• Appetitive augmental functions and common physical properties in a pain-tolerance metaphor: An extended replication

      Pendrous, Rosina; Hulbert-Williams, Lee; Hochard, Kevin; Hulbert-Williams, Nicholas J.
      Relational frame theory claims that the tacit understanding of metaphorical language rests upon our ability to derive relations based on relevant contextual cues; with metaphor aptness being a function of learning history and the number and nature of contextual cues presented. Recent experimental research has explored whether metaphor aptness plays a role in changing behaviour. Sierra, Ruiz, Flórez, Riaño Hernández, and Luciano (2016) demonstrated that the presence of common physical properties (herein common properties; “cold”) within a perseverance metaphor increased pain tolerance to the cold pressor task. When the metaphor also specified appetitive augmental functions (herein augmentals; “something important to you”), pain tolerance also increased. We tested the replicability of these findings under more stringent conditions, using a stratified (by sex) double-blind randomised-controlled experimental design. Eighty-nine participants completed baseline measures of psychological flexibility, cognitive fusion, generalised pliance, and analogical reasoning ability. Participants were then allocated to a pre-recorded audio-delivered metaphor exercise containing either: (i) common properties; (ii) augmentals; (iii) both; or (iv) neither (control condition). Participants completed the cold pressor task before and after intervention. We found no change in pain tolerance following intervention in any condition. Given potential implications for apt metaphor use for changing behaviour, further work is required to establish why the original study's findings were not replicated, to identify boundary conditions for the putative effect, and test metaphor use in ecologically valid settings.
    • Evaluating process and effectiveness of a low-intensity CBT intervention for women with gynaecological cancer (the EPELIT Trial)

      Hulbert-Williams, Nicholas J.; Hulbert-Williams, Lee; Flynn, Ryan J.; Pendrous, Rosina; MacDonald-Smith, Carey; Mullard, Anna; Swash, Brooke; Evans, Gemma; Price, Annabel; University of Chester; North Wales Cancer Treatment Centre; Ysbyty Gwynedd; Addenbrooke's Hospital Cambridge (F1000Research, 2021-03-29)
      Background: Improving survival from gynaecological cancers is creating an increasing clinical challenge for long-term distress management. Psychologist-led interventions for cancer survivors can be beneficial, but are often costly. The rise of the Psychological Wellbeing Practitioner (PWP) workforce in the UK might offer a cheaper, but equally effective, intervention delivery method that is more sustainable and accessible. We aimed to test the effectiveness of a PWP co-facilitated intervention for reducing depression and anxiety, quality of life and unmet needs. Methods: We planned this trial using a pragmatic, non-randomised controlled design, recruiting a comparator sample from a second clinical site. The intervention was delivered over six-weekly sessions; data were collected from participants at baseline, weekly during the intervention, and at one-week and three-month follow-up. Logistical challenges meant that we only recruited 8 participants to the intervention group, and 26 participants to the control group. Results: We did not find significant, between-group differences for depression, quality of life or unmet needs, though some differences at follow-up were found for anxiety (p<.001). Analysis of potential intervention mediator processes indicated the potential importance of self-management self-efficacy. Low uptake into the psychological intervention raises questions about (a) patient- driven needs for group-based support, and (b) the sustainability of this intervention programme. Conclusions: This study failed to recruit to target; the under-powered analysis likely explains the lack of significant effects reported, though some trends in the data are of interest. Retention in the intervention group, and low attrition in the control group indicate acceptability of the intervention content and trial design; however a small baseline population rendered this trial infeasible in its current design. Further work is required to answer our research questions, but also, importantly, to address low uptake for psychological interventions in this group of cancer survivors.
    • Examining the relationship between autism traits and sleep duration as predictors of suicidality

      Hochard, Kevin D.; Pendrous, Rosina; Mari, Tyler; Flynn, Samantha; University of Chester; University of Warwick
      Short sleep duration is a known risk factor for suicidality in the general population, yet it is unclear how short sleep interacts with autism traits in predicting suicidality. In this cross-sectional online study, a general population sample (N = 650) completed measures assessing autism traits, suicidal ideation, and sleep duration. Moderated hierarchical regressions demonstrated that higher autism traits and shorter sleep were independent predictors of increased suicide ideation. However, sleep duration did not significantly moderate the autism trait to suicide ideation relationship. Future work should explore this relationship longitudinally using objective measures before intervention work to increase sleep duration in those with elevated autism traits be consider.
    • In search of scope: A response to Ruiz et al. (2020)

      Hulbert-Williams, Lee; Hulbert-Williams, Nicholas J; Pendrous, Rosina; Hochard, Kevin D; University of Chester
      Deliberate and explicit replication attempts are becoming more common across the behavioral sciences. Whilst replicability has been recognized as a core feature of science for decades (if not centuries), the directness of today’s replication work requires us to consider carefully how we communicate our research and how we conceptualize our theories in light of differing findings. This paper uses a concrete example to make a number of suggestions for how we, as a scientific community, ought to engage with replication attempts. Within Relational Frame Theory (RFT) there is a growing body of applied research on the effective use of metaphors to increase tolerance of aversive states. We conducted a replication of an earlier experimental analogue study (2020, this journal) and failed to find the specified effect. Ruiz et al. (2020, also this journal) have recently published a critical response in which they list a number of differences between our two studies which might account for the negative findings. We will use this series of three papers as our exemplum. We also take the opportunity to acknowledge some points of critique provided by Ruiz et al., and to set the record straight with respect to the differences between the original study and our replication attempt. We hope this discussion might help the CBS community to develop a coherent approach to the very current issue of replication.
    • Recruiting cancer survivors into research studies using online methods: a secondary analysis from an international cancer survivorship cohort study.

      Hulbert-Williams, Nicholas J.; Pendrous, Rosina; Hulbert-Williams, Lee; Swash, Brooke; University of Chester (ecancer Global Foundation, 2019-12-12)
      Recruiting participants into cancer survivorship research remains a significant challenge. Few studies have tested and compared the relative use of non-clinical online recruitment methods, especially in samples of adult cancer survivors. This paper reports on the feasibility of recruiting a representative cohort of cancer survivors using online social media. Two-hundred participants with a cancer diagnosis within the past 12 months were recruited via social media (Facebook, Twitter, Reddit) into a longitudinal questionnaire study. Different methods of online recruitment proved to be more effective than others over time. Paid Facebook boosting, Reddit posts, and Twitter adverts placed by existing cancer charities proved most helpful in reaching our recruitment target (contributing 27%, 22% and 32% respectively). Recruiting online achieved a more demographically and clinically representative sample for our study: our sample was younger, less heteronormative, including those with a range of clinical diagnoses, primary and recurrence illness, and patients who had both completed and were still receiving treatment. This was certainly not a quick method of sample recruitment but that could have been optimised by focussing only on the three most effective methods describe earlier. Whilst we found that online recruitment is significantly lower cost than traditional recruitment methods, and can reduce some biases, there still remains the potential for some biases (e.g. excluding much older participants) and ethical/methodological issues (e.g. excluding those without access to the internet). We outline our recruitment strategy, retention rates, and a cost breakdown in order to guide other researchers considering such methods for future research in cancer survivorship.