Compared to women, men are less likely to seek help for mental health difficulties. Despite considerable interest, a paucity in evidence-based solutions remains to solve this problem. The current review sought to synthesize the specific techniques within male-specific interventions that may contribute to an improvement in psychological help-seeking (attitudes, intentions, or behaviors). A systematic review identified 6,598 potential articles from three databases (MEDLINE, EMBASE, and PsycINFO). Nine studies were eligible. A meta-analysis was problematic due to disparate interventions, outcomes, and populations. The decision to use an innovative approach that adopted the Behavior Change Technique (BCT) taxonomy to synthesize each intervention’s key features likely to be responsible for improving help-seeking was made. Of the nine studies, four were engagement strategies (i.e., brochures/documentaries), two randomized controlled trials (RCTs), two pilot RCTs, and one retrospective review. Regarding quality assessment, three were scored as “strong,” five as “moderate,” and one as “weak.” Key processes that improved help-seeking attitudes, intentions, or behaviors for men included using role models to convey information, psychoeducational material to improve mental health knowledge, assistance with recognizing and managing symptoms, active problem-solving tasks, motivating behavior change, signposting services, and, finally, content that built on positive male traits (e.g., responsibility and strength). This is the first review to use this novel approach of using BCTs to summarize and identify specific techniques that may contribute to an improvement in male help-seeking interventions, whether engagement with treatment or the intervention itself. Overall, this review summarizes previous male help-seeking interventions, informing future research/clinical developments.

There is no gold standard for measuring adherence to prescribed home exercise. Self-report diaries are commonly used however lack of standardisation, inaccurate recall and self-presentation bias limit their validity. A valid and reliable tool to assess exercise adherence behaviour is required. Consequently, this article reports the development and psychometric evaluation of the Exercise Adherence Rating Scale (EARS). Development of a questionnaire. Secondary care in physiotherapy departments of three hospitals. A focus group consisting of 8 patients with chronic low back pain (CLBP) and 2 physiotherapists was conducted to generate qualitative data. Following on from this, a convenience sample of 224 people with CLBP completed the initial 16-item EARS for purposes of subsequent validity and reliability analyses. Construct validity was explored using exploratory factor analysis and item response theory. Test-retest reliability was assessed 3 weeks later in a sub-sample of patients. An item pool consisting of 6 items was found suitable for factor analysis. Examination of the scale structure of these 6 items revealed a one factor solution explaining a total of 71% of the variance in adherence to exercise. The six items formed a unidimensional scale that showed good measurement properties, including acceptable internal consistency and high test-retest reliability. The EARS enables the measurement of adherence to prescribed home exercise. This may facilitate the evaluation of interventions promoting self-management for both the prevention and treatment of chronic conditions.

PSYCHLOPS (Psychological Outcome Profiles) is a recently developed, client‐generated, psychometric instrument that can be used as an outcome measure. Based on a similar instrument developed primarily for use in physical illnesses (MYMOP — ‘Measure Your Medical Outcome Profile’), it seeks the client's perspective on their psychological distress. It asks them to describe and then score the problem that troubles them the most at the start of counselling. We describe the development of PSYCHLOPS, including the involvement of the Plain English Campaign and two national mental health organisations: the mental health charity and support group, Depression Alliance (DA) and Primary Care Mental Health Education (PRIMHE). We review the literature and suggest that PSYCHLOPS, by focusing on the problems of greatest priority to the client, might prove a sensitive measure of improvement after counselling.

Purpose: Exercise (planned, structured, repetitive movement) improves pain and function in people with persistent musculoskeletal pain ( PMSK ), but adherence is often poor. This systematic review evaluates the evidence from randomized controlled trials ( RCT s) on the effectiveness of interventions to improve exercise adherence in people with PMSK and describes the content, context, and theoretical underpinning of behaviour change interventions designed to increase adherence. Methods: Nine electronic databases were searched from inception dates to August 2017. Studies were included if they were RCT s that included adults with PMSK ≥3 months; ≥one measure of exercise adherence, exercise prescribed to both groups, and employed ≥one behaviour change technique ( BCT ) in the treatment group. Independent data extraction, theory coding, BCT taxonomy coding, and quality assessment using Cochrane Risk of Bias (RoB) tool was conducted by two reviewers. Results: Eight RCT s (five low, three high RoB) met inclusion criteria. Five trials reported between‐group differences in exercise adherence, favouring the treatment group. Three trials reported theoretical underpinning. There was moderate evidence that five BCT s, social support, goal setting, instruction of behaviour, demonstration of behaviour, and practice/rehearsal, improved exercise adherence. Interventions employing ≤seven BCT s, unique to those included in the control group, were most effective at enhancing exercise adherence. Conclusions: Limited moderate‐quality evidence supports using a small number of BCT s to enhance exercise adherence in people with PMSK . Further research should explore the associations and synergies between BCT s and explicitly report how theory was utilized. This may inform recommendations for health care professionals working with this population. Statement of contribution: What is already known on this subject? Exercise (i.e., planned, structured, repetitive movements) improves pain and function in people with persistent musculoskeletal pain (PMSK). Many people with PMSK do not adhere to exercises prescribed by a health care professional. Little research has explored how to enhance adherence to prescribed exercise in people with PMSK. What does this study add? Moderate‐quality evidence from eight trials suggests behaviour change interventions enhance exercise adherence. Social support, goal setting, demonstration, instruction, and rehearsal were employed in effective interventions. Interventions with ≤7 behaviour change techniques were more effective at improving adherence than those employing >7.

Background: Fatigue is the central symptom in chronic fatigue syndrome (CFS) and yet very little is known about its neural correlates. The aim of this study was to explore the functional brain response, using functional magnetic resonance imaging (fMRI), to the imaginal experience of fatigue in CFS patients and controls.Method: We compared the blood oxygen level dependent (BOLD) responses of 12 CFS patients and 11 healthy controls to a novel fatigue provocation procedure designed to mimic real-life situations. A non-fatiguing anxiety-provoking condition was also included to control for the non-specific effects of negative affect.Results: During the provocation of fatigue, CFS patients reported feelings of both fatigue and anxiety and, compared to controls, they showed increased activation in the occipito-parietal cortex, posterior cingulate gyrus and parahippocampal gyrus, and decreased activation in dorsolateral and dorsomedial prefrontal cortices. The reverse pattern of findings was observed during the anxiety-provoking scenarios.Conclusions: The results may suggest that, in CFS patients, the provocation of fatigue is associated with exaggerated emotional responses that patients may have difficulty suppressing. These findings are discussed in relation to the cognitive-behavioural model of CFS.