Robin Bailey

Men who have sex with men (MSM) living with HIV tend to experience a range of mental health issues, in particular generalised anxiety disorder (GAD), often caused and maintained by psychosocial variables including HIV stigma, discrimination, self-esteem issues, substance abuse and loneliness. This is particularly problematic in countries like Nigeria where same sex activity is illegal and can result in up to 14 years imprisonment. An important psychological variable that may contribute to the experience of GAD are metacognitive beliefs. Participants (
 = 311) completed measures to examine the relationship between these variables. Results indicated that metacognition was associated with, and significantly predicted, GAD in this population. Moderation analysis showed that the effect of HIV stigma on GAD was explained by the proposed interaction with metacognition. Findings suggest that metacognition may be an important variable in explaining GAD symptoms in MSM living with HIV in Nigeria.

Purpose
Health anxiety is a multidimensional trait characterized by a predominant fear of having a serious illness. This study aims to examine the impact of somatosensory amplification on health anxiety and explores the mediating role of metacognitive beliefs.

Design/methodology/approach
Participants (n = 307) were recruited online from university students to complete the measures of health anxiety (C-HAQ), metacognitive beliefs (MCQ-HA) and somatosensory amplification (SSAS).

Findings
The results suggest that somatosensory amplification is a significant predictor of health anxiety. Each of the three dimensions of metacognition partially mediated the effect of somatosensory amplification on health anxiety. In the parallel mediation model, two metacognitive beliefs partially mediated the relationship between somatosensory amplification and health anxiety, while the mediation effect of biased thinking beliefs did not reach significance. In summary, individuals with a higher tendency toward somatosensory amplification exhibit more health anxiety-related metacognitions and subsequently experience higher levels of health anxiety, supporting the Self-Regulatory Executive Function (S-REF) model.

Originality/value
This study validates the importance of metacognition in the maintenance and development of health anxiety, demonstrating the utility of metacognitive therapy for individuals experiencing health anxiety.

Chronic pelvic pain affects 38 per 1,000 women yearly (Daniels & Khan, 2010; Zondervan et al., 1999), accompanied by various psycho-logical sequelae. Positive psychology may offer new approaches to pelvic pain that complement existing interventions; these include post-traumatic growth (PTG), optimism, resilience, and models of recovery. In a sample of 132 females (aged 16 to 45), cross- sectional research revealed that participants with pelvic pain of unknown cause had the highest levels of post-traumatic stress dis-order (PTSD) symptoms. A regression analysis revealed that intrusive rumination, avoidant coping, and resilience were significant predictors of PTSD symptoms, and resilience and social support were predictors of PTG. Understanding the elements of positive psychology could help create positive psychology interventions focusing on chronic pelvic pain?s impact on mental health.

•We evaluated the feasibility of delivering MCT for health anxiety and to collect pilot data on the treatment's preliminary efficacy as measured by the whiteley index.•MCT was found to be feasible and acceptable for individuals with health anxiety, with clinically significant changes and large effects (Hedges’ g = 3.18).•The results support continued evaluation of MCT in health anxiety and a large-scale randomised trial is supported. Health anxiety is a pervasive mental health condition, in which people worry about having or developing a serious illness or disease. Cognitive behavioural therapy (CBT) is currently considered the most researched psychological treatment for health anxiety, although several systematic reviews and meta-analysis have shown mixed findings for its efficacy. More efficacious interventions that can be easily integrated within services are required. An alternative to CBT, that has proven more effective in some other disorders, is metacognitive therapy (MCT). The aim was to evaluate the feasibility of delivering MCT for health anxiety and to collect pilot data on the treatment's preliminary efficacy. Twenty participants with health anxiety were recruited to an open randomized feasibility trial and randomized to MCT or waitlist control. Acceptability and feasibility of MCT was based on recruitment rates, withdrawal, and drop-out, number of MCT sessions attended, completion of questionnaires, and any adverse reactions observed. The study was also used to evaluate initial treatment effects. MCT was found to be feasible and acceptable for individuals with health anxiety. Recruitment and retention of all participants was high, and no adverse events were observed in either group. Pre to post between group effect sizes on the primary outcome measure The Whiteley Index (Pilowsky, 1967) were large (Hedges’ g = 3.18-Mdiff= 26.2, [95 % CI=18.7–33.6]) in favour of MCT. Clinically significant recovery rates were 80 % at post treatment and follow up. The results suggest that a trial of MCT was acceptable and feasible in individuals with health anxiety and the treatment effects were statistically significant in comparison to the waiting list. Based upon the design used in this study MCT should be compared with active treatments such as medication, treatment as usual or specific cognitive behaviour therapy protocols in a future definitive randomised trial.