ORCID Profile
0000-0002-6784-3972
Current Organisation
Deakin University
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Publisher: Cambridge University Press (CUP)
Date: 24-02-2023
DOI: 10.1017/S0033291722000332
Abstract: The mental health impact of the initial years of military service is an under-researched area. This study is the first to explore mental health trajectories and associated predictors in military members across the first 3–4 years of their career to provide evidence to inform early interventions. This prospective cohort study surveyed Australian Defence personnel ( n = 5329) at four time-points across their early military career. Core outcomes were psychological distress (K10+) and posttraumatic stress symptoms [four-item PTSD Checklist (PCL-4)] with intra-in idual, organizational and event-related trajectory predictors. Latent class growth analyses (LCGAs) identified subgroups within the s le that followed similar longitudinal trajectories for these outcomes, while conditional LCGAs examined the variables that influenced patterns of mental health. Three clear trajectories emerged for psychological distress: resilient (84.0%), worsening (9.6%) and recovery (6.5%). Four trajectories emerged for post-traumatic stress, including resilient (82.5%), recovery (9.6%), worsening (5.8%) and chronic subthreshold (2.3%) trajectories. Across both outcomes, prior trauma exposure alongside modifiable factors, such as maladaptive coping styles, and increased anger and sleep difficulties were associated with the worsening and chronic subthreshold trajectories, whilst members in the resilient trajectories were more likely to be male, report increased social support from family/friends and Australian Defence Force (ADF) sources, and use adaptive coping styles. The emergence of symptoms of mental health problems occurs early in the military lifecycle for a significant proportion of in iduals. Modifiable factors associated with wellbeing identified in this study are ideal targets for intervention, and should be embedded and consolidated throughout the military career.
Publisher: Wiley
Date: 05-05-2021
DOI: 10.1111/JCPP.13410
Abstract: This study investigates the sex, ethnic and socioeconomic inequalities in emotional difficulties over childhood and adolescence using longitudinal cohort studies in the UK and Australia. Estimating cross‐national differences contributes to understanding of the consistency of inequalities in mental health across contexts. Data from 19,748 participants in two contemporary representative s les in Australia ( Growing Up in Australia : The Longitudinal Study of Australian Children, n = 4,975) and UK (Millennium Cohort Study, n = 14,773) were used. Emotional difficulties were assessed using the parent‐reported Strengths and Difficulties Questionnaire at ages 4/5, 6/7, 11/12 and 14/15 years and the self‐reported Short Moods and Feelings Questionnaire at age 14/15. Latent Growth Curve Modelling was used to examine mental health over time. There were significant increases in emotional difficulties in both countries over time. Emotional difficulties were higher in Australian children at all ages. The gender gap in self‐reported depressive symptoms at age 14/15 was larger in the UK (8% of UK and 13% of Australian boys were above the depression cut‐off, compared with 23% of girls). Ethnic minority children had higher emotional difficulties at age 4/5 years in both countries, but over time this difference was no longer observed in Australia. In the UK, this reversed whereby at ages 11/12 and 14/15 ethnic minority children had lower symptoms than their White majority peers. Socioeconomic differences were more marked based on parent education and employment status in Australia and by parent income in the UK. UK children, children from White majority ethnicity and girls evidenced steeper worsening of symptoms from age 4/5 to 14/15 years. Even in two fairly similar countries (i.e. English‐speaking, high‐income, industrialised), the observed patterns of inequalities in mental health symptoms based on sociodemographics are not the same. Understanding country and context‐specific drivers of different inequalities provides important insights to help reduce disparities in child and adolescent mental health.
Publisher: Informa UK Limited
Date: 2021
Publisher: American Psychological Association (APA)
Date: 11-2018
DOI: 10.1037/SER0000239
Abstract: Telepsychology holds promise as a treatment delivery method that may increase access to services as well as reduce barriers to treatment accessibility. The aim of this rapid evidence assessment was to assess the evidence for synchronous telepsychology interventions for 4 common mental health conditions (depression, anxiety, posttraumatic stress disorder, and adjustment disorder). Randomized controlled trials published between 2005 and 2016 that investigated synchronous telepsychology (i.e., telephone delivered, video teleconference delivered, or Internet delivered text based) were identified through literature searches. From an initial yield of 2,266 studies, 24 were included in the review. Ten studies investigated the effectiveness of telephone-delivered interventions, 11 investigated the effectiveness of video teleconference (VTC) interventions, 2 investigated Internet-delivered text-based interventions, and 2 were reviews of multiple telepsychology modalities. There was sufficient evidence to support VTC and telephone-delivered interventions for mental health conditions. The evidence for synchronous Internet-delivered text-based interventions was ranked as "unknown." Telephone-delivered and VTC-delivered psychological interventions provide a mode of treatment delivery that can potentially overcome barriers and increase access to psychological interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
Publisher: SAGE Publications
Date: 22-10-2019
Abstract: Prolonged exposure (PE) therapy is an evidence-based psychological treatment of post-traumatic stress disorder (PTSD), yet uptake amongst practitioners is less than desirable. The aim of this study was to evaluate the efficacy of a PE training workshop plus intensive consultation programme to improve practitioners’ self-efficacy and outcome expectations as well as uptake of PE for emergency service patients with PTSD. Forty-five psychologists attended a PE training workshop in Sydney. Participants completed questionnaires at pre- and post-workshop and six-month follow-up. The findings suggest that participation in the programme was associated with improvements in practitioners’ beliefs in their ability to deliver PE to patients, an increase in their use of a range of PE components and an increase in their use of in vivo exposure with a greater proportion of patients. Effective training approaches for evidence-based treatments of PTSD should incorporate intensive consultation following training. Future studies should consider additional strategies to encourage practitioners to deliver PE to more patients with PTSD.
Publisher: Wiley
Date: 16-01-2021
DOI: 10.1002/JTS.22650
Abstract: The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP) is an intervention that targets common mechanisms that maintain symptoms across multiple disorders. The UP has been shown to be effective across many disorders, including generalized anxiety disorder, major depressive episode (MDE), and panic disorder, that commonly codevelop following trauma exposure. The present study represented the first randomized controlled trial of the UP in the treatment of trauma‐related psychopathology, including posttraumatic stress disorder (PTSD), depression, and anxiety symptoms. Adults ( N = 43) who developed posttraumatic psychopathology that included PTSD, MDE, or an anxiety disorder after sustaining a severe injury were randomly assigned to receive 10–14 weekly, 60‐min sessions of UP ( n = 22) or usual care ( n = 21). The primary treatment outcome was PTSD symptom severity, with secondary outcomes of depression and anxiety symptom severity and loss of diagnosis for any trauma‐related psychiatric disorder. Assessments were conducted at intake, posttreatment, and 6‐month follow‐up. Posttreatment, participants who received the UP showed significantly larger reductions in PTSD, Hedges’ g = 1.27 anxiety, Hedges’ g = 1.20 and depression symptom severity, Hedges’ g = 1.40, compared to those receiving usual care. These treatment effects were maintained at 6‐month follow‐up for PTSD, anxiety, and depressive symptom severity. Statistically significant posttreatment loss of PTSD, MDE, and agoraphobia diagnoses was observed for participants who received the UP but not usual care. This study provides preliminary evidence that the UP may be an effective non–trauma‐focused treatment for PTSD and other trauma‐related psychopathology.
Publisher: SAGE Publications
Date: 2020
Abstract: Qualitative research plays an important role in helping us describe, interpret and generate theories about complex phenomena in healthcare. Complete and transparent reporting of research informs readers about the significance and rigor of the work. The aim of this scientometric study was to determine the quality of reporting of qualitative research in nursing social science. Studies were identified by manually searching the table of contents for qualitative papers published in the June (or closest subsequent) 2018 issue of 115 nursing journals. Adherence with the 32-item Consolidated Criteria for REporting Qualitative (COREQ) research was determined for each study by two researchers. Additional information about the study (e.g., s le size, field of nursing) and the publishing journal (e.g., endorsement of COREQ) were also extracted. Using established criteria, COREQ compliance was coded either good (≥ 25 items), moderate (17 to 24), poor (9 to 16), very poor (≤ 8) based on the number of items addressed in each study. One hundred and ninety-seven manuscripts were included. The quality of reporting was generally rated as either moderate (57%) or poor (38%). Journal endorsement of qualitative reporting guidelines was associated with better reporting. The reporting of qualitative research in nursing social science journals is suboptimal. Researchers, authors, reviewers and journal editors need to ensure their papers comprehensively address the requirements of COREQ to ensure comprehensive and transparent reporting of their research.
Publisher: Medknow
Date: 2019
DOI: 10.4103/HM.HM_64_19
Publisher: American Psychological Association (APA)
Date: 05-2018
DOI: 10.1037/TRA0000274
Abstract: In the aftermath of a potentially traumatic event, people may experience a range of mental health outcomes, including subclinical symptoms and distress. There is growing evidence that trauma survivors with subclinical symptoms are at increased risk of developing later psychiatric disorders, and this is especially the case with severe injury survivors. There is a need to develop evidence-based, early, brief interventions for those who are at risk of developing trauma-related psychopathology. To date, interventions for this at-risk group have largely been derived from expert consensus. This study therefore aimed to understand the early psychosocial difficulties and perceived needs from the perspective of trauma survivors to further inform intervention development. Forty-three survivors of a serious injury, identified as high risk for developing trauma-related psychopathology, were interviewed and qualitative methods (Thematic Analysis) were used to synthesize the data gathered. Participants described 5 main stressors: trauma-related psychological reactions, relationship stress, unsatisfactory services and support systems, reduced functioning, and negative thoughts and emotions in relation to recovery. In addition, participants described 3 main factors that were helpful in recovery: positive coping, professional support, and social support. These findings can inform posttrauma intervention development for those at risk of later psychological symptoms. In particular, the results support approaches focusing on promoting activity, supporting social relationships, stress and arousal management, and cognitive restructuring. In addition, future interventions might helpfully target rumination, worry, and reexperiencing symptoms. (PsycINFO Database Record
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 14-07-2021
Publisher: American Psychological Association (APA)
Date: 07-2019
DOI: 10.1037/TRA0000520
Abstract: Psychiatric comorbidity is common among veterans with posttraumatic stress disorder (PTSD), but there is little known about the patterns of co-occurring mental health problems and implications for treatment. The aim of this study was to identify comorbidity profiles among veterans at treatment intake and assess associations with PTSD and quality of life (QOL) outcomes. The study included 2,522 veterans accessing outpatient treatment for PTSD in Australia who self-completed measures of comorbid issues including depression, anger, alcohol use problems, guilt, and dissociation. Latent Profile Analysis (LPA) was used to identify subgroups based on comorbidity profiles, and their association with outcomes. LPA suggested 5 comorbidity profiles: (a) low comorbidity severity, (b) moderate comorbidity severity with low alcohol, (c) moderate comorbidity severity with high alcohol, (d) high comorbidity severity with low alcohol, and (e) high comorbidity severity with high alcohol. The absence of alcohol problems was associated with improved treatment outcomes when overall comorbidity severity was high but not moderate. While all profiles evidenced symptom improvement from intake to discharge and follow-up, this did not correspond to quality of life improvements equally across classes. The highest severity comorbidity class experienced no improvement on psychological quality of life. The comorbidity profiles of veterans in treatment for PTSD can be distinguished by levels of severity and the specific presence or absence of alcohol use problems. Alcohol use problems have discernible implications for treatment in the context of comorbidity. Group treatments for PTSD should consider tailoring interventions to comorbidity profiles. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
No related grants have been discovered for Sonia Terhaag.