1,376 research outputs found
How are falls and fear of falling associated with objectively measured physical activity in a cohort of community-dwelling older men?
No full textFalls affect approximately one third of community-dwelling older adults each year and have serious health and social consequences. Fear of falling (FOF) (lack of confidence in maintaining balance during normal activities) affects many older adults, irrespective of whether they have actually experienced falls. Both falls and fear of falls may result in restrictions of physical activity, which in turn have health consequences. To date the relation between (i) falls and (ii) fear of falling with physical activity have not been investigated using objectively measured activity data which permits examination of different intensities of activity and sedentary behaviour
Exposure and the reduction of fear of pain
No full textThis research investigated interoceptive exposure as a treatment option for disabling pain-related fear. Interoceptive exposure was conceptualised as an extension of the Fear Avoidance Model and a literature review highlighted three important areas: attention/hypervigilance to pain and its threat value, fear-avoidance and the acceptance of pain. A treatment manual was developed based on a literature review and an elaborated single case experimental design methodology was used to determine treatment efficacy.
Seven participants were recruited and four completed treatment which was designed as an ABC sequence: A, baseline; B, education; C interoceptive exposure. Follow up data were obtained at three months post-treatment. Data were obtained from psychometrically standardised assessments, daily measures of the treatment target, and sessional process measures. Participants completed a post-treatment Change Interview in an attempt to evaluate treatment causality in a non-biased way.
There was variation on the standard measures; all of the participants made significant changes on some but not all of the measures. Target measures showed both variation and stability. Process measures showed that all of the participants could engage in the treatment exercises. The participants rated the treatment as being fairly logical however there was differences in expectations about how successful the treatment would be. At the Change Interview, all of the participants described changes which they stated were important and unlikely to occur without therapy.
There is some evidence at different levels that this treatment may be effective. A combination of attention, fear-avoidance and acceptance of pain treatment approach has not been used before and this research indicates promising results for those suffering with chronic pain. However further research is necessary. The procedure could be refined; interoceptive exposure could be explored in more depth and pain and avoidance behaviour could be considered in relation to other goals
Fear of emotion in adolescents: the Modified Affective Control Scale for Adolescents-Revised
No full textDifficulties in emotion regulation, in the form of fear of emotion, have been studied in adults but have received scant attention within the adolescent population. This omission is partly due to the lack of comprehensive and cross-culturally valid emotion measures that adequately assess emotion dysregulation in adolescents. The current research looks at evaluating the psychometric properties and clinical relevance of the Modified Affective Control Scale for Adolescents-Revised (MACSA-Revised), which measures adolescents’ fear of losing control over emotions or their reactions to emotions.
Study 1 examined the psychometric properties and construct validity of the MACSARevised in a community sample of 595 Singaporean students, aged 12 to 18 years. Exploratory factor analysis indicated that data was best explained by a 5-factor solution and reliability and validity of the MACSA-Revised was demonstrated. Although it was noted that females reported significantly higher fear of emotion than males, and upper secondary students reported significantly higher fear of emotion than lower secondary students, these differences produced only small effect sizes.
Study 2 examined the clinical utility of the MACSA-Revised by comparing the responses of a matched sample of 40 clinical adolescent participants from a mental health clinic in Singapore and 40 community adolescent participants. Evidence of criterion-related validity of the MACSA-Revised was demonstrated. Clinical participants reported a heightened fear of emotion as compared to community participants. In addition, gender Fear of Emotion in Adolescents and year-level main effects were found in the combined clinical and community sample (N = 80).
Although limitations of the two studies are noted, the MACSA-Revised appears to be a psychometrically sound measure for the assessment of fear of emotions in adolescents. Having an emotion measure with cross-cultural applicability that is suitable for adolescents will be helpful for future research when looking at pathways of emotion dysregulation that contribute to adolescent psychopathology.
Keywords: Fear of emotion, adolescents, emotion regulation, emotion dysregulation, culture and emotion
CLUSTER RANDOMIZED CONTROLLED TRIAL TO EVALUATE THE EFFECTIVENESS OF A MULTIFACETED ACTIVE STRATEGY TO IMPLEMENT LOW BACK PAIN PRACTICE GUIDELINES; EFFECT ON COMPETENCE, PROCESS OF CARE AND PATIENT OUTCOMES IN PHYSICAL THERAPY
No full textThe study was a cluster randomized controlled trial designed to evaluate the effectiveness of an active strategy to implement practice guidelines for low back pain in physical therapy. Physical therapy clinics (clinics=28, therapists=41) were randomized to receive a multifaceted active intervention (education, audit, feedback) (clinics=16, therapists=24) to increase awareness regarding key recommendations in guidelines or mailed guidelines (clinics=12, therapists=18). Primary outcome measures were change in pre to post intervention competence score (18 clinical vignettes), adherence to guidelines and change in patient Oswestry scores from first to last visit. The competence test was administered at baseline and on completion of the education course. Data on LBP patients treated by participating therapists in a 12-week pre (therapists=41, patients=50) and post (therapists=41, patients=107) intervention period (education, audit and feedback) was extracted from the UPMC electronic database. Patient care was classified as being adherent or non-adherent using 6 quality indicators developed to reflect recommendations in the guidelines. Overall percentage of adherence and adherence to individual criterion on the guidelines were also calculated. The results of the study indicated that education did not have an effect improving knowledge measured by change in total competence score. However, there were significant differences between groups on the ability to appropriately identify directional preference with movement testing, where the intervention group did better than the control. Adherence to guidelines and patient outcomes did not improve as a result of the active intervention strategy. The groups were not significantly different when comparing overall adherence to guidelines or to individual criterion on guidelines. There was an underutilization of mobilization thrust (82.3%), traction (78.5%) and graded exercises (47.6%) for fear avoidant patients, while stabilization was over-utilized in 51% of patients. Although therapists demonstrated moderate to high scores on the competence test, they failed to apply this knowledge in clinical practice. Future research should focus on a qualitative inquiry into organizational and environmental barriers to adoption of clinical practice guidelines. These include evaluating if payment policies and reimbursement from providers are aligned with guidelines and also assessing the extent to which patient demands and compliance influences adherence to guidelines
Gender, fear of crime, and self-presentation: An experimental investigation.
No full textThe authors investigate gendered norms associated with the fear of crime. A sample of 100 men and women in a British market town completed a fear of crime survey having been instructed either to be 'totally honest and accurate', or to respond in a way that portrays them 'in the best possible light' ('fake good'). Men asked to 'fake good' reported less fear than men asked to respond honestly. This result is consistent with theories of masculinity that emphasize the importance of emotional invulnerability and self-sufficiency. In contrast, women asked to 'fake good' tended to report more fear than those asked to respond honestly. This result extends theories of how fear of crime curtails women's freedoms. Specifically, the fear of crime may be a prescriptive gendered norm in its own right, causing women (and men) to feel that their expressed fear is a yardstick by which they might be judged
Crime, community, context & fear : influences on informal social control in an affluent English suburb
No full textBased on ethnographic research, involving observations, participant
observation and in-depth interviews, this thesis explores the impact of crime
and the influences on informal social control in an affluent, middle class
suburb. The research focused on the interaction between estate design, the
environment, social and community life, and fear of crime, and their effects on
residents in the neighbourhood. Despite low recorded crime rates, crime was
perceived to be a problem. This situation arose from a paradox of community
dynamics which, on the one hand, increased fear of crime, but on the other,
contained crime. Apart from small-scale and extremely localised solidarities, a
socially fragmented community existed in which limited and loose-knit local
social networks, strong desires for privacy, and atomisation prevailed. These
factors, coupled with busy lifestyles and features of the suburban environment,
resulted in isolation and enhanced fear of crime.
However, fear arose more from concerns about crime in wider society together
with general anxieties rooted in change in late-modernity, than actual risk of
victimisation. Crime control was rarely based on conm-iunity action, instead
being individualistic and reliant on sophisticated target hardening. Low crime,
therefore, was less attributable to the pursuits of 'active citizens' envisaged by
community crime prevention policies and more to structural processes of
affluence, status and property ownership which created an exclusive and
exclusionary community of vested interest, common identity and shared values.
As a study of affluent suburban life, the research contributes to the community
studies tradition. However, the main importance of the research is its
implications for community crime prevention. By highlighting the complex and
contextual nature of informal social control and the influences which impact on
it, the necessity to tailor crime prevention more to local needs is emphasised
A Narrative Account of an Arts Psychotherapies Service Response to the COVID-19 crisis: Challenges and Recommendations
No full textAvailable for purchase at: https://www.amazon.com/Living-Fear-Reflections-Ade-Odunlade/dp/1838536035 .This chapter describes perspectives from the academic and practice arts psychotherapies leads within a large NHS Trust in the UK. This was written from the perspective two leads with experience in senior management, research and clinical practice. The first author is an art therapist and a consultant and the second author is a music therapist and Head of Profession. As part of the core psychological provision, the arts psychotherapies service employs arts psychotherapists, arts psychotherapies trainees and honorary professionals to deliver specialist care and treatment for patients across mental health services. The chapter is written during the time of crisis, when the peak has been reached but the end of the crisis and lockdown remains unclear. The authors take stock of the changes that have taken place to a community arts psychotherapies service during the COVID-19 crisis, making reference to the changes in staff provision and practice. During this time, clear lessons have already been learnt, observations made, and inquiries have resulted in broad recommendations which are relevant to health services where there may be similar events taking place. These recommendations relate to how at an operational level the clinical work, staff capability and capacity to adapt are kept in mind and responded to during and after a pandemic
Threat modulates perception of looming visual stimuli
No full textSummaryAmong the most critical of visual functions is the detection of potentially hazardous or threatening aspects of the environment. For example, objects on a collision course with an observer must be quickly identified to allow sufficient time to prepare appropriate defensive or avoidant responses. Directly approaching objects produce a specific accelerating pattern of optical expansion, known as ‘looming, which in theory exactly specifies time-to-collision independent of object size or distance. Such looming stimuli have been shown to trigger stereotyped defensive responses in both monkeys [1] and human infants [2]. Psychophysical results in adult participants have similarly suggested sensitivity to looming at early stages of visual processing [3]. Such findings indicate specialization of the visual system to detect and react to such ‘looming’ stimuli, and have contributed to the traditional view of looming as a purely optical cue to imminent collision [1]. Here, we investigated whether the semantic content of a looming visual stimulus affects perceived time-to-collision by manipulating its threat value. We show that time-to-collision is underestimated for threatening (snakes and spiders) compared to non-threatening (butterflies and rabbits) stimuli. Further, the magnitude of this effect is correlated with self-reported fear. Our results demonstrate affective modulation of the perception of looming stimuli, and suggest that emotion shapes basic aspects of visual perception
A facial expression for anxiety
No full textAnxiety and fear are often confounded in discussions of human emotions. However, studies of rodent defensive reactions under naturalistic conditions suggest anxiety is functionally distinct from fear. Unambiguous threats, such as predators, elicit flight from rodents (if an escape-route is available), whereas ambiguous threats (e.g., the odor of a predator) elicit risk assessment behavior, which is associated with anxiety as it is preferentially modulated by anti-anxiety drugs. However, without human evidence, it would be premature to assume that rodent-based psychological models are valid for humans. We tested the human validity of the risk assessment explanation for anxiety by presenting 8 volunteers with emotive scenarios and asking them to pose facial expressions. Photographs and videos of these expressions were shown to 40 participants who matched them to the scenarios and labeled each expression. Scenarios describing ambiguous threats were preferentially matched to the facial expression posed in response to the same scenario type. This expression consisted of two plausible environmental-scanning behaviors (eye darts and head swivels) and was labeled as anxiety, not fear. The facial expression elicited by unambiguous threat scenarios was labeled as fear. The emotion labels generated were then presented to another 18 participants who matched them back to photographs of the facial expressions. This back-matching of labels to faces also linked anxiety to the environmental-scanning face rather than fear face. Results therefore suggest that anxiety produces a distinct facial expression and that it has adaptive value in situations that are ambiguously threatening, supporting a functional, risk-assessing explanation for human anxiet
Threatening communication: a critical re-analysis and a revised meta-analytic test of fear appeal theory
No full textDespite decades of research, consensus regarding the dynamics of fear appeals remains elusive. A meta-analysis was conducted that was designed to resolve this controversy. Publications that were included in previous meta-analyses were re-analysed, and a number of additional publications were located. The inclusion criteria were full factorial orthogonal manipulations of threat and efficacy, and measurement of behaviour as an outcome. Fixed and random effects models were used to compute mean effect size estimates. Meta-analysis of the six studies that satisfied the inclusion criteria clearly showed a significant interaction between threat and efficacy, such that threat only had an effect under high efficacy (d = 0.31), and efficacy only had an effect under high threat (d = 0.71). Inconsistency in results regarding the effectiveness of threatening communication can likely be attributed to flawed methodology. Proper tests of fear appeal theory yielded the theoretically hypothesised interaction effect. Threatening communication should exclusively be used when pilot studies indicate that an intervention successfully enhances efficacy
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