Associate Professor Nathan Sacha Consedine

PhD (Psychology) (Canterbury)

Biography

Nathan Consedine joined the faculty in the Department of Psychological Medicine as Associate Professor. After graduating from the University of Canterbury (New Zealand) in 2000 I began a three-year postdoctoral fellowship in ethnogerontology at the Center for Studies of Ethnicity and Human Development. I 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 I 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, I am 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.  Current research interests include experimental studies of emotions in health and decision-making, mindfulness, compassion and self-compassion in medical and health settings, links between emotion regulatory skills and health outcomes, and placebo responding.

Research | Current

Medical compassion

Compassion – the desire to alleviate the suffering of others – is a critical aspect of effective care. Compassion is expected by regulatory bodies, patients, and physicians themselves; initial data indicate that compassionate physicians promote better patient outcomes.  However, while physicians are expected to care, many “burn out” and experience compassion fatigue.

Currently, research treats compassion fatigue as a consequence of depleted compassion “reserves.” However, this approach has struggled to identify the specific intrapersonal, patient, environment, and system factors that might inform medical training or interventions. Recent studies among New Zealand physicians offer an alternative to the notion that doctors cease to care because they get tired of caring. 

Recent publications:

Fernando, A. T. & Consedine, N. S. (2014).  Beyond compassion fatigue: Development and preliminary validation of the Barriers to Physician Compassion QuestionnairePostgraduate Medical Journal, 90, 388-395. DOI: 10.1136/postgradmedj-2013-132127

Fernando, A. T., & Consedine, N. S. (2014).  Beyond compassion fatigue: the transactional model of physician compassionJournal of Pain and Symptom Management, 48 (2), 289-298DOI: 10.1016/j.jpainsymman.2013.09.014

Fernando, A. T., Consedine, N. S., & Hill, A. G. (2014).  Mindfulness for surgeonsAustralian & New Zealand Journal of Surgery, 84, 722-724.

 

Emotion regulatory skill and health

Particular patterns of regulating emotion are reliably linked to morbidity, mortality, and the success with which individuals adapt to chronic conditions.  Most work has, however, measured emotion regulation in terms of self-reported traits; such data are prone to bias and may not capacitate viable interventions. 

An extensive research program is using novel laboratory paradigms to assess the ability of objectively-assessed emotion regulatory skills to predict physical health symptoms, relative health and wellbeing, heart rate variability and measures of immune functioning.

Recent publications:

Tuck, N. L. Mauss, I. B., & Consedine, N. S. (2014).  Are we really getting better?  Lifespan differences in emotion regulatory ability from the perspective of developmental functionalism. Invited submission to the Bulletin of the International Society for the Study of Behavioral Development, 38 (3), 22-26.

Consedine, N. S. & Mauss, I. (2014).  Tasks, capacities, and tactics - A skill-based conceptualization of emotion regulation across the lifespan.  Chapter in P. Verhaeghen & C. Hertzog (Eds.), Handbook of emotion, social cognition, and everyday problem solving in adulthood (pp. 142-154).  Oxford University Press. DOI: 10.1093/oxfordhb/9780199899463.013.009

 

Fear, embarrassment, and disgust in health avoidance

Delay and avoidance are widespread problems in health and are associated with a range of negative health, social, and economic consequences. Despite extensive research, an understanding of why delay and avoidance occur remains poorly developed, with most work examining demographic and cognitive factors. A long-term research program is examining how fear, embarrassment, and disgust promote health-related avoidance.

Recent publications:

McCambridge, S. A. & Consedine, N. S. (2014).  For whom the bell tolls: Experimentally-manipulated disgust and embarrassment cause anticipated sexual health avoidance among some people. Emotion, 14 (2), 407-415. DOI: 10.1037/a0035209

Reynolds, L. M., Consedine, N. S., & McCambridge, S. A. (2014). Experimentally induced disgust and avoidance in colorectal cancer scenarios: The role of non-judging and non-reacting mindfulness. Mindfulness, 5 (4), 442-452.  DOI: 10.1007/s12671-013-0200-3.

Reynolds, L. M., Lin, Y-S., Zhou, E., & Consedine, N. S. (2015). Does a state mindfulness induction moderate disgust-driven social avoidance and decision-making?  An experimental investigation. Journal of Behavioral Medicine, 38 (1), 98-109. DOI: 10.1007/s10865-014-9582-5

Reynolds, L. M., McCambridge, S. A., Bissett, I. P., & Consedine, N. S. (2014). Trait and state disgust: An experimental investigation of disgust and avoidance in colorectal cancer decision scenarios. Health Psychology, 33 (12), 1495-1506. DOI: 10.1037/hea0000023

Reynolds, L. M., McCambridge, S. A., & Consedine, N. S. (2014). Self-disgust and adaptation to chronic health conditions: Implications for avoidance and withdrawal.  In. P. Powell, P. Overton, & J. Simpson (Eds.), The revolting self: psychological and clinical perspectives on self-directed disgust.  Karnac.

 

Mindfulness, self-compassion, and yoga as interventions in chronic disease

As the management of chronic disease improves and people live an increasing proportion of their lives in the presence of chronic conditions, there is an increasing need to develop and evaluate psychosocial interventions.  In many cases, patient populations have very particular psychological and physical challenges.  An ongoing program is evaluating the possible utility of yoga-, mindfulness-, and self-compassion based approaches in chronic disease.

Recent publications:

Fogarty, F. A., Booth, R. J., Gamble, G. D., Dalbeth, N., & Consedine, N. S. (2015). The effect of mindfulness-based stress reduction on disease activity in people with rheumatoid arthritis: a randomised controlled trial. Annals of Rheumatic Disease, 74 (2), 472-474DOI: 10.1136/annrheumdis-2014-205946. 

Friis, A., Consedine, N. S., & Johnson, M. H. (in press). Does kindness matter?  Diabetes, depression, and self-compassion: a preliminary review and research agenda. Diabetes Spectrum.  DOI: 10.1111/codi.12781

Friis, A., Johnson, M. H., Cutfield, R. & Consedine, N. S. (in press). Does kindness matter?  Self-compassion buffers the impact of diabetes distress on HbA1c. Diabetic Medicine. E-pub: April 21st, 2015. DOI: 10.1111/dme.12774

Hagins, M., Rundle, A., Consedine, N. S., Khalsa, S. B., & Weber, M. (2014).  A randomized controlled trial comparing the effects of yoga to traditional exercise on ambulatory blood pressure in individuals with Pre- and Stage 1 HypertensionJournal of Clinical Hypertension, 16 (1), 54-62. DOI: 10.1111/jch.12244

Sistig, B. Hatters-Friedman, S., McKenna, B., & Consedine, N. S. (in press). Mindful yoga as an adjunct treatment for forensic inpatients: A preliminary evaluationJournal of Forensic Psychiatry and Psychology.

 

Research projects 2014 -

  • Emotions in sustainable behaviour

Collaborative project with Sheffield University: n.consedine@auckland.ac.nz

  • Emotions and health in smoking behaviour

MHealthPsyc student Amy Jackson: ajac092@aucklanduni.ac.nz

  • Emotion regulation and inflammation

PhD student Natalie Tuck: n.tuck@auckland.ac.nz

  • Self-management of abdominal discomfort or pain

PhD student Victoria Rowe: v.rowe@auckland.ac.nz

  • Clinical decision-making processes

Medical student Lauren Barker: lbar303@aucklanduni.ac.nz

  • The effects of acute and chronic pain on emotion regulatory skill

MHealthPsyc student Duncan Edwards: dedw122@aucklanduni.ac.nz

 

Postgraduate supervision

2010 – 2011: Frequency, duration, and intensity: Different emotional metrics with different links to health?  (MSc Thesis. Hayley Butler, Auckland)

2010 – 2011: Are there ethnic differences in the effects of acculturation stress on health and health behaviors among immigrant international students? (MSc Thesis.  Pratyusha Jawalker, Auckland)

2010 – Mindfulness and emotion regulation – mechanisms of action among rheumatoid arthritis patients.  (Ph.D. Thesis. Francesca Fogarty, University of Auckland)

2011 – Self management of migraines – an identity perspective.  (MSc Thesis.  Jade Chan, Auckland)

2011 – Disgust in colorectal cancer contexts: does it cause avoidance and could mindfulness help? (Ph.D. Thesis. Lisa Reynolds, University of Auckland)

2011 – Living and thriving: exploring resilience in advanced age (Ph.D. Thesis. Karen Hayman, University of Auckland)

2011 – Development and validation of a measure of compassion among physicians (Ph.D. Thesis. Antonio Fernando, University of Auckland)

2012 – Personality and placebo responses in non-pain paradigms: building a Transactional Model of Placebo Responding (Ph.D. Thesis, Margot Darragh, University of Auckland)

2012 – Disgust, embarrassment, and sexual health: an experimental study of behavioural delay and avoidance.  (MSc Thesis.  Sarah McCambridge, Auckland)

2012 – Disgust and health-related behaviour: the association between disgust sensitivity and health-promoting and health-deleterious avoidance.  (MSc Thesis.  Jessica Suri, Auckland)

2012 – Emotional disclosure, health and wellbeing – the effect of re-reading.  (MSc Thesis.  Teresa Nagel, Auckland)

2012 – Evaluating the effectiveness of a structured hatha yoga program on mindfulness, anxiety, perceived stress and clinical outcomes, in a forensic psychiatric setting: A feasibility study (MHS Thesis.  Brigitte Sistig, Auckland)

2013 – Treating depression among diabetic patients – a compassionate approach (Ph.D. Thesis, Anna Friis, Auckland)

2013 – Emotion regulatory skills and health across the lifespan – a prospective multi-modal study (Ph.D. Thesis, Natalie Tuck, Auckland)

2013 – Explaining variation in the use of mental health legislation (Ph.D. Thesis, Anthony O’Brien, Auckland)

2014 – Physician and patient factors interactively predict compassion in medicine: an experimental study (MHealthPsyc Thesis, Kat Skinner, Auckland)

2015 – The influence of psychosocial factors and stress on autonomic nervous system function in Irritable Bowel Syndrome: Profiles and implications for treatment (Ph.D. Thesis, Victoria Rowe, Auckland)

2015 – Emotions, health, and organ donation behavior: an experimental study (MHealthPsyc Thesis, Alysha Simonsen, Auckland)

2015 – Emotions, health, and smoking behavior: an experimental study (MHealthPsyc Thesis, Amy Jackson, Auckland)

2015 – The effects of acute and chronic pain on emotion regulatory skill: an experimental and case-control study (MHealthPsyc Thesis, Duncan Edwards, Auckland)

2015 – The psychophysiological predictors of craving: stress and cue processes among smokers (Ph.D. Thesis, Justinn Cochran, Auckland)

 

 

Selected publications and creative works (Research Outputs)

  • Friis, A. M., Johnson, M. H., Cutfield, R. G., & Consedine, N. S. (2016). Kindness Matters: A Randomized Controlled Trial of a Mindful Self-Compassion Intervention Improves Depression, Distress, and HbA1c Among Patients With Diabetes. Diabetes care, 39 (11), 1963-1971. 10.2337/dc16-0416
    Other University of Auckland co-authors: Malcolm Johnson, Anna Friis