Understanding the experience of physical symptoms and developing and evaluating cognitive behavioural interventions in women's health, cardiology and oncology.

Recent research includes the development and evaluation of a multidisciplinary, stepped care programme for people with non-cardiac chest pain, and three RCTs of cognitive behavioural interventions for menopausal hot flushes and night sweats (HFNS) (Mann et al 2012, Ayers et al 2012 and Duitjs et al 2012). Group and self help CBT were found to reduce the impact of HFNS and the interventions were effective for women going through the natrual menopause as well as women having HFNS following treatments for breast cancer, such as endocrine therapy and chemotherapy. The intervention appeared to work by changing cognitive appraisal, while the intervention had an impact upon physiological measures of HFNS for well women, but not for women who had had breast cancer. Current work aims to find optimal ways to increase access to these interventions, such as self help book with telephone support which has been found to be effective; training health professionals, such as psychologists and breast cancer nurses; on-line interventions for breast cancer patients (with a Dutch team) and by publishing the self help book (Hunter & Smith Managing Hot Flushes and Night Sweats, Routledge, 2013) and a manual for Health Professionals (Hunter and Smith Routledge, 2015). The approach has also been shown to be effective in alleviating hot flushes experienced by men who have these symptoms following treatment for prostate cancer (Stefanopoulou et al Psychooncology 2015). 

Related studies include investigations of the impact of climate, altitude and temperature upon experience of vasomotor symptoms (hot flushes and night sweats) (IMS-CAT), an exploratory study of Attention Bias Modification (ABM) for menopausal symptoms (Stefanopoupou), meeting the needs of women with early menopause (Singer et al), investigating factors affecting adherence to tamoxifen (with Hughes, Moss-Morris). Collaborations include a study of interventions for 'medically unexplained physical symptoms' (Chalder et al) and investigation of food intolerance and food allergies (Godfrey et al), the  development and evaluation of a CBT based intervention for antenatal depression (Howard et al) and an investigation of Neurokinin-B as a potential biomarker of hot flushes (Dhillo et al 2015).