Exploring the associations shared by mood,pain-related attention and pain outcomes related to sleep disturbance in a chronic pain sample

Objective: Sleep disturbance in chronic pain is common, occurring in two-thirds of patients. There is a complex relationship between chronic pain and sleep; pain can disrupt sleep and poor sleep can exaggerate pain intensity. This may have an impact on both depressive symptoms and attention to pain. This study aims to evaluate the relationship between chronic pain and sleep, and the role of mood and attention.

Methods: Chronic pain patients, recruited from a secondary care outpatient clinic, completed self-report measures of pain, sleep, depressive symptoms and attention to pain. Hierarchical regression and structural equation modelling were used to explore the relationships between these measures. Participants (n = 221) were aged between 20 and 84 (mean = 52) years.

Results: The majority of participants were found to be ‘poor sleepers’ (86%) with increased pain severity, depressive symptoms and attention to pain. Both analytical approaches indicated that sleep disturbance is indirectly associated with increased pain severity Instead the relationship shared by sleep disturbance and pain severity was further associated with depressive symptoms and attention to pain.

Conclusions: Our results indicate that sleep disturbance may contribute to clinical pain severity indirectly though changes in mood and attention. Prospective studies exploring lagged associations between these constructs could have critical information relevant to the treatment of chronic pain.     

The Development and Testing of a New Version of the Cognitive Reflection Test Applying Item Response Theory (IRT)

The cognitive reflection test (CRT) is a short measure of a person's ability to resist intuitive response tendencies and to produce a normatively correct response, which is based on effortful reasoning. Although the CRT is a very popular measure, its psychometric properties have not been extensively investigated. A major limitation of the CRT is the difficulty of the items, which can lead to floor effects in populations other than highly educated adults. The present study aimed at investigating the psychometric properties of the CRT applying item response theory analyses (a two‐parameter logistic model) and at developing a new version of the scale (the CRT‐long), which is appropriate for participants with both lower and higher levels of cognitive reflection. The results demonstrated the good psychometric properties of the original, as well as the new scale. The validity of the new scale was also assessed by measuring correlations with various indicators of intelligence, numeracy, reasoning and decision‐making skills, and thinking dispositions. Moreover, we present evidence for the suitability of the new scale to be used with developmental samples. Finally, by comparing the performance of adolescents and young adults on the CRT and CRT‐long, we report the first investigation into the development of cognitive reflection. Copyright © 2015 John Wiley & Sons, Ltd.     

Movies on the couch: The MOVIE model of film therapy

Film therapy, the therapeutic use of movies in psychological therapies, is a growing area of interest to therapists and researchers. This paper discusses the benefits of film therapy and presents a method, the MOVIE model of film therapy, a widely applicable, trauma-informed framework for individual or group therapy, counsellor education and self-help. Film or cinema therapy is a highly accessible and relatable method for many diverse groups. The benefits identified include emotional processing, greater ease of dialogue, increased empathy, interpersonal learning, new perspectives and learning skills. Following the model's reflective steps, clients mindfully observe and voice their emotional and psychological responses to movie-watching; identify how the imagery, characters, themes and story symbolise personal experience; and consider any new possibilities that emerged for their own lives. The model is informed by a practice-focussed review of literature and draws on methods from mindfulness and experiential and narrative therapies. The steps are widely applicable in a range of settings and can be adapted across counselling modalities. Further research to consider the outcomes of using the model, alongside qualitative research on clients' experiences of working this way with film, is recommended.     

The impact of bundle comparisons on bundle preference

The bundling literature largely holds that a person's reaction to a given product bundle depends only on the characteristics of the products contained in the bundle. This paper, instead, proposes that people evaluate bundles in reference to other bundles that they have seen. Prior research indicates that people are sensitive to a bundle's “attribute inventory” or the aggregate level of comparable attributes possessed by its constituent products. We show that when people evaluate a bundle, they compare the attribute inventories that it offers to those offered by other bundles that they have seen. The resulting compositional comparisons can occur without changes to the products that comprise the target and contextual bundles, vary by attribute comparability and attentional focus, and coexist with (and at times reverse the effects of) well‐established product‐specific context effects, which are determined solely by the products and their attributes.     

Drinking to belong: The effect of a friendship threat and self-esteem on college student drinking

The current study examined how implicit and explicit self-esteem and time spent drinking with friends influence college student drinking after a friendship threat manipulation. Poisson regression analyses revealed that students with low implicit self-esteem showed a greater increase in alcohol consumption when drinking with friends after experiencing a friendship threat than in the control condition. These effects were not found among students with high implicit self-esteem. A similar, but weaker, pattern emerged when testing the independent effects of explicit self-esteem. We suggest that low self-esteem students are drinking because they lack the self-resources to deal with unmet belongingness needs. These findings suggest that low implicit self-esteem may be a risk factor for college student drinking.     

Creating state of the art,next-generation Virtual Reality exposure therapies for anxiety disorders using consumer hardware platforms: design considerations and future directions

Decades of research and more than 20 randomized controlled trials show that Virtual Reality exposure therapy (VRET) is effective in reducing fear and anxiety. Unfortunately, few providers or patients have had access to the costly and technical equipment previously required. Recent technological advances in the form of consumer Virtual Reality (VR) systems (e.g. Oculus Rift and Samsung Gear), however, now make widespread use of VRET in clinical settings and as self-help applications possible. In this literature review, we detail the current state of VR technology and discuss important therapeutic considerations in designing self-help and clinician-led VRETs, such as platform choice, exposure progression design, inhibitory learning strategies, stimuli tailoring, gamification, virtual social learning and more. We illustrate how these therapeutic components can be incorporated and utilized in VRET applications, taking full advantage of the unique capabilities of virtual environments, and showcase some of these features by describing the development of a consumer-ready, gamified self-help VRET application for low-cost commercially available VR hardware. We also raise and discuss challenges in the planning, development, evaluation, and dissemination of VRET applications, including the need for more high-quality research. We conclude by discussing how new technology (e.g. eye-tracking) can be incorporated into future VRETs and how widespread use of VRET self-help applications will enable collection of naturalistic “Big Data” that promises to inform learning theory and behavioral therapy in general.     

Iraqi refugee men’s experiences of psychotherapy: clinical implications and the proposal of a pluralistic model

The psychotherapy experiences of a sample of Iraqi refugee men, in later stages of exile, were explored with the aim of shedding some light on how this client group can experience therapy. Ten adult male Iraqi refugees – who had lived in Sweden for at least five years and had been psychotherapy clients at some point during that time – were recruited for this study. Using individual semi-structured interviews (in Arabic), three main areas were explored with each participant: (1) reasons for seeking psychotherapy; (2) perceptions of the psychotherapy professional; and (3) experiences of the psychotherapy process and outcome. The interviews were then translated into English, transcribed, and then analysed using Interpretative Phenomenological Analysis (IPA). Most participants/clients described exile-related stressors as their main reason for seeking psychotherapy, but some described distress due to a combination of pre-migration trauma and post-migration stress. They also found some aspects of therapy to be positive (mainly verbalising ones thoughts and feelings, and feeling less marginalised) and some negative (mainly experiencing racist or culturally insensitive treatment by therapists, and experiencing a lack of competence and transparency in therapists). The findings were explored in terms of clinical implications and a pluralistic model was proposed to address the identified needs.