Nathan Consedine joined the faculty in the Department of Psychological Medicine as Associate Professor in 2009 and was promoted to Full Professor in 2017. After graduating from the University of Canterbury (New Zealand) in 2000 he completed a three-year postdoctoral fellowship in ethnogerontology at the Center for Studies of Ethnicity and Human Development. He had thought to do a few years internationally, but 3 years turned into 10 and I was the Deputy Director of this institute from 2003 until 2009. The entirety of this time was on soft money and he initiated a funded program of work examining the links between psychological characteristics (particularly fear and embarrassment) and health behaviors (notably cancer screening) in the diverse ethnic populations of Brooklyn, New York.
Despite having published in several applied areas including emotion, emotion regulation and health behavior, cancer screening, comparative social gerontology, and adult attachment, he is fundamentally interested in basic questions. The return to New Zealand together with being based in a hospital is thus a nice opportunity to begin testing specific ideas in experimental and clinical designs.
Background and objectives: Gay and bisexual men (GBM) are deferred from donating blood in many co... more Background and objectives: Gay and bisexual men (GBM) are deferred from donating blood in many countries. Perceptions by GBM that blood donor deferral policies are unjustifiably discriminatory, especially due to advances in HIV prevention, could contribute to non-compliance and need to be understood. We explore blood donation interest and history among GBM and attitudes towards donor deferral policies for the first time in New Zealand (NZ). Materials and methods: Data from a cross-sectional online survey of GBM in NZ were examined. We constructed three groups: (1) never donated blood and not interested; (2) never donated but expressed interest; and (3) previously donated blood. We tested these for association with demographic and behavioural variables, as well as attitudes towards blood donation policy. Results: A total of 607 GBM were eligible for the study, of whom 32.9% reported having donated blood previously, 44.3% had never donated blood but expressed interest and 22.7% expressed no interest in donating. Among previous donors, a third (8.6% of the total sample) reported non-compliance with the deferral policy. Most participants found the 12-month deferral policy to be too strict (81.8%), unfair (75.4%) and homophobic (68.8%). Conclusion: We estimate that, for the first time in NZ, almost 10% of the sample did not report compliance with the 12-month deferral policy for men who have sex with men (MSM). Negative attitudes towards the deferral policy were common and could potentially increase the risk to the blood supply if compliance reduces. Further work is needed to inform a deferral policy that is accepted by GBM while maintaining the safety of NZ's blood supply.
Delay and avoidance are massive problems in cancer screening. While work continues to examine dem... more Delay and avoidance are massive problems in cancer screening. While work continues to examine demographic and cognitive factors, emotions are central and likely causally implicated. In this chapter, a discrete emotions view of the origins of cancer screening is presented. After characterizing emotions, focus rests on evaluating the evidence regarding how and why three avoidance-promoting emotions (fear, embarrassment, and disgust) are implicated. The chapter describes the symptoms and medical examinations that elicit these emotions and suggests that people fail to screen for breast, colorectal, and prostate cancers because screenings elicit (or are anticipated to elicit) these feelings. It concludes by assessing some of the measurement, design, and interpretative challenges in the area, considers the sexual nature of many screens, and discusses the fact that screenings may elicit multiple emotional responses.
Although compassion in healthcare differs in important ways from compassion in everyday life, it ... more Although compassion in healthcare differs in important ways from compassion in everyday life, it provides a key, applied microcosm in which the science of compassion can be applied. Compassion is among the most important virtues in medicine, expected from medical professionals and anticipated by patients. Yet, despite evidence of its centrality to effective clinical care, research has focused on compassion fatigue or barriers to compassion and neglected to study the fact that most healthcare professionals maintain compassion for their patients. In contributing to this understudied area, the present report provides an exploratory investigation into how healthcare professionals report trying to maintain compassion. In the study, 151 professionals were asked questions about how they maintained compassion for their patients. Text responses were coded, with a complex mixture of internal vs. external, self vs. patient, and immediate vs. general strategies being reported. Exploratory analy...
Background Patients undergoing chemotherapy experience a range of aversive symptoms. These sympto... more Background Patients undergoing chemotherapy experience a range of aversive symptoms. These symptoms vary across individuals and at least some of this variation can be predicted by psychological factors, such as distress. However, while psychological distress predicts some of the symptoms, it is limited in important ways. Purpose To (a) assess the viability of disgust—a discrete emotion that specifically evolved for health-related reasons—as a predictor of chemotherapy-related symptoms (particularly, taste- and smell-related changes) and (b) compare the predictive utility of disgust sensitivity and propensity against the most commonly used affective predictor, that is, psychological distress. Methods Patients with cancer (N = 63) about to initiate chemotherapy were recruited in a prospective observational study. Psychosocial predictor variables were assessed at baseline, and outcomes (i.e., physical symptoms, body mass index [BMI], and food-based sensory-processing changes) were asse...
International journal of nursing studies, Jan 21, 2018
Burnout has numerous negative consequences for nurses, potentially impairing their ability to del... more Burnout has numerous negative consequences for nurses, potentially impairing their ability to deliver compassionate patient care. However, the association between burnout and compassion and, more specifically, barriers to compassion in medicine is unclear. This article evaluates the associations between burnout and barriers to compassion and examines whether dispositional self-compassion might mitigate this association. Consistent with prior work, the authors expected greater burnout to predict greater barriers to compassion. We also expected self-compassion - the ability to be kind to the self during times of distress - to weaken the association between burnout and barriers to compassion among nurses. Registered nurses working in New Zealand medical contexts were recruited using non-random convenience sampling. Following consent, 799 valid participants completed a cross-sectional survey including the Copenhagen Burnout Inventory, the Barriers to Physician Compassion scale, and a me...
OBJECTIVE Mood difficulties are common among patients with diabetes and are linked to poor blood ... more OBJECTIVE Mood difficulties are common among patients with diabetes and are linked to poor blood glucose control and increased complications. Evidence on psychological treatments that improve both mood and metabolic outcomes is limited. Greater self-compassion predicts better mental and physical health in both healthy and chronically ill populations. Thus, the purpose of this randomized controlled trial (RCT) was to evaluate the effects of self-compassion training on mood and metabolic outcomes among patients with diabetes. RESEARCH DESIGN AND METHODS This RCT tested the effects of a standardized 8-week mindful self-compassion (MSC) program (n = 32) relative to a wait-list control condition (n = 31) among patients with type 1 and type 2 diabetes. Measures of self-compassion, depressive symptoms, diabetes-specific distress, and HbA1c were taken at baseline (preintervention), at week 8 (postintervention), and at 3-month follow-up. RESULTS Repeated-measures ANOVA using intention to tre...
The Australian and New Zealand journal of psychiatry, Jan 16, 2015
With a healthcare system burdened by symptomatic and mental-health related conditions, the placeb... more With a healthcare system burdened by symptomatic and mental-health related conditions, the placebo effect may represent a useful clinical tool. First, however, there is a need to broaden research attention and investigate placebo effects outside laboratories and beyond experimental pain. This study investigated the effectiveness of a take-home placebo treatment in the short-term alleviation of stress, anxiety and symptoms of depression in a non-patient population. A sample of 77 participants was randomized to either the 'oxytocin' treatment group (n = 22), the 'serotonin' treatment group (n = 22) or the wait-list control group (n = 33). The two treatment groups were given an 'anti-stress treatment spray' (placebo) to self-administer for 3 days, and completed online measures of perceived stress (Perceived Stress Scale-10), anxiety (Cognitive Somatic Anxiety Questionnaire) and symptoms of depression (Centre for Epidemiological Studies - Depression) before and a...
Depression and severe psychological distress are frequently co-morbid with diabetes, and are asso... more Depression and severe psychological distress are frequently co-morbid with diabetes, and are associated with reduced adherence to medication and lifestyle regimes, poorer glycemic control, and increased complications. The mixed success of existing treatments for depression in diabetes patients suggests a need for supplementary approaches to this common problem. This paper reviews recent evidence for the benefits of self-compassion in chronically ill patients, suggesting its utility as a clinical tool for improving self-care, depression, and glycemic control in diabetes. Possible physical and psychological pathways by which self-compassion may promote better outcomes in diabetes patients are considered, with particular attention given to reductions in negative self-judgment and improved motivation to undertake self-care.
Background: Higher self-compassion is associated with mental and physical health benefits in both... more Background: Higher self-compassion is associated with mental and physical health benefits in both healthy and chronically-ill populations. The current study investigated the role of self-compassion in predicting depression, diabetes-specific distress, and HbA1c in diabetes patients. Aims: To assess the specific operationalization of negative emotionality that best predicted HbA1c and to test whether self-compassion would buffer diabetes patients’ HbA1c against the negative effects of distress. Methods: Diabetes patients (n = 110) completed measures assessing trait self-compassion, depression and diabetes-distress. HbA1c results were obtained through medical records. Results: As expected, diabetes-specific distress was a better predictor of HbA1c than depression; self-compassion moderated the relationship between distress and HbA1c such that higher distress predicted higher HbA1c at lower levels of self-compassion, but not at higher levels of self-compassion. Conclusions: In addition...
To investigate placebo effects on heart rate (HR) and heart rate variability (HRV) in recovery fr... more To investigate placebo effects on heart rate (HR) and heart rate variability (HRV) in recovery from a psychosocial stressor. A healthy sample underwent two mental arithmetic stress tests in one experimental session. After undergoing the baseline test, participants were randomized into control or placebo groups. Prior to the second stress test, the placebo group received an intranasal dose of 'serotonin' (placebo) with the suggestion that it would enhance recovery. HR and HRV were assessed throughout procedures. There was an increase in vagally-mediated HRV in the placebo group. The change in heart rate did not differ between groups. Placebo suggestion can enhance autonomic recovery after psychosocial stress. Findings are consistent with notion of top-down mechanisms of placebo effects, but further research would need to specifically examine the role of top-down regulatory pathways as possible mediators of placebo-induced changes in autonomic function.
""Aim: Fitting trainee physicians to career pat... more ""Aim: Fitting trainee physicians to career paths remains an ongoing challenge in a highly fluid health workforce environment. Studies attempting to explain low interest in surgical careers have typically examined the relative impact of career and lifestyle values. The current work argues that emotional proclivities are potentially more important and that disgust sensitivity may help explain both low surgical interest as well as the tendency for female students to avoid surgical careers. Method: 216 medical students attending a required course in human behavior completed measures of career intention, traditional predictors of career intention and dispositional disgust sensitivity. Results: As predicted, logistic regression showed that greater disgust sensitivity predicted lower surgical career intention even when controlling for traditional career values (OR = .45, 95%CI = .21-.95). Additionally, the gender effect indexing low female interest in surgical careers was no longer significant once disgust sensitivity was added to the model. Conclusion: The impact of disgust sensitivity on surgical interest was substantial and on par with established predictors of career intention. Disgust sensitivity may represent a potentially modifiable factor impacting surgical career choice, particularly among female students who are typically more disgust sensitive.""
Background and objectives: Gay and bisexual men (GBM) are deferred from donating blood in many co... more Background and objectives: Gay and bisexual men (GBM) are deferred from donating blood in many countries. Perceptions by GBM that blood donor deferral policies are unjustifiably discriminatory, especially due to advances in HIV prevention, could contribute to non-compliance and need to be understood. We explore blood donation interest and history among GBM and attitudes towards donor deferral policies for the first time in New Zealand (NZ). Materials and methods: Data from a cross-sectional online survey of GBM in NZ were examined. We constructed three groups: (1) never donated blood and not interested; (2) never donated but expressed interest; and (3) previously donated blood. We tested these for association with demographic and behavioural variables, as well as attitudes towards blood donation policy. Results: A total of 607 GBM were eligible for the study, of whom 32.9% reported having donated blood previously, 44.3% had never donated blood but expressed interest and 22.7% expressed no interest in donating. Among previous donors, a third (8.6% of the total sample) reported non-compliance with the deferral policy. Most participants found the 12-month deferral policy to be too strict (81.8%), unfair (75.4%) and homophobic (68.8%). Conclusion: We estimate that, for the first time in NZ, almost 10% of the sample did not report compliance with the 12-month deferral policy for men who have sex with men (MSM). Negative attitudes towards the deferral policy were common and could potentially increase the risk to the blood supply if compliance reduces. Further work is needed to inform a deferral policy that is accepted by GBM while maintaining the safety of NZ's blood supply.
Delay and avoidance are massive problems in cancer screening. While work continues to examine dem... more Delay and avoidance are massive problems in cancer screening. While work continues to examine demographic and cognitive factors, emotions are central and likely causally implicated. In this chapter, a discrete emotions view of the origins of cancer screening is presented. After characterizing emotions, focus rests on evaluating the evidence regarding how and why three avoidance-promoting emotions (fear, embarrassment, and disgust) are implicated. The chapter describes the symptoms and medical examinations that elicit these emotions and suggests that people fail to screen for breast, colorectal, and prostate cancers because screenings elicit (or are anticipated to elicit) these feelings. It concludes by assessing some of the measurement, design, and interpretative challenges in the area, considers the sexual nature of many screens, and discusses the fact that screenings may elicit multiple emotional responses.
Although compassion in healthcare differs in important ways from compassion in everyday life, it ... more Although compassion in healthcare differs in important ways from compassion in everyday life, it provides a key, applied microcosm in which the science of compassion can be applied. Compassion is among the most important virtues in medicine, expected from medical professionals and anticipated by patients. Yet, despite evidence of its centrality to effective clinical care, research has focused on compassion fatigue or barriers to compassion and neglected to study the fact that most healthcare professionals maintain compassion for their patients. In contributing to this understudied area, the present report provides an exploratory investigation into how healthcare professionals report trying to maintain compassion. In the study, 151 professionals were asked questions about how they maintained compassion for their patients. Text responses were coded, with a complex mixture of internal vs. external, self vs. patient, and immediate vs. general strategies being reported. Exploratory analy...
Background Patients undergoing chemotherapy experience a range of aversive symptoms. These sympto... more Background Patients undergoing chemotherapy experience a range of aversive symptoms. These symptoms vary across individuals and at least some of this variation can be predicted by psychological factors, such as distress. However, while psychological distress predicts some of the symptoms, it is limited in important ways. Purpose To (a) assess the viability of disgust—a discrete emotion that specifically evolved for health-related reasons—as a predictor of chemotherapy-related symptoms (particularly, taste- and smell-related changes) and (b) compare the predictive utility of disgust sensitivity and propensity against the most commonly used affective predictor, that is, psychological distress. Methods Patients with cancer (N = 63) about to initiate chemotherapy were recruited in a prospective observational study. Psychosocial predictor variables were assessed at baseline, and outcomes (i.e., physical symptoms, body mass index [BMI], and food-based sensory-processing changes) were asse...
International journal of nursing studies, Jan 21, 2018
Burnout has numerous negative consequences for nurses, potentially impairing their ability to del... more Burnout has numerous negative consequences for nurses, potentially impairing their ability to deliver compassionate patient care. However, the association between burnout and compassion and, more specifically, barriers to compassion in medicine is unclear. This article evaluates the associations between burnout and barriers to compassion and examines whether dispositional self-compassion might mitigate this association. Consistent with prior work, the authors expected greater burnout to predict greater barriers to compassion. We also expected self-compassion - the ability to be kind to the self during times of distress - to weaken the association between burnout and barriers to compassion among nurses. Registered nurses working in New Zealand medical contexts were recruited using non-random convenience sampling. Following consent, 799 valid participants completed a cross-sectional survey including the Copenhagen Burnout Inventory, the Barriers to Physician Compassion scale, and a me...
OBJECTIVE Mood difficulties are common among patients with diabetes and are linked to poor blood ... more OBJECTIVE Mood difficulties are common among patients with diabetes and are linked to poor blood glucose control and increased complications. Evidence on psychological treatments that improve both mood and metabolic outcomes is limited. Greater self-compassion predicts better mental and physical health in both healthy and chronically ill populations. Thus, the purpose of this randomized controlled trial (RCT) was to evaluate the effects of self-compassion training on mood and metabolic outcomes among patients with diabetes. RESEARCH DESIGN AND METHODS This RCT tested the effects of a standardized 8-week mindful self-compassion (MSC) program (n = 32) relative to a wait-list control condition (n = 31) among patients with type 1 and type 2 diabetes. Measures of self-compassion, depressive symptoms, diabetes-specific distress, and HbA1c were taken at baseline (preintervention), at week 8 (postintervention), and at 3-month follow-up. RESULTS Repeated-measures ANOVA using intention to tre...
The Australian and New Zealand journal of psychiatry, Jan 16, 2015
With a healthcare system burdened by symptomatic and mental-health related conditions, the placeb... more With a healthcare system burdened by symptomatic and mental-health related conditions, the placebo effect may represent a useful clinical tool. First, however, there is a need to broaden research attention and investigate placebo effects outside laboratories and beyond experimental pain. This study investigated the effectiveness of a take-home placebo treatment in the short-term alleviation of stress, anxiety and symptoms of depression in a non-patient population. A sample of 77 participants was randomized to either the 'oxytocin' treatment group (n = 22), the 'serotonin' treatment group (n = 22) or the wait-list control group (n = 33). The two treatment groups were given an 'anti-stress treatment spray' (placebo) to self-administer for 3 days, and completed online measures of perceived stress (Perceived Stress Scale-10), anxiety (Cognitive Somatic Anxiety Questionnaire) and symptoms of depression (Centre for Epidemiological Studies - Depression) before and a...
Depression and severe psychological distress are frequently co-morbid with diabetes, and are asso... more Depression and severe psychological distress are frequently co-morbid with diabetes, and are associated with reduced adherence to medication and lifestyle regimes, poorer glycemic control, and increased complications. The mixed success of existing treatments for depression in diabetes patients suggests a need for supplementary approaches to this common problem. This paper reviews recent evidence for the benefits of self-compassion in chronically ill patients, suggesting its utility as a clinical tool for improving self-care, depression, and glycemic control in diabetes. Possible physical and psychological pathways by which self-compassion may promote better outcomes in diabetes patients are considered, with particular attention given to reductions in negative self-judgment and improved motivation to undertake self-care.
Background: Higher self-compassion is associated with mental and physical health benefits in both... more Background: Higher self-compassion is associated with mental and physical health benefits in both healthy and chronically-ill populations. The current study investigated the role of self-compassion in predicting depression, diabetes-specific distress, and HbA1c in diabetes patients. Aims: To assess the specific operationalization of negative emotionality that best predicted HbA1c and to test whether self-compassion would buffer diabetes patients’ HbA1c against the negative effects of distress. Methods: Diabetes patients (n = 110) completed measures assessing trait self-compassion, depression and diabetes-distress. HbA1c results were obtained through medical records. Results: As expected, diabetes-specific distress was a better predictor of HbA1c than depression; self-compassion moderated the relationship between distress and HbA1c such that higher distress predicted higher HbA1c at lower levels of self-compassion, but not at higher levels of self-compassion. Conclusions: In addition...
To investigate placebo effects on heart rate (HR) and heart rate variability (HRV) in recovery fr... more To investigate placebo effects on heart rate (HR) and heart rate variability (HRV) in recovery from a psychosocial stressor. A healthy sample underwent two mental arithmetic stress tests in one experimental session. After undergoing the baseline test, participants were randomized into control or placebo groups. Prior to the second stress test, the placebo group received an intranasal dose of 'serotonin' (placebo) with the suggestion that it would enhance recovery. HR and HRV were assessed throughout procedures. There was an increase in vagally-mediated HRV in the placebo group. The change in heart rate did not differ between groups. Placebo suggestion can enhance autonomic recovery after psychosocial stress. Findings are consistent with notion of top-down mechanisms of placebo effects, but further research would need to specifically examine the role of top-down regulatory pathways as possible mediators of placebo-induced changes in autonomic function.
""Aim: Fitting trainee physicians to career pat... more ""Aim: Fitting trainee physicians to career paths remains an ongoing challenge in a highly fluid health workforce environment. Studies attempting to explain low interest in surgical careers have typically examined the relative impact of career and lifestyle values. The current work argues that emotional proclivities are potentially more important and that disgust sensitivity may help explain both low surgical interest as well as the tendency for female students to avoid surgical careers. Method: 216 medical students attending a required course in human behavior completed measures of career intention, traditional predictors of career intention and dispositional disgust sensitivity. Results: As predicted, logistic regression showed that greater disgust sensitivity predicted lower surgical career intention even when controlling for traditional career values (OR = .45, 95%CI = .21-.95). Additionally, the gender effect indexing low female interest in surgical careers was no longer significant once disgust sensitivity was added to the model. Conclusion: The impact of disgust sensitivity on surgical interest was substantial and on par with established predictors of career intention. Disgust sensitivity may represent a potentially modifiable factor impacting surgical career choice, particularly among female students who are typically more disgust sensitive.""
Darragh, M., Vanderboor, T., Booth, R. J., Sollers, J. J., & Consedine, N. S. (2015). Placebo ‘se... more Darragh, M., Vanderboor, T., Booth, R. J., Sollers, J. J., & Consedine, N. S. (2015). Placebo ‘serotonin’increases heart rate variability in recovery from psychosocial stress. Physiology & behavior, 145, 45-49.
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Papers by Nathan Consedine