Establishing how psychological therapies work: the importance of mediation analysis

Windgassen, Sula; Goldsmith, Kimberley; Moss‐Morris, Rona; Chalder, Trudie

doi:10.3109/09638237.2015.1124400

Cited by 43 publications

(32 citation statements)

References 69 publications

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“…We found that perceived risk and fear can contribute to increased mental health problems among healthcare professionals, which may have temporal or long-term psychological consequences and tested mediating effects of resilience and fear between perceived risk and mental health problems. Although mediational studies do not test causality directly, they are very fruitful in terms of providing evidence that helps in changing therapeutic or intervention approaches (Windgassen et al 2016). Investigating directionality and mechanism between the variables is a critical requirement for causality.…”

Section: Discussionmentioning

confidence: 99%

Perceived Risk and Mental Health Problems among Healthcare Professionals during COVID-19 Pandemic: Exploring the Mediating Effects of Resilience and Coronavirus Fear

Yıldırım

Arslan

Özaslan

2020

Int J Ment Health Addiction

168

152

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During coronavirus (COVID-19) pandemic, healthcare professionals were particularly at high-risk of developing symptoms of mental health problems due to being on the frontline in the battle against COVID-19. This study examined the mediating roles of resilience and coronavirus fear in the relationship between perceived risk and mental health problems among healthcare professionals including doctors and nurses who were actively treating patients confirmed with COVID-19. We recruited 204 healthcare professionals (50% females) with a mean age of 32.92 years ( SD = 7.01). Results showed that perceived risk and coronavirus fear positively predicted depression, anxiety, and stress while resilience negatively predicted those mental health problems. Coronavirus fear mediated the relationship between perceived risk and resilience, depression, anxiety, and stress. Additionally, resilience mitigated the effect of coronavirus fear on depression, anxiety, and stress. This study is among the first indicating the importance of resilience and fear as a critical mechanism that explains the relationship between perceived risk and mental health problems among health professionals directly caring for COVID-19 patients.

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Section: Discussionmentioning

confidence: 99%

Perceived Risk and Mental Health Problems among Healthcare Professionals during COVID-19 Pandemic: Exploring the Mediating Effects of Resilience and Coronavirus Fear

Yıldırım

Arslan

Özaslan

2020

Int J Ment Health Addiction

168

152

View full text Add to dashboard Cite

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“…Specifically, it investigated whether modifiable emotional, cognitive and behavioural factors, shown to be associated with fatigue in other longterm conditions, 33,35,84 were also related to fatigue in patients with IBD. Potentially identifying parallels and drawing from existing treatment models in other conditions, can aid in uncovering processes of fatigue that can be applied trans-diagnostically across different conditions, [85][86][87] and ultimately in synthesising new constructs to target in intervention research in IBD. 31 The results of the study showed emotional, cognitive and behavioural factors were associated with fatigue and QoL above and beyond the influence of sociodemographic and clinical factors.…”

Section: Discussionmentioning

confidence: 99%

The contribution of clinical and psychosocial factors to fatigue in 182 patients with inflammatory bowel disease: a cross‐sectional study

Artom

Czuber‐Dochan

Sturt

et al. 2016

Aliment Pharmacol Ther

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“…A survey of two Norwegian patient organizations reported also that 79% of patients with experience of graded training considered that it worsened their health status (Bjorkum et al, ). A meta‐analysis concluded that CBT and GET are equally efficacious treatments for CFS/ME, but that CBT may be more effective when patients have comorbid anxiety and/or depression (Moss‐Morris et al, ; Windgassen et al, ). In a more recent study of a multidisciplinary intervention, which combined group CBT and GET with pharmacological treatment, at 12 months after completion, GET was slightly inferior to usual medical care alone, had not improved fatigue or health‐related quality of life, and resulted in worse physical function and bodily pain scores (Nunez et al, ).…”

Section: Non‐pharmacological Approaches: Counselling Behavioural and Rmentioning

confidence: 99%

Treatment and management of chronic fatigue syndrome/myalgic encephalomyelitis: all roads lead to Rome

Castro-Marrero

Sáez-Francàs

Santillo

et al. 2017

British J Pharmacology

105

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This review explores the current evidence on benefits and harms of therapeutic interventions in chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME) and makes recommendations. CFS/ME is a complex, multi‐system, chronic medical condition whose pathophysiology remains unknown. No established diagnostic tests exist nor are any FDA‐approved drugs available for treatment. Because of the range of symptoms of CFS/ME, treatment approaches vary widely. Studies undertaken have heterogeneous designs and are limited by sample size, length of follow‐up, applicability and methodological quality. The use of rintatolimod and rituximab as well as counselling, behavioural and rehabilitation therapy programs may be of benefit for CFS/ME, but the evidence of their effectiveness is still limited. Similarly, adaptive pacing appears to offer some benefits, but the results are debatable: so is the use of nutritional supplements, which may be of value to CFS/ME patients with biochemically proven deficiencies. To summarize, the recommended treatment strategies should include proper administration of nutritional supplements in CFS/ME patients with demonstrated deficiencies and personalized pacing programs to relieve symptoms and improve performance of daily activities, but a larger randomized controlled trial (RCT) evaluation is required to confirm these preliminary observations. At present, no firm conclusions can be drawn because the few RCTs undertaken to date have been small‐scale, with a high risk of bias, and have used different case definitions. Further, RCTs are now urgently needed with rigorous experimental designs and appropriate data analysis, focusing particularly on the comparison of outcomes measures according to clinical presentation, patient characteristics, case criteria and degree of disability (i.e. severely ill ME cases or bedridden).

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Establishing how psychological therapies work: the importance of mediation analysis

Cited by 43 publications

References 69 publications

Perceived Risk and Mental Health Problems among Healthcare Professionals during COVID-19 Pandemic: Exploring the Mediating Effects of Resilience and Coronavirus Fear

Perceived Risk and Mental Health Problems among Healthcare Professionals during COVID-19 Pandemic: Exploring the Mediating Effects of Resilience and Coronavirus Fear

The contribution of clinical and psychosocial factors to fatigue in 182 patients with inflammatory bowel disease: a cross‐sectional study

Treatment and management of chronic fatigue syndrome/myalgic encephalomyelitis: all roads lead to Rome

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