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Background: This study investigated the impact of Chronic Low Back Pain (CLBP) on individuals' physical activity (PA) behaviours, specifically, how they modify, cease, or continue PA when experiencing CLBP. The primary aim was to explore the relationship between CLBP and PA and how this is influenced in different contexts (e.g., necessity of a task). Methods: A mixed‐methods survey was administered to 220 participants, including self‐reported outcomes, and capturing responses to three distinct questions related to PA and CLBP. The data was analysed via a content analysis. Results: The findings revealed that individuals with CLBP are most likely to modify PA in work‐related contexts and least likely to cease it in the same setting. Housework emerged as the most common domain for cessation of PA, while work/study activities were predominantly continued. Reasons for these trends were typically task‐based rather than health or enjoyment based and influenced by the perceived necessity of the task in question. Conclusion: The study highlights the role of occupational and educational settings in individual responses to CLBP. The findings also highlight a gap in public awareness regarding effective CLBP management strategies, emphasising the need for increased education and awareness programs. [ABSTRACT FROM AUTHOR]

Objective: To explore the effectiveness of a modified fear hierarchy on measuring improvements in movement‐associated fear in chronic low back pain. Methods: A modified 3‐item fear hierarchy was created and implemented based on principles of graded exposure. This study was an exploratory analysis of the modified 3‐item fear hierarchy from a larger clinical trial data set. Both groups received pain education and exercise, either bodyweight or strength training. Both groups performed item one on the hierarchy, the squat. Only the strength training group performed item 2, the deadlift. Neither group performed item 3, the overhead press. Analysis of Covariance and stepwise linear regression were used to explore results. Results: Improvement in movement‐associated fear was conditional upon graded exposure. Both groups improved in the squat movement (p ≤ 0.05), which both performed. Only the strength training group improved in the deadlift (p ≤ 0.01), and neither improved in the overhead press (p ≥ 0.05). Conclusion: Reductions in movement‐associated fear are conditional upon graded exposure, based on the use of a novel modified 3‐item fear hierarchy. Further research is needed to understand the utility of this tool in a patient‐led approach to co‐designing a graded exposure‐based intervention. [ABSTRACT FROM AUTHOR]

The study aimed to examine the role of, and potential interplay between, cue utilisation and cognitive reflection in email users' ability to accurately (and efficiently) differentiate between phishing and genuine emails. 145 participants completed the Cognitive Reflection Test (CRT), a phishing diagnostic task, and the Expert Intensive Skill Evaluation (EXPERTise 2.0) battery, which provided a gauge of users' cue utilisation in the domain. The results revealed an interaction between users' cognitive utilisation and cue reflection, whereby users low in both facets performed significantly worse in diagnosing phishing emails than all other groups. Further, those participants with both higher cue utilisation and cognitive reflection took significantly longer to make their diagnosis. It is concluded that a high level of cognitive reflection was able to compensate for a lower level of cue utilisation, and vice versa. Participants reported using seven types of cue during diagnosis, however, there was no significant relationship between the types of cues used and users' level of cue utilisation. Taken together, the findings have implications to the design of user-level interventions in relation to the identification of vulnerable users, as well as the need to consider training approaches that extend beyond the use of simple cue inventories. [ABSTRACT FROM AUTHOR]

Study Design: Cross-sectional survey.Objective: This study surveyed the attitudes and beliefs of physiotherapists and accredited exercise physiologists (AEP) toward chronic low back pain (CLBP), in Australia. The objective of this study was to investigate the effect of biomedical and biopsychosocial attitudes and beliefs toward CLBP on clinical decision making in exercise-based practitioners.Summary Of Background Data: The attitudes and beliefs of AEPs toward CLBP have not been studied. Literature regarding physiotherapists suggests a biomedical approach leading to more conservative treatment and on occasion, treatment going against practice guidelines.Methods: Seventy five AEPs and 75 physiotherapists were surveyed using the pain attitudes and beliefs scale for physiotherapists, which consists of both a biomedical and biopsychosocial subscale. Clinical decision making was assessed using two patient vignettes.Results: AEPs held higher biomedical beliefs compared with physiotherapists. No between-group differences were observed on the biopsychosocial subscale. Indeed, biomedical attitudes and beliefs did explain clinical decision making with higher scores reflecting a more conservative approach. However, biomedical beliefs influenced decision making regardless of profession.Conclusion: Biomedical attitudes and beliefs regarding CLBP influence clinical decision making in exercise-based practitioners, regardless of profession. AEPs reported higher biomedical scores, suggesting more frequent choice of conservative care. Thus, patients may receive inconsistent care and advice from practitioners within the same field. Based on clinical practice guidelines and the positive associations on clinical decision making of the biopsychosocial model, it is necessary to understand how best to provide exercise-based practitioners with education on how to apply a biopsychosocial approach to CLBP.Level of Evidence: 3. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Previous experimental research has yielded inconclusive findings regarding the effects of Holocaust trauma to survivors’ descendants, while qualitative studies have suggested diverse long‐term impacts of this traumatic past. While the extant literature has focused mainly on Israeli and North American children of survivors, this study drew on theories of transgenerational trauma transmission to explore the lived experiences of six Jewish Australian grandchildren of Holocaust survivors. Method: Data from semi‐structured interviews were analyzed using interpretative phenomenological analysis to investigate how the impacts of historical trauma are experienced across generations in an Australian sample. Results: The impact of their grandparents’ Holocaust experiences was found to echo across the participants’ affective experiences, their sense of connection to family histories, their understanding of being different to others, and their political and ethical values. An analysis of these findings suggested that the participants define themselves in a collective manner as part of a group of survivors’ descendants, with their post‐Holocaust positioning existing in a state of tension alongside their Australian identity. Conclusions: This study extends the literature on transgenerational trauma by shedding light on how the identities of Australian grandchildren of Holocaust survivors continue to be profoundly informed by their identification with familial narratives of trauma, despite their generational distance from the Holocaust. [ABSTRACT FROM AUTHOR]

At present, selection into Masters and Doctorate level Clinical Psychology programs in many countries largely relies upon undergraduate grades (i.e., Grade Point Average; GPA) and the honors year thesis. The use of objective, non-cognitive measures of ability are virtually non-existent. One measure seemingly relevant to the field of clinical psychology is the Mayer-Salovey-Caruso Emotional Intelligence Test (MSCEIT), an ability-based measure of emotional intelligence (EI). EI, the ability to identify and regulate one’s own (and others’) emotions, may act as a worthwhile predictor of performance within domains requiring advanced communication and empathy skills, such as clinical psychology. Testing a sample of first year Masters of Clinical Psychology students (n = 9), this study investigated the relationship between EI as measured by the MSCEIT, performance in clinical tasks (simulated Cognitive Behavioral assessment and Cognitive Therapy (CT) competencies), and GPA. Despite a modest sample size, results indicated a significant correlation between EI and results from the clinical tasks, but there was no significant relationship between assessment performance and GPA. Implications to higher education selection and the clinical psychology profession are discussed. [ABSTRACT FROM AUTHOR]

Despite being a first-line treatment recommendation, there is uncertainly for how exercise helps people with chronic low back pain. We designed this study to examine how exercise might help people with chronic low back pain by following a large community sample for 1-year. Qualitative questionnaires and self-report measures were collected every 3-months for 1-year in 400 people with chronic low back pain. People were not provided any specific treatment advice as part of this study but were allowed to engage with any normal physical activity, treatment, or medication as part of their normal life. Exercise engagement was defined from inspection of participant qualitative responses, according to minimum acceptable levels of exercise that elicit symptom reduction. Multiple mediation analysis was performed to examine the effect of exercise engagement on disability through the proposed mediators (pain, fear, catastrophizing, depression, anxiety, self-efficacy). The significant effect of exercise engagement on reductions in disability at 6- and 12-months was explained through pain and catastrophizing. People with chronic low back pain who reported worsening of symptoms over the year had similar reporting of exercise throughout the 12-months to people who had improvements in disability. Exercise can reduce disability through the effect on pain and catastrophizing, but how this effect occurs (i.e., an active or passive component of exercise) is unclear., Competing Interests: Declaration of competing interest PM received funding support from the Sydney Spine and Pain Clinics during the data collection phase of this project for unrelated work, and has commenced unpaid advisory work for TBI Health (NZ) in 2021. SMS receives salary support from the National Health and Medical Research Council of Australia (1105040). The remaining authors have no conflicts of interest to declare., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

Objectives: The fear-avoidance model (FAM) is used to explain pain-related disability and design targeted interventions for people with chronic low back pain. While treatment engagement is critical, it is unknown how treatment moderates the FAM., Methods: This study examined whether pathways within the FAM were moderated by treatment engagement in 508 people with chronic low back pain. Measures of disability, pain, fear, catastrophizing, anxiety, depression, and self-efficacy were collected through self-report, and descriptors of treatment engaged within the last month (physical activity type, medication, allied and medical health practitioner). Moderated mediation analyses were performed to examine the conditional effect of treatment engagement on fear-avoidance pathways., Results: The conditional effect of anxiety on disability was only significant for people who did not report any treatment engagement in the last month (B=1.03, 95% confidence interval: 0.53-1.53, P<0.001). The effect of depression increased for people reporting more different types of treatment in the last month (1 level of treatment increase, B=0.27, 95% confidence interval: 0.05-0.50, P=0.019). Conversely, greater treatment engagement had a positive influence on the mediating effect of self-efficacy. That is, the effect of pain on efficacy reduced with greater treatment engagement, with a concomitant increased effect of self-efficacy on disability., Discussion: Clinicians should explore the history and rationale behind patient treatment seeking behavior to ensure this is not reinforcing the negative effects of depressive symptoms on pain-related disability., Competing Interests: The authors declare no conflict of interest., (Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.)

Background: The relationship of low back pain, the world's top disabling condition, with functional disability is often explained by the mediation effect of fear, catastrophizing, and psychological distress. These relationships have not been explored within chronic back pain patients from a low socio-economic, predominantly Muslim country. Thus, it was unclear whether previously established pathways would be consistent in Pakistani pain patients to help guide Pakistani clinicians caring for back pain patients. This cross-sectional study translated English versions of questionnaires within the fear-avoidance model into Urdu, tested the clinimetric properties of the Urdu versions for people with chronic low back pain (CLBP) in Pakistan, and performed mediation analysis to investigate pathways of the fear-avoidance model., Methods: Translation of questionnaires was completed in 4 steps using the forward-backward technique, with subsequent analyses for internal consistency (Cronbach's α), construct validity (Pearson's r -value), and test-retest reliability (ICC r -value). Multiple mediation analysis with bootstrapping was performed to analyze pathways within the fear-avoidance model from the Urdu translated questionnaires., Results: A total of 151 people from Pakistan with CLBP completed the questionnaires, with good results for internal consistency ( r > 0.85), convergent validity ( r > 0.59), and test-retest reliability (ICC r > 0.85). The association of pain with disability was significant ( B =2.36, r 2 = 0.19, p <0.001), and the indirect effect of the mediators explained 81% of pain intensity's total effect on disability. All mediators, apart from physical activity-related fear-avoidance beliefs, were significant mediators of the effect of pain intensity on disability., Conclusion: The Urdu versions of the fear-avoidance questionnaires show good clinimetric properties for use in clinical settings and research in Pakistan. These analyses support existing data for the mediation effect of catastrophizing, psychological distress, and self-efficacy on pain-related disability, and extends these findings to suggest that fear about work may be more important in a relatively lower socioeconomic sample of pain patients., Competing Interests: The authors declare that they have no competing interests. The authors received no specific funding for this work., (© 2020 Khan et al.)

Gender, a personal history of trauma and attitudes towards continuous vs recovered memories of abuse significantly impact the believability of Child Sexual Abuse (CSA) disclosures in community samples. Yet, whether these variables influence the believability of CSA disclosure and subsequent clinical decisions made by practicing psychologists is underexplored. A vignette of trauma disclosure from a hypothetical adult client was presented via an online survey to 292 registered psychologists. Participants rated the believability of the disclosure, answered an open-ended item regarding treatment planning, and completed the Brief Betrayal Trauma Survey to measure personal trauma history. Results indicated that female psychologists believed disclosures significantly more than male psychologists and that disclosures comprised of continuous memories were believed more than recently recovered memories. A significant interaction between gender and personal trauma history was also revealed. Female psychologists believed disclosures regardless of their personal trauma history, while male psychologists with a personal history of trauma believed disclosures significantly more than male psychologists without personal trauma history. Reported believability of the disclosure, while unrelated to treatment planning, was associated with a reported intention to validate the client's experience. The results support that, similar to community samples, gender and a personal trauma history impact psychologist believability of CSA disclosure. The research further supports that psychologist level of belief then translates into clinical implications., (Copyright © 2018 Elsevier Ltd. All rights reserved.)