Attentional processing of information related to illness: Biases and associations with emotional response in young adults with different levels of illness anxiety.

This study investigated attentional processing of illness-related information and associations with emotional reactivity. 100 young adults with low to high illness anxiety levels underwent free and cued viewing tasks, while eye-tracking and emotional reactivity were recorded. During free viewing, participants showed early orienting bias and sustained vigilance bias toward illness vs neutral pictures. Increased illness anxiety predicted vigilance bias to illness vs fearful pictures. During cued viewing, participants showed avoidance bias for illness vs neutral pictures, predicted by greater cardiac acceleration. Task nature appears to influence attentional processing patterns of illness stimuli. Preliminary evidence supports that attention allocation may be an emotion regulation mechanism.

Emotional responses to illness imagery in young adults: Effects of attention to somatic sensations and levels of illness anxiety.

This study investigated the effect of interoceptive attention on emotional responses during illness imagery, and the moderating role of illness anxiety. 101 students (81 female; 18-35 years old) with low, moderate and high levels of illness anxiety had to imagine personally relevant illness scenarios and standardized fearful, joyful and neutral scenarios, after undergoing an attention manipulation to direct their attention towards interoceptive or exteroceptive stimuli. Emotional responses assessed included self-reports of arousal, valence and somatic sensations, and psychophysiological measures of heart rate reactivity and variability, skin conductance level, and facial electromyography. Findings showed increased reports of emotional arousal, negative affect and somatic symptoms, accompanied by negative emotion expressions, but a hypo-arousal physiological response pattern (i.e. low heart rate reactivity) during illness imagery after interoceptive attention, irrespective of illness anxiety levels. Under directed attention, the observed emotional response to illness imagery may increase the risk for developing and perpetuating illness anxiety.

Coping with psychosomatic symptoms: The buffering role of psychological flexibility and impact on quality of life.

Individual differences in avoidant coping were hypothesized to exacerbate quality of life impairment associated with somatization and illness anxiety symptoms; psychological flexibility was expected to moderate this impairment. Individuals from a random community sample ( N = 298; 182 females), who met screening criteria for somatization and illness anxiety, reported lower quality of life and psychological flexibility and greater avoidant coping compared to controls. Psychological flexibility significantly moderated the impact of somatization and illness anxiety on quality of life domains. Findings suggest that decreasing avoidant coping through therapy may be promising in mitigating the negative impact of these symptom categories.

Smoking Consequences Questionnaire: Factor Structure and Invariance among Smokers and Non-Smokers.

BACKGROUND: The Smoking Consequences Questionnaire was developed to assess smoking expectancies, which have been found to be linked to the initiation and maintenance of smoking. OBJECTIVES: The purpose of the current study was to examine the factor structure of a modified brief version of the instrument in Greek and to test its invariance between groups of smokers and nonsmokers. METHODS: Participants were 813 Greek-Cypriot university students (524 females; Mean age =20.94, SD = 2.70) who completed this brief version of the instrument translated into Greek using the forward-backward method. RESULTS: Confirmatory factor analysis supported a four-factor structure: Negative Consequences, Positive Reinforcement, Negative Reinforcement and Appetite/Weight Control. Multigroup confirmatory factor analysis indicated configural, metric and partial scalar invariance of the instrument in groups of smokers and nonsmokers. Comparison of the mean difference in the invariant factors showed significant difference in appetite/weight control mean scores, whereas mean difference in negative consequences was not significant. Conclusions/Importance. Findings support the four-factor structure of the brief Greek version of the SCQ in a sample of young adults, and factorial invariance between smokers and nonsmokers. More expectancies about appetite/weight control among smokers compared to nonsmokers suggest focusing on this category of smoking expectancies in smoking prevention and cessation programs.

How do illness-anxious individuals process health-threatening information? A systematic review of evidence for the cognitive-behavioral model.

According to the cognitive-behavioral model, illness anxiety is developed and maintained through biased processing of health-threatening information and maladaptive responses to such information. OBJECTIVE: This study is a systematic review of research that attempted to validate central tenets of the cognitive-behavioral model regarding etiological and maintenance mechanisms in illness anxiety. METHODS: Sixty-two studies, including correlational and experimental designs, were identified through a systematic search of databases and were evaluated for their quality. RESULTS: Outcomes were synthesized following a qualitative thematic approach under categories of theoretically driven mechanisms derived from the cognitive-behavioral model: attention, memory and interpretation biases, perceived awareness and inaccuracy in perception of somatic sensations, negativity bias, emotion dysregulation, and behavioral avoidance. CONCLUSIONS: Findings partly support the cognitive-behavioral model, but several of its hypothetical mechanisms only receive weak support due to the scarcity of relevant studies. Directions for future research are suggested based on identified gaps in the existing literature.

Experiences of caregivers of patients with metastatic cancer: What can we learn from them to better support them?

PURPOSE: Family caregivers of cancer patients often face strains within their role and report various unmet needs. The aim of this qualitative study was to examine metastatic cancer caregivers' experiences within their role. METHODS: A cross-sectional study using focus group interviews with caregivers of metastatic cancer patients (n = 17) recruited from an oncology hospital in Cyprus was conducted. Data were analysed following the content analysis approach with inductive coding for the development of themes. RESULTS: Content analysis identified four categories of themes, which were further divided into sub-categories: difficulties in their role as caregivers, impact of cancer diagnosis on interpersonal relationships, support and strength resources and unmet needs. Findings replicated existing evidence regarding caregiving difficulties and unmet needs in caregivers with a different cultural background and provided further evidence for similarities and variations within caregiving experiences relating mostly to caregiver-patient relationships. Caregivers also highlighted coping and support resources that they effectively use for better adjustment to their role. CONCLUSION: The identified variations in experiences in relation to participants' characteristics, in addition to the information about preferred by caregivers coping and support resources provide a direction for future efforts to develop interventions for this population.

Do alexithymic individuals avoid their feelings? Experiential avoidance mediates the association between alexithymia, psychosomatic, and depressive symptoms in a community and a clinical sample.

OBJECTIVE: Alexithymia is defined as the trait associated with difficulty in identifying and describing feelings as well as poor fantasy and imagery. While alexithymia is related to psychopathology in general, it has been associated with increased reporting of medically unexplained symptoms and depression in particular. This study attempts to assess the extent to which alexithymia represents a learned, avoidant coping strategy against unwanted emotions. In this way the study aims to identify a potential mechanism that may elucidate the relationship between alexithymia and psychological symptoms. METHOD: Alexithymia is examined in two different samples, students from two universities in Cyprus and intensive outpatients/residents in an American anxiety disorder treatment program. We examine whether alexithymia predicts psychosomatic and depressive symptoms respectively through the mediating role of experiential avoidance, a coping mechanism believed to be reinforced because of the immediate relief it provides. RESULTS: Experiential avoidance was found to correlate strongly with alexithymia, especially its difficulty in identifying feelings factor, while the mediation hypothesis was supported in all models tested. Furthermore, results from the clinical sample suggest that clinical improvement in depression was associated with a decrease in alexithymia, especially difficulty in identifying feelings, mediated by decreased experiential avoidance. CONCLUSIONS: Alexithymia, and more specifically its difficulty in identifying feelings aspect, may be a learned behavior used to avoid unwanted emotions. This avoidant behavior may form the link between alexithymia and psychopathology. Implications for alexithymia theory and treatment are discussed.