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Hallford DJ, Austin DW, Takano K, Yeow JJ, Rusanov D, Fuller-Tyszkiewicz M, Raes F. Improving usual care outcomes in major depression in youth by targeting memory specificity: A randomized controlled trial of adjunct computerized memory specificity training (c-MeST). J Affect Disord 2024; 358:500-512. [PMID: 38663556 DOI: 10.1016/j.jad.2024.04.078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 02/11/2024] [Accepted: 04/21/2024] [Indexed: 05/20/2024]
Abstract
OBJECTIVE Extending on previous findings that computerized Memory Specificity Training (c-MeST) improves memory specificity and depressive symptoms in Major Depressive Disorder (MDD) in adults, this study aimed to assess the effects of c-MeST in youth with MDD on memory specificity and depression in addition to other treatment. METHODS Participants aged 15-25 (N = 359, 76 % female; M age = 19.2, SD = 3.1), receiving predominantly psychological therapy or counseling (85 %) and/or antidepressants (52 %) were randomized to usual care and c-MeST or usual care. Cognitive and clinical outcomes were assessed at baseline and at one, three, and six-month follow-ups. RESULTS The usual care and c-MeST group reported higher memory specificity at one-month (d = 0.42, p = .022), but not at three or six months (d's < 0.15, p's > 0.05). The rate of MDE was numerically lower in the c-MeST group at each follow-up time-point, but group was not a statistically significant predictor at one month (64 % usual care and c-MeST vs. 68 % usual care, OR = 0.81, p = .606), three months (67 % usual care and c-MeST vs. 72 % usual care, OR = 0.64, p = .327) or six months (55 % usual care and c-MeST vs. 68 % usual care, OR = 0.56, p = .266). The usual care and c-MeST group did report lower depressive symptoms at one month (d = 0.42, p = .023) and six-months (d = 0.84, p = .001), but not three-months (d = 0.13, p > .05). CONCLUSIONS c-MeST may reduce symptoms in youth with MDD when provided alongside other treatments. However, there are significant limitations to this inference, including high attrition in the study and a need for more data on the acceptability of the intervention.
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Affiliation(s)
- David John Hallford
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia.
| | - David W Austin
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia
| | - Keisuke Takano
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, Leopoldstr. 13, Munich, Germany
| | - Joesph J Yeow
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia
| | - Danielle Rusanov
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia
| | - Matthew Fuller-Tyszkiewicz
- School of Psychology, 1 Gheringhap Street, Deakin University, Geelong, Victoria 3220, Melbourne, Australia
| | - Filip Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Box 3712, 3000 Leuven, Belgium
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Kuoch KLJ, Meyer D, Austin DW, Knowles SR. Socio-cognitive processes associated with bladder and bowel incontinence anxiety: A proposed bivalent model. Curr Psychol 2021. [DOI: 10.1007/s12144-019-00496-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Dowling NA, Merkouris SS, Rodda SN, Smith D, Aarsman S, Lavis T, Lubman DI, Austin DW, Cunningham JA, Battersby MW, O SC. GamblingLess: A Randomised Trial Comparing Guided and Unguided Internet-Based Gambling Interventions. J Clin Med 2021; 10:2224. [PMID: 34063826 PMCID: PMC8196610 DOI: 10.3390/jcm10112224] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/10/2021] [Accepted: 05/13/2021] [Indexed: 12/11/2022] Open
Abstract
There is little evidence relating to the effects of adding guidance to internet-based gambling interventions. The primary aim was to compare the effectiveness of an online self-directed cognitive-behavioural gambling program (GamblingLess) with and without therapist-delivered guidance. It was hypothesised that, compared to the unguided intervention, the guided intervention would result in superior improvements in gambling symptom severity, urges, frequency, expenditure, psychological distress, quality of life and help-seeking. A two-arm, parallel-group, randomised trial with pragmatic features and three post-baseline evaluations (8 weeks, 12 weeks, 24 months) was conducted with 206 gamblers (106 unguided; 101 guided). Participants in both conditions reported significant improvements in gambling symptom severity, urges, frequency, expenditure, and psychological distress across the evaluation period, even after using intention-to-treat analyses and controlling for other low- and high-intensity help-seeking, as well as clinically significant changes in gambling symptom severity (69% recovered/improved). The guided intervention resulted in additional improvements to urges and frequency, within-group change in quality of life, and somewhat higher rates of clinically significant change (77% cf. 61%). These findings, which support the delivery of this intervention, suggest that guidance may offer some advantages but further research is required to establish when and for whom human support adds value.
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Affiliation(s)
- Nicki A. Dowling
- School of Psychology, Deakin University, Geelong, VIC 3220, Australia; (S.S.M.); (S.A.); (D.W.A.)
- Melbourne Graduate School of Education, University of Melbourne, Parkville, VIC 3010, Australia
| | - Stephanie S. Merkouris
- School of Psychology, Deakin University, Geelong, VIC 3220, Australia; (S.S.M.); (S.A.); (D.W.A.)
| | - Simone N. Rodda
- School of Psychology, Deakin University, Geelong, VIC 3220, Australia; (S.S.M.); (S.A.); (D.W.A.)
- School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand;
- Turning Point, Eastern Health, 110 Church St, Richmond, VIC 3121, Australia
| | - David Smith
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia; (D.S.); (M.W.B.)
| | - Stephanie Aarsman
- School of Psychology, Deakin University, Geelong, VIC 3220, Australia; (S.S.M.); (S.A.); (D.W.A.)
| | - Tiffany Lavis
- School of Psychology, Faculty of Health and Medical Sciences, The University of Adelaide, Adelaide, SA 5000, Australia;
| | - Dan I. Lubman
- Turning Point, Eastern Health and Monash Addiction Research Centre, Eastern Health Clinical School, Richmond, VIC 3121, Australia;
| | - David W. Austin
- School of Psychology, Deakin University, Geelong, VIC 3220, Australia; (S.S.M.); (S.A.); (D.W.A.)
| | - John A. Cunningham
- National Addiction Centre, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London WC2R 2LS, UK;
- Centre for Addiction and Mental Health, Toronto, ON M6J 1H4, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON M5T 1R8, Canada
| | - Malcolm W. Battersby
- College of Medicine and Public Health, Flinders University, Bedford Park, SA 5042, Australia; (D.S.); (M.W.B.)
| | - Seung Chul O
- Faculty of Health, Deakin University, Geelong, VIC 3220, Australia;
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Hallford DJ, Austin DW. Wanting and Liking: Testing the Factor Structure of The Temporal Experience of Pleasure Scale in Major Depression and Community Samples. Assessment 2021; 29:1033-1044. [PMID: 33729003 DOI: 10.1177/1073191121998767] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The Temporal Experience of Pleasure Scale (TEPS) is a multidimensional self-report measure that has been used to improve understanding of anticipation ("wanting") and consummation ("liking") of reward. The TEPS has been used to assess anhedonia in clinical depression, but its factor structure has not yet been confirmed in this population. This seems important given mixed findings on the model fit and factor structure of the TEPS in other clinical and community samples. To remedy this, the current study used confirmatory factor analysis to test models of the TEPS items across three studies: (a) in adults with major depression (n = 334), (b) in youth with major depression (n = 305), and (c) in a community sample (n = 320). In summary, the model fit of the two-factor TEPS scales was adequate in depressed and community Australian samples. Nevertheless, some items may require removal or revision based on cultural preferences for pleasurable experiences.
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Affiliation(s)
| | - David W Austin
- Deakin University, 1 Gheringhap Street, Geelong, Victoria, Australia
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Hallford DJ, Takano K, Raes F, Austin DW. Psychometric Evaluation of an Episodic Future Thinking Variant of the Autobiographical Memory Test – Episodic Future Thinking-Test (EFT-T). European Journal of Psychological Assessment 2020. [DOI: 10.1027/1015-5759/a000536] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. Future-oriented variants of the Autobiographical Memory Test (AMT) are often used to assess the generation of specific episodic future thoughts, however, as yet the underlying factor structure of items in this modified test has not been examined. Therefore, over two studies we examined the factor structure and validity of an episodic future thinking variant of the Autobiographical Memory Test (Episodic Future Thinking-Test; EFT-T). In Study 1, exploratory factor analysis ( N = 466) showed a one-factor structure underlying responses to positive, negative, and concrete noun cue words on the EFT-T. In Study 2, confirmatory factor analysis with a different sample ( N = 304) and using different cue words showed a good fit for a single-factor structure. In both studies, good convergent validity was found with scores on the EFT-T correlating with autobiographical memory specificity scores, with support for divergent factors also. Mixed support was found for associations with measures of mental imagery, and the implications for measurement are discussed. These studies provide the first evidence that the EFT-T unidimensionally assesses specificity in episodic future thinking across two cue word sets.
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Affiliation(s)
- David J. Hallford
- School of Psychology, Deakin University, Geelong, Victoria, Australia
| | - Keisuke Takano
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, Germany
| | - Filip Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Belgium
| | - David W. Austin
- School of Psychology, Deakin University, Geelong, Victoria, Australia
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Schnabel A, Hallford DJ, Stewart M, McGillivray JA, Forbes D, Austin DW. An Initial Examination of Post‐Traumatic Stress Disorder in Mothers of Children with Autism Spectrum Disorder: Challenging Child Behaviors as Criterion A Traumatic Stressors. Autism Res 2020; 13:1527-1536. [DOI: 10.1002/aur.2301] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 03/10/2020] [Accepted: 03/22/2020] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Michelle Stewart
- School of Psychology Deakin University Geelong Victoria Australia
| | | | - David Forbes
- Phoenix Australia–Centre for Posttraumatic Mental Health, Department of Psychiatry The University of Melbourne Melbourne Australia
| | - David W. Austin
- School of Psychology Deakin University Geelong Victoria Australia
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Chillemi K, Abbott JAM, Austin DW, Knowles A. A Pilot Study of an Online Psychoeducational Program on Cyberbullying That Aims to Increase Confidence and Help-Seeking Behaviors Among Adolescents. Cyberpsychol Behav Soc Netw 2020; 23:253-256. [PMID: 32083494 DOI: 10.1089/cyber.2019.0081] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This pilot study obtained preliminary data on the effectiveness of an online, self-guided cognitive behavioral therapy-based psychoeducational program for coping with a potential experience of cyberbullying. The aim of the increasing resilience to cyberbullying (IRCB) program was to increase adolescents' likelihood of employing coping skills that may be helpful for a victim of cyberbullying, and to increase confidence in their ability to cope and/or help a friend cope with an experience of cyberbullying. Online questionnaires were administered to participants at baseline (preprogram, n = 54) and after program completion (postprogram, n = 54). Participants were year 9 or 10 students from Australian secondary schools (M = 14.70 years, SD = 0.57; 89% male). Results indicated significant increases in adolescents' likelihood of using the coping skills of self-compassion and challenging unhelpful thinking to cope with an experience of cyberbullying. There was also a significant increase in adolescents' help-seeking attitudes and behavioral intentions to engage with counseling services in the event of being victim of cyberbullying. There was no evidence to suggest that the IRCB program significantly increased adolescents' confidence in their ability to cope and/or help a friend cope with an experience of cyberbullying. The majority (87%) of participants (n = 34) described the IRCB program as helping them. Results suggest that an online intervention has the potential to provide adolescents with a free and easily accessible intervention that helps ameliorate the effect of cyberbullying, by promoting effective coping skills.
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Affiliation(s)
- Kerry Chillemi
- Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Australia
| | - Jo-Anne M Abbott
- Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Australia
| | - David W Austin
- Faculty of Health, Deakin University, Burwood, Australia
| | - Ann Knowles
- Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Australia
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Martin CA, Hiscock H, Rinehart N, Heussler HS, Hyde C, Fuller-Tyszkiewicz M, McGillivray J, Austin DW, Chalmers A, Sciberras E. Associations Between Sleep Hygiene and Sleep Problems in Adolescents With ADHD: A Cross-Sectional Study. J Atten Disord 2020. [PMID: 29542374 DOI: 10.1177/1087054718762513] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Objective: To determine whether self-reported sleep hygiene practices are associated with self- and parent-reported behavioral sleep problems in adolescents with ADHD. Method: Participants included 79 adolescents with ADHD (13-17 years) and their parents. Adolescents were asked to report on their sleep hygiene (Adolescent Sleep Hygiene Scale) and sleep (Adolescent Sleep Wake Scale). Parents also reported on their adolescent's sleep (Sleep Disturbance Scale for Children). Results: Poorer sleep hygiene was associated with higher total self-reported behavioral sleep problems and most self-reported sleep problems: falling asleep, reinitiating sleep, and returning to wakefulness. The association was also apparent for total parent-reported behavioral sleep problems, problems with initiating and maintaining sleep, and excessive somnolence. Conclusion: This study demonstrates small-to-moderate relationships between poor sleep hygiene practices and sleep problems in adolescents with ADHD, by both self- and parent-report.
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Affiliation(s)
| | - Harriet Hiscock
- Murdoch Children's Research Institute, Parkville, Victoria, Australia.,The Royal Children's Hospital, Parkville, Victoria, Australia.,University of Melbourne, Parkville, Victoria, Australia
| | | | - Helen S Heussler
- The University of Queensland, South Brisbane, Queensland, Australia
| | | | | | | | | | | | - Emma Sciberras
- Deakin University, Geelong, Victoria, Australia.,Murdoch Children's Research Institute, Parkville, Victoria, Australia.,University of Melbourne, Parkville, Victoria, Australia
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9
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Hallford DJ, Carmichael AM, Austin DW, Takano K, Raes F, Fuller-Tyszkiewicz M. A study protocol for a randomised trial of adjunct computerised memory specificity training (c-MeST) for major depression in youth: targeting cognitive mechanisms to enhance usual care outcomes in mental health settings. Trials 2020; 21:85. [PMID: 31937350 PMCID: PMC6961400 DOI: 10.1186/s13063-019-4036-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 12/29/2019] [Indexed: 12/31/2022] Open
Abstract
Background Youth depression is highly prevalent and is related to impairments in academic, social and behavioural functioning. Evidence-based treatments are available, but many young people do not respond or sufficiently recover with first-line options, and a significant proportion experience relapse. Consequently, there is clear scope to enhance intervention in this critical period of early-onset depression. Memory specificity training (MeST) is a low-intensity intervention for depression that targets reduced specificity when recalling memories of the past, a common cognitive vulnerability in depression. This randomised controlled trial will assess the efficacy of adding a computerised version of MeST (c-MeST) to usual care for youth depression. Methods/design Young people aged 15–25 years with a major depressive episode (MDE) will be recruited and randomised to have immediate access to the seven session online c-MeST program in addition to usual care, or to usual care and wait-list for c-MeST. The primary outcomes will be diagnostic status of an MDE and self-reported depressive symptoms assessed at baseline, 1-, 3- and 6-month intervals. Autobiographical memory specificity and other variables thought to contribute to the maintenance of reduced memory specificity and depression will be assessed as mediators of change. Discussion Online provision of c-MeST provides a simple, low-intensity option for targeting a cognitive vulnerability that predicts the persistence of depressive symptoms. If found to be efficacious as an adjunct to usual care for depressed youth, it could be suitable for broader roll-out, as c-MeST is highly accessible and implementation requires only minimal resources due to the online and automated nature of intervention. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12619000234112p. Registered on the 18 February 2019. All items from the WHO Trial Registration Data Set can be found within the protocol. Protocol version 1.0
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Affiliation(s)
- D J Hallford
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, Victoria, 3220, Australia. .,School of Psychology, Deakin University, 221 Burwood Hwy, Burwood, Melbourne, Victoria, 3125, Australia.
| | - A M Carmichael
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, Victoria, 3220, Australia
| | - D W Austin
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, Victoria, 3220, Australia
| | - K Takano
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, Leopoldstr. 131, 80802, Munich, Germany
| | - F Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Box 3712, 3000, Leuven, Belgium
| | - M Fuller-Tyszkiewicz
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, Victoria, 3220, Australia
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Hallford DJ, Barry TJ, Austin DW, Raes F, Takano K, Klein B. Impairments in episodic future thinking for positive events and anticipatory pleasure in major depression. J Affect Disord 2020; 260:536-543. [PMID: 31539690 DOI: 10.1016/j.jad.2019.09.039] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 08/09/2019] [Accepted: 09/08/2019] [Indexed: 12/15/2022]
Abstract
BACKGROUND Characteristic of the cardinal symptom of anhedonia, people with clinical depression report lower levels of anticipatory pleasure. However, the psychological mechanisms underlying these deficits are poorly understood. This is the first study to assess whether, and to what extent, phenomenological characteristics of episodic future thinking for positive future events are associated with anticipatory pleasure among depressed individuals. METHODS Individuals with a Major Depressive Episode (MDE; N = 117) and without (N = 47) completed ratings scales for depressive symptoms and trait anticipatory and consummatory pleasure. They then provided descriptions of personally-relevant positive future events and rated them for phenomenological characteristics and state anticipatory pleasure. RESULTS Between-groups analysis showed that those with MDE reported lower trait anticipatory and consummatory pleasure. They also simulated future events with less specificity, less detail/vividness, less use of mental imagery, less use of first-person perspective, less plausibility/perceived likelihood of occurring, and reported less associated state anticipatory pleasure. In regression analyses in the depressed group, lower scores for detail/vividness, mental imagery, and personal significance all uniquely predicted lower state anticipatory pleasure. LIMITATIONS Cognitive functioning was not assessed, which may help clarify deficits that underpin these findings. History of previous depressive episodes in the comparison group were not assessed, which may mean the observed between-group effects are underestimated. CONCLUSIONS This study provides further evidence of deficits in episodic future thinking and anticipatory pleasure in depressed individuals. It also establishes links between particular characteristics of episodic future thinking and state anticipatory pleasure, and indicates cognitive targets that may be amenable to intervention in order to reduce anhedonia.
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Affiliation(s)
- D J Hallford
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, Victoria, 3220, Australia.
| | - T J Barry
- Department of Psychology, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - D W Austin
- School of Psychology, Deakin University, 1 Gheringhap Street, Geelong, Melbourne, Victoria, 3220, Australia
| | - F Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Tiensestraat 102, Leuven, Box 3712, 3000, Belgium
| | - K Takano
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, Geschwister-Scholl-Platz 1, München, 80539, Germany
| | - B Klein
- School of Health and Life Sciences, Federation University, University Dr, Mount Helen, VIC, 3350, Australia
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Abstract
The current research investigates the development and validation of the Bladder and Bowel Incontinence Phobia Severity Scale (BBIPSS). Over two studies, two independent samples consisting of university students and respondents from the general public were used to validate the scale (study 1 n = 226; study 2 n = 377). A 15-item, two-factor model was confirmed in study 2 where strong construct (convergent and divergent) validity was demonstrated. The BBIPSS did not display significant correlations with openness and gender (divergent validity) and displayed significant correlations with depression, anxiety, and stress scores (DASS), alongside paruresis and parcopresis scores (Shy Bladder and Bowel Scale [SBBS]; convergent validity) and the Bowel and Bladder-Control Anxiety Scale [BoBCAtS]. The BBIPSS also demonstrated strong test-retest reliability (bladder r = 0.89; bowel r = 0.86) in a small sample of adults (n = 13). Overall, this scale provides researchers and clinicians with a reliable and psychometrically valid assessment tool to measure bladder and bowel incontinence phobia severity.
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Affiliation(s)
- Kenley L J Kuoch
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Denny Meyer
- Department of Statistics, Data Science and Epidemiology, Swinburne University of Technology, Melbourne, Australia
| | - David W Austin
- School of Psychology, Deakin University, Geelong, Australia
| | - Simon R Knowles
- Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia.,Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia.,Department of Medicine, The University of Melbourne, Melbourne, Australia.,Department of Gastroenterology and Hepatology, Royal Melbourne Hospital, Melbourne, Australia
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Kuoch KL, Hebbard GS, O'Connell HE, Austin DW, Knowles SR. Urinary and faecal incontinence: psychological factors and management recommendations. N Z Med J 2019; 132:25-33. [PMID: 31581179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Urinary and faecal incontinence substantially impacts upon physical health and is associated with significant psychological distress and reduced quality of life. Due to stigma and embarrassment, many patients do not present for management of their incontinence. AIM The objective of this article is to summarise the forms and causes of urinary and faecal incontinence, highlight the psychological mechanisms and psychopathology associated with incontinence, and provide management recommendations. CONCLUSION Urinary and faecal incontinence can have a significant impact on an individual's psychological wellbeing and quality of life. Psychological factors may either contribute to or arise from incontinence and should be addressed as part of the overall management plan.
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Affiliation(s)
- Kenley Lj Kuoch
- PhD (Psychology) Candidate, Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia
| | - Geoffrey S Hebbard
- Consultant Gastroenterologist; Director of Gastroenterology; Professor of Medicine, Department of Medicine, The University of Melbourne, Melbourne, Australia; Department of Gastroenterology and Hepatology, Royal Melbourne Hospital, Melbourne, Australia
| | - Helen E O'Connell
- Urological Surgeon; Head of Urology; Director of Surgery, Department of Surgery, Western Health, Melbourne, Australia
| | - David W Austin
- Professor of Psychology; Associate Dean, School of Psychology, Deakin University, Geelong, Australia
| | - Simon R Knowles
- Clinical Psychologist; Senior Lecturer, Department of Psychological Sciences, Swinburne University of Technology, Melbourne, Australia; Department of Medicine, The University of Melbourne, Melbourne, Australia; Department of Gastroenterology and Hepatology, Royal Melbourne Hospital, Melbourne, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
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Schnabel A, Youssef GJ, Hallford DJ, Hartley EJ, McGillivray JA, Stewart M, Forbes D, Austin DW. Psychopathology in parents of children with autism spectrum disorder: A systematic review and meta-analysis of prevalence. Autism 2019; 24:26-40. [DOI: 10.1177/1362361319844636] [Citation(s) in RCA: 41] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Parents of children with autism spectrum disorder appear to experience high levels of psychological distress, yet little is known about the prevalence of psychological disorders in this population. The aim of this systematic review and meta-analysis was to estimate the proportion of these parents who experience clinically significant psychopathology. Articles reporting proportions of psychological disorders in a sample of parents of children with autism spectrum disorder were located. The initial search returned 25,988 articles. Thirty-one studies with a total sample of 9208 parents were included in the final review. The median meta-analytic proportions were 31% (95% confidence interval = [24%, 38%]) for depressive disorders, 33% (95% confidence interval = [20%, 48%]) for anxiety disorders, 10% (95% confidence interval = [1%, 41%]) for obsessive-compulsive disorder, 4% (95% confidence interval = [0%, 22%]) for personality disorders, 2% (95% confidence interval = [1%, 4%]) for alcohol and substance use disorders and 1% (95% confidence interval = [0%, 5%]) for schizophrenia spectrum disorders. Significant heterogeneity was detected in these categories. Further research is needed to gain more insight into variables that may moderate parental psychopathology. This review and meta-analysis is the first to provide prevalence estimates of psychological disorders in parents of children with autism spectrum disorder.
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Affiliation(s)
| | - George J Youssef
- Deakin University, Australia
- Murdoch Children’s Research Institute, Australia
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15
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Abstract
INTRODUCTION Major depression is a prevalent and debilitating disorder, but many sufferers do not receive support or respond to current treatments. The development of easily accessible and low-intensity treatments that have clear cognitive mechanisms of change is indicated. Memory specificity training (MeST) is an intervention for depression that targets deficits in recalling detailed memories of past experiences through repeated practice of autobiographical memory retrieval. This randomised controlled trial will assess the efficacy of an online, computerised version of MeST (c-MeST). METHODS AND ANALYSIS Adults aged 18 and over with a current major depressive episode (MDE) will be recruited and randomised to have access to the seven session, online c-MeST programme for 2 weeks, or to a wait-list control group. The primary outcomes will be diagnostic status of MDE and self-reported depressive symptoms at postintervention. One-month and three-month follow-ups will be collected. Increases in autobiographical memory specificity will be assessed as a mediator of change, as well as other variables thought to contribute to reduced memory specificity, such as rumination and cognitive avoidance. ETHICS AND DISSEMINATION Ethics approval has been granted by the Deakin University Human Research Ethics Committee to conduct the study (ID: 2017_168). The findings will be disseminated through scholarly publications and workshops and will inform future trials, such as with an active comparator or as an adjunct treatment. TRIAL REGISTRATION NUMBER ACTRN12618000257268; Pre-results.
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Affiliation(s)
- David J Hallford
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - David W Austin
- School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria, Australia
| | - Filip Raes
- Faculty of Psychology and Educational Sciences, KU Leuven, Leuven, Vlaanderen, Belgium
| | - Keisuke Takano
- Division of Clinical Psychology and Psychotherapy, Department of Psychology, Ludwig-Maximilians-University Munich, Munich, Bavaria, Germany
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16
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Russell L, Ugalde A, Orellana L, Milne D, Krishnasamy M, Chambers R, Austin DW, Livingston PM. A pilot randomised controlled trial of an online mindfulness-based program for people diagnosed with melanoma. Support Care Cancer 2018; 27:2735-2746. [DOI: 10.1007/s00520-018-4574-6] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2018] [Accepted: 11/22/2018] [Indexed: 11/30/2022]
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17
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Takano K, Hallford DJ, Vanderveren E, Austin DW, Raes F. The computerized scoring algorithm for the autobiographical memory test: updates and extensions for analyzing memories of English-speaking adults. Memory 2018; 27:306-313. [PMID: 30081736 DOI: 10.1080/09658211.2018.1507042] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The Autobiographical Memory Test (AMT) has been central in psychopathological studies of memory dysfunctions, as reduced memory specificity or overgeneralised autobiographical memory has been recognised as a hallmark vulnerability for depression. In the AMT, participants are asked to generate specific memories in response to emotional cue words, and their responses are scored by human experts. Because the manual coding takes some time, particularly when analysing a large dataset, recent studies have proposed computerised scoring algorithms. These algorithms have been shown to reliably discriminate between specific and non-specific memories of English-speaking children and Dutch- and Japanese-speaking adults. The key limitation is that the algorithm is not developed for English-speaking adult memories, which may cover a wider range of vocabulary that the existing algorithm for English-speaking child memories cannot process correctly. In the present study, we trained a new support vector machine to score memories of English-speaking adults. In a performance test (predicting memory specificity against human expert coding), the adult-memory algorithm outperformed the child-memory variant. In another independent performance test, the adult-memory algorithm showed robust performances to score memories that were generated in response to a different set of cues. These results suggest that the adult-memory algorithm reliably scores memory specificity.
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Affiliation(s)
- Keisuke Takano
- a Division of Clinical Psychology and Psychotherapy, Department of Psychology , Ludwig-Maximilians-University Munich , Munich , Germany
| | - David J Hallford
- b School of Psychology , Deakin University , Geelong , Australia
| | - Elien Vanderveren
- c Center for the Psychology of Learning and Experimental Psychopathology , University of Leuven , Leuven , Belgium
| | - David W Austin
- b School of Psychology , Deakin University , Geelong , Australia
| | - Filip Raes
- c Center for the Psychology of Learning and Experimental Psychopathology , University of Leuven , Leuven , Belgium
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18
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Russell L, Ugalde A, Milne D, Krishnasamy M, O Seung Chul E, Austin DW, Chambers R, Orellana L, Livingston PM. Feasibility of an online mindfulness-based program for patients with melanoma: study protocol for a randomised controlled trial. Trials 2018; 19:223. [PMID: 29653555 PMCID: PMC5899401 DOI: 10.1186/s13063-018-2575-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2017] [Accepted: 03/08/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People with a melanoma diagnosis are at risk of recurrence, developing a new primary or experiencing disease progression. Previous studies have suggested that fear of a cancer recurrence is clinically relevant in this group of patients and, if not addressed, can lead to distress. Mindfulness-based interventions have been shown to alleviate symptoms of anxiety and depression among various groups of cancer patients. Online mindfulness-based interventions have the potential to reach people unable to attend face-to-face interventions due to limitations such as cancer-related illness, transportation or time constraints. This study aims to (1) examine whether individuals with a melanoma diagnosis are willing to participate and adhere to a 6-week online mindfulness-based intervention and (2) explore potential benefits of the program on fear of cancer recurrence, worries, rumination, perceived stress and trait mindfulness to inform the design of a clinical trial. METHODS/DESIGN This is a single-site randomised controlled trial of a feasibility study. Seventy-five participants with stage 2c or 3 melanoma will be recruited from a melanoma outpatient clinic and randomised (2:1) either to an online mindfulness-based program (intervention) or to usual care (control). The intervention is a 6-week program specifically developed for this study. It consists of videos describing the concept of mindfulness, short daily guided meditation practices (5-10 min), automated meditation reminders and instructions for applying mindfulness in daily life to enhance wellbeing. All participants will complete questionnaires at baseline and at 6-week post-randomisation. Participants in the control group will be given access to the online program at the end of the study. Primary outcomes are overall recruitment; retention; extent of questionnaire completion; and usability and acceptability of, and adherence to, the program. The secondary outcomes are fear of cancer recurrence, worries, rumination, perceived stress and trait mindfulness measured using validated instruments. DISCUSSION This feasibility study will evaluate participants' satisfaction with the program and identify barriers to recruitment and adherence. The recruitment and data collection process will highlight methodological aspects to address in the planning of a larger scale study assessing the impact of an online mindfulness-based intervention on fear of cancer recurrence and wellbeing. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry, ACTRN12617000081314 . Registered on 16 January 2017.
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Affiliation(s)
- Lahiru Russell
- Deakin University, School of Nursing and Midwifery, Faculty of Health, Geelong, Australia.
| | - Anna Ugalde
- Deakin University, School of Nursing and Midwifery, Faculty of Health, Geelong, Australia
| | - Donna Milne
- Skin and Melanoma Services/Department of Cancer Experiences Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | - Meinir Krishnasamy
- Department of Nursing, School of Health Sciences, University of Melbourne, Melbourne, Australia.,Victorian Comprehensive Cancer Centre, Melbourne, Victoria, Australia
| | - Eric O Seung Chul
- Deakin University, School of Psychology, Faculty of Health, Geelong, Australia
| | - David W Austin
- Deakin University, School of Psychology, Faculty of Health, Geelong, Australia
| | - Richard Chambers
- Campus Community Division, Monash University, Clayton, Australia
| | - Liliana Orellana
- Deakin University, Biostatistics Unit, Faculty of Health, Geelong, Australia
| | - Patricia M Livingston
- Deakin University, School of Nursing and Midwifery, Faculty of Health, Geelong, Australia
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19
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Berk L, Hallam KT, Venugopal K, Lewis AJ, Austin DW, Kulkarni J, Dodd S, de Castella A, Fitzgerald PB, Berk M. Impact of irritability: a 2-year observational study of outpatients with bipolar I or schizoaffective disorder. Bipolar Disord 2017; 19:184-197. [PMID: 28470892 DOI: 10.1111/bdi.12486] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2014] [Accepted: 03/12/2017] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Many people experience irritability when manic, hypomanic, or depressed, yet its impact on illness severity and quality of life in bipolar and schizoaffective disorders is poorly understood. This study aimed to examine the relationship between irritability and symptom burden, functioning, quality of life, social support, suicidality, and overall illness severity in a naturalistic cohort of people with bipolar I or schizoaffective disorder. METHODS We used data from 239 adult outpatients with bipolar I or schizoaffective disorder in the Bipolar Comprehensive Outcomes Study (BCOS) - a non-interventional observational study with a 2-year follow-up period. Baseline demographic and clinical characteristics of participants with and without irritability were compared. A mixed-model repeated measures analysis was conducted to examine the longitudinal effect of irritability on clinical and quality-of-life variables over follow-up using significant baseline variables. RESULTS At baseline, 54% of participants were irritable. Baseline irritability was associated with illness severity, mania, depression, psychotic symptoms, suicidality, poor functioning, and quality of life, but not diagnosis (schizoaffective/bipolar disorder). Participants with irritability were less likely to have a partner and perceived less adequate social support. On average, over follow-up, those with irritability reported more symptoms, functional impairment, and suicidality. Furthermore, the effects of irritability could not be fully explained by illness severity. CONCLUSIONS Irritability was associated with more negative symptomatic, functional, and quality-of-life outcomes and suicidality. The identification, monitoring, and targeted treatment of irritability may be worth considering, to enhance health and wellbeing outcomes for adults with bipolar and schizoaffective disorders.
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Affiliation(s)
- Lesley Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Vic., Australia.,Department of Psychiatry, University of Melbourne, Parkville, Vic., Australia.,Melbourne School of Global and Population Health, University of Melbourne, Parkville, Vic., Australia
| | - Karen T Hallam
- Department of Psychology, The University of Melbourne, Parkville, Vic., Australia.,Department of Psychology, Victoria University, Melbourne, Vic., Australia
| | - Kamalesh Venugopal
- South Australian Department for Health and Ageing, Adelaide, SA, Australia
| | - Andrew James Lewis
- School of Psychology & Exercise Science, Murdoch University, Murdoch, WA, Australia.,Harry Perkins Institute of Medical Research, Fiona Stanley Hospital, Murdoch, WA, Australia
| | - David W Austin
- School of Psychology, Faculty of Health, Deakin University, Burwood, Vic., Australia
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre (MAPrc), Monash University Central Clinical School and The Alfred, Melbourne, Vic., Australia
| | - Seetal Dodd
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Vic., Australia.,Department of Psychiatry, University of Melbourne, Parkville, Vic., Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Vic., Australia
| | - Anthony de Castella
- Monash Alfred Psychiatry Research Centre (MAPrc), Monash University Central Clinical School and The Alfred, Melbourne, Vic., Australia
| | - Paul B Fitzgerald
- Monash Alfred Psychiatry Research Centre (MAPrc), Monash University Central Clinical School and The Alfred, Melbourne, Vic., Australia
| | - Michael Berk
- Deakin University, IMPACT Strategic Research Centre, School of Medicine, Barwon Health, Geelong, Vic., Australia.,Department of Psychiatry, University of Melbourne, Parkville, Vic., Australia.,Centre for Youth Mental Health, University of Melbourne, Parkville, Vic., Australia.,Florey Institute for Neuroscience and Mental Health, Parkville, Vic., Australia
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20
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Wootten AC, Meyer D, Abbott JAM, Chisholm K, Austin DW, Klein B, McCabe M, Murphy DG, Costello AJ. An online psychological intervention can improve the sexual satisfaction of men following treatment for localized prostate cancer: outcomes of a Randomised Controlled Trial evaluating My Road Ahead. Psychooncology 2016; 26:975-981. [PMID: 27503036 DOI: 10.1002/pon.4244] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2015] [Revised: 07/17/2016] [Accepted: 07/19/2016] [Indexed: 11/09/2022]
Abstract
BACKGROUND Prostate cancer treatment often results in significant psycho-sexual challenges for men following treatment; however, many men report difficulty in accessing appropriate care. METHODS A randomized controlled trial was undertaken to assess the efficacy of a 10-week self-guided online psychological intervention called My Road Ahead (MRA) for men with localized prostate cancer in improving sexual satisfaction. Participants were randomized to 1 of 3 conditions MRA alone or MRA plus online forum, or forum access alone. Pre, post, and follow-up assessments of overall sexual satisfaction were conducted. Mixed models and structural equation modeling were used to analyze the data. RESULTS One hundred forty-two men (mean age 61 y; SD = 7) participated. The majority of participants had undergone radical prostatectomy (88%) and all men had received treatment for localized prostate cancer. Significant differences were obtained for the 3 groups (P = .026) and a significant improvement in total sexual satisfaction was observed only for participants who were allocated to MRA + forum with a large effect size (P = .004, partial η2 = 0.256). Structural equation modeling indicated that increases in sexual function, masculine self-esteem, and sexual confidence contributed significantly to overall sexual satisfaction for the MRA + forum plus forum condition. CONCLUSIONS This study is the first, to our knowledge, that has evaluated a self-guided online psychological intervention tailored to the specific needs of men with prostate cancer. The findings indicate the potential for MRA to deliver support that men may not otherwise receive and also highlight the importance of psychological intervention to facilitate improved sexual outcomes.
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Affiliation(s)
- Addie C Wootten
- Department of Urology, The Royal Melbourne Hospital, Parkville, VIC, Australia.,Epworth Prostate Centre, Epworth Healthcare, Richmond, VIC, Australia.,Australian Prostate Cancer Research, East Melbourne, VIC, Australia
| | - Denny Meyer
- Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Jo-Anne M Abbott
- National eTherapy Centre, Swinburne University of Technology, Hawthorn, VIC, Australia
| | - Katherine Chisholm
- Department of Urology, The Royal Melbourne Hospital, Parkville, VIC, Australia.,School of Psychology, Deakin University, Geelong, VIC, Australia
| | - David W Austin
- School of Psychology, Deakin University, Geelong, VIC, Australia
| | - Britt Klein
- Centre for Biopsychosocial and eHealth Research & Innovation; School of Health Sciences & Psychology, Federation University Australia, Ballarat, VIC, Australia
| | - Marita McCabe
- Australian Catholic University, Institute for Health and Ageing, Melbourne, VIC, Australia
| | - Declan G Murphy
- Epworth Prostate Centre, Epworth Healthcare, Richmond, VIC, Australia.,Division of Cancer Surgery, Peter MacCallum Cancer Centre, University of Melbourne, East Melbourne, VIC, Australia
| | - Anthony J Costello
- Department of Urology, The Royal Melbourne Hospital, Parkville, VIC, Australia.,Epworth Prostate Centre, Epworth Healthcare, Richmond, VIC, Australia.,Australian Prostate Cancer Research, East Melbourne, VIC, Australia
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21
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Abstract
To promote efficient clinical practice, interest has been growing in brief assessment scales to replace full-scale versions in some circumstances. In nonclinical populations, the Wechsler Abbreviated Scale of Intelligence (WASI) has substituted for the Wechsler Intelligence Scale for Children—Third Edition (WISC-III). Agreement between these scales remains untested in clinical populations. Twenty-five children, aged 6 to 15 years old were assessed. A correlational and within-participant design was used. These scales were significantly correlated. Despite a fourth edition of the WISC now available, WASI administration alone would at times appear to be a quick and valid estimate of IQ. Replication with the WISC-IV seems necessary to clarify the verbal/ performance distance criterion discrepancy and also the meaning of some variability between the scale and subtests.
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22
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Knowles SR, Austin DW, Sivanesan S, Tye-Din J, Leung C, Wilson J, Castle D, Kamm MA, Macrae F, Hebbard G. Relations between symptom severity, illness perceptions, visceral sensitivity, coping strategies and well-being in irritable bowel syndrome guided by the common sense model of illness. PSYCHOL HEALTH MED 2016; 22:524-534. [PMID: 27045996 DOI: 10.1080/13548506.2016.1168932] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Irritable Bowel Syndrome (IBS) is a common condition affecting around 10-20% of the population and associated with poorer psychological well-being and quality of life. The aim of the current study was to explore the efficacy of the Common Sense Model (CSM) using Structural Equation Modelling (SEM) in an IBS cohort. One hundred and thirty-one IBS patients (29 males, 102 females, mean age 38 years) participating in the IBSclinic.org.au pre-intervention assessment were included. Measures included IBS severity (Irritable Bowel Syndrome Severity Scoring System), coping patterns (Carver Brief COPE), visceral sensitivity (Visceral Sensitivity Index), illness perceptions (Brief Illness Perceptions Questionnaire), psychological distress (Depression, Anxiety and Stress Scale), and quality of life (IBS Quality of Life scale; IBS-QoL). Using SEM, a final model with an excellent fit was identified (χ2 (8) = 11.91, p = .16, χ2/N = 1.49, CFI > .98, TLI > .96, SRMR < .05). Consistent with the CSM, Illness perceptions were significantly and directly influenced by IBS severity (β = .90, p < .001). Illness perceptions in turn directly influenced maladaptive coping (β = .40, p < .001) and visceral sensitivity (β = .70, p < .001). Maladaptive coping and visceral sensitivity were significantly associated with psychological distress (β = .55, p < .001; β = .22, p < .01) and IBS-QoL (β = -.28, p < .001; β = -.62, p < .001). Based on these findings, we argue that to augment the adverse impact of IBS severity on IBS-QoL and psychological distress, psychological interventions will be best to target the mediating psychological processes including illness beliefs, visceral sensitivity and maladaptive coping.
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Affiliation(s)
- Simon R Knowles
- a Faculty Health, Arts, and Design, Department of Psychology , Swinburne University of Technology , Melbourne , Australia.,b Department of Medicine , The University of Melbourne , Melbourne , Australia.,c Department of Psychiatry , St Vincent's Hospital , Melbourne , Australia.,d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia
| | - David W Austin
- e Department of Psychology , Deakin University , Melbourne , Australia
| | - Suresh Sivanesan
- d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia
| | - Jason Tye-Din
- d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia.,f Walter and Eliza Hall Institute , Melbourne , Australia
| | - Chris Leung
- d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia.,g The Austin Hospital , Melbourne , Australia
| | | | - David Castle
- b Department of Medicine , The University of Melbourne , Melbourne , Australia.,c Department of Psychiatry , St Vincent's Hospital , Melbourne , Australia
| | - Michael A Kamm
- b Department of Medicine , The University of Melbourne , Melbourne , Australia.,i Department of Gastroenterology and Medicine , St Vincent's Hospital , Melbourne , Australia.,j Division of Immunology , Imperial College , London , UK
| | - Finlay Macrae
- d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia
| | - Geoff Hebbard
- b Department of Medicine , The University of Melbourne , Melbourne , Australia.,d Department of Gastroenterology and Hepatology , Royal Melbourne Hospital , Melbourne , Australia
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23
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Tribbick D, Salzberg M, Ftanou M, Connell WR, Macrae F, Kamm MA, Bates GW, Cunningham G, Austin DW, Knowles SR. Prevalence of mental health disorders in inflammatory bowel disease: an Australian outpatient cohort. Clin Exp Gastroenterol 2015; 8:197-204. [PMID: 26213474 PMCID: PMC4512611 DOI: 10.2147/ceg.s77567] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND This study aimed to characterize prevalence of anxiety and depressive conditions and uptake of mental health services in an Australian inflammatory bowel disease (IBD) outpatient setting. METHODS Eighty-one IBD patients (39 males, mean age 35 years) attending a tertiary hospital IBD outpatient clinic participated in this study. Disease severity was evaluated according to the Manitoba Index. Diagnosis of an anxiety or depressive condition was based upon the Mini-International Neuropsychiatric Interview and the Hospital Anxiety and Depression Scale. RESULTS Based on Hospital Anxiety and Depression Scale subscale scores >8 and meeting Mini-International Neuropsychiatric Interview criteria, 16 (19.8%) participants had at least one anxiety condition, while nine (11.1%) had a depressive disorder present. Active IBD status was associated with higher prevalence rates across all anxiety and depressive conditions. Generalized anxiety was the most common (12 participants, 14.8%) anxiety condition, and major depressive disorder (recurrent) was the most common depressive condition reported (five participants, 6.2%). Seventeen participants (21%) reported currently seeking help for mental health issues while 12.4% were identified has having at least one psychological condition but not seeking treatment. CONCLUSION We conclude that rates of anxiety and depression are high in this cohort, and that IBD-focused psychological services should be a key component of any holistic IBD service, especially for those identified as having active IBD.
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Affiliation(s)
- Davina Tribbick
- Faculty of Life and Social Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Michael Salzberg
- Department of Psychiatry, St Vincent’s Hospital, Melbourne, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
| | - Maria Ftanou
- Department of Psychiatry, St Vincent’s Hospital, Melbourne, VIC, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, Australia
| | - William R Connell
- Department of Gastroenterology, St Vincent’s Hospital, Melbourne, VIC, Australia
| | - Finlay Macrae
- Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Melbourne, VIC, Australia
- Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
| | - Michael A Kamm
- Department of Gastroenterology, St Vincent’s Hospital, Melbourne, VIC, Australia
- Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Melbourne, VIC, Australia
- Imperial College, London, UK
| | - Glen W Bates
- Faculty of Life and Social Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Georgina Cunningham
- Department of Gastroenterology, St Vincent’s Hospital, Melbourne, VIC, Australia
| | - David W Austin
- Department of Psychology, Deakin University, Melbourne, VIC, Australia
| | - Simon R Knowles
- Faculty of Life and Social Sciences, Swinburne University of Technology, Melbourne, VIC, Australia
- Department of Psychiatry, St Vincent’s Hospital, Melbourne, VIC, Australia
- Department of Psychiatry, The University of Melbourne, Melbourne, VIC, Australia
- Colorectal Medicine and Genetics, The Royal Melbourne Hospital, Melbourne, VIC, Australia
- Department of Medicine, University of Melbourne, Melbourne, VIC, Australia
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24
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Lauder S, Chester A, Castle D, Dodd S, Gliddon E, Berk L, Chamberlain J, Klein B, Gilbert M, Austin DW, Berk M. A randomized head to head trial of MoodSwings.net.au: an Internet based self-help program for bipolar disorder. J Affect Disord 2015; 171:13-21. [PMID: 25282145 DOI: 10.1016/j.jad.2014.08.008] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2014] [Revised: 07/25/2014] [Accepted: 08/06/2014] [Indexed: 12/13/2022]
Abstract
BACKGROUND Adjunctive psychosocial interventions are efficacious in bipolar disorder, but their incorporation into routine management plans are often confounded by cost and access constraints. We report here a comparative evaluation of two online programs hosted on a single website (www.moodswings.net.au). A basic version, called MoodSwings (MS), contains psychoeducation material and asynchronous discussion boards; and a more interactive program, MoodSwings Plus (MS-Plus), combined the basic psychoeducation material and discussion boards with elements of Cognitive Behavioral Therapy. These programs were evaluated in a head-to-head study design. METHOD Participants with Bipolar I or II disorder (n=156) were randomized to receive either MoodSwings or MoodSwings-Plus. Outcomes included mood symptoms, the occurrence of relapse, functionality, Locus of Control, social support, quality of life and medication adherence. RESULTS Participants in both groups showed baseline to endpoint reductions in mood symptoms and improvements in functionality, quality of life and medication adherence. The MoodSwings-Plus group showed a greater number of within-group changes on symptoms and functioning in depression and mania, quality of life and social support, across both poles of the illness. MoodSwings-Plus was superior to MoodSwings in improvement on symptoms of mania scores at 12 months (p=0.02) but not on the incidence of recurrence. LIMITATIONS The study did not have an attention control group and therefore could not demonstrate efficacy of the two active arms. There was notable (81%) attrition by 12 months from baseline. CONCLUSION This study suggests that both CBT and psychoeducation delivered online may have utility in the management of bipolar disorder. They are feasible, readily accepted, and associated with improvement.
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Affiliation(s)
- Sue Lauder
- The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; DVC-Research and Innovation Portfolio & School of Health Sciences, and the Collaborative Research Network Federation University, Ballarat, Victoria, Australia.
| | - Andrea Chester
- RMIT University, Building 6, Level 5 Bowen Street, Melbourne 3000, Australia
| | - David Castle
- The University of Melbourne, Department of Psychiatry, St Vincent׳s Hospital, P.O. Box, 2900, Fitzroy 3065, Australia
| | - Seetal Dodd
- The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; IMPACT Strategic Research Center, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong 3220, Australia
| | - Emma Gliddon
- The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; IMPACT Strategic Research Center, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong 3220, Australia
| | - Lesley Berk
- The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; Orygen Youth Health Research Center, 35 Poplar Road, Parkville 3052, Australia
| | | | - Britt Klein
- DVC-Research and Innovation Portfolio & School of Health Sciences, and the Collaborative Research Network Federation University, Ballarat, Victoria, Australia; National Institute for Mental Health Research, The Australian National University, Building 63, Canberra 2000, Australia; National eTherapy Center, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Monica Gilbert
- Healthmaps Pty Ltd, PO Box 2501, Fitzroy, 3065 Melbourne, Australia
| | - David W Austin
- Deakin University, School of Psychology, Faculty of Health, Burwood Campus, 221 Burwood Highway, Burwood 3125, Victoria Australia
| | - Michael Berk
- The University of Melbourne, Department of Psychiatry, Royal Melbourne Hospital, Level 1 North, Main Block, Victoria 3050, Australia; IMPACT Strategic Research Center, School of Medicine, Deakin University, Barwon Health, P.O. Box 291, Geelong 3220, Australia; Orygen Youth Health Research Center, 35 Poplar Road, Parkville 3052, Australia; Florey Institute for Neuroscience and Mental Health, The University of Melbourne, Kenneth Myer Building, 30 Royal Parade, 3052 Parkville, Victoria, Australia
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25
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Abbott JAM, Klein B, McLaren S, Austin DW, Molloy M, Meyer D, McLeod B. Out & Online; effectiveness of a tailored online multi-symptom mental health and wellbeing program for same-sex attracted young adults: study protocol for a randomised controlled trial. Trials 2014; 15:504. [PMID: 25534310 PMCID: PMC4308019 DOI: 10.1186/1745-6215-15-504] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2014] [Accepted: 12/08/2014] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Same-sex attracted young adults have been found to experience higher rates of mental health problems and greater difficulties in accessing specialist mental health care services compared to their heterosexual peers. Internet-based mental health interventions have the potential to be more engaging and accessible to young adults compared to those delivered face-to-face. However, they are rarely inclusive of lesbian women and gay men. Thus, the current study aims to evaluate the effectiveness of an online mental health and wellbeing program, Out & Online (http://www.outandonline.org.au), in comparison to a wait-list control group, for reducing anxiety and depressive symptoms in same-sex attracted young adults aged between 18 and 25 years. METHODS/DESIGN We are recruiting, through media and community organisations, 200 same-sex attracted young adults with anxiety and/or depressive symptoms and mild to moderate psychological distress (Kessler-10 score between 16 to 21). Participants will be randomly allocated to the intervention (the online program) or the wait-list control group based on a permuted blocked randomisation method to allow for stratification by gender. Participants in the intervention group will receive a tailored program for up to three types of mental health difficulties simultaneously. The primary outcome of anxiety and/or depressive symptoms, and secondary outcomes related to psychological distress, wellbeing and health behaviour will be measured at pre-intervention (0 week), post-intervention (8 weeks) and at a 3-month follow-up (20 weeks). DISCUSSION This online mental health and wellbeing program will be one of the first online interventions to be designed specifically to be relevant for same-sex attracted individuals. If the program is found to be effective it will improve access to specialist same-sex attracted-relevant mental health services for young adults and will facilitate wellbeing outcomes for these individuals. This program will also be a significant development in the delivery of tailored interventions that target multiple types of mental health conditions simultaneously. TRIAL REGISTRATION Australian New Zealand Clinical Trials Registry: ACTRN12611000700932. Date registered: 7 July 2011.
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Affiliation(s)
- Jo-Anne M Abbott
- />National eTherapy Centre, Brain and Psychological Sciences Research Centre, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria Australia
- />National eTherapy Centre, Faculty of Health, Arts and Design, Swinburne University of Technology, Mail H99, P.O. Box 218, Hawthorn, 3122 Australia
| | - Britt Klein
- />National eTherapy Centre, Brain and Psychological Sciences Research Centre, Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria Australia
- />DVC-Research & Innovation Portfolio, School of Health Sciences and Psychology, and the Collaborative Research Network, Federation University Australia, Ballarat, Victoria Australia
- />National Institute for Mental Health Research, The Australian National University, Canberra, Australian Capital Territory Australia
| | - Suzanne McLaren
- />School of Health Sciences and Psychology, Faculty of Health, Federation University Australia, Ballarat, Victoria Australia
| | - David W Austin
- />School of Psychology, Faculty of Health, Deakin University, Burwood, Victoria Australia
| | - Mari Molloy
- />School of Health Sciences and Psychology, Faculty of Health, Federation University Australia, Ballarat, Victoria Australia
| | - Denny Meyer
- />Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria Australia
| | - Bronte McLeod
- />Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria Australia
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Hadjistavropoulos HD, Pugh NE, Nugent MM, Hesser H, Andersson G, Ivanov M, Butz CG, Marchildon G, Asmundson GJG, Klein B, Austin DW. Therapist-assisted Internet-delivered cognitive behavior therapy for depression and anxiety: translating evidence into clinical practice. J Anxiety Disord 2014; 28:884-93. [PMID: 25445078 DOI: 10.1016/j.janxdis.2014.09.018] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2014] [Revised: 06/23/2014] [Accepted: 09/22/2014] [Indexed: 11/19/2022]
Abstract
This dissemination study examined the effectiveness of therapist-assisted Internet-delivered Cognitive Behavior Therapy (ICBT) when offered in clinical practice. A centralized unit screened and coordinated ICBT delivered by newly trained therapists working in six geographically dispersed clinical settings. Using an open trial design, 221 patients were offered 12 modules of ICBT for symptoms of generalized anxiety (n=112), depression (n=83), or panic (n=26). At baseline, midpoint and post-treatment, patients completed self-report measures. On average, patients completed 8 of 12 modules. Latent growth curve modeling identified significant reductions in depression, anxiety, stress and impairment (d=.65-.78), and improvements in quality of life (d=.48-.66). Improvements in primary symptoms were large (d=.91-1.25). Overall, therapist-assisted ICBT was effective when coordinated across settings in clinical practice, but further attention should be given to strategies to improve completion of treatment modules.
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Affiliation(s)
- H D Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, Canada S4S 6J4.
| | - N E Pugh
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, Canada S4S 6J4.
| | - M M Nugent
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, Canada S4S 6J4.
| | - H Hesser
- Department of Behavioural Sciences and Learning, Linköping University, SE-581 83 Linköping, Sweden.
| | - G Andersson
- Department of Behavioural Sciences and Learning, Linköping University and Department of Clinical Neuroscience, Karolinska Institute, SE-581 83 Linköping, Sweden.
| | - M Ivanov
- Department of Computer Science, University of Regina, 3737 Wascana Parkway, Regina, SK, Canada S4S 6J4.
| | - C G Butz
- Department of Computer Science, University of Regina, 3737 Wascana Parkway, Regina, SK, Canada S4S 6J4.
| | - G Marchildon
- Johnson-Shoyama Graduate School of Public Policy, 3737 Wascana Parkway, Department of Psychology, University of Regina, Regina, SK, Canada S4S 6J4.
| | - G J G Asmundson
- Department of Psychology, University of Regina, 3737 Wascana Parkway, Regina, SK, Canada S4S 6J4.
| | - B Klein
- School of Health Sciences and DVC-Research Portfolio, Federation University Australia, Victoria, Australia; Centre of Mental Health Research, The Australian National University, Canberra, Australia; The National eTherapy Centre, Swinburne University of Technology, Lydiard St S, Ballarat, VIC 3350, Australia.
| | - D W Austin
- Centre for Mental Health and Wellbeing Research, School of Psychology, Deakin University, 221 Burwood Highway, Burwood, VIC 3125, Australia.
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Wootten AC, Abbott JAM, Meyer D, Chisholm K, Austin DW, Klein B, McCabe M, Murphy DG, Costello AJ. Preliminary results of a randomised controlled trial of an online psychological intervention to reduce distress in men treated for localised prostate cancer. Eur Urol 2014; 68:471-9. [PMID: 25454611 DOI: 10.1016/j.eururo.2014.10.024] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Accepted: 10/14/2014] [Indexed: 11/25/2022]
Abstract
BACKGROUND Prostate cancer (PCa) poses many emotional and physical challenges for men following treatment. The unmet support needs of these men are well documented, and access to psychosocial support remains problematic. OBJECTIVES To assess the efficacy of an online psychological intervention for men who have localised PCa. DESIGN, SETTING, AND PARTICIPANTS We undertook a randomised controlled trial to evaluate the intervention. Participants were randomly allocated to one of three conditions: My Road Ahead (MRA) alone (MRA Only), MRA plus access to an online forum (MRA+Forum), and access to the forum alone (Forum). INTERVENTION The intervention was a 10-week self-guided online psychological intervention called My Road Ahead that consisted of six themed modules designed to facilitate improved emotional well-being in the context of PCa as well as a moderated peer forum. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS Pre- and postintervention assessments of psychological distress (the 21-question Depression, Anxiety and Stress Scale) [1] and the Prostate Cancer-related Quality of Life scale [2] were conducted. Multivariate analysis of variance, regression, and structural equation modelling were used to analyse the data. RESULTS AND LIMITATIONS In total, 142 participants were randomly allocated to one of the three intervention arms. The mean age of participants was 61 yr of age (standard deviation: 7), and 88% had undergone radical prostatectomy. A significant improvement in psychological distress was observed for participants who had access to the combined condition (MRA+Forum) with a moderate effect size (p=0.02; partial η(2)=0.07). In particular, the decline in the mean level of psychological distress was 8.8 units larger for the MRA+Forum group than the Forum group (95% confidence interval [CI], 0.9-16.7). Although the decline in the mean level of psychological distress was 7.0 units larger for the MRA+Forum group than for the MRA Only group, this difference was not significant (95% CI, 1.1-15.1). Structural equation modelling indicated that reductions in health worry and regret contributed significantly to the reductions in psychological distress for the MRA+Forum condition. CONCLUSIONS This study is the first, to our knowledge, that has evaluated a self-guided online psychological intervention tailored to the specific needs of men who have PCa. The findings of this study indicate the potential for this programme to deliver support that men may not otherwise receive. PATIENT SUMMARY This study found that men who have localised prostate cancer who received access to the online psychological intervention called My Road Ahead combined with the online peer discussion forum had significantly improved reductions in distress compared with those who received access to the online intervention alone or the forum alone.
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Affiliation(s)
- Addie C Wootten
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Epworth Prostate Centre, Epworth Healthcare, Richmond, Victoria, Australia; Australian Prostate Cancer Research, East Melbourne, Victoria, Australia.
| | - Jo-Anne M Abbott
- National eTherapy Centre, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Denny Meyer
- Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Katherine Chisholm
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Department of Psychology, Deakin University, Burwood, Victoria, Australia
| | - David W Austin
- Department of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Britt Klein
- DVC-Research & Innovation Portfolio, the School of Health Sciences, and the Collaborative Research Network, Federation University, Ballarat, Australia; National Institute for Mental Health Research, The Australian National University, Canberra, Australia; Faculty of Health, Arts and Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Marita McCabe
- Department of Psychology, Deakin University, Burwood, Victoria, Australia
| | - Declan G Murphy
- Epworth Prostate Centre, Epworth Healthcare, Richmond, Victoria, Australia; Peter MacCallum Cancer Centre, East Melbourne, Victoria, Australia
| | - Anthony J Costello
- Department of Urology, Royal Melbourne Hospital, Parkville, Victoria, Australia; Epworth Prostate Centre, Epworth Healthcare, Richmond, Victoria, Australia; Australian Prostate Cancer Research, East Melbourne, Victoria, Australia
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Brown CM, Austin DW, Busija L. Observable essential fatty acid deficiency markers and autism spectrum disorder. Breastfeed Rev 2014; 22:21-26. [PMID: 25109097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Autism Spectrum Disorder (ASD) has been associated with essential fatty acid (EFA) deficiencies, with some researchers theorising that dysregulation of phospholipid metabolism may form part of the biological basis for ASD. This pilot study compared observable signs of fatty acid status of 19 children with an ASD diagnosis to 23 of their typically developing siblings. A pregnancy, birth and breastfeeding history was also obtained from their parents, which included a measure of infant intake of fatty acid rich colostrum immediately post-partum. When considered within their family group, those infants not breastfed (with colostrum) within the first hour of life and who had a history of fatty acid deficiency symptoms were more likely to have an ASD diagnosis. Other variables such as formula use, duration of breastfeeding, gestational age and Apgar scores were not associated with group membership. The results of this study are consistent with previous research showing a relationship between fatty acid metabolism, breastfeeding and ASD such that early infant feeding practices and the influence this has on the fatty acid metabolism of the child may be a risk factor for ASD.
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Wootten AC, Abbott JM, Osborne D, Austin DW, Klein B, Costello AJ, Murphy DG. The impact of prostate cancer on partners: a qualitative exploration. Psychooncology 2014; 23:1252-8. [PMID: 24764291 DOI: 10.1002/pon.3552] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2013] [Revised: 03/24/2014] [Accepted: 03/24/2014] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Prostate cancer and its treatment can result in numerous physical and psychological morbidities for the patient as well as his partner. This qualitative study aimed to explore the experiences of intimate spouses or partners of men diagnosed and/or treated for prostate cancer to better understand the personal impact of prostate cancer on the partner. METHODS Twenty-seven partners participated in this study. Six focus groups were convened, and one in-depth interview was undertaken to explore the practical impact of prostate cancer on the intimate spouse/partner. All discussions were audio-recorded and transcribed and then coded using a thematic approach. RESULTS Six themes emerged: (a) The influence of the man's response to prostate cancer on the partner, (b) The need to be involved in treatment and medical decision making, (c) Supporting a man who is experiencing a loss of masculinity, (d) Degree of congruence between each partner's coping responses, (e) Constrained communication, and (f) Changed roles and increased practical management. CONCLUSIONS It is clear that prostate cancer impacts substantially on many areas of partner well-being. An effective intervention provided to this population seems warranted and may lead to improvements in partner well-being, assist the couple in lessening the impact of prostate cancer and its treatment on their relationship, and assist in the man's recovery.
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Affiliation(s)
- A C Wootten
- Department of Urology, Royal Melbourne Hospital, Parkville, Vic., Australia; Epworth Prostate Centre, Epworth Healthcare, Richmond, Vic., Australia; Australian Prostate Cancer Research, East Melbourne, Vic., Australia
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Shandley K, Austin DW, Bhowmik JL. Are Urinary Porphyrins a Valid Diagnostic Biomarker of Autism Spectrum Disorder? Autism Res 2014; 7:535-42. [DOI: 10.1002/aur.1385] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 03/25/2014] [Indexed: 01/13/2023]
Affiliation(s)
- Kerrie Shandley
- School of Psychology; Faculty of Health; Deakin University; Burwood Victoria Australia
| | - David W. Austin
- School of Psychology; Faculty of Health; Deakin University; Burwood Victoria Australia
| | - Jahar L. Bhowmik
- Faculty of Life and Social Sciences; Swinburne University of Technology; Hawthorn Victoria Australia
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Wootten AC, Abbott JAM, Chisholm KE, Austin DW, Klein B, McCabe MP, Meyer D, Costello AJ, Murphy DG. My Road Ahead study protocol: a randomised controlled trial of an online psychological intervention for men following treatment for localised prostate cancer. BMC Cancer 2014; 14:83. [PMID: 24517384 PMCID: PMC3927819 DOI: 10.1186/1471-2407-14-83] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Accepted: 02/04/2014] [Indexed: 01/22/2023] Open
Abstract
Background There is a need for psychosocial interventions for men with prostate cancer to promote adaptive coping with the challenges and distress associated with diagnosis, treatment and recovery. In addition, interventions are needed that help to overcome barriers to psychosocial treatment such as limited face-to-face psychosocial support services, a shortage of adequately trained professionals, geographical distance, perceived and personal stigma and a preference for consumer-centric and self-directed learning. My Road Ahead is an online cognitive behaviour therapy (CBT) intervention for prostate cancer. This protocol describes a randomised controlled trial (RCT) that will evaluate the efficacy of this online intervention alone, the intervention in combination with a moderated online forum, and the moderated online forum alone. Methods/design This study utilises a RCT design with three groups receiving: 1) the 6-module My Road Ahead intervention alone; 2) the My Road Ahead intervention plus a moderated online forum; and 3) the moderated online forum alone. It is expected that 150 men with localised prostate cancer will be recruited into the RCT. Online measures will assess men’s psychological distress as well as sexual and relationship adjustment at baseline, post-intervention, 3 month follow-up and 6 month follow-up. The study is being conducted in Australia and participants will be recruited from April 2012 to Feb 2014. The primary aim of this study is to evaluate the efficacy of My Road Ahead in reducing psychological distress. Discussion To our knowledge, My Road Ahead is the first self-directed online psychological intervention developed for men who have been treated for localised prostate cancer. The RCT will assess the efficacy of this intervention in improving psychological well-being, sexual satisfaction, relationship satisfaction and overall quality of life. If successful, this intervention could provide much needed support to men receiving treatment for localised prostate cancer in a highly accessible manner. Trial registration Australian New Zealand Clinical Trials Registry Identifier: ACTRN12611000278932
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Affiliation(s)
- Addie C Wootten
- Department of Urology, Royal Melbourne Hospital, Parkville, VIC, Australia.
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Pugh NE, Hadjistavropoulos HD, Klein B, Austin DW. A Case Study Illustrating Therapist-Assisted Internet Cognitive Behavior Therapy for Depression. Cognitive and Behavioral Practice 2014. [DOI: 10.1016/j.cbpra.2013.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Gondalia SV, Palombo EA, Knowles SR, Cox SB, Meyer D, Austin DW. Molecular characterisation of gastrointestinal microbiota of children with autism (with and without gastrointestinal dysfunction) and their neurotypical siblings. Autism Res 2012; 5:419-27. [PMID: 22997101 DOI: 10.1002/aur.1253] [Citation(s) in RCA: 142] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 08/27/2012] [Indexed: 12/14/2022]
Abstract
Many children with autism spectrum disorders (ASDs) suffer from gastrointestinal problems such as diarrhoea, constipation and abdominal pain. This has stimulated investigations into possible abnormalities of intestinal microbiota in autistic patients. Therefore, we designed this study to identify differences (and/or similarities) in the microbiota of children with autism (without gastrointestinal dysfunction: n = 23; with gastrointestinal dysfunction: n = 28) and their neurotypical siblings (n = 53) who share a similar environment using bacterial tag-encoded FLX amplicon pyrosequencing. Regardless of the diagnosis and sociodemographic characteristics, overall, Firmicutes (70%), Bacteroidetes (20%) and Proteobacteria (4%) were the most dominant phyla in samples. Results did not indicate clinically meaningful differences between groups. The data do not support the hypothesis that the gastrointestinal microbiota of children with ASD plays a role in the symptomatology of ASD. Other explanations for the gastrointestinal dysfunction in this population should be considered including elevated anxiety and self-restricted diets.
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Affiliation(s)
- Shakuntla V Gondalia
- Swinburne Autism Bio-Research Initiative (SABRI), Faculty of Life and Social Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia.
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Hadjistavropoulos HD, Thompson MJ, Klein B, Austin DW. Dissemination of therapist-assisted internet cognitive behaviour therapy: development and open pilot study of a workshop. Cogn Behav Ther 2012; 41:230-40. [PMID: 22428582 DOI: 10.1080/16506073.2011.645550] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
There is considerable research suggesting that therapist-assisted Internet cognitive behaviour therapy (ICBT) is efficacious in the treatment of depression and anxiety. Given this research, there is a growing interest in training students in therapist-assisted ICBT in order to assist with the dissemination of this emerging modality into routine clinical practice. In this study, we developed, delivered, and evaluated a therapist-assisted ICBT workshop for clinical psychology graduate students (n=20). The workshop provided both research evidence and practical information related to the delivery of therapist-assisted ICBT. The workshop also incorporated an experiential component with students working on and discussing responses to client e-mails. Before and after the workshop, we measured knowledge of therapist-assisted ICBT research and professional practice issues, as well as attitudes towards and confidence in delivering therapist-assisted ICBT. Statistically significant changes were observed in all areas. Eighty-five per cent of students are now offering therapist-assisted ICBT under supervision. We conclude by discussing future research directions related to disseminating therapist-assisted ICBT.
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Austin DW, Jamieson RS, Richards JC, Winkelman J. The Relationship Between Attachment Style, Anxiety Sensitivity and Interpretive Bias Among Adolescent Nonclinical Panickers. Behav change 2012. [DOI: 10.1375/bech.23.1.31] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
AbstractElevated anxiety sensitivity and the tendency to catastrophically misinterpret ambiguous bodily sensations has been demonstrated in people who experience nonclinical levels of panic (Richards, Austin, & Alvarenga, 2001), and anxiety sensitivity has been shown to be associated with insecure attachment in adolescents and young adults (Weems, Berman, Silverman, & Saavedra, 2001). This study investigated the relationship between attachment style, anxiety sensitivity and catastrophic misinterpretation among 11 nonclinical panickers and 58 nonanxious controls aged 18 to 19 years. Participants completed the Brief Bodily Sensations Interpretation Questionnaire (BBSIQ), Anxiety Sensitivity Index (ASI) and an attachment questionnaire. The hypothesis that insecurely attached individuals would demonstrate greater catastrophic misinterpretation and higher anxiety sensitivity than securely attached individuals was not supported; however, nonclinical panickers gave more anxiety-related interpretations of ambiguous internal stimuli than nonanxious controls. Results do not support the notion that attachment style is related to anxiety sensitivity or catastrophic misinterpretation (regardless of panic experience). Results do, however, support the notion that anxiety-related misinterpretation of ambiguous somatic sensations precedes the onset of panic disorder.
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Garrecht M, Austin DW. The plausibility of a role for mercury in the etiology of autism: a cellular perspective. Toxicol Environ Chem 2011; 93:1251-1273. [PMID: 22163375 PMCID: PMC3173748 DOI: 10.1080/02772248.2011.580588] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2011] [Accepted: 04/10/2011] [Indexed: 05/23/2023]
Abstract
Autism is defined by a behavioral set of stereotypic and repetitious behavioral patterns in combination with social and communication deficits. There is emerging evidence supporting the hypothesis that autism may result from a combination of genetic susceptibility and exposure to environmental toxins at critical moments in development. Mercury (Hg) is recognized as a ubiquitous environmental neurotoxin and there is mounting evidence linking it to neurodevelopmental disorders, including autism. Of course, the evidence is not derived from experimental trials with humans but rather from methods focusing on biomarkers of Hg damage, measurements of Hg exposure, epidemiological data, and animal studies. For ethical reasons, controlled Hg exposure in humans will never be conducted. Therefore, to properly evaluate the Hg-autism etiological hypothesis, it is essential to first establish the biological plausibility of the hypothesis. This review examines the plausibility of Hg as the primary etiological agent driving the cellular mechanisms by which Hg-induced neurotoxicity may result in the physiological attributes of autism. Key areas of focus include: (1) route and cellular mechanisms of Hg exposure in autism; (2) current research and examples of possible genetic variables that are linked to both Hg sensitivity and autism; (3) the role Hg may play as an environmental toxin fueling the oxidative stress found in autism; (4) role of mitochondrial dysfunction; and (5) possible role of Hg in abnormal neuroexcitory and excitotoxity that may play a role in the immune dysregulation found in autism. Future research directions that would assist in addressing the gaps in our knowledge are proposed.
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Affiliation(s)
- Matthew Garrecht
- Swinburne Autism Bio-Research Initiative, Faculty of Life and Social Sciences, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
| | - David W. Austin
- Swinburne Autism Bio-Research Initiative, Faculty of Life and Social Sciences, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia
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Kerrie S, Austin DW. Ancestry of pink disease (infantile acrodynia) identified as a risk factor for autism spectrum disorders. J Toxicol Environ Health A 2011; 74:1185-94. [PMID: 21797771 PMCID: PMC3173747 DOI: 10.1080/15287394.2011.590097] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2011] [Accepted: 05/05/2011] [Indexed: 05/22/2023]
Abstract
Pink disease (infantile acrodynia) was especially prevalent in the first half of the 20th century. Primarily attributed to exposure to mercury (Hg) commonly found in teething powders, the condition was developed by approximately 1 in 500 exposed children. The differential risk factor was identified as an idiosyncratic sensitivity to Hg. Autism spectrum disorders (ASD) have also been postulated to be produced by Hg. Analogous to the pink disease experience, Hg exposure is widespread yet only a fraction of exposed children develop an ASD, suggesting sensitivity to Hg may also be present in children with an ASD. The objective of this study was to test the hypothesis that individuals with a known hypersensitivity to Hg (pink disease survivors) may be more likely to have descendants with an ASD. Five hundred and twenty-two participants who had previously been diagnosed with pink disease completed a survey on the health outcomes of their descendants. The prevalence rates of ASD and a variety of other clinical conditions diagnosed in childhood (attention deficit hyperactivity disorder, epilepsy, Fragile X syndrome, and Down syndrome) were compared to well-established general population prevalence rates. The results showed the prevalence rate of ASD among the grandchildren of pink disease survivors (1 in 22) to be significantly higher than the comparable general population prevalence rate (1 in 160). The results support the hypothesis that Hg sensitivity may be a heritable/genetic risk factor for ASD.
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Affiliation(s)
- Shandley Kerrie
- Swinburne Autism Bio-Research Initiative (SABRI), Brain and Psychological Sciences Research Centre, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - David W. Austin
- Swinburne Autism Bio-Research Initiative (SABRI), Brain and Psychological Sciences Research Centre, Swinburne University of Technology, Hawthorn, Victoria, Australia
- Address correspondence to David W. Austin, Swinburne Autism Bio-Research Initiative (SABRI), Brain and Psychological Sciences Research Centre, Swinburne University of Technology, Mail H29, PO Box 218, Hawthorn, Victoria 3122, Australia. E-mail:
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Abstract
Dysregulated phospholipid metabolism has been proposed as an underlying biological component of neurodevelopmental disorders such as autistic disorder (AD) and attention-deficit/hyperactivity disorder (ADHD). This review provides an overview of fatty acid and phospholipid metabolism and evidence for phospholipid dysregulation with reference to the membrane hypothesis of schizophrenia. While there is evidence that phospholipid metabolism is at least impaired in individuals with AD, it has not been established whether phospholipid metabolism is implicated in causal, mechanistic or epiphenomenological models. More research is needed to ascertain whether breastfeeding, and specifically, the administration of colostrum or an adequate substitute can play a preventative role by supplying the neonate with essential fatty acids (EFAs) at a critical juncture in their development. Regarding treatment, further clinical trials of EFA supplementation are essential to determine the efficacy of EFAs in reducing AD symptomatology and whether supplementation can serve as a cost-effective and readily available intervention.
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Affiliation(s)
- Christine M Brown
- Swinburne Autism Bio-Research Initiative, Faculty of Life and Social Sciences, Swinburne University of Technology, Hawthorn, Victoria 3122, Australia.
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Abstract
Despite the removal of the mercury (Hg)-based preservative thimerosal from vaccines listed on the Australian Immunization Program Schedule for children, concerns remain among some researchers and parents for the safety of the present schedule, in part due to a fear of residual trace levels of Hg. The purpose of this study was to independently assess childhood vaccines for the presence of Hg. Eight vaccines administered to children under the age of 5 yr were assessed for Hg content via a DMA-80 direct mercury analyzer. Seven of the 8 vaccines contained no detectable levels of Hg (less than 1 ppb); however, 1 vaccine (Infanrix hexa) tested positive for Hg at 10 ppb. The result was confirmed and validated by retesting the original sample. Follow-up testing was conducted on three additional samples of Infanrix hexa (one from the same production lot and two from a different lot). All three tested positive for Hg (average of 9.7 ppb). Although the levels of Hg detected are substantially lower than any established exposure safety limits, the results of this study reveal that inaccuracies exist in public health messages, professional communications, and official documentation regarding Hg content in at least one childhood vaccine. In the interests of public health, it is incumbent on vaccine manufacturers and responsible agencies such as the Therapeutic Goods Administration and the Federal Department of Health and Ageing to address this issue as a matter of urgency.
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Affiliation(s)
- David W Austin
- Faculty of Life and Social Sciences, Swinburne University of Technology, Melbourne, Australia.
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Kiropoulos LA, Klein B, Austin DW, Gilson K, Pier C, Mitchell J, Ciechomski L. Is internet-based CBT for panic disorder and agoraphobia as effective as face-to-face CBT? J Anxiety Disord 2008; 22:1273-84. [PMID: 18289829 DOI: 10.1016/j.janxdis.2008.01.008] [Citation(s) in RCA: 161] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2007] [Revised: 01/08/2008] [Accepted: 01/10/2008] [Indexed: 11/29/2022]
Abstract
This study compared Panic Online (PO), an internet-based CBT intervention, to best-practice face-to-face CBT for people with panic disorder with or without agoraphobia. Eighty-six people with a primary diagnosis of panic disorder were recruited from Victoria, Australia. Participants were randomly assigned to either PO (n=46) or best practice face-to-face CBT (n=40). Effects of the internet-based CBT program were found to be comparable to those of face-to-face CBT. Both interventions produced significant reductions in panic disorder and agoraphobia clinician severity ratings, self reported panic disorder severity and panic attack frequency, measures of depression, anxiety, stress and panic related cognitions, and displayed improvements in quality of life. Participants rated both treatment conditions as equally credible and satisfying. Participants in the face-to-face CBT treatment group cited higher enjoyment with communicating with their therapist. Consistent with this, therapists' ratings for compliance to treatment and understanding of the CBT material was higher in the face-to-face CBT treatment group. PO required significantly less therapist time than the face-to-face CBT condition.
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Affiliation(s)
- Litza A Kiropoulos
- Department of General Practice, School of Primary Health Care, Monash University, Building 1, 270 Ferntree Gully Road, Notting Hill, Victoria 3168, Australia.
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Clarke DM, Piterman L, Byrne CJ, Austin DW. Somatic symptoms, hypochondriasis and psychological distress: a study of somatisation in Australian general practice. Med J Aust 2008; 189:560-4. [DOI: 10.5694/j.1326-5377.2008.tb02180.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2008] [Accepted: 08/13/2008] [Indexed: 11/17/2022]
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Austin DW, Abbott JM, Carbis C. The use of virtual reality hypnosis with two cases of autism spectrum disorder: a feasibility study. ACTA ACUST UNITED AC 2008. [DOI: 10.1002/ch.349] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Pier C, Austin DW, Klein B, Mitchell J, Schattner P, Ciechomski L, Gilson KJ, Pierce D, Shandley K, Wade V. A controlled trial of internet-based cognitive-behavioural therapy for panic disorder with face-to-face support from a general practitioner or email support from a psychologist. Ment Health Fam Med 2008; 5:29-39. [PMID: 22477844 PMCID: PMC2777548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Background Panic disorder (PD) is one of the most common anxiety disorders seen in general practice, but provision of evidence-based cognitive-behavioural treatment (CBT) is rare. Many Australian GPs are now trained to deliver focused psychological strategies, but in practice this is time consuming and costly.Objective To evaluate the efficacy of an internet-based CBT intervention (Panic Online) for the treatment of PD supported by general practitioner (GP)-delivered therapeutic assistance.Design Panic Online supported by GP-delivered face-to-face therapy was compared to Panic Online supported by psychologist-delivered email therapy.Methods Sixty-five people with a primary diagnosis of PD (78% of whom also had agoraphobia) completed 12 weeks of therapy using Panic Online and therapeutic assistance with his/her GP (n = 34) or a clinical psychologist (n = 31). The mean duration of PD for participants allocated to these groups was 59 months and 58 months, respectively. Participants completed a clinical diagnostic interview delivered by a psychologist via telephone and questionnaires to assess panic-related symptoms, before and after treatment.Results The total attrition rate was 20%, with no group differences in attrition frequency. Both treatments led to significant improvements in panic attack frequency, depression, anxiety, stress, anxiety sensitivity and quality of life. There were no statistically significant differences in the two treatments on any of these measures, or in the frequency of participants with clinically significant PD at post assessment.Conclusions When provided with accessible online treatment protocols, GPs trained to deliver focused psychological strategies can achieve patient outcomes comparable to efficacious treatments delivered by clinical psychologists. The findings of this research provide a model for how GPs may be assisted to provide evidence-based mental healthcare successfully.
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Affiliation(s)
- Ciaran Pier
- Lecturer in Psychology, School of Psychology, Deakin University, Victoria, Australia
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Abstract
OBJECTIVE The discriminant validity of the Sensory Profile was evaluated by comparing the sensory processing scores of Australian children, 5 to 8 years of age, diagnosed with autism spectrum disorder (ASD) to a control group of children with typical development matched for age and gender. METHOD Twenty-six parents of children with ASD and 26 parents of typically developing children without ASD completed the Sensory Profile. Sensory Profile category, factor, and quadrant scores were compared using multivariate analysis to investigate if there were differences between the two groups. RESULTS The results indicated that the children with ASD had significantly lower sensory processing scores on all fourteen categories, eight out of nine factors, and all four quadrants of the Sensory Profile. CONCLUSION The results also provide evidence of discriminant validity of Sensory Profile scores between children with ASD and children with typical development. In addition, the study findings indicate that the Sensory Profile can be used with confidence in cross-cultural contexts, such as Australia.
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Affiliation(s)
- Ted Brown
- Department of Occupational Therapy, School of Primary Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University-Peninsula Campus, Victoria, Australia.
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Abstract
Two recent studies, from France (Nataf et al., 2006) and the United States (Geier & Geier, 2007), identified atypical urinary porphyrin profiles in children with an autism spectrum disorder (ASD). These profiles serve as an indirect measure of environmental toxicity generally, and mercury (Hg) toxicity specifically, with the latter being a variable proposed as a causal mechanism of ASD (Bernard et al., 2001; Mutter et al., 2005). To examine whether this phenomenon occurred in a sample of Australian children with ASD, an analysis of urinary porphyrin profiles was conducted. A consistent trend in abnormal porphyrin levels was evidenced when data was compared with those previously reported in the literature. The results are suggestive of environmental toxic exposure impairing heme synthesis. Three independent studies from three continents have now demonstrated that porphyrinuria is concomitant with ASD, and that Hg may be a likely xenobiotic to produce porphyrin profiles of this nature.
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Affiliation(s)
- David W Austin
- Swinburne Autism Bio-Research Initiative (SABRI), Faculty of Life and Social Sciences, Swinburne University of Technology, Melbourne, Australia.
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Richards JC, Klein B, Austin DW. Internet cognitive behavioural therapy for panic disorder: Does the inclusion of stress management information improve end-state functioning? CLIN PSYCHOL-UK 2007. [DOI: 10.1080/13284200500378795] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Jeffrey C. Richards
- Department of General Practice, Monash University , Melbourne, Victoria, Australia
| | - Britt Klein
- Department of General Practice, Monash University , Melbourne, Victoria, Australia
| | - David W. Austin
- Department of General Practice, Monash University , Melbourne, Victoria, Australia
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Austin DW, Richards JC, Klein B. Modification of the Body Sensations Interpretation Questionnaire (BSIQ-M): validity and reliability. J Anxiety Disord 2006; 20:237-51. [PMID: 16464707 DOI: 10.1016/j.janxdis.2005.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2004] [Revised: 09/13/2004] [Accepted: 01/25/2005] [Indexed: 11/18/2022]
Abstract
The catastrophic misinterpretation model [Behav. Res. Ther. 24 (1986) 461-470] proposes that panic attacks result from misinterpretation of interoceptive stimuli as precursors to physical or psychological emergency. Inconclusive evidence for the model may be partly explained by limitations of the questionnaires developed to measure catastrophic misinterpretation. For example, the Body Sensations Interpretation Questionnaire (BSIQ) is unable to clarify whether anxiety-related interpretations of ambiguous interoceptive stimuli represent catastrophic misinterpretations or responses masking feared outcomes (e.g., heart failure). Additionally, it lacks items relating to several DSM-IV criteria for panic, thereby limiting content validity. Reliability is also potentially compromised due to experimenter-coding of participant-generated responses. A modified form of the BSIQ was developed to address these limitations and evaluated with non-anxious controls (n=34) and people with panic disorder (n=38). The revised questionnaire demonstrated good to excellent internal consistency, inter-rater reliability, and construct validity and is a useful development of the BSIQ.
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Affiliation(s)
- David W Austin
- Department of General Practice, Faculty of Medicine, Nursing and Health Sciences, Monash University, 867 Centre Road, East Bentleigh, Vic., Australia.
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Abstract
Fifty-five people with panic disorder (PD) were randomised to internet-based cognitive behavioural panic treatment (CBT) (with email contact), therapist-assisted CBT manual or information-only control (both with telephone contact). Both CBT treatments were more effective in reducing PD symptomatology, panic-related cognition, negative affect, and number of GP visits and improving physical health ratings. Internet treatment was more effective than CBT manual in reducing clinician-rated agoraphobia and number of GP visits at post-assessment. At follow-up, these effects were maintained for both CBT groups, with internet CBT better at improving physical health ratings and reducing GP visits. This study provides support for the efficacy of internet-based CBT.
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Affiliation(s)
- Britt Klein
- University of Ballarat, Ballarat, Australia.
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Austin DW, Allen MS, McCollum JM, Dar RD, Wilgus JR, Sayler GS, Samatova NF, Cox CD, Simpson ML. Gene network shaping of inherent noise spectra. Nature 2006; 439:608-11. [PMID: 16452980 DOI: 10.1038/nature04194] [Citation(s) in RCA: 202] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2005] [Accepted: 09/05/2005] [Indexed: 11/08/2022]
Abstract
Recent work demonstrates that stochastic fluctuations in molecular populations have consequences for gene regulation. Previous experiments focused on noise sources or noise propagation through gene networks by measuring noise magnitudes. However, in theoretical analysis, we showed that noise frequency content is determined by the underlying gene circuits, leading to a mapping between gene circuit structure and the noise frequency range. An intriguing prediction from our previous studies was that negative autoregulation shifts noise to higher frequencies where it is more easily filtered out by gene networks--a property that may contribute to the prevalence of autoregulation motifs (for example, found in the regulation of approximately 40% of Escherichia coli genes). Here we measure noise frequency content in growing cultures of E. coli, and verify the link between gene circuit structure and noise spectra by demonstrating the negative autoregulation-mediated spectral shift. We further demonstrate that noise spectral measurements provide mechanistic insights into gene regulation, as perturbations of gene circuit parameters are discernible in the measured noise frequency ranges. These results suggest that noise spectral measurements could facilitate the discovery of novel regulatory relationships.
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Affiliation(s)
- D W Austin
- Molecular-Scale Engineering and Nanoscale Technologies Group, Oak Ridge National Laboratory, Bethel Valley Road, Oak Ridge, Tennessee 37831, USA
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