Luca Mallia

AB0924 The role of self limiting behaviour, depression and sleep in the severity of fatigue in patients with fibromyalgia

Background Fatigue and sleep disturbances are prominent symptoms in Fibromyalgia (FM) and significantly affect the level of the patients impairment. Some studies reported a synergic interaction of depression and poor sleep quality associated with fatigue (e.g. [1]); while Marques et al. [2] showed a significant association of the fatigue severity with a limiting behaviour self-regulatory style of the patients, i.e. reducing daily activities and excessive resting. Objectives The purpose of this cross-sectional study was to analyse the predictors of severity of fatigue in Italian patients with FM. Methods Outpatients with a FM diagnosis who fulfilled both ACR/EULAR 1990 and 2010 criteria [3,4], after a medical visit at the Fibromyalgia center at Sapienza University Hospital “Umberto I”, were invited to participate in a study on their cognitions and behaviours wearing for one week a wrist actigraph (AMI Motionlogger Watch). Actigraphic sleep parameters were averaged over six days. After 7 days the participants returned the actigraph and answered a structured interview conducted by a trained psychologist which included validated scales measuring depression (Brief Symptom Inventory [5]), perceived fatigue (Checklist of Individual Strength [6]), sleep habits (Sleep Disorder Questionnaire [7]) and behaviour regulation patterns (All-or-nothing and Limiting behaviour scales from Behavioural Responses to Illness Questionnaire [8]). In the previous month and during the study, pharmacological and non-pharmacological treatments were unchanged. Results Actigraphic monitoring and structured interview were completed by 39 female FM patients, with a mean age of 44.9 years (SD=8.55) and an illness mean duration of 6.5 years (SD=5.72). The majority of the patients reported insomnia complaints, and 29 (74.4%) met the DSM criteria for chronic insomnia. Fatigue severity resulted as the best subjective measure of fatigue, and was positively and significantly correlated with self-management through limiting behaviour, and with Total Time in Bed (TTB) measured through actigraphy. The correlation between TTB and Total Time Slept (TTS) and depression were not significant. Hierarchical regression considering TTB, Depression and Limiting behaviour, showed that all these variables give a significant independent contribution to the prediction of perceived severity of fatigue (47% of variance): limiting behaviour (β=0.52, p<0.01), TTB (β=0.31, p<0.05), Depression (β=0.29, p<0.05). Conclusions These correlational findings suggest that self-regulation through limiting activity should be given priority attention in cognitive behavioural interventions aimed at reducing subjective fatigue. References Nicassio et al. Pain 2002;100:271–9. Marques et al. Int J Behav Med 2013;20:229–38. Wolfe et al. Arthritis Rheum 1990. Wolfe et al. Arthritis Care Res (Hoboken) 2010;62:600–10. Derogatis et al. Pearson; 1993. Beurskens et al. Occup Environ Med 2000;57:353–7. Violani et al. Brain Res Bull 2004;63:415–21. Spence et al. Psychol Med 2005;35:583–93. Disclosure of Interest None declared

Psychological charachteristics contributing to young drivers risk of sleep-related car crashes

Background:This correlational study examined the value of the HAPA theory at predicting weight-loss in a weight-loss trial. n nMethods:Participants (N¼22) undergoing an 8-week weight-loss programme were recruited from aprivate hospital. Baseline questionnaires measured demographics, height, weight, self-efficacy,risk-perception, outcome-expectancies and intentions. n nFindings:Questionnaires at 4 and 8 weeks measured weight-loss behaviours – physical activity,dietary variables, effort and weight. The HAPA was able to significantly predict weight-loss(RAˆ2¼0.57,p¼0.027). Self-efficacy and risk-perceptions were significantly related to intention(r¼0.80,p50.001 andr¼�0.48,p50.01 respectively). Intentions were significantly related to weight-loss behaviour was significantly related toweight-loss (r¼0.73,p50.01). The study provides evidence for the predictive value of the HAPAat predicting weight-loss. n nDiscussion:Findings build on current knowledge of the cognitions and behaviours involved insuccessful weight-loss and may contribute to the development of interventions designed to increaseweight-loss in the overweight and clinically obese population.Background: Previous reports of this prospective study highlight the psychological benefits of a breast screening programme for younger women with a family history of breast cancer. The present paper identified risk factors for cancer worry in these women. Methods: 1286 women completed questionnaires one month prior to screening (T1), and one (T2)and six (T3) months after screening results. Breast cancer worry, perceived risk, cognitive appraisals, ncoping, and dispositional optimism were measured. nFindings: T1 cancer worry explained 56/61% and 54/57% of the variance in worry at T2 and T3 respectively. Other salient predictors included high perceived risk of breast cancer, appraisals of high relevance and threat associated with the family history, and low perceived ability to cope nemotionally. A false positive screening result, pessimistic personality, and religion/substance use coping predicted outcomes at T2 but not T3. Discussion: Interventions to ameliorate high levels of cancer worry and negative appraisals are needed.Background: Personal disclosures of patients may influence how they are evaluated by others. These evaluations may be influenced by the information the patient provides but also by the recipients needs. Methods: In an experimental study, healthy female participants (N = 61) listened to a female cancer patient’s testimonial (25 minutes) in which the patient told about either her negative emotions during radiation therapy or coping strategies she used. The dependent variable was participant’s evaluation of the patient. Findings: The results showed a main effect of condition, meaning that patients who told about their coping were perceived as more sympathetic, courageous and realistic. As indicated by a significant interaction, this effect was especially strong in participants with a strong inclination to compare themselves to others. Discussion: These data show that the personal information that patients provide to others influences how others perceive them. This may have consequences for the others’ motivation to provide social support.Background: Ovarian cancer is known as the “silent killer”. A prospective psychological evaluation study (PsyFOCS) is underway in partnership with the UK Familial Ovarian Cancer Screening Study, which aims to determine the clinical effectiveness of ovarian screening for high risk women. n nMethods: Prior to screening, 991 women completed the Illness Perception Questionnaire (adapted for ovarian cancer risk), Impact of Event Scale (IES), and Hospital Anxiety and Depression Scale. n nFindings: Over one third of women were moderately or highly distressed about their risk according to IES scores. Hierarchical multiple regression showed that negative emotional representations (p<.001), higher anxiety (p<.001), stronger ovarian cancer screening control beliefs (p<.01), and past ovarian cancer screening recall (p<.05) were associated with higher pre-screening distress. n nDiscussion: The association between ovarian cancer screening control beliefs and distress suggests that more distressed women may place greater faith in screening as a means of controlling genetic risk.