ABSTRACT
BACKGROUND: Considering the persistent nature and higher prevalence of insomnia in cancer patients and survivors compared with the general population, there is a need for effective management strategies. This systematic review and meta-analysis aimed to comprehensively evaluate the available evidence for the efficacy of pharmacological and nonpharmacological interventions for insomnia in adult cancer patients and survivors. METHODS: Following the PRISMA guidelines, we analyzed data from 61 randomized controlled trials involving 6528 participants. Interventions included pharmacological, physical, and psychological treatments, with a focus on insomnia severity and secondary sleep and non-sleep outcomes. Frequentist and Bayesian analytical strategies were employed for data synthesis and interpretation. RESULTS: Cognitive-Behavioral Therapy for Insomnia (CBT-I) emerged as the most efficacious intervention for reducing insomnia severity in cancer survivors and further demonstrated significant improvements in fatigue, depressive symptoms, and anxiety. CBT-I showed a large postintervention effect (g = 0.86; 95% confidence interval [CI] = 0.57 to 1.15) and a medium effect at follow-up (g = 0.55; 95% CI = 0.18 to 0.92). Other interventions such as bright white light therapy, sleep medication, melatonin, exercise, mind-body therapies, and mindfulness-based therapies showed benefits, but the evidence for their efficacy was less convincing compared with CBT-I. Brief Behavioral Therapy for Insomnia showed promise as a less burdensome alternative for patients in active cancer treatment. CONCLUSIONS: CBT-I is supported as a first-line treatment for insomnia in cancer survivors, with significant benefits observed across sleep and non-sleep outcomes. The findings also highlight the potential of less intensive alternatives. The research contributes valuable insights for clinical practice and underscores the need for further exploration into the complexities of sleep disturbances in cancer patients and survivors.
Subject(s)
Cancer Survivors , Cognitive Behavioral Therapy , Depression , Neoplasms , Sleep Initiation and Maintenance Disorders , Adult , Humans , Anxiety/therapy , Anxiety/etiology , Depression/etiology , Depression/therapy , Exercise Therapy , Fatigue/therapy , Fatigue/etiology , Hypnotics and Sedatives/therapeutic use , Hypnotics and Sedatives/administration & dosage , Melatonin , Mind-Body Therapies , Mindfulness , Neoplasms/complications , Neoplasms/therapy , Neoplasms/psychology , Phototherapy , Sleep Aids, Pharmaceutical/therapeutic use , Sleep Initiation and Maintenance Disorders/therapy , Sleep Initiation and Maintenance Disorders/etiologyABSTRACT
ABSTRACT: The idea that emotions can influence pain is generally recognized. However, a synthesis of the numerous individual experimental studies on this subject is lacking. The aim of the present systematic review and meta-analysis was to synthesize the existing evidence on the effect of experimental emotion induction on experimental pain in nonclinical adults. PsycInfo and PubMed were searched up until April 10, 2023, for studies assessing differences in self-reported pain between emotion induction groups and/or control groups or between conditions within group. Risk of bias was assessed for the individual studies. The literature search yielded 78 relevant records of 71 independent studies. When compared with control conditions, the pooled results revealed a statistically significant pain-attenuating effect of positive emotion induction (between-group: Hedges g = -0.48, 95% CI: -0.72; -0.25, K = 9; within-group: g = -0.24, 95% CI: -0.32; -0.15, K = 40), and a statistically significant pain-exacerbating effect of negative emotion induction in within-group analyses but not between-group analyses (between-group: g = -0.29, 95% CI: -0.66; 0.07, K = 10; within-group: g = 0.14, 95% CI: 0.06; 0.23, K = 39). Bayesian meta-analysis provided strong support for an effect of positive emotion induction but weak support for an effect of negative emotion induction. Taken together, the findings indicate a pain-attenuating effect of positive emotion induction, while the findings for negative emotion induction are less clear. The findings are discussed with reference to theoretical work emphasizing the role of motivational systems and distraction for pain. Limitations include considerable heterogeneity across studies limiting the generalizability of the findings.
Subject(s)
Emotions , Pain , Adult , Humans , Bayes Theorem , Pain/etiologyABSTRACT
In light of the recent rise of right-wing populist parties across Europe, it is an intriguing question under which conditions people agree with right-wing political statements. The present study investigates whether mere labelling of political statements as endorsed by a right-wing populist party influences people's agreement with such statements. In the study (pre-registered; N = 221 German voters), it is shown than that supporters of the right-wing populist party indicated higher agreement with the statements when they were labelled as being endorsed by the party (vs. not labelled), whereas non-supporters indicated lower agreement with the labelled than with the non-labelled statements. We conclude that labelling of the very same political statements changes voters' agreement with these statements. The results imply that rather than (dis)agreeing with the content of the statements per se, people may (dis)agree with right-wing populist statements because they come from a specific source (i.e., the right-wing populist party).
