Rachael Yielder

All Publications

• Employing illness perceptions and mindsets in health contexts: towards an integrative framework. Health psychology review Yielder, R., Crum, A., Weinman, J., Petrie, K. J. 2025: 1-26

  Abstract

  Beliefs about illness powerfully shape how people experience and respond to health conditions. The dominant theory underpinning illness perception - Leventhal's Common-Sense Model - proposes that individuals construct cognitive representations of illness based on specific beliefs about its features and likely course (e.g., symptom severity, timeline, controllability). These perceptions predict key outcomes, including functioning, quality of life, emotional distress, and treatment adherence. Mindsets are related but distinct: they are broader, more abstract beliefs about the nature and meaning of illness (e.g., viewing cancer as 'manageable' or 'a catastrophe'). While the illness perception literature is well established, mindset research in the health context is more recent, with promising findings and emerging tools for intervention. In this paper, we critically review both constructs, highlight their complementary strengths and limitations, and propose an integrative framework that unites them. We argue that combining these perspectives can sharpen measurement, deepen theoretical understanding, and enhance the impact of belief-based interventions in healthcare.

  View details for DOI 10.1080/17437199.2025.2552244

  View details for PubMedID 40910891

• Can catastrophes be opportunities? A randomized clinical trial testing a brief mindset intervention for reducing inflammation and depression following COVID-19. Brain, behavior, and immunity Barrera, J. A., Straube, L. D., Huml, Z., Yielder, R. M., Zion, S. R., Evans, K. M., Louis, K., Moriarity, D. P., Gasteiger, C., Slavich, G. M., Crum, A. J. 2025

  Abstract

  Survivors of major catastrophes face significant mental health risks but may also experience growth in meaning, relationships, and self-esteem. Two years after the onset of the Coronavirus disease 2019 (COVID-19) pandemic, we conducted a randomized clinical trial to test the effects of an intervention that promotes the mindset that "catastrophes can be opportunities in the long-term" on mental health and well-being. Adults were randomized to a mindset intervention (n = 226) or control group (n = 153). The mindset group watched five brief videos that reinforced that "catastrophes can be opportunities in the long-term" and wrote about their mindsets toward the COVID-19 pandemic and how these might encourage or discourage post-traumatic growth. The control group watched videos on the chronology of the pandemic and completed questions reviewing their knowledge. Mindsets regarding catastrophes-as-opportunities, post-traumatic growth, anxiety, depression, and C-reactive protein were assessed. The mindset intervention significantly reduced C-reactive protein (p = 0.030) and depressive symptom levels (p = 0.009) at 3-months. In addition, changes in mindset significantly mediated the effects of the intervention on posttraumatic growth, depressive symptoms, and other domains of mental health and well-being. Brief mindset interventions may thus have beneficial biological and clinical effects for individuals going through major catastrophes.

  View details for DOI 10.1016/j.bbi.2025.07.011

  View details for PubMedID 40738267

• Changing mindsets about methotrexate in the rheumatology clinic to reduce side effects and improve adherence: a randomized controlled trial. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine Yielder, R., Leibowitz, K., Crum, A. J., Manley, P., Dalbeth, N., Petrie, K. J. 2024

  Abstract

  Patients' negative expectations about medication can exacerbate side effect burden leading to low adherence and persistence. A novel intervention involves targeting mindsets about non-severe symptoms; reframing them as encouraging signs of medication working.This study aimed to assess whether a brief symptom-mindset intervention can improve symptom experience and adherence in patients starting methotrexate to treat an inflammatory rheumatic disease.A randomized controlled trial was conducted with patients starting methotrexate. Participants were randomly assigned (1:1) to a mindset intervention or standard information control condition. Symptom mindset was assessed after 4 weeks to check intervention efficacy. The primary outcome was symptom experience after 4 weeks. Secondary outcomes were adherence and motivation to take methotrexate (4 weeks), as well as continuation and C-reactive protein (12 weeks).Forty-seven participants were randomly assigned to the intervention (n = 24) or control group (n = 23). All participants completed the study. After 4 weeks, compared to the control group, intervention participants endorsed more positive symptom mindsets, experienced less symptom burden (mean difference -2.70 [95% CI, -4.50, -0.90] P = .005), fewer general symptoms (3.53 [-6.99, .79] P = .045) and a similar number of methotrexate-specific symptoms (-0.79 [-2.29, 0.71] P = .295). The intervention group had better motivation and adherence to methotrexate at 4 weeks and better continuation, and C-reactive protein at 12 weeks than the control group. There was no difference in side effect attribution.In patients starting methotrexate, a mindset intervention reframing the role of non-severe side effects is a promising approach for improving symptom experience and early stage medication persistence.

  View details for DOI 10.1093/abm/kaae089

  View details for PubMedID 39715363

• Using word clouds to reveal patients' perceptions about their arthritis. Health psychology : official journal of the Division of Health Psychology, American Psychological Association Yielder, R., Gasteiger, C., Pennebaker, J. W., Douglas, M., Dalbeth, N., Petrie, K. J. 2024

  Abstract

  Patients' perceptions about their illness have the power to influence health outcomes. However, existing illness belief measures can be burdensome. Using word clouds to illustrate patients' experiences is potentially a novel solution, but research is lacking in this area. This study aimed to explore whether word clouds illustrate patients' perceptions about their illness and to determine commonalities and differences in experiences of rheumatic diseases.A cross-sectional study was conducted with 323 patients with rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, or gout in New Zealand. Participants reported two words describing their inflammatory arthritis experience and completed the Brief Illness Perception Questionnaire. Word clouds were generated from participants' responses, and analysis of variance models were used to explore perceptions between groups.Eleven themes were identified, with each constituting a percentage of total word occurrence and weighting in word clouds. Symptom/sensation was the most prominent theme across all conditions (35%-61%), followed by affect/emotional experience (16%-25%). Theme prevalence varied across word clouds for each condition. Social impact was more prevalent for gout, and burden/intrusion was more prominent for ankylosing spondylitis. Functioning was less prevalent in the gout word cloud than in other conditions. There was moderate overlap between word cloud themes and illness perception domains. Word clouds uniquely identified themes related to burden/intrusion, functioning, opportunity, and social impact of illness.This study supports using word clouds as a low-burden method of examining the experiences of patients with inflammatory arthritis and could be tested with other patient groups. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

  View details for DOI 10.1037/hea0001432

  View details for PubMedID 39418406

• Changing Mindsets About Side Effects of the COVID-19 Vaccination: A Randomized Controlled Trial. Annals of behavioral medicine : a publication of the Society of Behavioral Medicine Crum, A. J., Heathcote, L. C., Morrison, Z., Yielder, R., Leibowitz, K., Petousis-Harris, H., Thomas, M. G., Prober, C. G., Berek, J. S., Petrie, K. J. 2023

  Abstract

  BACKGROUND: Side-effect concerns are a major barrier to vaccination against COVID-19 and other diseases. Identifying cost- and time-efficient interventions to improve vaccine experience and reduce vaccine hesitancy-without withholding information about side effects-is critical.PURPOSE: Determine whether a brief symptom as positive signals mindset intervention can improve vaccine experience and reduce vaccine hesitancy after the COVID-19 vaccination.METHODS: English-speaking adults (18+) were recruited during the 15-min wait period after receiving their second dose of the Pfizer COVID-19 vaccination and were randomly allocated to the symptom as positive signals mindset condition or the treatment as usual control. Participants in the mindset intervention viewed a 3:43-min video explaining how the body responds to vaccinations and how common side effects such as fatigue, sore arm, and fever are signs that the vaccination is helping the body boost immunity. The control group received standard vaccination center information.RESULTS: Mindset participants (N = 260) versus controls (N = 268) reported significantly less worry about symptoms at day 3 [t(506)=2.60, p=.01, d=0.23], fewer symptoms immediately following the vaccine [t(484)=2.75, p=.006, d=0.24], and increased intentions to vaccinate against viruses like COVID-19 in the future [t(514)=-2.57, p=.01, d=0.22]. No significant differences for side-effect frequency at day 3, coping, or impact.CONCLUSIONS: This study supports the use of a brief video aimed at reframing symptoms as positive signals to reduce worry and increase future vaccine intentions.CLINICAL TRIAL INFORMATION: Australian New Zealand Clinical Trials Registry: ACTRN12621000722897p.

  View details for DOI 10.1093/abm/kaad020

  View details for PubMedID 37279932