the most common methods of suicide, accounting for 79% of all deaths. The implications of these and other findings are discussed.