A randomised controlled trial of a brief cognitive behavioural intervention for men who have hot flushes following prostate cancer treatment (MANCAN).

OBJECTIVE: Hot flushes and night sweats (HFNS) are experienced by up to 80% of prostate cancer patients undergoing androgen deprivation therapy (ADT). This study evaluates the effects of a guided self-help cognitive behavioural therapy (CBT) intervention on HFNS problem-rating (primary outcome), HFNS frequency, mood and health-related quality of life (secondary outcomes) in patients undergoing ADT. METHODS: Patients reporting treatment-induced HFNS were randomly assigned to CBT (n = 33) or treatment as usual (TAU) (n = 35), stratified for cancer type. The CBT intervention included a booklet, CD plus telephone contact during a 4-week period. Validated self-report questionnaires were completed at baseline, 6 weeks and 32 weeks after randomisation. The primary outcome was HFNS problem rating (perceived burden of HFNS) at 6 weeks after randomisation. Potential moderators and mediators were examined. Data analysis was conducted on a modified intention-to-treat basis. RESULTS: Compared with TAU, CBT significantly reduced HFNS problem rating (adjusted mean difference: -1.33, 95% CI -2.07 to -0.58; p = 0.001) and HFNS frequency (-12.12, 95% CI -22.39 to -1.84; p = 0.02) at 6 weeks. Improvements were maintained at 32 weeks, but group differences did not reach significance. There were significant reductions in negative HFNS Beliefs and Behaviours following CBT, but not in mood or quality of life. CONCLUSIONS: Guided self-help CBT appears to be a safe and effective brief treatment for men who have problematic HFNS following prostate cancer treatments. Further research might test the efficacy of the intervention in a multicentre trial.

The bolstering effect of conceptual priming on psychological help-seeking attitudes in men.

BACKGROUND: It is a well-established finding that men are often unwilling to engage with mental health services, and that they hold negative attitudes toward psychological help-seeking. Consequently, men's psychological problems often remain untreated, which in turn can compromise their quality of life. AIMS: The present experiment addresses this problem using a conceptual priming paradigm from social psychology called Scrambled Sentence Test as an intervention to change men's negative attitudes toward psychological help-seeking. METHOD: The Scrambled Sentence Test works by asking participants to unscramble sentences that unbeknownst to them include priming words--in this case, openness and communication-related words. Sixty-nine men completed the task (with priming or control words) under the instructions of a condition-blind experimenter. RESULTS: The primed group showed more positive attitudes (Mdn = 56.5) toward seeking psychological help compared to controls (Mdn = 40.0), p < 0.01; r = 0.38. CONCLUSION: The findings are the first to suggest that conceptual priming of this kind can be used an as effective and time-efficient intervention by mental health professionals to encourage men to seek help for psychological problems.

The emotional and attitudinal consequences of religious hypocrisy: experimental evidence using a cognitive dissonance paradigm.

We explored the emotional and attitudinal consequences of personal attitude-behavior discrepancies using a religious version of the hypocrisy paradigm. We induced cognitive dissonance in participants (n = 206) by making them feel hypocritical for advocating certain religious behaviors that they had not recently engaged in to their own satisfaction. In Experiment 1, this resulted in higher levels of self-reported guilt and shame compared to the control condition. Experiment 2 further showed that a religious self-affirmation task eliminated the guilt and shame. In Experiment 3, participants boosted their religious attitudes as a result of dissonance, and both religious and non-religious self-affirmation tasks eliminated this effect. The findings provide evidence that dissonance induced through religious hypocrisy can result in guilt and shame as well as an attitude bolstering effect, as opposed to the attitude reconciliation effect that is prevalent in previous dissonance research.

A randomised controlled trial of a cognitive behavioural intervention for men who have hot flushes following prostate cancer treatment (MANCAN): trial protocol.

BACKGROUND: This randomised controlled trial (RCT) aims to evaluate the effectiveness of a guided self-help cognitive behavioural intervention to alleviate problematic hot flushes (HF) and night sweats (NS) in men who are undergoing prostate cancer treatment. The trial and the self-help materials have been adapted from a previous RCT, which showed that a cognitive behavioural intervention reduced the self-reported problem-rating of hot flushes in women with menopausal symptoms, and in women undergoing breast cancer treatment. We hypothesize that guided self-help will be more effective than usual care in reducing HF/NS problem-rating at post treatment assessment. METHODS/DESIGN: Seventy men who are undergoing treatment for prostate cancer and who have been experiencing more than ten HF/NS weekly for over a month are recruited into the trial from urology clinics in London. They are randomly allocated to either a four-week self-help cognitive behavioural therapy (CBT) treatment or to their usual care (control group). The treatment includes information and discussion about hot flushes and night sweats in the context of prostate cancer, monitoring and modifying precipitants, relaxation and paced respiration, stress management, cognitive therapy for unhelpful thoughts and beliefs, managing sleep and night sweats, and advice on maintaining these changes. Prior to randomisation, men attend a clinical interview, undergo 24-48-hour sternal skin conductance monitoring, and complete pre-treatment questionnaires (e.g., problem-rating and frequency of hot flushes and night sweats; quality of life; mood; hot flush beliefs and behaviours). Post-treatment measures (sternal skin conductance and the above questionnaires) are collected four-six weeks later, and again at a six-month follow-up. DISCUSSION: MANCAN is the first randomised controlled trial of cognitive behavioural therapy for HF/NS for men that measures both self-reported and physiologically indexed symptoms. The results will inform future clinical practice by evaluating an evidence-based, non-medical treatment, which can be delivered by trained health professionals. TRIAL REGISTRATION: UK Clinical Research Network UKCRN10904.

How Health-Related Behaviors Predict Body-Esteem in Men.

While there is a general consensus on the biological implications of health-related behaviors, there is little research on the implications of health-related behaviors on body-esteem in a nonclinical population of men. This study aimed to examine, using a multidimensional measure of health-related behaviors and controlling for body mass index (BMI), whether body-esteem in men can be predicted by health-related behaviors. Five hundred and sixty-one men between the ages of 30 and 45 years ( M = 35.42, SD = 4.41) completed the Body-Esteem Scale (BES), the Health Behaviour Inventory (HBI), and a questionnaire covering anthropometric measures including height and weight. Multiple regression analyses revealed that health-related behaviors (including positive nutrition habits, positive attitude, and healthy practices) significantly predicted body-esteem, R2adj = 0.05, F(5, 540) = 6.91, p < .001. The results are discussed in relation to healthy lifestyle promotion interventions targeting men.

Dispositional Mindfulness and Psychological Health: a Systematic Review.

Interest in the influence of dispositional mindfulness (DM) on psychological health has been gathering pace over recent years. Despite this, a systematic review of this topic has not been conducted. A systematic review can benefit the field by identifying the terminology and measures used by researchers and by highlighting methodological weaknesses and empirical gaps. We systematically reviewed non-interventional, quantitative papers on DM and psychological health in non-clinical samples published in English up to June 2016, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A literature search was conducted using PsycINFO, PubMED, Medline and Embase, and 93 papers met the inclusion criteria. Within these, three main themes emerged, depicting the relationship between DM and psychological health: (1) DM appears to be inversely related to psychopathological symptoms such as depressive symptoms, (2) DM is positively linked to adaptive cognitive processes such as less rumination and pain catastrophizing and (3) DM appears to be associated with better emotional processing and regulation. These themes informed the creation of a taxonomy. We conclude that research has consistently shown a positive relationship between DM and psychological health. Suggestions for future research and conceptual and methodological limitations within the field are discussed.

A systematic review of the factors associated with delays in medical and psychological help-seeking among men.

Despite a growing literature on the factors associated with men's low rates of medical and psychological help-seeking, a systematic review of these is missing. Such an overview can help to inform health psychologists of the barriers to the performance of adaptive health behaviours, such as prompt help-seeking, and could inform theoretical advancements and the development of targeted interventions to facilitate prompt help-seeking among men. We systematically reviewed quantitative and qualitative empirical papers on factors associated with delays in men's medical and psychological help-seeking. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and we used the databases PsycINFO, Medline, Embase and PsycARTICLES (with keywords: men/male*/gender*, help*/seek* and health*/service*/utili*[sation]) for papers in English. 41 citations (amounting to 21,787 participants aged 15-80 + ) met the inclusion criteria. Approximately half of these used qualitative methodologies (i.e., semi-structured interviews and focus groups), while half used quantitative methodologies (i.e., questionnaires). We identify a number of recurring cognitive, emotional, health-service related and socio-demographic help-seeking factors/predictors from the 41 papers. Of these, the most prominent barriers to help-seeking were disinclination to express emotions/concerns about health, embarrassment, anxiety and fear, and poor communication with health-care professionals.