Omar Yousaf

A systematic review of the factors associated with delays in medical and psychological help-seeking among men

Despite a growing literature on the factors associated with mens low rates of medical and psychological help-seeking, a systematic review of these is missing. Such an overview can help to inform health psychologists of the barriers to the performance of adaptive health behaviours, such as prompt help-seeking, and could inform theoretical advancements and the development of targeted interventions to facilitate prompt help-seeking among men. We systematically reviewed quantitative and qualitative empirical papers on factors associated with delays in mens medical and psychological help-seeking. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed, and we used the databases PsycINFO, Medline, Embase and PsycARTICLES (with keywords: men/male*/gender*, help*/seek* and health*/service*/utili*[sation]) for papers in English. 41 citations (amounting to 21,787 participants aged 15–80 + ) met the inclusion criteria. Approximately half of these used qualitative methodologies (i.e., semi-structured interviews and focus groups), while half used quantitative methodologies (i.e., questionnaires). We identify a number of recurring cognitive, emotional, health-service related and socio-demographic help-seeking factors/predictors from the 41 papers. Of these, the most prominent barriers to help-seeking were disinclination to express emotions/concerns about health, embarrassment, anxiety and fear, and poor communication with health-care professionals.

The Emotional and Attitudinal Consequences of Religious Hypocrisy: Experimental Evidence Using a Cognitive Dissonance Paradigm

ABSTRACT We explored the emotional and attitudinal consequences of personal attitude-behavior discrepancies using a religious version of the hypocrisy paradigm. We induced cognitive dissonance in participants (n = 206) by making them feel hypocritical for advocating certain religious behaviors that they had not recently engaged in to their own satisfaction. In Experiment 1, this resulted in higher levels of self-reported guilt and shame compared to the control condition. Experiment 2 further showed that a religious self-affirmation task eliminated the guilt and shame. In Experiment 3, participants boosted their religious attitudes as a result of dissonance, and both religious and non-religious self-affirmation tasks eliminated this effect. The findings provide evidence that dissonance induced through religious hypocrisy can result in guilt and shame as well as an attitude bolstering effect, as opposed to the attitude reconciliation effect that is prevalent in previous dissonance research.

A randomised controlled trial of a cognitive behavioural intervention for men who have hot flushes following prostate cancer treatment (MANCAN): trial protocol

BackgroundThis randomised controlled trial (RCT) aims to evaluate the effectiveness of a guided self-help cognitive behavioural intervention to alleviate problematic hot flushes (HF) and night sweats (NS) in men who are undergoing prostate cancer treatment. The trial and the self-help materials have been adapted from a previous RCT, which showed that a cognitive behavioural intervention reduced the self-reported problem-rating of hot flushes in women with menopausal symptoms, and in women undergoing breast cancer treatment. We hypothesize that guided self-help will be more effective than usual care in reducing HF/NS problem-rating at post treatment assessment.Methods/DesignSeventy men who are undergoing treatment for prostate cancer and who have been experiencing more than ten HF/NS weekly for over a month are recruited into the trial from urology clinics in London. They are randomly allocated to either a four-week self-help cognitive behavioural therapy (CBT) treatment or to their usual care (control group). The treatment includes information and discussion about hot flushes and night sweats in the context of prostate cancer, monitoring and modifying precipitants, relaxation and paced respiration, stress management, cognitive therapy for unhelpful thoughts and beliefs, managing sleep and night sweats, and advice on maintaining these changes.Prior to randomisation, men attend a clinical interview, undergo 24-48-hour sternal skin conductance monitoring, and complete pre-treatment questionnaires (e.g., problem-rating and frequency of hot flushes and night sweats; quality of life; mood; hot flush beliefs and behaviours). Post-treatment measures (sternal skin conductance and the above questionnaires) are collected four-six weeks later, and again at a six-month follow-up.DiscussionMANCAN is the first randomised controlled trial of cognitive behavioural therapy for HF/NS for men that measures both self-reported and physiologically indexed symptoms. The results will inform future clinical practice by evaluating an evidence-based, non-medical treatment, which can be delivered by trained health professionals.Trial registrationUK Clinical Research Network UKCRN10904.

A randomised controlled trial of a brief cognitive behavioural intervention for men who have hot flushes following prostate cancer treatment (MANCAN)

Hot flushes and night sweats (HFNS) are experienced by up to 80% of prostate cancer patients undergoing androgen deprivation therapy (ADT). This study evaluates the effects of a guided self‐help cognitive behavioural therapy (CBT) intervention on HFNS problem‐rating (primary outcome), HFNS frequency, mood and health‐related quality of life (secondary outcomes) in patients undergoing ADT.

Dispositional Mindfulness and Psychological Health: a Systematic Review

Interest in the influence of dispositional mindfulness (DM) on psychological health has been gathering pace over recent years. Despite this, a systematic review of this topic has not been conducted. A systematic review can benefit the field by identifying the terminology and measures used by researchers and by highlighting methodological weaknesses and empirical gaps. We systematically reviewed non-interventional, quantitative papers on DM and psychological health in non-clinical samples published in English up to June 2016, following the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. A literature search was conducted using PsycINFO, PubMED, Medline and Embase, and 93 papers met the inclusion criteria. Within these, three main themes emerged, depicting the relationship between DM and psychological health: (1) DM appears to be inversely related to psychopathological symptoms such as depressive symptoms, (2) DM is positively linked to adaptive cognitive processes such as less rumination and pain catastrophizing and (3) DM appears to be associated with better emotional processing and regulation. These themes informed the creation of a taxonomy. We conclude that research has consistently shown a positive relationship between DM and psychological health. Suggestions for future research and conceptual and methodological limitations within the field are discussed.

Barriers to medical help-seeking among older men with prostate cancer

ABSTRACT Objective: Mens disinclination to seek medical help has been linked to higher rates of morbidity and mortality compared to women. However, previous studies were conducted predominantly with healthy, young, and middle-aged men. We explored the perceived medical barriers to help-seeking in older men with prostate cancer. Method: 20 men with prostate cancer took part in semistructured interviews, which were analyzed using thematic analysis. Results: Three themes were identified related to negative attitudes toward help-seeking: male gender role; fear of the health condition, medical and treatment procedures; and embarrassment as a consequence of medical examinations, communication with health (and nonhealth) professionals, and the disclosure of sexual-related symptoms. Conclusion: The barriers identified in our study strengthen the evidence for the impact of traditional masculinity on help-seeking in men.

Men’s experience of a guided self-help intervention for hot flushes associated with prostate cancer treatment

Abstract Up to 80% of men who receive androgen deprivation therapy report hot flushes and for many these are associated with reduced quality of life. However it is recognised that there are a number of barriers to men’s engagement with support to manage symptoms and improve quality of life. This qualitative study was embedded within a larger randomised controlled trial (MANCAN) of a guided self-help cognitive behavioural intervention to manage hot flushes resulting among men receiving androgen deprivation therapy. The study aimed to explore the engagement and experiences with the guided self-help intervention. Twenty men recruited from the treatment arm of the MANCAN trial participated in a semi-structured interview exploring acceptability of the intervention, factors affecting engagement and perceived usefulness of the intervention. Interviews were audio-recorded, transcribed verbatim and analysed using a Framework approach. Over two thirds of respondents (69%) reported reading the intervention booklet in full and over 90% reporting practising the relaxation CD at least once a week. Analysis of the interviews identified three super-ordinate themes and these related to changes in hot flush symptomatology (learned to cope with hot flushes in new ways), the skills that participants had derived from the intervention (promoting relaxation and reducing stressors), and to a broader usefulness of the intervention (broader impact of the intervention and skills). The present study identified positive engagement with a guided self-help intervention and that men applied the skills developed through the intervention to help them undertake general lifestyle changes. Psycho-educational interventions (e.g. cognitive behaviour therapy, relaxation, and positive lifestyle elements) offer the potential to be both effective and well received by male cancer survivors.

The Hot Flush Beliefs and Behaviour Scale for Men (HFBBS-Men) undergoing treatment for prostate cancer.

OBJECTIVE Hot flushes and night sweats (HFNS) are commonly experienced by men receiving treatment for prostate cancer. Cognitive behavioural therapy (CBT) has been found to be an effective treatment for HFNS in women, but cognitions and behavioural reactions to HFNS in men are under-researched. This study describes the development of the HFNS beliefs and behaviour scale for men. METHODS HFNS beliefs and behaviour items were generated from a qualitative study, from pilot interviews with men with prostate cancer and HFNS, and from scales used for women. 118 men with prostate cancer, aged above 18, English-speaking, who had minimum of seven HFNS weekly for at least 1 month, completed the initial measure, and measures of HFNS frequency, problem rating, anxiety and depression (HADS). Principal components analyses with orthogonal rotation determined the most coherent solution. RESULTS Exploratory factor analysis culminated in a 17-item HFNS beliefs and behaviour scale for men (HFBBS-Men) with three subscales: (1) HFNS social context and sleep, (2) Calm/Acceptance, (3) Humour/Openness. The subscales had reasonable internal consistency (Cronbach alpha 0.56-0.83). Validity was supported, by correlations between subscale 1, HFNS frequency, problem-rating and mood; men with locally advanced cancer more likely to adopt Calm/Acceptance and those with metastatic cancer Humour/Openness. CONCLUSIONS Preliminary analysis of the HFBBS-Men suggests that it is a psychometrically sound instrument, grounded in mens experiences. As a measure of cognitive and behavioural reactions to HF/NS, the HFBBS-Men should increase understanding of the mediators of outcomes of psychological interventions, such as CBT.

The bolstering effect of conceptual priming on psychological help-seeking attitudes in men

Abstract Background: It is a well-established finding that men are often unwilling to engage with mental health services, and that they hold negative attitudes toward psychological help-seeking. Consequently, men’s psychological problems often remain untreated, which in turn can compromise their quality of life. Aims: The present experiment addresses this problem using a conceptual priming paradigm from social psychology called Scrambled Sentence Test as an intervention to change men’s negative attitudes toward psychological help-seeking. Method: The Scrambled Sentence Test works by asking participants to unscramble sentences that unbeknownst to them include priming words – in this case, openness and communication-related words. Sixty-nine men completed the task (with priming or control words) under the instructions of a condition-blind experimenter. Results: The primed group showed more positive attitudes (Mdn = 56.5) toward seeking psychological help compared to controls (Mdn = 40.0), p < 0.01; r = 0.38. Conclusion: The findings are the first to suggest that conceptual priming of this kind can be used an as effective and time-efficient intervention by mental health professionals to encourage men to seek help for psychological problems.

The effect of personal attitudes on information processing biases in religious individuals

ABSTRACT Selective exposure, the confirmation bias of preferring attitude-consistent over attitude-inconsistent information, is empirically a well-established phenomenon of human behaviour. However, most of the research on selective exposure has been conducted either on what material participants select or what they attend to once the material is presented. We extended a selective exposure paradigm by measuring biases at both the selection and the reading stages of information processing. After Christian participants (n = 41) were asked about their views on tithing (a religious practice of giving charity), selective exposure biases were not systematic but were moderated by participants’ views on tithing. That is, those who were in favour of tithing showed a preference for anti-tithing material (i.e. attitude-inconsistent material), whereas those who were not in favour of tithing also showed a preference for anti-tithing material (i.e. attitude-consistent material). Our study indicates that resistance to persuasion might in some cases depend on attitude direction.