Reducing Worry for Asthma Patients REWRAP

  • Research type

    Research Study

  • Full title

    Can non-pharmacological interventions improve asthma outcomes by reducing worrying thoughts?

  • IRAS ID

    244951

  • Contact name

    Ben Ainsworth

  • Contact email

    b.ainsworth@bath.ac.uk

  • Sponsor organisation

    University of Southampton

  • Duration of Study in the UK

    1 years, 3 months, 30 days

  • Research summary

    Asthma is a long-term health condition that can have a significant impact on quality of life. It has been suggested that a reduction in quality of life in those with asthma is related to anxiety. Research suggests that anxiety increases the likelihood that people with asthma will have an acute exacerbation of symptoms (Thomas, Bruton, Moffat & Cleland, 2011). Furthermore, anxiety is the strongest independent predictor of unpleasantness rating for breathlessness at each level of bronchoconstriction (Spinhoven, Peski-Oosterbaan, Van der Dooes, Willelms, Sterk, 1997).\n\nMaladaptive attentional biases are one of the factors implicated in the development and maintenance of anxiety. The Attentional Control Theory of Anxiety (ACT; Eysenck, Derakshan, Santos & Calvo, 2007) proposes that this occurs because anxiety increases the effect of the “bottom-up” attentional systems whilst decreasing the “top – down” goal-directed systems. This serves to increase hypervigilance for threat related information, such as breathlessness in asthma sufferers, and to reduce cognitive efficiency. Furthermore, worry which is highly correlated with anxiety, further reduces ability to process information and can be maintained by misdirected control of attention (Hirsch & Mathews, 2012). Research suggests that lack of attentional control is associated with high levels of worry (Eysenck & Derakshan, 2011). \nIt was found that high worriers showed increased response interference in a flanker task compared to low worriers (Fox, Dutton, Yates, Georgiou, Mouchlianitis, 2015). Furthermore, the higher response interference the more worry thought intrusions experienced. This suggests that deficits in attentional control are related to high levels of worry. This idea is further supported by findings that a reduction in attentional bias can reduce negative thought intrusions (Mogg & Bradley, 2016).\nSimilar attentional processes can be implicated in the perception of asthma symptoms. It is suggested that anxious individuals tend to identify respiratory symptoms as more threatening (Stegen, Van Diest, Van de Woestijne & Van der Bergh, 2000) and therefore divert attention away from low-threat stimuli. This heightened attention on the symptom may lead to elevated level of asthma symptoms (Janssens et al, 2009). Interventions targeting attention such as channelling attention away from threat cues rather than towards them may benefit those with asthma related anxiety. Mindfulness is the practice of focused attention and non-judgemental acceptance of sensations, thoughts, feelings and memories (Baer, 2003). Mindfulness techniques have been found to be effective in improving quality of life, reducing stress and leading to a decrease in need for medication in those with asthma (Pbert et al, 2012).\n

  • REC name

    South West - Cornwall & Plymouth Research Ethics Committee

  • REC reference

    18/SW/0143

  • Date of REC Opinion

    1 Jun 2018

  • REC opinion

    Further Information Favourable Opinion