Louise Sharpe

The University of Sydney · School of Psychology

Growing research demonstrates that death anxiety is strongly associated with numerous mental health conditions. It is possible that death anxiety may similarly contribute to behaviours associated with muscle dysmorphia (MD). The current pre-registered study examined this possibility in 322 young men with an interest in health and fitness. The morta...

Background: As COVID-19 spread across the globe, cancer services were required to rapidly pivot to minimise risks without compromising outcomes for patients or staff. The aim of this study was to document changes to Oncology services as a result of COVID-19 from the perspectives of both providers and receivers of care during the initial phase of th...

Several authors have claimed that death anxiety may be a transdiagnostic construct, underlying a range of psychological disorders. One category of disorders that may be influenced by death anxiety is eating disorders (EDs). Terror Management Theory (TMT) argues that pursuing the ‘thin ideal’ may be one way that women can defend against fears of dea...

Cross-sectional research has highlighted the emotional impacts of coronavirus disease 2019 (COVID-19) in cancer communities. The aim of this study was to extend findings and to provide a longitudinal perspective of emotional effects of COVID-19 on a range of participants, including patients with cancer, their family members, and oncology health pro...

The DSM‐5 Section III alternative model of personality disorder (AMPD) and the International Classification of Diseases – 11th Edition's (ICD‐11) personality disorder classification allow clinicians to identify individual trait domains in which people score highly. However, how these domains relate to constructs associated with efficacious treatmen...

Background Using fear to increase the uptake of preventative health behaviours is a longstanding practice, which could be useful in mitigating the spread of COVID-19. However, the impact of fear campaigns beyond behavioural outcomes has rarely been considered. It is possible that these threatening health messages could heighten health-related anxie...

Despite the theoretical prominence of expectancy and anxiety as potential mechanisms of the nocebo effect, not all studies measure expectancy and/or anxiety, and there are inconsistent findings among those that do. The purpose of the present study was to systematically review and meta-analyse available data to evaluate the relationship between expe...

Cognitive bias modification for interpretation (CBM-I) is an effective intervention for anxiety, but there is only a single trial in people with chronic pain. The aim of this randomized controlled trial was to test CBM-I with and without psychoeducation for people with chronic pain. We randomized 288 participants to 4 groups comprising treatment (C...

Objective: The Cancer Threat Interpretation model proposes that clinically significant fear of cancer recurrence/progression (FCR/P) can occur when people misinterpret ambiguous physical symptoms as a sign of recurrence. The aim of this research is to test whether interpretation biases moderate the relationship between pain and FCR/P in women with...

Fear of cancer recurrence (FCR) is the most common psychological issue for cancer survivors, and research shows that caregivers are as fearful of the cancer returning as patients. However, there is relatively little research on caregiver FCR. The aim of this systematic review was to provide a metasynthesis of qualitative research to determine (a) w...

Objectives: Research spanning the fields of clinical, social and health psychology suggests that death anxiety is an important construct. However, no comprehensive, psychometrically adequate measure of the construct exists. The current studies outline the development of a new measure of death anxiety, the Death Anxiety Beliefs and Behaviours Scale...

Objectives People living with multimorbidity often rely on the support of informal family carers, yet challenges frequently arise when carers of people with multimorbidity (PwM) interact with health professionals (HPs) and healthcare systems. This study aimed to provide insights into the experiences and challenges involved in working with carers of...

Purpose Approximately 50% of cancer survivors experience moderate-severe fear of cancer recurrence (FCR). Self-guided digital interventions have potential to address the high level of FCR-related unmet needs at scale, but existing digital interventions have demonstrated variable engagement and efficacy. This study aimed to evaluate the feasibility...

Background Fatigue is the most frequent and burdensome symptom of patients with diffuse glioma. It is closely linked to decreased health-related quality of life and symptoms such as depression and sleep disturbances. Currently, there is no evidence-based treatment that targets severe fatigue in patients with brain tumours. Cognitive behavioural the...

Introduction Psychosocial treatments have been shown to benefit people with rheumatoid arthritis (RA) on various outcomes. Two evidence-based interventions are cognitive behavioural therapy (CBT) and mindfulness-based stress reduction (MBSR). However, these interventions have been compared only once. Results showed that CBT outperformed MBSR on som...

Background: The predominant definition of fear of cancer recurrence (FCR) conflates FCR with fear of progression (FOP). However, this assumption has never been tested. Importantly, if FCR and FOP are distinct and have different predictors, existing interventions for FCR may not be equally effective for survivors who fear progression rather than re...

Introduction: Psychological adjustment to chronic health conditions is important, as poor adjustment predicts a range of adverse medical and psychosocial outcomes. Psychological treatments demonstrate efficacy for people with chronic health conditions, but existing research takes a disorder-specific approach and they are predominately delivered in...

Fear of cancer recurrence (FCR) is the most common psychosocial issue amongst cancer survivors. However, fear of progression (FoP) has been studied outside of the cancer context. This review aimed to: (1) meta-synthesize qualitative studies of FoP in illnesses other than cancer; and (2) quantify the relationship between FoP and anxiety, depression,...

Background Evidence shows small positive effects associated with psychological treatments for people with multiple sclerosis (PwMS). In a recent meta-analysis, the treatment with the largest effect size was a mindfulness-based intervention (MBI). Objectives We aimed to determine whether an Internet-delivered MBI was beneficial for PwMS. Furthermor...

Objective: To determine the efficacy of psychological interventions in studies of adults with migraine, in reducing pain, and functional and psychosocial difficulties. Background: A recently published Cochrane Review showed no strong evidence for psychological intervention for adults with migraine. However, this review was limited by stringent i...

Objective Cancer patients, carers and oncology health professionals have been impacted by the COVID-19 pandemic in many ways, but their experiences and psychosocial responses to the pandemic are still being explored. This study aimed to document the experience of Australians living with cancer, family carers, and Oncology health professionals (HPs)...

Recent sham-controlled studies suggest placebo effects contribute to acute pain relief following mindfulness interventions. However, the specific effects of mindfulness processes and their interaction with placebo effects remain unclear. This study aimed to characterize the role of mindfulness and placebo processes underlying mindfulness-based pain...

Avoidance is a hallmark symptom and a primary maintaining factor in anxiety disorders. Theories of anxiety disorders have focused not only on overt avoidance, but also on more subtle avoidance known as ‘safety behaviours’. Safety behaviours involve behaviours which aim to reduce anxiety or prevent a feared outcome from occurring. In the long-term,...

The aim of this systematic review and meta-analysis was to determine the pattern of cognitive processing biases (ie, attentional, interpretation, and memory bias) towards headache and pain information observed in individuals with frequent or chronic headaches or migraines, compared with individuals without. We identified 11 studies (total N = 841)....

Background: Fear of cancer recurrence or progression (FCR) is common amongst cancer survivors and an important minority develop clinically significant levels of FCR. However, it is unclear how current clinical services might best support the growing numbers of cancer survivors. Purpose: The aim of this study is to develop recommendations for fut...

The COVID-19 pandemic has been associated with increased uncertainty, fear and worry in everyone’s life. The effect of changes in daily life has been studied widely, but we do not know how emotion-regulation strategies influence adaptation to a new situation to help them overcome worry in the face of uncertainty. Here, 1,064 self-selected Farsi spe...

Importance Single-blind placebo run-in (PRI) periods are common in randomized clinical trials (RCTs) of treatment for depression. They aim to increase sensitivity to detect drug effects; however, the association of PRI periods with study outcomes remains unclear. This is concerning given the costs of PRI periods to patients and investigators. Obje...

Successful blinding in double-blind RCTs is crucial for minimizing bias, however studies rarely report information about blinding. Among RCTs for depression, the rates of testing and success of blinding is unknown. We conducted a systematic review and meta-analysis of the rates of testing, predictors, and success of blinding in RCTs of antidepressa...

Our vision is more ambitious than the provision of neuropalliative care: a unifying multidisciplinary speciality that would involve specialists in clinical psychology, nursing, social work, psychiatry, neurology, and neuropalliative care, dedicated to improving clinical and psychosocial care for all patients with neurological disorders across their...

Background Fear of cancer recurrence, depressive symptoms, and cancer-related fatigue are prevalent symptoms among cancer survivors, adversely affecting patients’ quality of life and daily functioning. Effect sizes of interventions targeting these symptoms are mostly small to medium. Personalizing treatment is assumed to improve efficacy. However,...

Emerging research suggests that death anxiety is a transdiagnostic construct, which may underpin a number of mental illnesses. Although cognitive behaviour therapy (CBT) has been found to be the most effective treatment for death anxiety, no self-guided treatments for this construct exist at present. Furthermore, there is a growing need for accessi...

The aim of the present study was to investigate the role of cognitive processing biases in Type 2 diabetes (T2D) and chronic pain, two conditions that are highly co-morbid. The final sample comprised 333 individuals (86 with T2D and chronic pain, 65 with chronic pain, 76 with T2D, 106 without any form of diabetes or pain). Participants completed qu...

Background older people coping with the impacts of living with multimorbidity are at increased risk of developing a depressive disorder. Objective this article reports the 24-month results of a randomised controlled trial of an internet-delivered cognitive behaviour therapy, which aimed to test whether depressive disorders could be prevented in th...

Objectives: A diagnostic system that fails to deliver clinically useful information will not be utilized and consequently will be unable to provide valuable data for health policy and clinical decision making. Therefore, it is imperative to obtain an accurate depiction of the clinical utility of the eleventh revision of the International Classifica...

Background Models of fear of cancer recurrence or progression (FCR/P) suggest that the way in which people interpret ambiguous physical symptoms is an important contributor to the development and maintenance of FCR/P, but research has not investigated this claim. The aim of this study is to fill that gap. Methods This was a cross-sectional study....

While cancer survivors commonly experience fear and anxiety, a substantial minority experience an enduring and debilitating fear that their cancer will return; a condition commonly referred to as fear of cancer recurrence (FCR). Despite recent advances in this area, little is known about FCR among people from Indigenous or other ethnic and racial m...

Introduction:. Placebo and nocebo effects in pain are well documented. One leading explanation is that instructions indicating that pain will either increase or decrease after receipt of a treatment give rise to expectations for increased or decreased pain. However, the psychological mechanisms through which expectations affect pain perception are...

Background: Side effect warnings can contribute directly to their occurrence via the nocebo effect. This creates a challenge for clinicians and researchers, because warnings are necessary for informed consent, but can cause harm. Positive framing has been proposed as a method for reducing nocebo side effects whilst maintaining the principles of in...

Background: Fear of cancer recurrence or progression (FCR/P) is a common challenge experienced by people living with and beyond cancer and is frequently endorsed as the highest unmet psychosocial need amongst survivors. This has prompted many cancer organizations to develop self-help resources for survivors to better manage these fears through psyc...

Background Fear of cancer recurrence (FCR) is common amongst cancer survivors. There is rapidly growing research interest in FCR but a need to prioritize research to address the most pressing clinical issues and reduce duplication and fragmentation of effort. This study aimed to establish international consensus among clinical and academic FCR expe...

While it is often stated that psychiatric co-morbidity in PWE is under-recognized and under-treated, little research has directly examined this assertion. The aims of this study were to understand the rates of confirmed diagnosis and treatment of depression and anxiety in people with epilepsy (PWE). Two samples were recruited: a hospital sample of...

This chapter presents the theory underpinning metacognitive therapy (MCT) and evidence for the efficacy of MCT in psychological disorders generally and its application in addressing anxiety and mood disorders in psycho-oncology specifically. MCT is a third-wave therapy that targets the processes that maintain psychopathology, such as worry, ruminat...

Nocebo hyperalgesia is a pervasive problem that significantly adds to the burden of pain. Conditioning is a key mechanism of nocebo hyperalgesia and recent evidence indicates that, once established, nocebo hyperalgesia is resistant to extinction. This means that preventive strategies are critical. We therefore tested whether two novel strategies –...

Introduction Insomnia is a prevalent sleep disorder that causes substantial personal and societal harm. There is evidence that placebo interventions can reduce insomnia symptoms, but this research has involved deceptively administering the placebo under the guise of a real medication (conventional placebo, CP), which has obvious ethical constraints...

Psycho-Oncology, 4th edition, follows the publication of Psycho-Oncology, 3rd edition in 2015. This is the latest in the series of textbooks which have defined the field of psycho-oncology. William Breitbart, MD, serves as the new senior editor along with associate editors Phyllis N. Butow, PhD, MPH, of the University of Sydney; Paul B. Jacobsen, P...

Pain is a ubiquitous experience encompassing perceptual, autonomic, and motor responses. Expectancy is known to amplify the perceived and autonomic components of pain, but its effects on motor responses are poorly understood. Understanding expectancy modulation of corticospinal excitability has important implications regarding deployment of adaptiv...

Psychological models of chronic pain (CP) highlight cognitive-processing biases (ie, attentional biases, interpretation biases, and attentional control) as pivotal processes that uniquely and synergistically impact the development and maintenance of CP. Very few studies explore multiple cognitive biases, and no studies have examined these 3 process...

Introduction Research indicates that body image disturbance is associated with poorer psychosocial outcomes for individuals with physical health conditions, with poorest body image reported for individuals with visible bodily changes. Using White’s (2000) theoretical model of body image the present paper aimed to examine the nature of these relatio...

Objective Little is known about the role of attentional processes in the context of cancer. This systematic review aimed to (1) synthesize the literature on attentional biases in cancer survivors; and (2) assess if these biases are associated with indicators of psychological distress. Method Studies were identified through a systematic search in P...

Purpose To assess the feasibility, acceptability, and preliminary effects of a nurse-led intervention for managing fear of cancer progression in advanced cancer patients. Methods A single group mixed methods study was conducted in patients with stage III or IV gynecologic or lung cancer (n = 31) with dysfunctional levels of fear of progression or...

People in our society are living longer, at least in part due to improvement in the medical management of chronic illnesses. As people live for longer, they are often affected by one or more chronic medical illness. Given that the risk factors for most of the leading diseases (e.g., cancer, cardiovascular problems, diabetes) are shared, it is incre...

Objective: Meta-analyses indicate mindfulness meditation is efficacious for chronic and acute pain, but most available studies lack active control comparisons. This raises the possibility that placebo-related processes may account, at least in part, for mindfulness effects. The objective of this study was to develop a closely matched sham mindfuln...

Background: Treatments for cancer-related anxiety show modest benefits, but most have been trialled in patients with early stage disease or patients who are currently disease free. However, many patients with cancer have incurable disease, or their disease is slowly progressing or likely to recur. Treating anxiety in the context of realistic threa...

Previous meta-analyses investigating attentional biases towards pain have utilized reaction time measures. Eye-tracking methods have been adopted to more directly and reliably assess biases, but this literature has not been synthesized in relation to pain. This meta-analysis aimed to investigate the nature and time-course of attentional biases to p...

Objective: Ovarian cancer remains an understudied cancer with poor prognosis, few effective treatments and little understanding of the how individuals and their families face the challenges and uncertainty following diagnosis. This study synthesized the subjective experiences of individuals and their caregivers in the face of the uncertainty produ...

Background: Many patients with bipolar II disorder (BPII) prefer to be more informed and involved in their treatment decision-making than they currently are. Limited knowledge and involvement in one's treatment is also likely to compromise optimal BPII management. This Phase II RCT aimed to evaluate the acceptability, feasibility, and safety of a...

Recent theoretical and empirical research has demonstrated a relationship between death anxiety and obsessive-compulsive disorder (OCD), with a focus on compulsive washing. However, no study has examined whether death anxiety plays an important role across various symptom domains of OCD. The present studies explored the relationship between death a...

Background: Fear of cancer recurrence or progression (FOP) is a significant concern for cancer survivors. With the advent of new targeted therapies and immunotherapy, many patients with advanced cancer are living longer while dealing with uncertainty and fears related to cancer progression. Although some level of FOP is normal and adaptive, high l...

Cognitive models of chronic pain emphasize the critical role of pain catastrophizing in attentional bias to pain-related stimuli. The aim of this study was (a) to investigate the relationship between pain catastrophizing and the ability to inhibit selective attention to pain-related faces (attentional bias); and (b) to determine whether attentional...

Objective The sudden cardiac death (SCD) of a young person is a devastating event for any parent. Inherited heart disease is often either identified or assumed to be the cause. Few studies have explored the psychosocial impact to the surviving at-risk family members. We sought to investigate the needs of parents who have experienced the SCD of thei...

Recent meta-analyses have shown MBIs to be effective for chronic pain, but no pooled estimates of the effect of MBIs on acute pain are available. This meta-analysis was conducted to fill that gap. A literature search was conducted in four databases. Articles were eligible if they reported on randomized controlled trials of MBIs for people with acut...

Study Objectives Poor sleep is commonly problematic during pregnancy and postpartum and is associated with depression. This trial investigated the efficacy of prenatal brief, group sleep psychoeducation in improving postpartum maternal sleep and depression. Methods 215 healthy expectant first-time mothers were cluster randomised (1:1) to receive e...

BACKGROUND Mindfulness-based stress reduction (MBSR) is an efficacious treatment for people with chronic health problems but is highly intensive and time consuming which is a barrier for service provision. OBJECTIVE This study aimed to develop an online version of MBSR for people with MS (PwMS), to make the intervention more accessible. METHODS W...

Background Mindfulness-based stress reduction is an efficacious treatment for people with chronic health problems; however, it is highly intensive and time-consuming, which is a barrier for service provision. Objective This study aims to develop an internet-delivered adapted version of mindfulness-based stress reduction for people with multiple scl...

We recently proposed a model of cancer-related anxiety to account for the etiology and maintenance of clinically significant anxiety in the context of cancer. This study tested predictions arising from the model to explain fear of cancer recurrence or progression (FCR). Patients with cancer were recruited from a research registry or outpatient hosp...

Background: There are various approaches to the psychological management of chronic pain and it is difficult to know which components of psychological therapies are necessary or desirable for the effective management of chronic pain. Methods: We conducted a Delphi study to develop a consensus on the necessary and desirable psychological interven...

Background: People with a Fontan circulation experience a range of physical, psychosocial and neurodevelopmental challenges alongside, or caused by, their cardiac condition, with significant consequences for health‐related quality of life (HRQOL). We meta‐analyzed HRQOL outcomes reported by people with a Fontan circulation or their proxies and eval...

Background: Life expectancy of people living with HIV (PLWH) is increasing. Effective biomedical prevention methods (treatment as prevention and preexposure prophylaxis) are being widely implemented in high-income nations. Therefore, research into quality of life, including sexual adjustment, is of increasing importance to HIV care. Yet, sexual ad...

Objective: The aim of this systematic review and meta-analysis was to provide an estimate of the prevalence of anxiety and depressive disorders in youth with epilepsy (YWE). It also aimed to calculate the overall magnitude of observed differences in anxiety and depressive symptoms reported by YWE compared with healthy controls and investigate whet...

Objective: Two previous individual participant data meta-analyses (IPDMAs) found that different diagnostic interviews classify different proportions of people as having major depression overall or by symptom levels. We compared the odds of major depression classification across diagnostic interviews among studies that administered the Depression s...

Objective: Without an agreed-upon set of characteristics that differentiate clinical from non-clinical levels of fear of cancer recurrence (FCR), it is difficult to ensure that FCR severity is appropriately measured, and that those in need of intervention are identified. The objective of this study was to establish expert consensus on the defining...

Background: Multimorbidity, which commonly impacts older adults is associated with higher rates of depression. We aimed to investigate whether internet delivered cognitive-behaviour therapy (iCBT) could prevent depressive disorders in older adults with multimorbidity who were not currently depressed. Method: 302 primary care and community partic...

This paper addresses the problem of long-term opioid use by chronic pain patients. The study involved a secondary analysis of unanalysed data from a published study of two versions of CBT-based interdisciplinary treatment for chronic pain. In this paper we examined whether the use of opioids by 140 chronic pain patients could be ceased sustainably...