
Nicholas A TroopUniversity of Plymouth | UoP · School of Psychology
Nicholas A Troop
Doctor of Psychology
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109
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Publications (109)
Background
The associations between compassion, self-compassion, and body image are well established. However, there is not yet a compassion-informed measure of body compassion that can be applied to any aspect of one’s body.
Method
Items for The Body Compassion Questionnaire (BCQ) were derived from an earlier expressive writing study on self-comp...
Background
Emotional disclosure is the therapeutic expression of emotion. It holds potential as a means of providing psychological support. However, evidence of its efficacy in palliative settings is mixed. This may be due to variation in intervention characteristics.
Aim
To derive a greater understanding of the characteristics of potentially effe...
The aim of this study was to test the multilevel multidimensional finite mixture item response model of the Forms of Self-Criticising/Attacking and Self-Reassuring Scale (FSCRS) to cluster respondents and countries from 13 samples ( N = 7,714) and from 12 countries. The practical goal was to learn how many discrete classes there are on the level of...
Objective: In relation to sitting behaviour, to investigate which theoretical domains best formed the Capability, Opportunity, and Motivation constructs of the COM-B, and compare the predictive validity to the Theory of Planned Behaviour (TPB), taking habit strength into consideration.
Design: Using a prospective design, 186 adults completed measu...
Aim: to examine healthcare professionals’ (HP) perceptions and experiences in relation to adherence to prophylactic treatment among young people living with haemophilia (YPH).
Methods: All HPs in four haemophilia centres across England and Wales were invited to participate, and all HPs who agreed to take part (n = 6) were interviewed. Interviews we...
The purpose of this study was to examine the measurement invariance of the Forms of Self-Criticising/Attacking & Self-Reassuring Scale (FSCRS) in terms of Item Response Theory differential test functioning in thirteen distinct samples (N = 7714) from twelve different countries. We assessed differential test functioning for the three FSCRS subscales...
Background:
Expressive writing involves writing about stressful or traumatic experiences. Despite trials in people with advanced disease, no systematic review to date has critiqued the evidence on expressive writing in this population. To synthesise the evidence of the effects of expressive writing on pain, sleep, depression and anxiety in people...
The Eating Disorder Examination Questionnaire (EDE-Q) is a widely used assessment of eating disorder psychopathology; however, EDE-Q norms are yet to be provided within a non-clinical UK adult sample. Secondly, there is considerable disagreement regarding the psychometric properties of this measure. Several alternative factor structures have been p...
There is considerable evidence that self-criticism plays a major role in the vulnerability to and recovery from psychopathology. Methods to measure this process, and its change over time, are therefore important for research in psychopathology and well-being. This study examined the factor structure of a widely used measure, the Forms of Self-Criti...
Introduction: Reported levels of adherence to prophylaxis among young people with haemophilia (YPH) vary widely and are predominately based on estimations made by healthcare professionals and parents. Reasons for (non)adherence among YPH in particular have not been evidenced.
Aim: to examine experiences in relation to prophylaxis with YPH themselve...
The full-text of the article is available here https://rdcu.be/WX1o
There is considerable evidence that self-criticism plays a major role in the vulnerability to and recovery from psychopathology. Methods to measure this process, and its change over time, are therefore important for research in psychopathology and wellbeing. This study examined th...
Introduction: Previous research demonstrating emotional influences on eating and weight suggest that emotionally expressive writing may have a significant impact on reducing risk of eating pathology. This study examined the effects of writing about Intensely Positive Experiences on weight and disordered eating during a naturalistic stressor.
Method...
Physical inactivity and sedentary behavior relate to poor health outcomes independently. Healthy inactive adults are a key target population for prevention. This systematic review and meta-analysis aimed to evaluate the effectiveness of physical activity and/or sedentary behavior interventions, measured postintervention (behavior change) and at fol...
This study examined the constructs of capability, opportunity and motivation from the COM-B model and their influence on moderate-to-vigorous physical activity. Using a prospective survey design, 186 healthy adults completed measures representing the theoretical domains framework mapped to the COM-B, and moderate-to-vigorous physical activity 1 wee...
Background: Evidence suggests that stress plays a role in changes in body weight and disordered eating. The present study examined the effect of mood, affect systems (attachment and social rank) and affect regulatory processes (self-criticism, self-reassurance) on the stress process and how this impacts on changes in weight and disordered eating.
M...
Introduction
haemophilia is an inherited bleeding disorder caused by a deficiency in one of the blood coagulation factors. For people affected by severe haemophilia, the deficiency can cause spontaneous internal bleeding. Most young people with severe haemophilia in the UK follow a preventative treatment regimen (prophylaxis) consisting of several...
Objective:
To conduct a systematic review and meta-analysis to summarize evidence and determine the impact of coronary revascularization (CR) on cardiac patients' Health-Related Quality of Life (HRQoL), highlighting factors that may affect this outcome in patients.
Methods:
A systematic search of Medline (Pubmed), EMBASE, Cochrane Library, Scive...
We describe the development of a brief version of the Bi-Directional Changes in Being Scale (BCIBS; Hiskey, Troop, & Joseph, 2006 ), a measure of phenomenological change following stressful and traumatic life events. The psychometric properties of the mini-BCIBS were explored using data drawn from a sample of female students, survivors of a discoth...
Studies have established a link between body shame and eating disorder symptoms and behaviours. However, few have differentiated current feelings of body shame from those anticipated with weight change and none has examined the effects of these on subsequent eating behaviour. In this paper, a measure of body pride and shame was developed (Study 1)...
Large proportions of the population are not meeting recommended levels of physical activity and have increasingly sedentary lifestyles. Low levels of physical activity are predictive of poor health outcomes and time spent sedentary is related to a host of risk factors independently of physical activity levels. Building an evidence base of the best...
This study explored the role of meaning in the link between stress and disordered eating, in particular focusing on social rank.
Two hundred and eleven women completed measures of eating pathology, depression, social comparison and life events where life events were assessed in terms of general loss, threat, shame and loss of social status.
Events...
Objective
To investigate the extent to which negative posttraumatic cognitions predict, and so can be best located within, the DSM-5 (APA, 2013) individual symptom clusters of posttraumatic stress disorder (PTSD).
Method
An online survey of traumatic experiences, featuring 528 adults.
Results
Negative posttraumatic cognitions seem best placed wit...
The Vulnerable Attachment Style Questionnaire (VASQ; Bifulco et al., Psychological Medicine, 33, 1099–1110, 2003) was developed to assess adult attachment as a vulnerability factor for developing depression and identified two subscales, insecure attachment and proximity-seeking. The present study sought to confirm and further validate the factor st...
Background:
Following previous cross-sectional research adopting an evolutionary approach to social rank and eating disorders, the present study explored the predictive value of social rank for changes in eating disorder symptoms in a 6-month longitudinal study.
Methods:
Seventy-three women and men with a history of eating disorders were followe...
Objectives:
Self-criticism and reassurance are important mechanisms for regulating negative emotions but relatively little attention has been paid to interventions aimed at improving them.
Design:
This study explored the use of an expressive writing task to increase self-reassurance and reduce self-criticism using a randomized controlled design....
Objectives:
Research indicates that constructs relevant to social rank predict a diagnosis of post-traumatic stress disorder (PTSD), including mental defeat, alienation, and shame. However, no studies have yet explored a social rank view explicitly.
Design:
This was a community-based study carried out online. Analyses were both cross-sectional a...
Avoidance is a key maintenance factor in traumatic reactions but currently no satisfactory measures of it exist. Previous factor analytic studies have demonstrated a distinction between conscious attempts to avoid trauma-related stimuli (e.g., trying not to talk or think about the event) versus nonconscious avoidance processes (e.g., emotional numb...
Individuals with bleeding disorders are at increased risk of variant Creutzfeldt-Jakob disease. This study explored social cognitive predictors of screening intentions. Ninety men and women with bleeding disorders, recruited through the Haemophilia Society, completed an extended Theory of Planned Behaviour questionnaire to predict intention to scre...
Objective:
Several studies have used the Forms of Self-Criticism/Reassurance Scale (FSCRS; Gilbert, Clarke, Hempel, Miles, & Irons, 2004) when exploring the role of emotion regulation in psychopathology. However, psychometric evaluation of the FSCRS is limited. The present study sought to confirm the factor structure of the FSCRS based on theoreti...
Helplessness and mastery in childhood and in response to the events that trigger onset are implicated in the development of eating disorders. However, no studies have yet explored how these are linked and whether the effects are additive or mediated.
Semi-structured interviews (Childhood Experience of Care and Abuse; Life Events and Difficulties Sc...
This study explored whether the effects of implementation intentions on increasing fruit and vegetable intake were moderated by dietary restraint. In total, 208 participants were randomly allocated to control or implementation intention conditions where they were asked to write down when, where and how they would increase their fruit and vegetable...
Studies have established a link between shame and eating disorder symptoms but have generally been cross-sectional or failed to differentiate between general shame and bodily shame. The present study addressed both these issues.
This study used a longitudinal panel design.
Fifty-five women with a past or current eating disorder participated. They c...
Objective:
Research has found that writing about stress can confer physical and psychological health benefits on participants and that adopting a self-compassionate stance may have additional benefits. This pilot study evaluated a self-compassionate expressive writing intervention in a Day Hospice setting.
Method:
Thirteen patients with life-lim...
To conduct a randomized, controlled, two-stage trial in the treatment of bulimia nervosa, comparing cognitive-behavioral therapy (CBT) versus motivational enhancement in Phase 1 followed by group versus individual CBT in Phase 2.
A total of 225 patients with bulimia nervosa or eating disorder not otherwise specified (EDNOS) were recruited into a ra...
In this chapter we argue that disgust processes (including basic disgust responses and the complex variant of shame) may play an underrecognized role in eating disorders. Studies on individual differences in disgust and disgust sensitivity, although not conclusive, do suggest that it is only disgust in relation to categories of food and body produc...
Several studies have investigated shame in eating disorders but most have used non-clinical samples examined only one type of eating disorder or included only a limited range of shame measures. The current study explored shame from multiple perspectives in women who report a range of eating disorder diagnoses and who are at different stages of illn...
It has been proposed that an evolutionary approach to understanding rank and social status may contribute to our understanding of eating disorder symptoms. The present study sought to explore the degree to which rank might be related to eating pathology independently of its known association with depression. A non-clinical sample of 74 women comple...
To investigate individual differences in the effects of stress on BMI.
Participants were 71 healthy women volunteers enrolled in a university-based nurse practitioner program. Predictors of change in BMI were hypothesized to be cortisol secretion, dietary restraint, binging, mastery, mood, and eating attitudes. Measures were made at the beginning o...
The present study examines the relation between fear and disgust and dieting concerns. A sample of women completed measures of eating behavior, attitudes, fear, and disgust. They also provided emotional responses to images depicting high- and low-energy food, overweight and normal body shapes, and disgusting and frightening photographs. Fear and di...
Recent studies into the underlying factor structure of posttraumatic stress symptoms often report factor structures that do not replicate the three symptom cluster of re-experiencing, avoidance and arousal symptoms as classified within the Diagnostic and Statistical Manual of Mental disorders (American Psychiatric Association, 1994, 2000). Data fro...
Previous research has suggested a role for bodily shame in the development of bulimia. The purpose of the present study was to extend this research by exploring a temporal perspective on bodily shame and eating pathology. Specifically, we were interested in whether bodily shame associated with the possibility of future weight gain was important in...
The goals of the current study were to develop a questionnaire measuring the pros and cons of eating disorder symptoms and to explore the themes endorsed by different eating disorder groups.
Participants recruited from an eating disorder volunteer register and an outpatient clinic completed the Pros and Cons of Eating Disorders scale (P-CED). Princ...
The conceptualisation and initial psychometric development of a measure of bi-directional phenomenological change following severely stressful and traumatic life events is detailed. Measure items were derived from a range of sources, most notably a series of focus group interviews (Study One). A grounded theory analysis of this data suggested that...
The conceptualisation and initial psychometric development of a measure of bi-directional phenomenological change following severely stressful and traumatic life events is detailed. Measure items were derived from a range of sources, most notably a series of focus group interviews (Study One). A grounded theory analysis of this data suggested that...
Introduction: Why Study Psychological Factors?Stress and CopingPersonalitySelf-esteemEmotionConclusion
References
Research has suggested that a fundamental aspect of anorexia nervosa (AN) is its egosyntonic nature, the fact that it is often valued by individuals with the disorder. The current study describes the development of the P-CAN, a quantitative measure of both positive (valued) and negative aspects of AN.
Items were derived from a previous qualitative...
Previous research using exploratory factor analysis of the Impact of Event Scale (Horowitz et al., 1979) has suggested structures that are not consistent with the original two-factor model. IES data from 485 emergency service personnel who had experienced traumatic events during the course of their work were submitted to confirmatory factor analysi...
Animal analogues of anorexia nervosa suggest that submissive behaviour and social defeat may be implicated in the onset of wasting diseases. Data from human sufferers of anorexia nervosa and bulimia nervosa are also consistent with the presence of submissive behaviours and perceived low social rank (e.g. low self-esteem, helplessness, and feelings...
IntroductionLimitations of Psychophysiological Assessment in Eating DisordersCue ReactivityReactivity to Food Cues in States of Normal and Abnormal Physiology or Psychopathology Restrained EatingBinge EatingAnorexia NervosaConclusionReactivity to Food Intake in States of Normal and Abnormal Physiology or PsychopathologyStress and Bulimia NervosaSum...
Shame has been shown to be related both to symptoms of depression and eating pathology. However, the independence of this relationship has not yet been established. The purpose of the present study was to determine whether the relationship between shame and eating disorder symptoms was independent of the relationships of these variables with depres...
Information on the relationship between anorexia nervosa (AN) and personality disorders (PDs) and dimensions of temperament and character (measured by the Temperament and Character Inventory [TCI; Cloninger, Przybeck Svrakic, & Wetzel, 1994]) is limited. This study examines the predictive validity of the TCI for PD diagnoses assessed by the Interna...
The purpose of this study was to advance understanding of the self-change process in recovery from anorexia nervosa (AN). This included the development of a measure for assessing readiness to change behaviors and/or cognitions associated with recovery from AN across five stages of change, based on the transtheoretical model of behavior change. Two-...
There is debate as to whether eating disorders may be culture-bound. However, accumulating evidence suggests that eating disorders may be found outside of the West, although the precise form of the eating disorder may differ.
There were two aims of this study: (1) to translate and establish the psychometric properties of standard questionnaires to...
The most widely used measures of avoidance strategies following stressful or traumatic experiences are unidimensional. However, recent work has emphasised the multifactorial nature of avoidance. One intriguing and as yet unexplored distinction is that between attempts at avoidance and successful avoidance. Two studies are reported with the aim of i...
Clinical descriptions of eating disorders emphasize the role of fear (e.g., fear of weight gain, weight phobia, morbid dread of fatness). The present study explored whether disgust, an emotion that is linked intimately with food, may also be an important emotional response to eating and weight-related issues in women with abnormal eating attitudes....
This article explores the viability of conducting longitudinal survey research using, the Internet in samples exposed to trauma. A questionnaire battery assessing psychological adjustment following adverse life experiences was posted online. Participants who signed up to take part in the longitudinal aspect of the study were contacted 3 and 6 month...
This article explores the viability of conducting longitudinal survey research using the Internet in samples exposed to trauma. A questionnaire battery assessing psychological adjustment following adverse life experiences was posted online. Participants who signed up to take part in the longitudinal aspect of the study were contacted 3 and 6 months...
While there is much evidence to suggest that women with eating disorders experience difficulties in the social domain, little has been done to establish whether such difficulties play a causal role or the extent to which these involve cognitive factors. The purpose of this report is to determine whether difficulties in certain aspects of the childh...
Disgust is an emotion that is intimately linked to food and eating and it has been proposed that disgust may therefore be an important emotion in eating disorders. However, empirical evidence has been mixed.
Two hundred and eight participants with a history of eating disorders completed measures of current and past eating disorder symptoms and a di...
Current diagnostic criteria for eating disorders emphasize the importance of issues concerning weight and shape for self-esteem and self-worth. However, this requirement is based on patients presenting at clinics in Western countries and it is not clear whether such overvaluation of weight and shape is also a feature of eating pathology in non-West...
There is a strong association between eating disorders and depression. However, because both eating disorder symptoms and depression are multifactorial, this study explored the relationship between these two disorders in women with eating disorders and women in remission.
Two hundred and eight (mostly female) volunteers with a history of eating dis...
This study investigated perceptual styles in anorexia nervosa (AN) and bulimia nervosa (BN) using a perceptual set task. We hypothesised that, consistent with personality style research. AN patients might be more rigid in style than those with BN or no eating disorder. We found that once an illusion had been established, participants with AN and BN...
To investigate the effect of compliance and its predictors on outcome.
62 patients with DSM-III-R bulimia nervosa (BN) were randomly assigned to a self-care manual plus eight fortnightly sessions of guided self-change or 16 sessions of weekly cognitive behavioural therapy.
At the end of treatment, the group of high compliers had not achieved higher...
This study examined changes in self-esteem before treatment of bulimia nervosa and 18 months later. In addition, the relationship between these changes and attribution of responsibility for the improvement or continuation of bulimic symptoms was also explored. One hundred and ten women with bulimia nervosa entered a treatment trial and completed me...
It is controversial whether males and females with eating disorders differ in a relevant way. We present a comparison of 30 male and 30 female patients assessed at The Maudsley Hospital in 2.5 years. Of the male group 33 per cent were anorexic, 50 per cent were bulimic, and 17 per cent met criteria for an eating disorder not otherwise specified. Th...
Objective
In a study comparing eight sessions of fortnightly guided self-change (GSC) with 16 sessions of weekly cognitive behaviour therapy (CBT) in bulimia nervosa (BN) we examined pre-treatment predictors of outcome.Method
Stepwise regression analyses were performed.ResultsIn the GSC group, a lower pre-treatment binge frequency predicted better...
Previous studies have explored differences in psychosocial and familial factors between women who develop anorexia nervosa and those who do not. However, these studies have generally used between-group comparisons. This study looks at the environmental factors which may be antecedents of anorexia nervosa looking at sister pairs where one had anorex...
Disgust is a basic emotion that has been relatively neglected in psychiatry in general and in eating disorders in particular. Nevertheless, there are features of disgust and its more complex derivatives (e.g., shame) which suggest that disgust may have a role to play in eating disorders.
Seventy-four patients with a DSM-IV diagnosis of anorexia ner...
Despite the major advances in the development of treatments for bulimia nervosa, drop-outs and a lack of engagement in treatment, continue to be problems. Recent studies suggest that the transtheoretical model of change may be applicable to bulimia nervosa. The aim of this study was to examine the roles of readiness to change and therapeutic allian...
Previous reports have suggested differences between early and late onset cases both in anorexia nervosa and bulimia nervosa. In anorexia nervosa, women with late onset are thought to be more likely to develop symptoms in response to life events than early onset cases. Women developing anorexia in response to life events are also considered to show...
An association between eating disorder symptoms and stress has been observed in a number of studies in both laboratory and clinical settings. A popular conclusion has been that eating disorder symptoms may represent a coping strategy. However, since coping is a part of the stress process, it is possible that many authors have confounded this proces...
Recent research has supported the role of stress in the development and maintenance of eating disorders. However, coping and crisis support, important aspects of this stress process, have received little systematic attention. The cognitive-transactional approach to coping emphasizes the importance of the relationship between the individual and the...
The aim of this study was to evaluate the effectiveness of guided self-change for bulimia nervosa.
Sixty-two patients with DSM-III-R-defined bulimia nervosa were randomly assigned to 1) use of a self-care manual plus eight fortnightly sessions of cognitive behavior therapy (guided self-change) or 2) 16 sessions of weekly cognitive behavior therapy....
We compared 8 fortnightly sessions plus a self-care manual (guided self change, GSC) with 16 weekly individual sessions of cognitive behaviour therapy (CBT). There were 31 sufferers of DSM-III-R-bulimia nervosa (BN) in each group. Both treatments resulted in significant improvements regarding self and interviewer based measures of bulimia nervosa a...
We compared 8 fortnightly sessions plus a self-care manual (guided self change, GSC) with 16 weekly individual sessions of cognitive behaviour therapy (CBT). There were 31 sufferers of DSM-III-R-bulimia nervosa (BN) in each group. Both treatments resulted in significant improvements regarding self and interviewer based measures of bulimia nervosa a...
A number of studies have proposed a role for stress in the onset of eating disorders. Initially the focus was on the life-events and difficulties themselves. However, the aim of this study was to examine the coping and support elicited in response to the crises that precipitate onset of eating disorders. Thirty-two women who had developed an eating...
This paper discusses the issue of differentiating between cognitive coping behaviors and appraisal processes. Although these can be separated in theory, and experimental procedures can manipulate appraisals independantly of coping, it is difficult to separate these constructs in naturalistic studies on appraisal and coping responses to real life st...
The prevalence of post-traumatic stress disorder (PTSD) and its relation to childhood adversity and Axis I psychiatric disorders was assessed in a clinical population of 164 eating disorders patients. Eleven per cent (18/164) had a lifetime history of PTSD. There was no difference in the prevalence of PTSD between the subgroups of eating disorders....
Previous studies have examined childhood factors that appear to increase the risk of developing an eating disorder (e.g. sexual abuse and parental care). Studies have not yet examined whether the way in which women cope with these adversities in childhood influences the risk.
Using a semi-structured interview, childhood helplessness and mastery wer...
Objective
To investigate the social support networks of patients with anorexia nervosa (AN) and bulimia nervosa (BN). Method: Social support was measured using the Significant Others Scale for 44 patients with AN, 81 patients with BN, and 86 polytechnic students. Results: Eating disorder patients had smaller social networks than the students. AN pa...
This study examined pretreatment variables to predict outcome in two treatments for bulimia nervosa.
Patients were offered either 16 weeks of cognitive-behavioral therapy (CBT) or a self-treatment manual followed by up to 8 weeks of CBT (sequential group). Using complete data, stepwise regression analyses were performed.
It was found that a longer...
Objective
This study examined pretreatment variables to predict outcome in two treatments for bulimia nervosa. Method: Patients were offered either 16 weeks of cognitive-behavioral therapy (CBT) or a self-treatment manual followed by up to 8 weeks of CBT (sequential group). Using complete data, stepwise regression analyses were performed. Results:...