Peter L Fisher

University of Liverpool | UoL · Institute of Psychology, Health and Society

Purpose The training of clinical psychologists is conducted by clinicians, academics, trainees, service users and carers. Often those working in clinical psychology do so due to their own lived experiences. These stakeholders may require navigating both personal and professional identities in their roles. This study aimed to understand identities w...

Background Cardiac rehabilitation improves health and quality of life and reduces risk of further cardiac events. Twenty-eight per cent of cardiac rehabilitation patients experience clinically significant anxiety and 19% suffer depression. Such patients are at greater risk of death, further cardiac events and poorer quality of life and use more hea...

Background Lived experience researchers draw on their lived and living experiences to either lead on or inform research. Their personal experiences are relevant to the research topic and so they must manage the interplay of their health and healthcare experiences with the research, population, and data they work with, as well as the more general ch...

PURPOSE The number of cancer survivors living with and beyond cancer treatment is rising globally. It is fundamental to understand the extent and type of psychosocial care services offered worldwide. We evaluated models of cancer survivorship care, psychosocial care practices in the post-treatment survivorship phase, and barriers/facilitators to de...

Emotional distress is common in young people with epilepsy (YPwE). According to the Self-Regulatory Executive Function (S-REF) model, maladaptive metacognitive beliefs and perseverative thinking are fundamental in the development and maintenance of emotional distress. As emotional distress and perseverative thinking can highly fluctuate over short...

Background Lived experience researchers draw on their lived experiences to inform and interpret their research. They bring complex service user and survivor histories to their work and must manage their health conditions and the interplay of their lived experiences with the research, population, and data they work with, as well as the more general...

Anxiety and depression are common in adolescents with epilepsy. Identifying psychosocial risk factors for anxiety and depression is essential for adolescents with epilepsy to receive appropriate support. This systematic review synthesised findings of studies examining the relationship between psychosocial factors and anxiety and/or depression in ad...

Introduction Psychological distress is common in intensive care unit (ICU) survivors and is anticipated in those who were treated for severe COVID-19 infection. This trainee-led, multicentre, observational, longitudinal study aims to assess the psychological outcomes of ICU survivors treated for COVID-19 infection in the UK at 3, 6 and/or 12 months...

Background Identity is how we understand ourselves and others through the roles or social groups we occupy. This review focuses on lived experience researchers and providers and the impact of these roles on identity. Lived experience researchers and providers use their lived experience of mental or physical disability either as experts by experien...

Objective: Adults with Diabetes Mellitus (DM) experience high levels of depression and anxiety that are not always effectively ameliorated by current therapeutic approaches. The Self-Regulatory Executive Function (S-REF) model, which underpins metacognitive therapy (MCT), posits that depression and anxiety become persistent when stored metacogniti...

Test anxiety is common among university students and impairs examination performance. Existing interventions for test anxiety are not particularly effective. Prior to developing an effective intervention, the key psychological beliefs that predict test anxiety need to be identified. Two transdiagnostic models, the intolerance of uncertainty (IU) an...

Background Anxiety and depression in cardiac rehabilitation (CR) are associated with greater morbidity, mortality, and increased healthcare costs. Current psychological interventions within CR have small effects based on low-quality studies of clinic-based interventions with limited access to home-based psychological support. We tested the effectiv...

Objectives To explore the experiences of therapists who delivered remote psychological therapy during the COVID-19 pandemic. Design This was a qualitative, phenomenological study. Interpretative Phenomenological Analysis elicited themes from semi-structured interviews. Methods A purposive sample of eight therapists was recruited from breast cance...

Introduction Head and neck cancer (HNC) diagnosis and treatment can be a significant life trauma. Some HNC survivors experience post-traumatic growth (PTG), which has been linked with better health-related quality-of-life. Empirical research on PTG, and theoretical models, point to the importance of being able to purposely make sense of the traumat...

Uveal melanoma (UM) survivors can experience significant emotional distress, although the factors underpinning this are poorly understood. Systematic reviews of distress in UM only include cross-sectional studies, thereby limiting our understanding of causal factors. This review identified prospective clinical, demographic, social and psychological...

Identity is how we understand ourselves and others through the roles or social groups we occupy. This review focusses on lived experience researchers and providers and the impact of these roles on identity. Performing roles simultaneously embodying professional and lived experiences contributes towards a lack of clarity to identity. This is not ade...

Background Understanding patient and health practitioner perspectives on clinical trials can inform opportunities to enhance trial conduct and design, and therefore patient experience. Patients with haematological cancers have faced additional risk and uncertainty during the pandemic but it is unclear how they and practitioners have experienced can...

Background Anxiety and depression contribute to poorer physical and mental health outcomes in cardiac patients. Psychological treatments are not routinely offered in cardiac care and have mixed and small effects. We conducted a series of studies under the PATHWAY research programme aimed at understanding and improving mental health outcomes for pat...

Background: One in three cardiovascular disease (CVD) patients experience significant anxiety and depression. Current psychological interventions have limited efficacy in reducing such symptoms and are offered as a face-to-face intervention that may be a barrier to accessing treatment. We evaluated the feasibility and acceptability of delivering as...

Background: People with either Type 1/Type 2 diabetes experiencing anxiety or depression experience worse clinical and social outcomes. Efficacy of available psychological and pharmacological treatments for anxiety and depression is unclear. Aggregate data meta-analyses (AD-MAs) have failed to consider the clinical relevance of any change these tr...

Background Technological advances have led to cancer prognostication that is increasingly accurate but often unalterable. However, a reliable prognosis of limited life expectancy can cause psychological distress. People should carefully consider offers of prognostication, but little is known about how and why they decide on prognostication. Using u...

Objective: Care for fear of cancer recurrence (FCR) is considered the most common unmet need among cancer survivors. Yet the prevalence of FCR and predisposing factors remain inconclusive. To support targeted care, we provide a comprehensive overview of the prevalence and severity of FCR among cancer survivors and patients, as measured using the s...

Purpose Prognostication in cancer is growing in importance as increasingly accurate tools are developed. Prognostic accuracy intensifies ethical concerns that a poor prognosis could be psychologically harmful to survivors. Uveal melanoma (UM) prognostication allows survivors to be reliably told that life expectancy is either normal (good prognosis)...

The Metacognitions Questionnaire-30 (MCQ-30) measures maladaptive metacognitive beliefs considered central to the metacognitive model of psychopathology. However, the psychometric properties of the MCQ-30 in test anxiety (TA) among university students are unknown. This study examined the MCQ-30 factor structure and concurrent validity in both trait...

Background Understanding patient and health practitioner perspectives on clinical trials can inform opportunities to enhance trial conduct and design, and therefore patient experience. Patients with haematological cancers have faced additional risk and uncertainty during the pandemic but it is unclear how they and practitioners have experienced can...

A number of patient-reported outcomes (PROs) predict increased mortality after primary cancer treatment. Studies, though, are sometimes affected by methodological limitations. They often use control variables that poorly predict life expectancy, examine only one or two PROs thus not controlling potential confounding by unmeasured PROs, and observe...

Background Test anxiety has a detrimental effect on test performance but current interventions for test anxiety have limited efficacy. Therefore, examination of newer psychological models of test anxiety is now required. Two transdiagnostic psychological models of emotional disorders that can account for anxiety are the intolerance of uncertainty m...

Objective The fear of cancer recurrence (FCR) in later survivorship can lead to poorer mental health, quality of life and physical and functional recovery. Later-occurring FCR may be a consequence of late-emerging physical symptoms and functional problems from cancer or its treatment. Based on the self-regulation model, we predicted that persistent...

Objective: Fear of cancer recurrence (FCR) is a significant concern for family caregivers of cancer survivors and is associated with many adverse outcomes, including increased emotional distress and poorer quality of life. Although several theoretical models have been proposed to account for FCR in cancer survivors, their applicability to caregiver...

Background: Depression and anxiety in cardiovascular disease are significant, contributing to poor prognosis. Unfortunately, current psychological treatments offer mixed, usually small improvements in these symptoms. The present trial tested for the first time the effects of group metacognitive therapy (MCT; 6 sessions) on anxiety and depressive s...

Aims To conduct an individual patient data meta-analysis of randomised controlled trials (RCTs) of manualised psychological treatments for obsessive-compulsive disorder (OCD), and examine the differential efficacy of psychological treatments by treatment type and format. Background Previous meta-analyses conclude that efficacious psychological tre...

Objective Approximately half of all people living with amyotrophic lateral sclerosis (ALS) experience persistent or recurrent emotional distress, yet little is known about the psychological processes that maintain emotional distress in this population. The self-regulatory executive functioning (S-REF) model specifies that maladaptive metacognitive...

Objective High levels of depression and anxiety are experienced alongside Chronic Fatigue Syndrome/Myalgic Encephalomyelitis (CFS/ME). Psychological causal and maintenance factors are not well-understood. Perfectionism is a multifactorial, transdiagnostic risk factor for various physical and mental health conditions. This systematic review assesses...

Objective Cancer survivors commonly experience long‐term anxiety and depression. Anxiety and depression might result from problems emerging during survivorship rather than illness and treatment. This study tested three potential causal paths: 1) concerns about physical symptoms and functional problems and fear of cancer recurrence (FCR) arising dur...

Background Emotional distress (defined as any negative mood state, including anxiety, depression, trauma symptoms and global distress) is common in people with multiple sclerosis (PwMS). To develop more integrated care for PwMS requires a better understanding of causal variables underlying persistent emotional distress. This systematic review criti...

Background Anxiety and depression are common in cardiac rehabilitation (CR) patients. However, CR programs which incorporate psychological techniques achieve modest reductions in emotional distress. More efficacious interventions that can be easily integrated within services are required. A promising alternative to current psychological interventio...

Previous meta-analyses conclude that psychological treatments are efficacious for emotional distress in breast cancer (BCa). However, the practical relevance of these meta-analyses is questionable; none focused specifically on clinically distressed patients or whether treatment effects were clinically significant. In a two-stage individual patient...

Background Previous meta-analyses conclude that efficacious psychological treatments for obsessive-compulsive disorder (OCD) exist. However, determining the efficacy of psychological treatments requires multiple forms of assessment. We conducted an individual patient data meta-analysis of randomised controlled trials (RCTs) of manualised psychologi...

Test anxiety is common among university students and more effective interventions are needed. The Intolerance of Uncertainty (IU) model underpins an effective intervention for anxiety. IU is the propensity to react negatively to uncertainty. The Intolerance of Uncertainty Scale – 12 (IUS-12) is the most common scale for measuring IU. This study exa...

Background Psychological distress is prevalent among patients with cardiovascular disease and is linked to increased risk of future cardiac events. Cardiac rehabilitation ( CR ) is widely recommended for treating psychological distress but has been of limited benefit. This study aims to understand how distressed cardiac patients describe their emot...

Objective: Anxiety and depression symptoms are common in patients with physical health conditions. In the metacognitive model, beliefs about cognition (metacognitions) are a key factor in the development and maintenance of anxiety and depression. The current study evaluated if metacognitions predict anxiety and/or depression symptoms and if differ...

Background Preliminary evidence suggests that metacognitive therapy (MCT), a brief, process-focused psychological intervention, alleviates distress in cancer survivors. In a longitudinal qualitative study nested in an open trial of MCT for cancer survivors, we explored how patients understood, experienced and applied MCT. Methods Patients received...

Test anxiety (TA) is highly distressing and can significantly undermine academic performance. Many rando-mized controlled trials (RCTs) of interventions for university students with TA have been conducted, but there has been no systematic review of their efficacy. This meta-analysis examines the efficacy of interventions for test-anxious university...

Background: Individual metacognitive therapy (MCT) for generalized anxiety disorder (GAD) is well established, but only one study has investigated the effectiveness of Group MCT (g-MCT) for GAD. The aim of the current study was therefore to evaluate the feasibility and effectiveness of g-MCT for GAD within a community mental health setting whilst a...

Background: Adult cancer survivors often experience substantial psychological morbidity following the completion of acute cancer treatment. Unfortunately, current psychological interventions are of limited efficacy. This study explored if metacognitive therapy (MCT); a brief transdiagnostic psychological intervention was potentially efficacious and...

Introduction: Cognitive behavioral therapy (CBT) alleviates emotional distress in mental health settings, but has only modest effects in cardiac patients. Metacognitive therapy (MCT) also alleviates depression and anxiety in mental health settings and is in its initial stages of evaluation for cardiac patients. Aim: Our objective is to compare how...

Objective Understanding of the factors that predict emotional distress in Amyotrophic Lateral Sclerosis (ALS) is limited. This systematic review critically appraised and synthesised the findings of longitudinal studies into baseline clinical, demographic, social, and psychological predictors of later emotional distress in people with ALS. Methods...

Background: procrastination is highly prevalent amongst students and impairs academic performance. The metacognitive model of procrastination explains a significant proportion of unintentional procrastination variance. However, the model has yet to be tested using academic performance as the dependent variable. We tested whether the metacognitive...

Background: Anxiety and depression are common among patients attending cardiac rehabilitation services. Currently available pharmacological and psychological interventions have limited effectiveness in this population. There are presently no psychological interventions for anxiety and depression integrated into cardiac rehabilitation services desp...

https://jnnp.bmj.com/content/early/2018/05/06/jnnp-2018-317997.responses#a-response-from-noble-et-al-to-e-letter-by-the-psychology-task-force-of-the-international-league-against-epilepsy

Background: Many psychotherapy practitioners draw from several psychotherapeutic models in an effort to maximise the help they can give to individual patients. Such “integrative” practice is promoted by training that typically encompasses multiple models, but might impair practitioners’ ability to learn any single approach proficiently. Aims: One w...

Purpose: Emotional distress is common in people with epilepsy (PWE) for which efficacious interventions are required. Developing evidence-based treatments should be based on testable models of the psychological mechanisms maintaining psychopathology. The Self-Regulatory Executive Function (S-REF) model proposes that maladaptive metacognitive belief...

Psychological treatment is recommended for depression and anxiety in those with epilepsy. This review used standardised criteria to evaluate, for the first time, the clinical relevance of any symptom change these treatments afford patients. Databases were searched until March 2017 for relevant trials in adults. Trial quality was assessed and trial...

ABSTRACT Purpose/Objectives: Adolescent and young adults who have survived cancer are at an increased risk of psychological distress.This study investigated whether metacognitive beliefs areassociated with emotional distress and trauma symptoms in adolescent and young adult (AYA) survivors of cancer independent of known covariates, including curren...

Background: Anxiety and depression are prevalent among cardiac rehabilitation patients but pharmacological and psychological treatments have limited effectiveness in this group. Furthermore, psychological interventions have not been systematically integrated into cardiac rehabilitation services despite being a strategic priority for the UK Nationa...

Table S1: EBSCO database search strategy

Table S2 Summary of study design and significant findings from included papers (grouped by outcome (DV))

Table S3: Glossary of distress measures (DVs) used in included papers

Objective Why some people recover emotionally after diagnosis and treatment of cancer and others do not is poorly understood. To identify factors around the time of diagnosis that predict longer-term distress is a necessary step in developing interventions to reduce patients' vulnerability. This review identified the demographic, clinical, social,...

Many adult cancer survivors experience persistent emotional distress after completing cancer treatment. The aim of this study was to test the potential of a brief transdiagnostic psychological intervention - metacognitive therapy (MCT) - in reducing emotional distress in adult cancer survivors. A non-concurrent multiple baseline design with 3-and 6...

Aims: Anxiety and depression are highly prevalent in people with diabetes (PwD). The most widely used psychological model to explain anxiety and depression in PwD is the Common-Sense Model, which gives a central role to illness perceptions. The Self-Regulatory Executive Function (S-REF) model proposes metacognitive beliefs are key to understanding...

Aim: Multiple sclerosis (MS) is a chronic demyelinating disease that poses significant life challenges. Depression and anxiety often occur in people with MS (PwMS). An information processing model of psychopathology, the Self-Regulatory Executive Function (S-REF) model specifies that maladaptive metacognitive beliefs play a fundamental role in the...

Purpose Anxiety and depressive disorders frequently occur in people with epilepsy (PWE). An information processing model of psychopathology, the Self-Regulatory Executive Function (S-REF) model specifies that maladaptive metacognitive beliefs and processes play a fundamental role in the development and maintenance of anxiety and depression. This st...

According to the metacognitive model three factors are important: the significance that the individual assigns to such inner events; the experiential perspective the person occupies in relation to them; and the choice of strategies for self-regulation. This chapter explains how these factors are central to the model and treatment and can explain th...

This randomized controlled trial examines the efficacy of metacognitive therapy (MCT) for depression. Thirty-nine patients with depression were randomly assigned to immediate MCT (10 sessions) or a 10-week wait list period (WL). The WL-group received 10 sessions of MCT after the waiting period. Two participants dropped out from WL and none dropped...

The relative efficacy of interventions for test anxiety in university students is unknown. Previous meta-analyses have reported treatment outcomes across all age groups rather than specifically reporting on the effects for university students. Therefore, a new review is needed to determine the efficacy of psychological, educational, and pharmacolog...

It is important to investigate whether metacognition is related to body dysmorphic disorder (BDD) as this has been found in related disorders such as obsessive-compulsive disorder. Our study tested whether metacognition along with unhelpful coping behaviors and avoidance explained significant variance in BDD symptoms after controlling for age, gend...

Background The Metacognitions Questionnaire-30 (MCQ-30) was developed to measure individual differences in metacognitive beliefs and processes, which are central to the metacognitive model of emotional disorders. Although previous research has supported the role of metacognitive beliefs and processes in obsessive-compulsive disorder (OCD), no studi...

Many psychological models have been developed to explain the development and maintenance of depression. The most widely evaluated model is the cognitive model of depression, and it is against this model that emerging models should be compared. Accordingly, this cross-sectional study examined whether metacognitive beliefs, as specified in the metaco...