ORCID Profile
0000-0002-6639-1767
Current Organisations
Tasmania Health Service
,
University of Tasmania
,
James Cook University
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
Publisher: Wiley
Date: 24-02-2005
DOI: 10.1111/J.1440-0979.2005.00353.X
Abstract: This paper describes the use of seclusion in a child and adolescent inpatient unit, including precipitating events, management strategies, details of seclusion episodes and in idual and family risk factors. Inpatient ward documentation of seclusion episodes, demographic data and measures of in idual psychopathology and impairment, parent mental health, life events and family functioning were used to compare secluded, non-secluded and outpatient groups. Secluded in iduals had elevated psychopathology compared with non-secluded inpatients and outpatients. Their families reported poorer parental mental health and family functioning and more recent stressful life events. The results indicate that seclusion is most common among high-risk inpatients.
Publisher: Wiley
Date: 07-06-2012
DOI: 10.1111/J.1651-2227.2012.02738.X
Abstract: Eating disorder screening tools have not been adequately validated for use with adolescents with type 1 diabetes. This study compared the Youth Eating Disorder Examination-Questionnaire (YEDE-Q) and the Eating Disorder Inventory-3 Risk Composite (EDI-3RC) against the child Eating Disorder Examination (chEDE). These screening tools were chosen because they broadly assess eating disorder psychopathology and have subscales helpful for clinical management. In this cross-sectional study, 124 adolescents with type 1 diabetes aged 13-18 years completed two self-administered questionnaires, the YEDE-Q and the EDI-3RC. Cronbach's alpha was used to assess internal consistency of the tools. Fifty-one adolescents, randomly selected, participated in the chEDE. Intraclass correlations and Spearman's correlations were used to measure concordance of the chEDE with the YEDE-Q and EDI-3RC. The YEDE-Q and EDI-3RC demonstrated good subscale internal consistency Cronbach's alpha for YEDE-Q (0.78-0.95) and EDI-3RC (0.79-0.94). High levels of concurrent validity with the chEDE were seen with both tools. Preliminary evidence is provided for the validation of the YEDE-Q and EDI-3RC for use in adolescents with type 1 diabetes. The YEDE-Q also defines in idual disturbed eating behaviours with frequency ratings which can be helpful for tailoring early intervention.
Publisher: Wiley
Date: 30-10-2017
DOI: 10.1111/JPC.13746
Abstract: The 22q11.2 deletion syndrome (22qDS) is a genetic syndrome that results in a complex physical, behavioural and psychological phenotype. Health-related quality of life (HRQOL) is an established clinical outcome that has been minimally studied in children with 22qDS. The purpose of this study was to explore HRQOL among children and adolescents with 22qDS from the perspective of the child and to determine how their HRQOL measures compare to those of a healthy peer group and a chronic disease peer group. We recruited in iduals between the ages of 8 and 18 with a positive genetic diagnosis of 22qDS (n = 28) and a parent of the child. Participants completed the paired Paediatric Quality of Life Inventory 4.0 questionnaires. Comparisons were made with a previous study of healthy and diseased children. Children with 22qDS had a significantly poorer HRQOL when compared to age-matched cohorts of healthy children and children with chronic disease. Within the study, there was variable proxy-self agreement, and children with 22qDS reported lower HRQOL than adolescents with 22qDS. This study is the first to explore HRQOL from the perspective of the child with 22qDS, and our findings support the existing literature that this condition is associated with a poor HRQOL.
Publisher: Wiley
Date: 02-12-2013
DOI: 10.1111/JPC.12014
Abstract: To describe the presence and type of disturbed eating behaviours and thoughts in a combined male/female Australian s le of adolescents with type 1 diabetes, and examine the association of eating behaviours and thoughts with glycaemic control as evidenced by high glycosylated haemoglobin levels (HbA1c). In this cross-sectional descriptive study, 124 adolescents aged 13-18 years were invited to complete three self-administered questionnaires. The Youth Eating Disorder Examination Questionnaire (YEDE-Q) and the Eating Disorder Inventory -3 Risk Composite (EDI-3RC) assessed risk for an eating disorder. The third questionnaire, the Strengths and Difficulties Questionnaire (SDQ) assessed emotional and behavioural concerns. Clinical data were collected from the medical records, routine clinic appointments and the adolescent. Any disturbed eating behaviour was reported by approximately one-third of participants (32.3%) and was common in females and males (37.9% vs. 25.9%). Binge eating (17.7%), driven exercise (13.0%) and dietary restraint (8.9%) were the most common disturbed eating behaviours, although restraint was not evident in males. Insulin manipulation/omission (5.6%), vomiting (3.3%), laxative (0.8%) or diuretic use (0.8%) were less common. Regression analysis showed a significant association between HbA1c and more disturbed eating behaviours and thoughts which remained significant when adjusted for confounders. High rates of disturbed eating behaviours and thoughts were seen in this Australian s le of adolescents with type 1 diabetes. High scores on both eating disorder measures were associated with poorer glycaemic control. These results highlight the need to screen for disordered eating in adolescents with type 1 diabetes.
Publisher: Wiley
Date: 08-12-2009
DOI: 10.1111/J.1651-2227.2009.01517.X
Abstract: To report the stability of parent-perceived child irregular eating from 6 months to 14 years of age and to investigate a predictive model inclusive of child and parent factors. Of the 7223 singleton children in a birth cohort, 5122 children were re-interviewed at 5 years and 4554 for the 14-year analysis. Information was obtained from structured interviews including questions answered by parents of the child at birth, 6 months, 5 years and 14 years and by teenagers at age 14 years and from physical measures of the child. The mother's perception that the child was an irregular eater at age 14 years was the major outcome variable of interest. Approximately 40% of irregular eaters at age 5 will still be irregular eaters at age 14 years. This was not related to maternal education or socio-economic class. Significant at multivariate analysis were infant feeding problems and the children's ability to regulate their sleep and mood. Significant maternal factors were greater age, not feeling positive about the baby and persistent maternal anxiety during the child's early years. Irregular eating behaviour displays considerable continuity from childhood to mid-adolescence. Independent contributions to this behavioural phenotype include child biological and psychological factors and maternal anxiety during the child's early years.
Publisher: Wiley
Date: 09-2019
DOI: 10.1111/IMJ.14211
Abstract: One in five adolescents and young adults (AYA) has a chronic health condition necessitating on-going engagement with healthcare systems. Despite increasing prevalence there remains limited understanding of the burden of illness they experience. Living with a chronic illness can challenge healthy adolescent development, with the unique health and developmental issues affecting AYA requiring different responses from the healthcare system. To examine and compare the burden of illness in this group across a large range of chronic health conditions. In a dedicated health service for AYA aged 15-25 years with chronic health conditions, (13-25 years for those with substance use issues) we detail a protocol where demographics, general health, disease-specific indicators and comprehensive psychosocial variables will be collected. The health conditions include chronic gastrointestinal disease, cystic fibrosis, chronic rheumatic disease, phenylketonuria, craniomaxillofacial deformities, renal transplant patients and problematic substance use. Results will be compared to AYA without chronic illness and AYA with diabetes. This protocol outlines a comprehensive screening study for AYA with a large range of chronic health conditions, inclusive of medical, mental health, impairment and quality of life variables. It will inform service planning and provide a foundation upon which allied health service requirements (e.g. psychology) can be based. Whilst currently cross-sectional we anticipate further utility in broadening outcomes to include non-physical illness-related constructs. The commonalities and differences between conditions will be examined to facilitate efficiencies of scale for systems and supports. Further iterations including quantifying access to allied health services will facilitate studying the impact of such interventions on treatment adherence and improving psychosocial functioning, quality of life and disease outcomes.
Publisher: BMJ
Date: 05-2005
DOI: 10.1136/EBMH.8.2.56
Publisher: Informa UK Limited
Date: 29-04-2010
DOI: 10.1080/15374411003691719
Abstract: This study reports on the results of a long-term follow-up of 60 (29 girls and 31 boys, all of Caucasian ethnicity) children and adolescents diagnosed with an anxiety disorder and treated 3 years earlier with child-focused cognitive behavior therapy (CBT) or child-focused CBT plus parental anxiety management (PAM). Sixty-seven children aged 7 to --14 years were assigned to either the "child anxiety only" or the "child + parental anxiety" condition based on parents' trait anxiety scores. Within conditions, participants were randomly assigned to one of the two treatment conditions. Results indicated that at follow-up, parental anxiety did not represent a risk factor for children's treatment outcome. In addition at follow-up, children who received the combined CBT + PAM intervention (regardless of parental anxiety status) were significantly more likely to be anxiety diagnosis free compared with children who received the child-focused CBT intervention only.
Publisher: Korean Society of Animal Science and Technology
Date: 2022
Publisher: Research Square Platform LLC
Date: 16-11-2021
DOI: 10.21203/RS.3.RS-1059119/V1
Abstract: Fast radio bursts (FRBs) are highly dispersed radio bursts prevailing in the universe. The recent detection of FRB~200428 from a Galactic magnetar suggested that at least some FRBs originate from magnetars, but it is unclear whether the majority of cosmological FRBs, especially the actively repeating ones, are produced from the magnetar channel. Here we report the detection of 1863 polarised bursts from the repeating source FRB~20201124A during a dedicated radio observational c aign of Five-hundred-meter Aperture Spherical radio Telescope (FAST). The large s le of radio bursts detected in 88 hr over 54 days indicate a significant, irregular, short-time variation of the Faraday rotation measure (RM) of the source during the first 36 days, followed by a constant RM during the later 18 days. Significant circular polarisation up to 75\\% was observed in a good fraction of bursts. Evidence suggests that some low-level circular polarisation originates from the conversion from linear polarisation during the propagation of the radio waves, but an intrinsic radiation mechanism is required to produce the higher degree of circular polarisation. All of these features provide evidence for a more complicated, dynamically evolving, magnetised immediate environment around this FRB source. Its host galaxy was previously known. Our optical observations reveal that it is a Milky-Way-sized, metal-rich, barred-spiral galaxy at redshift z=0.09795+-0.00003, with the FRB residing in a low stellar density, interarm region at an intermediate galactocentric distance, an environment not directly expected for a young magnetar formed during an extreme explosion of a massive star.
Publisher: American Psychological Association (APA)
Date: 10-2020
DOI: 10.1037/MEN0000259
Publisher: SAGE Publications
Date: 23-08-2013
Abstract: To describe PTSD symptom persistence and resolution, including the potential phenomenon of late-onset PTSD, in children and adolescents 18 months after a cyclone disaster and to investigate factors that predict longer-term symptom outcome. 71 children and 191 adolescents who were screened three months after a Category 5 Cyclone were re-screened 18 months post-disaster. Child-report measures included the PTSD Reaction Index, measures of event exposure and social connectedness. Approximately 1-in-5 children and 1-in-12 adolescents endorsed cyclone-related PTSD symptoms at the moderate to severe level 18 months post-disaster. Of these approximately one-half (44.8%) of children were in the ‘high-persister’ group at 18-month follow-up. Persistence of low symptoms was very common (97.6%) and late-onset PTSD was a rare phenomenon. This pattern was similar in adolescents: 25.0% were in the ‘high-persister’ group and few students experienced late-onset PTSD. In multivariate analysis, only initial severe to very severe PTSD category made a significant independent contribution to explaining persisting moderate to severe PTSD symptoms in primary school students (ORadj=8.33, 95% CI=1.45-47.84). There was a trend for a similar result in secondary students. A child or adolescent with few PTSD symptoms three months post-disaster is likely to remain so unless a further traumatic event occurs. However, if symptomatic at three months, there is approximately a 30-45% chance that the child or adolescent will still be symptomatic 18 months after the disaster. Given the high rate of students in the ‘resolver’ group, initial posttraumatic symptoms are a necessary but not sufficient condition for predicting chronic symptomatology. Other targets for predictive modelling include initial threat perception and high and low social connectedness.
Publisher: Elsevier BV
Date: 2015
Publisher: SAGE Publications
Date: 12-02-2015
Abstract: This study investigates if the routine use of the urine drug screen offers any diagnostic or management benefit in the assessment and treatment of psychiatry patients in a suburban psychiatry emergency service. Data was collected retrospectively from consecutive patients 18 years and above, who presented to a large suburban hospital emergency department and had a urine drug screen ordered in the emergency department. A total of 111 patients, (with mean age of participants being 34.9 years, SD 10.2 years, minimum 18 – maximum 62 years, 62.2% (69/111) were male) met the inclusion criteria. The most common drug group identified was benzodiazepines (59.5% 66/111), followed by cannabis (40.5% 45/111). Other drugs were identified at much lower levels, including hetamines (9.0% 10/111), opiates (4.5% 5/111) and methadone (0% 0/111). For most in iduals only one drug was detected (55.9% 62/111), with equal numbers (18.9%) with either zero or two drugs identified by a urine drug screen. Fewer patients had three drugs on a urine drug screen (5.4% 6/111) or four (0.9% 1/111). Qualitative urine drug screens provide limited additional information compared to history taking and has minimal impact on clinical management decisions in a psychiatry emergency service.
Publisher: Elsevier BV
Date: 02-2010
DOI: 10.1016/J.APNU.2009.01.002
Abstract: Aggression is common in mental health services, but little research has examined exposure to aggression and its impact on staff in children and adolescent settings. Staff members within a child and adolescent psychiatric inpatient unit were interviewed to examine exposure to aggression and perceptions about the impact of aggression. Involvement in episodes of physical aggression was common (84.8%, 28/33) and was linked to difficulty attending work and other emotional and professional sequelae. These findings suggest that aggression is an important issue for staff working in child and adolescent settings and that aggression may impair the therapeutic capacity of staff.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2008
Publisher: SAGE Publications
Date: 12-2005
DOI: 10.1080/J.1440-1665.2005.02232.X
Abstract: Objective: To identify services supporting the well-being of infants and their families in an area of South Brisbane, Australia, highlight problems of accessing these services and recommend strategies to make them more readily available. Method: Semistructured interviews were conducted with staff from 18 service providers offering antenatal services, or programmes primarily focused on children under the age of 2 years and/or their families. The interview aimed to identify the precise nature of the services offered, problems encountered in providing those services, perceived gaps in services and potential strategies for improvement. Results: Services were erse, provided by a range of different professionals, in varying locations (home, community, hospital) and with funding from various sources. The major findings were:(i) the fragmentation of services, lack of communication between them, and lack of continuity in services from one stage of family formation to another (ii) the shortage of services working with the parents and infant together and (iii) the difficulty ofproviding services for some at-risk populations. Conclusions: Recommendations included: (i) maintaining a range of different services networked through a centralized resource/referral centre (ii) expandingjoint mother–infant services and providing training for such services and (iii) supporting outreach services for difficult to engage populations.
Publisher: Springer Science and Business Media LLC
Date: 16-11-2010
Publisher: Informa UK Limited
Date: 10-06-2021
Publisher: MDPI AG
Date: 06-04-2022
Abstract: The coronavirus (COVID-19) disease pandemic has been associated with adverse psychological outcomes. This cross-cultural study (N = 1326, 71% female) aimed to investigate Canadian and Australian adolescents’ subjective experiences of COVID-19, gender differences, and psychological implications. Mixed-methods analyses were used to examine differences in COVID-19 experiences and mental health outcomes between country and gender in a Canadian (N = 913, 78% female) and an Australian s le (N = 413, 57% female) of adolescents. Canadian adolescents reported increased COVID-19 discussions and more concerns related to their COVID-19 experiences compared to Australian adolescents. Girls consistently reported more concerns related to COVID-19 and poorer psychological outcomes compared to boys. School lockdown for the Canadian s le may have played a role in these country differences. Further, girls might be at significantly more risk for mental health concerns during COVID-19, which should be considered in adolescent mental health initiatives during the pandemic. Although school disruption and separation of peers due to the pandemic likely have a role in adolescent perceived stressors and mental health, the differences between Canadian and Australian adolescents were less clear and future investigations comparing more objective pre-COVID-19 data to current data are needed.
Publisher: AMPCo
Date: 08-12-2020
DOI: 10.5694/MJA2.50886
Publisher: SAGE Publications
Date: 09-2004
DOI: 10.1080/J.1039-8562.2004.00536.X
Abstract: Objective: To review the origins, processes, clientele and outcomes of a child and youth interagency forum, a collaborative response to children and youth with severe and complex presentations. Methods: After a description of the Forum origins, membership and processes, both qualitative and quantitative information is provided on the Forum clientele. The Forum's effectiveness is considered in terms of changes in services provided to this group, as well as changes in agency and interagency work practices. Results: Forum clients were predominantly boys aged 12 years, with an overrepresentation of indigenous and intellectually disabled children. Few lived with biological parents, and on average had experienced five schools, 11 or more residential placements and were involved with six agencies. Disruptive behaviour symptoms were common, as were suicidal thoughts or actions (43%), history of physical (50%) or sexual abuse (21%), alcohol (29%) and drug use (14%). On average Forum clients were taking three psychotropic medications. Forum client impairment ranged from major impairment to gross impairment across several domains. Conclusions: While this is not a formal outcome study, evidence suggesting Forum usefulness included qualitative feedback from agencies, altered clinical and interagency practices, and decreased client impairment. Practical interventions for clients with chronic, complex multidomain impairments are discussed in the context of current Australian child and adolescent mental health services.
Publisher: Springer Science and Business Media LLC
Date: 28-10-2020
Publisher: SAGE Publications
Date: 27-03-2021
Abstract: Building upon the tripartite model of anxiety and depression, the current study aims to examine mechanisms of comorbidity between anxiety and depression using the ProQOL (Professional Quality of Life including the constructs of burnout, secondary traumatic stress, and compassion satisfaction) in a s le of Chinese health-care clinicians. A randomized cross-sectional survey was distributed to 1620 participants who were recruited from eight state-owned hospitals in a city in southern China between January and May 2017. A total of 1562 questionnaires were returned (a response rate of 96.4%). After the cases with more than 10% missing variables and multivariate outliers being removed, 1423 valid cases remained. Multiple mediator models were used for mediation analysis that was conducted using the PROCESS v3.1 macro for SPSS. The indirect effects of anxiety upon depression through burnout (a1 = . 601 (95% confidence interval (CI): .552, .650), p .001 b1 = .137 (95% CI: .101, .174), p .001) and compassion satisfaction (a3= −.297 (95% CI: −.352, −.241), p .001 b3 = −.069 (95% CI: −.100, −.039), p .001) were significant, while there was no evidence that anxiety influenced depression by changing secondary traumatic stress. The indirect effects of depression upon anxiety through secondary traumatic stress (a2 = . 535 (95% CI: .483, .588), p .001) b2 = .154 (95% CI: .120, .188), p .001) were both positive and significant, while there was no evidence that depression influenced anxiety by changing burnout and compassion satisfaction. In the current s le, burnout and compassion satisfaction mediated the effect of anxiety upon depression and secondary traumatic stress mediated the effect of depression upon anxiety. The findings of the current study offer support to the tripartite model.
Publisher: SAGE Publications
Date: 2022
DOI: 10.1177/15579883221079489
Abstract: The purpose of this study was to identify the risk factors associated with paternal perinatal mental distress in a s le of Australian men. A mixed-methods design was used. The qualitative component ( N = 13) using thematic analysis identified maternal depression, marital distress, masculine gender role stress, unplanned pregnancy, work–family conflict, and sleep disturbance as risk factors for paternal perinatal mental distress. The quantitative component ( N = 525) expanded on the qualitative findings and examined the associations between the identified risk factors and mental distress of fathers in the perinatal period measured by Edinburgh postnatal depression scale. Hierarchical multiple regression analysis revealed six significant predictors of paternal perinatal mental distress with masculine gender role stress being the most significant risk factor for paternal perinatal mental distress. The results from this study provide an insight into how masculine gender role may affect the expression and experience of mental distress in fathers within the perinatal period. Implications of research findings are discussed.
Publisher: SAGE Publications
Date: 12-2002
DOI: 10.1046/J.1440-1614.2002.01090.X
Abstract: Objective: Developmental approaches have not been widely used in child and adolescent posttraumatic stress disorder research, and little is known about developmental differences in response to postdisaster trauma. Our objective was to investigate postdisaster depression and emotional distress psychopathology across a broad child and adolescent developmental range. Method: Six months following a bushfire disaster, 2379 grade 4–12 school students completed an extensive self-report battery, which included the Impact of Event Scale and the Birleson Depression Inventory. Generalized linear models were constructed to model the effects of multiple covariates on continuous outcome measures of depression and emotional distress. Results: Significant independent predictors of persisting depressive symptoms were increased symptoms of emotional distress increased symptoms of anxiety evacuation experience and school grade. Significant independent predictors of emotional distress were persisting depressive symptoms perception of threat to self or to parents evacuation experience and school grade. Gender was not a significant predictor in either the depression or emotional distress multivariate models. Complex, non-linear relationships between depression, emotional distress and school grade were found. Conclusion: This study suggests that important developmental differences in postdisaster psychological responses exist across a broad spectrum of developmental stages in children.
Publisher: Wiley
Date: 07-04-2009
DOI: 10.1002/BMC.1204
Abstract: A simple, rapid, selective, accurate and precise method is described for the determination of risperidone and its active metabolite, 9-hydroxyrisperidone, in plasma using a chemical derivative of risperidone (methyl-risperidone) as the internal standard. The s le workup involved a single-step extraction of 1 mL plasma, buffered to pH 10, with heptane-isoamyl alcohol (98:2 v/v), then evaporation of the heptane phase and reconstitution of the residue in mobile phase. HPLC separation was carried out at on C(18) column using a mobile phase of 0.05 m dipotassium hydrogen orthophosphate (containing 0.3% v/v triethylamine) adjusted to pH 3.7 with orthophosphoric acid (700 mL), and acetonitrile (300 mL). Flow rate was 0.6 mL/min and the detection wavelength was 280 nm. Retention times were 2.6, 3.7 and 5.8 min for 9-hydroxy risperidone, risperidone and the internal standard, respectively. Linearity in spiked plasma was demonstrated from 2 to 100 ng/mL for both risperidone and 9-hydroxyrisperidone (r > or = 0.999). Total imprecision was less than 13% (determined as co-efficient of variation) and the inaccuracy was less than 12% at spiked concentrations of 5 and 80 ng/mL. The limit of detection, determined as three times the baseline noise, was 1.5 ng/mL. Clinical application of the assay was demonstrated for analysis of post-dose (0.55-4.0 mg/day) s les from 28 paediatric patients (aged 6.9-17.9 years) who were taking risperidone orally for behavioural and emotional disorders.
Publisher: Mary Ann Liebert Inc
Date: 02-2014
Publisher: SAGE Publications
Date: 04-2010
DOI: 10.3109/00048670903489916
Abstract: Objective: The aim of the present study was to investigate whether parent report of family resilience predicted children's disaster-induced post-traumatic stress disorder (PTSD) and general emotional symptoms, independent of a broad range of variables including event-related factors, previous child mental illness and social connectedness. Methods: A total of 568 children (mean age = 10.2 years, SD = 1.3) who attended public primary schools, were screened 3 months after Cyclone Larry devastated the Innisfail region of North Queensland. Measures included parent report on the Family Resilience Measure and Strengths and Difficulties Questionnaire (SDQ)–emotional subscale and child report on the PTSD Reaction Index, measures of event exposure and social connectedness. Results: Sixty-four students (11.3%) were in the severe–very severe PTSD category and 53 families (28.6%) scored in the poor family resilience range. A lower family resilience score was associated with child emotional problems on the SDQ and longer duration of previous child mental health difficulties, but not disaster-induced child PTSD or child threat perception on either bivariate analysis, or as a main or moderator variable on multivariate analysis (main effect: adjusted odds ratio (OR adj ) = 0.57, 95% confidence interval (CI) = 0.13–2.44). Similarly, previous mental illness was not a significant predictor of child PTSD in the multivariate model (OR adj = 0.75, 95%CI = 0.16–3.61). Conclusion: In this post-disaster s le children with existing mental health problems and those of low-resilience families were not at elevated risk of PTSD. The possibility that the aetiological model of disaster-induced child PTSD may differ from usual child and adolescent conceptualizations is discussed.
Publisher: Springer Science and Business Media LLC
Date: 10-11-2022
Publisher: Elsevier BV
Date: 05-2022
DOI: 10.1016/J.NEUBIOREV.2022.104605
Abstract: Adverse Childhood Experiences (ACEs) are stressful and/or traumatic experiences associated with an increased lifetime risk of negative health outcomes. The Allostatic Load (AL) is a measure of multisystem dysregulation, resulted by chronic stress. We systematically reviewed the English language literature on the association between ACEs and AL to identify the clinical risk profile, with the exclusion of reviews and preclinical studies. Searches covered the publication period up to the 1
Publisher: Hindawi Limited
Date: 27-01-2022
DOI: 10.1002/DA.23242
Publisher: Elsevier BV
Date: 06-2023
Publisher: Springer Science and Business Media LLC
Date: 15-09-2012
DOI: 10.1007/S10567-012-0124-9
Abstract: Accidental injuries represent the most common type of traumatic event to which a youth is likely to be exposed. While the majority of youth who experience an accidental injury will recover spontaneously, a significant proportion will go on to develop Post-Traumatic Stress Disorder (PTSD). And yet, there is little published treatment outcome research in this area. This review focuses on two key issues within the child PTSD literature--namely the role of parents in treatment and the timing of intervention. The issue of parental involvement in the treatment of child PTSD is a question that is increasingly being recognized as important. In addition, the need to find a balance between providing early intervention to at risk youth while avoiding providing treatment to those youth who will recover spontaneously has yet to be addressed. This paper outlines the rationale for and the development of a trauma-focused CBT protocol with separate parent and child programs, for use with children and adolescents experiencing PTSD following an accidental injury. The protocol is embedded within an indicated intervention framework, allowing for the early identification of youth at risk within a medical setting. Two case studies are presented in order to illustrate key issues raised in the review, implementation of the interventions, and the challenges involved.
Publisher: SAGE Publications
Date: 24-02-2021
Abstract: The primary aim was to examine differences in functional health outcomes in consumers entering a regional mental health service compared with a city service. A retrospective analysis of consumer outcomes and characteristics was undertaken. Consumer demographics and diagnoses were compared between the two services. Functional outcomes were measured using the 16-item Life Skills Profile (LSP-16). The data analysis plan utilised descriptive statistics. For between-clinic comparisons, relevant inferential statistics was used. Patients attending the regional health service were five times more likely to be in the high impairment category on the LSP-16, independent of demographic factors and diagnosis. Other independent contributions to high impairment were being male, Indigenous and a diagnosis of schizophrenia. Of the four LSP-16 subscales, regional consumers scored relatively higher on withdrawal, compliance and anti-social but not self-care subscales. There was a greater level of functional impairment in consumers attending the regional service. The independent contributions did not explain the higher impairment therefore, other factors such as socioeconomic disadvantage may explain the difference. Regional clinicians may need to consider recovery-orientated interventions that address a greater burden of functional impairments in regional services.
Publisher: SAGE Publications
Date: 09-2004
DOI: 10.1080/J.1440-1614.2004.01449.X
Abstract: Background: The Royal Australian and New Zealand College of Psychiatrists is coordinating the development of clinical practice guidelines (CPGs) in psychiatry, funded under the National Mental Health Strategy (Australia) and the New Zealand Ministry of Health. This CPG covers anorexia nervosa (AN). Method: The CGP team consulted with scientists, clinicians, carers and consumer groups in meetings of over 200 participants and conducted a systematic review of meta-analyses, randomized controlled trials and other studies. Treatment recommendations: It is extremely difficult to draw general conclusions about the efficacy of specific treatment options for AN. There are few controlled clinical trials and their quality is generally poor. These guidelines necessarily rely largely upon expert opinion and uncontrolled trials. A multidimensional approach is recommended. Medical manifestations of the illness need to be addressed and any physical harm halted and reversed. Weight restoration is essential in treatment, but insufficient evidence is available for any single approach. A lenient approach is likely to be more acceptable to patients than a punitive one and less likely to impair self-esteem. Dealing with the psychiatric problems is not simple and much controversy remains. For patients with less severe AN who do not require in-patient treatment, out-patient or day-patient treatment may be suitable, but this decision will depend on availability of such services. Family therapy is a valuable part of treatment, particularly for children and adolescents, but no particular approach emerges as superior to any other. Dietary advice should be included in all treatment programs. Cognitive behaviour therapy or other psychotherapies are likely to be helpful. Antidepressants have a role in patients with depressive symptoms and olanzapine may be useful in attenuating hyperactivity.
Publisher: Springer Science and Business Media LLC
Date: 29-06-2012
Publisher: SAGE Publications
Date: 02-2006
DOI: 10.1080/J.1440-1614.2006.01761.X
Abstract: Objective: To examine eating disorder attitudes and psychopathology among female university students in Australia and Thailand. Method: Participants were 110 Caucasian Australians, 130 Asian Australians and 101 Thais in Thailand. The instruments included the Eating Attitudes Test (EAT) and the Eating Disorders Inventory (EDI). Results: Eating disorder attitudes and psychopathology scores in the Thai group were found to be highest. The Asian Australian group did not have significantly higher scores on the EAT-26 than the Caucasian Australian group, but had higher scores in some subscales of the EDI-2. That the Thai group had the highest scores in susceptibility to developing an eating disorder and eating disorder psychopathology may be partially explained in sociocultural terms, with pressure to be thin more extreme in Thailand than in Australia. The evidence suggested that unhealthy eating disorder psychopathology is not limited to Western societies but is already present in Thai and other Asian societies.
Publisher: Informa UK Limited
Date: 06-2004
Publisher: Springer Science and Business Media LLC
Date: 27-11-2008
Publisher: SAGE Publications
Date: 12-1999
DOI: 10.1046/J.1440-1614.1999.00611.X
Abstract: Objective: Proactive, school-based psychological testing for emotional distress and depression was employed 6 months after a bushfire disaster. The service provision aim was to provide children with the greatest emotional distress the relatively limited therapeutic resources available in the post-disaster environment. Specific hypotheses were tested: that the prevalence of emotional distress and depression would be elevated 6 months post disaster that emotional distress would be correlated with traumatic events and that depression would be related to experiences of loss. Method: Six months after a bushfire disaster grade 4, 5, and 6 students (n = 601) participated in screening using a test battery measuring emotional distress, depressive symptoms and trait anxiety. Results: Twelve percent (n = 72) of children experienced severe emotional distress 6 months after the bushfire. Rates of depression were similar to rates in non-traumatised child community s les. Multivariate analysis suggested that emotional distress was significantly associated with trait anxiety, evacuation experience, the perception that parents may have died during the bushfire, and depressive symptoms. Depressive symptoms were associated with total distress score, trait anxiety and perception of threat to the parents. Conclusions: Substantial mental health morbidity was identified 6 months after a bushfire disaster. The usefulness of post-disaster service provision influenced by proactive screening is discussed and reasons for further research highlighted.
Publisher: SAGE Publications
Date: 28-08-2022
DOI: 10.1177/10398562221121213
Abstract: We evaluated the impact of medical emergency simulation training on self-reported attitudes, confidence level and knowledge amongst psychiatric doctors and mental health nurses. Before and following Essential Life Support (ELS) simulation training for medical emergencies, pre and post-questionnaires were employed. Paired t-tests were used to analyse change in self-reported attitudes, confidence in self and the team, and theoretical knowledge. In 37 participants we found significant improvement in doctors and nurses attitudes (t = 2.168 p .05 and 2.651 p .05) and doctor’s confidence t = 3.711 p .001) following training. Knowledge increased for all participants and was significant for doctors (t = 2.112, p .041). Comments supported training. Many doctors and nurses in mental health feel inadequately prepared and lack confidence in themselves and their colleagues to respond to medical emergencies. A structured simulation course was useful to change attitudes and increase confidence and knowledge which could benefit the team and patients.
Publisher: Elsevier BV
Date: 03-2006
DOI: 10.1016/J.JPSYCHORES.2005.08.004
Abstract: To compare the general psychopathology in an eating disorders (ED) and a child mental health outpatient s le and investigate the implications of comorbidity on psychological and physical measures of ED severity. One hundred thirty-six children and adolescents with a DSM-IV ED diagnosis were compared with age- and gender-matched controls. Measures included the Eating Disorders Examination and the Child Behavior Checklist. The ED group had lower general and externalizing psychopathology scores and no difference in internalizing (anxiety-depression) symptoms. Of the anorexia nervosa group, 49% experienced comorbid psychopathology. This group had significantly higher ED psychopathology, longer duration of illness, and more gastrointestinal symptoms, but no difference in malnutrition status. Eating disorders not otherwise specified (EDNos) group measures were less influenced by comorbidity status. Anxiety-depressive symptoms are very common in children and adolescents with EDs. Comorbidity status influences illness severity, especially in the anorexia nervosa group. The management implications of these findings are discussed.
Publisher: Royal College of Psychiatrists
Date: 14-08-2023
DOI: 10.1192/BJA.2023.39
Abstract: Multiaxial classification system development (organising important and relevant clinical factors under multiple headings or ‘axes’) has a long history stretching back to the 1940s. The World Health Organization supported the development of a multiaxial system of classification for children from the 1960s and in the 1990s produced a comprehensive multiaxial system which could be used with ICD-10. Using the multiaxial approach provides for an atheoretical framework that can integrate factors from within the child and the environmental influences on the child. This article presents a variety of ways in which the ICD-10 multiaxial framework can be extended from its classic usage to provide clinicians with valuable tools to assist in a biopsychosocial clinical assessment. Using the multiaxial system in an extended format allows a more comprehensive diagnosis and planning of treatments and is helpful in the training and teaching of juniors. It is also useful in evaluating responses to medication when it is combined with a chronological analysis and can provide other useful ways of integrating information relevant to understanding clinical cases.
Publisher: Informa UK Limited
Date: 31-01-2019
DOI: 10.1080/14656566.2018.1561862
Abstract: Conduct disorder (CD) is a common mental health disorder of childhood and adolescence. CD's complexity, with its heterogenous clinical manifestations and overlapping comorbidities makes the application of evidence-based management approaches challenging. This article aims to combine a systematic review of the available literature, with a consensus opinion from both child and adolescent psychiatrists and developmental pediatricians on the clinical and pharmacological management of children and adolescents with conduct disorder (CD). The authors review the CD population and provide a systematic review and meta-analysis of the effectiveness and safety of pharmacotherapies using preferred reporting items for systematic review and meta-analysis (PRISMA) and strength of evidence recommendation taxonomy (SORT) guidelines. The authors then provide an expert clinical opinion for the use of different pharmacotherapies to address aggressive and disruptive behavior in children. Atypical antipsychotics (e.g. risperidone) demonstrate evidence for efficacy in CD. Other pharmacotherapies (e.g. mood stabilizers, anticonvulsants, psychostimulants and selective norepinephrine reuptake inhibitors) have a low level of evidence for CD alone, however, can sometimes be effective in managing the symptoms of CD when other psychiatric disorders are also present.
Publisher: SAGE Publications
Date: 06-2000
DOI: 10.1080/J.1440-1614.2000.00753.X
Abstract: Objective: The prevalence of posttraumatic stress disorder (PTSD) and general psychopathology in children following motor vehicle accidents (MVA) was investigated. Method: Twenty-six subjects aged 8–13 years presenting to an emergency department following an MVA were assessed 3 months after the accident using a standard clinical psychiatric assessment, a structured research interview and self- and parent-report questionnaires. Results: A higher prevalence of psychopathology was seen in the s le compared with community controls. Self-report of PTSD symptoms revealed 22% subjects in the moderate or severe PTSD range and 35% of mild severity. There was significant concordance between self-report PTSD scores and a clinical diagnosis of PTSD. Perception of threat and the internalising subscale on the Child Behaviour Checklist were significantly correlated with PTSD scores. Conclusions: PTSD and other symptoms of emotional distress are common following MVAs. The clinical and public health implications are discussed, and areas for further research highlighted.
Publisher: SAGE Publications
Date: 12-2007
DOI: 10.1080/00048670701689436
Abstract: Objective: The aim of the present study was to compare the relative effectiveness of group and in idual formats of a family-focused cognitive–behavioural intervention, for the treatment of childhood anxiety disorders. Method: Twenty-nine clinically anxious children aged between 7 and 12 years were randomly allocated to either in idual cognitive–behaviour therapy (ICBT) or group cognitive–behaviour therapy (GCBT). Results: At post-treatment assessment 57% of children in the ICBT condition no longer met criteria for any anxiety disorder, compared to 47% of children in the GCBT condition. At 3 month follow up these improvements were retained with some weakening. By the 6 month follow up 50% of children in the ICBT compared to 53% of children in the GCBT condition were anxiety diagnosis free. In terms of questionnaire data, no significant differences were detected between the ICBT and GCBT conditions at any of the follow-up points. However, a significant treatment effect for time was found, with both self-reports and parent reports indicating a significant reduction over time in anxiety symptoms. Conclusion: Overall, results suggest that children with anxiety disorders appear to improve following a family-focused cognitive behavioural intervention, regardless of in idual or group administration. The interpretation and potential clinical implications of these findings are discussed, together with the limitations of this study and suggestions for future research.
Publisher: Wiley
Date: 03-2005
DOI: 10.1111/J.1834-7819.2005.TB00079.X
Abstract: This article is a review of the recent literature pertaining to the oral sequelae of eating disorders (EDs). Dentists are recognized as being some of the first health care professionals to whom a previously undiagnosed eating disorder patient (EDP) may present. However, despite the prevalence (up to 4 per cent) of such conditions in teenage girls and young adult females, there is relatively little published in the recent literature regarding the oral sequelae of EDs. This compares unfavourably with the attention given recently in the dental literature to conditions such as diabetes mellitus, which have a similar prevalence in the adult population. The incidence of EDs is increasing and it would be expected that dentists who treat patients in the affected age groups would encounter more in iduals exhibiting EDs. Most of the reports in the literature concentrate on the obvious clinical features of dental destruction (perimolysis), parotid swelling and biochemical abnormalities particularly related to salivary and pancreatic amylase. However, there is no consistency in explanation of the oral phenomena and epiphenomena seen in EDs. Many EDPs are nutritionally challenged there is a relative lack of information pertaining to non-dental, oral lesions associated with nutritional deficiencies.
Publisher: Wiley
Date: 04-2017
DOI: 10.1111/IMJ.13375
Abstract: Routine psychosocial screening and management of people with diabetes is recommended. To profile demographic, medical and psychosocial characteristics of young people with diabetes, and to develop a screening tool and care pathway for routine use. Indices of diabetes control and recorded diabetes complications were complimented by psychosocial screening tools assessing psychological, diabetes specific and perceived stress (Kessler 10, Problem Area in Diabetes, Perceived Stress Scale), well-being (World Health Organization Well Being Index-5), disordered eating (Eating Disorder Risk Inventory-3 Risk Composite), compensatory behaviour questionnaire, social support (Multidimensional Scale of Perceived Social Support), resilience (Connor Davidson Resilience Scale - 2 item) and financial concerns. Service provision and demographic data were also collected. Diabetes and mental health clinicians then identified a subset of measures to use for routine screening along with care pathways. Psychosocial screening was well accepted. Participants (151) had suboptimal glycaemic control (glycated haemoglobin 8.0 interquartile range 1.8%/64 interquartile range 22 mmol/mol). Severe diabetes-related distress (Problem Area in Diabetes ≥40) was found in 19.4% and 26.0% reported difficulties managing healthcare costs. A mental health disorder was likely in 9.7%, whilst 23.4% had high Kessler 10 scores. Low World Health Organization Well Being Index-5 scores (≤13) were seen in 29.0%. Risk for an eating disorder (Eating Disorder Risk Inventory-3 Risk Composite) was 12.7%, whereas approximately 36.0% had disturbed eating behaviours. Psychosocial screening of young adults with diabetes identified complex needs. A brief psychosocial screening tool and associated care pathways were developed for routine use in a young adult tertiary referral diabetes clinic. The tool assesses constructs, such as diabetes distress, depression, anxiety, well-being, hypoglycaemia-unawareness, fear of hypoglycaemia, social support, weight, shape and eating concerns and financial concerns. This will provide a longitudinal data source for further research to inform clinical practice.
Publisher: Wiley
Date: 12-2021
DOI: 10.1111/IMJ.15034
Abstract: This study examined the psychosocial burden of inflammatory bowel disease (IBD) in young people aged 15–25 years attending a tertiary specialist health centre for adolescents and young adults in Brisbane. To describe the impact of IBD on psychosocial well‐being in young people and to compare well‐being in the IBD cohort to well‐being among young people with other chronic conditions, with a view to identifying characteristics and challenges unique to those with IBD. Young people with IBD provided demographic information and psychosocial data through a cross‐sectional self‐report survey. Psychosocial data included the Kessler Psychological Distress Scale, Perceived Stress Scale, Brief Illness Perception Questionnaire, World Health Organisation Well‐being Index, Paediatric Quality of Life Inventory, Short Quality of Life Questionnaire for IBD, Multidimensional Scale of Perceived Social Support, Connor Davidson Resilience Scale 2 and the Multidimensional Health Locus of Control Scale. Surveys were collected from 51 young people with IBD and compared with surveys from 210 young people with juvenile rheumatic disease ( n = 31), phenylketonuria ( n = 21), cystic fibrosis ( n = 33), renal transplants ( n = 14) and craniomaxillofacial conditions ( n = 111). On the psychosocial domains, 41% of young people with IBD had poor well‐being and 37% were at risk of depression. When assessed against the comparison group, young people with IBD reported higher depressive symptoms ( P = 0.04), worse illness perceptions ( P 0.01) and lower internal locus of control ( P 0.01). Early recognition and treatment of depression and other psychosocial comorbidities within integrated pathways of care is crucial in adolescents and young adults with IBD and likely to improve the course of IBD and their overall health and well‐being. Interventions aimed at enhancing self‐efficacy and increasing public awareness are also likely to be helpful.
Publisher: Elsevier BV
Date: 04-2002
DOI: 10.1016/S1056-4993(01)00010-4
Abstract: This article reviews the place of in idual therapy in the suite of treatment services required by children and adolescents with an eating disorder. In idual therapy is defined and traced from historical origins in psychoanalytic practice with later important modifications by Hilda Bruch and Arthur Crisp. More recent developments, based primarily on cognitive and learning theory are discussed, as is the timing of in idual therapy with respect to illness stage and patient motivation. Evidence for therapy effectiveness is reviewed where possible. At present, treatment evidence in the pediatric mental health field must be inferred from adult research.
Publisher: SAGE Publications
Date: 11-2018
Abstract: We aimed to report substance use across a five-year period in in iduals admitted to an acute mental health unit, utilizing data from a routine clinical measure, diagnoses, and findings related to gender, ethnicity and the implementation of a new dual-diagnosis policy. Data was extracted from the electronic records of 2118 in iduals who had consecutive admissions to the acute inpatient unit. Analysis focused on demographic and diagnosis variables and the drug and alcohol question in the Health of the Nations Outcome Scale. Some 57.6% of the s le was in the at-risk drug and alcohol category. Male and indigenous inpatients were most at risk. More than 50% of patients with schizophrenia, anxiety and personality disorders were deemed at-risk. Following implementation of the dual-diagnosis policy, recorded primary and secondary substance use disorder (SUD) diagnoses significantly increased. The study replicated previous findings of a high proportion of patients with co-morbid drug and alcohol use. In this s le it seems likely that the dual-diagnosis policy and related activities increased the rate of SUD diagnoses recorded, although it is likely to still be under-reported.
Publisher: Asian Australasian Association of Animal Production Societies
Date: 12-2022
DOI: 10.5713/AB.22.0150
Abstract: Objective: The primary goal was to identify the effectiveness of chemical or biological additives in delaying the deterioration of early-harvested wilted rye silage after exposure to air.Methods: Rye harvested as a whole plant at the early heading stage was wilted for 24 h. The wilted forage was ided into treatments including sodium diacetate (SDA) at 3 (SDA3) and 6 g/kg (SDA6), i Lactobacillus plantarum /i (LP), i L. buchneri /i (LB), or their equal mixture (LP+LB) at 1×10 sup /sup colony-forming unit/g fresh matter.Results: After 60 d of conservation in 20-L silos, lactic acid was greater in LP and LP+LB silages than other treatments (102 vs 90.2 g/kg dry matter [DM]). Acetic acid was greatest in SDA6 (32.0 g/kg DM) followed by LB (26.1 g/kg DM) and was lowest in LP treatment (4.73 g/kg DM). Silage pH was lower with microbial inoculation and the lowest and highest values were observed in LP and untreated silages, respectively. After 60 d, neutral detergent fiber concentration was lowest in SDA6 silages, resulting in the greatest i in vitro /i DM digestibility (846 g/kg DM). Aerobic stability was longest in SDA6 (176 h) followed by LB treatment (134 h). Instability after aerobiosis was greatest in LP silages (68 h), about 8 h less than untreated silages. After aerobic exposure, yeast and mold numbers were lowest in SDA6 silages, resulting in DM loss minimization. Exhaustion of acetic acid and lactic acid after aerobic exposure was lowest with SDA6 but greatest with untreated and LP silages.Conclusion: Treatment of early-cut wilted rye forage with SDA at 6 g/kg resulted in silages with higher feeding value and fermentation quality, and substantially delayed deterioration after aerobic exposure, potentially qualifying SDA at this load for promotion of silage quality and delaying aerobic spoilage of early-harvested (low DM) rye forage.
Publisher: Wiley
Date: 28-01-2005
DOI: 10.1111/J.1440-1819.2005.01332.X
Abstract: The present study aimed to compare the attitudes and psychopathology of eating disorders between Asian and Caucasian adolescent girls and investigate the relationship between acculturation and the attitudes and psychopathology of eating disorders in subgroups of Asian girls. Two groups of non-clinical adolescent girls in Perth, Western Australia, were compared using a survey method. There were 17 Asian and 25 Caucasian adolescent girls, aged 14-17 drawn from private high schools in Perth who were screened using the Eating Attitudes Test (EAT-26), the Eating Disorders Inventory (EDI-2), and an acculturation index. The psychopathology scores for eating disorders of the Asian group were significantly higher than that of the Caucasian group in terms of total EDI-2 score, Interpersonal Distrust, Maturity Fears, Impulse Regulation and Social Insecurity subscales. Eating attitudes measured by Dieting subscale of the EAT-26 was significantly different. Within the Asian group, the less acculturated girls had higher scores on the EAT-26 and the EDI-2 than the more acculturated. Less acculturated Asian girls appeared to have unhealthier attitudes and psychopathology toward eating.
Publisher: AMPCo
Date: 10-2013
DOI: 10.5694/MJA13.10307
Abstract: To assess the population prevalence of property, income and emotional impacts of the 2010-2011 Queensland floods and cyclones. Cross-sectional telephone-based survey using a brief trauma exposure and impact screening instrument, conducted between 11 March and 6 June 2011, of 6104 adults who answered natural disaster and mental health questions. Natural disaster property damage exposure and emotional wellbeing impacts. Two-thirds of respondents (62%) reported being affected by the disasters, with property damage exposure ranging from 37.2% (suburb or local area) to 9.2% (own home, with 2.1% living elsewhere at least temporarily). Income was reduced for 17.0% of respondents and 11.7% of income-producing property owners reported damage to those properties. Trauma impacts ranged from 14.3% of respondents feeling "terrified, helpless or hopeless" to 3.9% thinking they might be "badly injured or die". Up to 5 months after the disasters, 7.1% of respondents were "still distressed" and 8.6% were "worried about how they would manage". Adults of working age and residents of regional and remote areas and of socioeconomically disadvantaged areas were disproportionately likely to report exposure to damage and emotional impacts. Weather-related disasters exact a large toll on the population through property damage and resultant emotional effects. Vulnerable subpopulations are more severely affected. There is a need for realistic, cost-effective and rapid-deployment mass interventions in the event of weather disasters.
Publisher: SAGE Publications
Date: 26-01-2017
Abstract: This study estimates the prevalence of chlamydia infection amongst teenage substance users aged 14–18years and investigates risk factors associated with a positive diagnosis of chlamydia infection. Data was collected from the medical files of adolescents who attended a statewide drug and alcohol treatment facility during a three-year period commencing June 2011. The highest rate of chlamydia detection (18.0%) was found in the group with a reported history of abuse, a non-substance use psychiatric diagnosis, and in iduals who did not complete year 10 education. Adolescents attending a detoxification facility are a suitable group for targeted chlamydia infection screening and early treatment.
Publisher: Springer Science and Business Media LLC
Date: 09-2020
Publisher: Wiley
Date: 02-2015
DOI: 10.1002/JTS.21981
Abstract: Screening is recommended as a simple method for identifying those who should be monitored for risk following trauma. Effective methods for implementing large-scale screening programs are yet to be established. This study tested the feasibility and utility of a screening program with hospitalized youth exposed to injury in 3 Australian hospitals. Eligible families (N = 1,134) were contacted and 546 children (48.0%) screened for risk of posttraumatic stress disorder (PTSD) at 1-2 weeks postinjury. There were 95 (17.4%) children whose screen result was at risk. A rescreening phase was introduced during the study, with 68 children completing the rescreen at 4-6 weeks postinjury, and 26 (38.2% of those rescreened) still at risk. Of those initially screened, 29 (5.3%) completed diagnostic assessments, 21 (3.8%) were diagnosed with partial or full PTSD, and 17 (3.1%) commenced treatment. Screening was successful at identifying and reaching children with PTSD, but the response rate was lower than expected, which limited the utility of the program. The addition of a rescreening phase demonstrated that not all at-risk children required intervention. These findings replicate previous studies that have shown natural remission in PTSD symptoms and highlight the potential for rescreening as part of a watchful waiting approach.
Publisher: SAGE Publications
Date: 06-2002
DOI: 10.1046/J.1440-1665.2002.00422.X
Abstract: Objectives: To describe from an academic and practical perspective the process of organisational change associated with the introduction of an innovative child and adolescent mental health service. Method: The project consultation process is described. Process redesign literature is reviewed and the application of the principles to the project process is discussed. Results: The project successfully produced a unified, inter-sector recommendation for a new service which had achieved wide endorsement. Understanding and utilising process redesign principles was confirmed to be advantageous. Further, an evidence based approach was found to be helpful in uniting the sectors and in accelerating change. Obstacles to innovation were identified and specifically addressed by the planning process. Conclusions: Restructuring of services or the introduction of new services in response to policy changes or to changes in available resources is commonplace. Often it is assumed that the benefits expected from proposed changes will automatically flow and little effort is made to employ current knowledge from the literature regarding the successful implementation of organisational change. A rigorous planning process is required for service change, particularly when innovative treatments are being considered.
Publisher: Frontiers Media SA
Date: 26-06-2020
Publisher: SAGE Publications
Date: 29-09-2022
DOI: 10.1177/10398562221128214
Abstract: Founded at the beginning of the COVID-19 pandemic, Hand-n-Hand Peer Support (HnH) offers free, confidential peer support to healthcare workers (HCWs) across Australia and New Zealand. This survey aimed to evaluate HCWs experiences of peer support and collect demographic data about what groups of HCWs were seeking support. An online survey was conducted in November 2021 of HCWs who were either active or past HnH participants ( n = 158). Questions included 5-point Likert scales, multiple choice and free text responses. We received 66 responses (42% response rate). The median age range of respondents was 41–45 years and most were female (87.9%). Most respondents (57.4%) reported experiencing no barriers to accessing peer support. The vast majority (81.4%) of HCWs reported a ‘good’ or ‘very good’ peer support experience. Respondents felt peer support helped in multiple ways, particularly in feeling less alone and having a safe space to discuss issues. Australian HCWs accessing peer support tended to be female and more senior clinicians. Most HCWs engaged in HnH reported overall very positive experiences. Our survey helped to identify several areas for improvement in HnH, including clearer marketing about peer support and more targeted triage assessments.
Publisher: Informa UK Limited
Date: 11-07-2014
Publisher: Wiley
Date: 11-02-2011
DOI: 10.1111/J.1440-1754.2010.01985.X
Abstract: Medication adherence is poor in many young people with chronic illness. However, little research has examined medication adherence in clinic s les of young people receiving psychotropic medication, and whether factors such as disorder or drug type influence adherence. This study aimed to examine medication adherence in children and adolescents receiving psychotropic medication. Young people receiving psychotropic medication and their caregivers were recruited from pharmacy and mental health services within a large metropolitan hospital. A brief cross-sectional survey examined medication history, missed doses within the previous week and other clinical information. Multiple regression analysis examined whether child characteristics, drug type and regimen characteristics were associated with medication adherence. Poor adherence was associated with lack of parental involvement in medication routines (P < 0.05), use of complementary medicines (P < 0.01) and difficulty remembering doses (P < 0.01). Developmental diagnoses (P < 0.05), use of antipsychotics (P < 0.05) and use of concomitant non-psychotropic medication (P < 0.05) were predictors of good adherence. Encouraging parental involvement in medication routines may be a practical target for clinicians aiming to improve medication adherence in young people. Use of complementary medicines may indicate a group with a higher risk of poorer adherence.
Publisher: Springer Science and Business Media LLC
Date: 16-04-2016
DOI: 10.1007/S11920-016-0691-4
Abstract: There is widespread support for the hypothesis that, post-disaster, children's mental health is impacted--at least in part--via the impact on parents, parenting, parent-child interactions, and the family environment. To some degree, the enthusiasm with which this hypothesis is held outstrips the evidence examining it. The current paper critically evaluates the empirical evidence for this hypothesis and concludes that although limited (both in terms of number of existing studies and methodological flaws), the extant literature indicates some parent-related variables, as well as some aspects of the family environment are likely to constitute risk or protective factors for children. Given that parenting is modifiable, it is proposed that the identified parent- and family-related factors represent important therapeutic targets, and a universal post-disaster parenting intervention (Disaster Recovery Triple P) is described.
Publisher: SAGE Publications
Date: 12-01-2021
Abstract: The study evaluated the workload and workflow of registrars engaged in a psychiatry after-hours roster, quantified their perceptions of this experience and provided recommendations for system redesign. Multiple sources of information, including medical student observers and telephone logs, quantified the tasks performed during shifts. Registrars completed a satisfaction questionnaire. After-hours shifts often started with a lack of attendance of key clinicians at handover. Tasks handed over and completed during shifts varied there was very little difference between evening, weekends and night shifts except for the higher likelihood of seclusion reviews on weekends. Registrars experienced a significant and complex workload including emergency department and ward reviews, and admissions. Workflow interruptions were frequent the high number of phone calls and critical incidence warrant further investigation. Registrars were confident in their own ability, but had less confidence in other key clinicians. Many registrars did not discuss after-hours work during supervision. The after-hours experience of psychiatry registrars at a university hospital is arduous and includes a wide range of clinical tasks. This activity is an essential service provision undertaking as well as a training activity. This must be weighed against the impact of after-hours work on registrar well-being.
Publisher: Elsevier BV
Date: 10-2018
Publisher: Wiley
Date: 30-05-2022
DOI: 10.1111/JPC.16026
Abstract: In child and adolescent psychiatry, the multiaxial classification approach has been developed over some decades and remains very relevant as it encapsulates the biopsychosocial approach, an approach which is also central to paediatric practice. There is considerable overlap between developmental‐behavioural paediatrics and child and adolescent mental health, including presenting clinical problems, diagnoses, multidisciplinary and holistic approach to assessment and management, and similar use of pharmacological agents and psychosocial interventions. Multiaxial classification can be of use to paediatricians in a variety of ways, both in clinical practice and for teaching purposes. It can improve communication between the two disciplines and promotes a more holistic diagnostic representation in a structured and consistent format. Presented here are a number of practical ways in which the multiaxial biopsychosocial framework can be used, including case description, formulation, timeline and interventions, training and teaching.
Publisher: Informa UK Limited
Date: 05-11-2013
DOI: 10.1080/10615806.2013.853049
Abstract: We compared executive functions (EFs) of traumatized preadolescent children with and without marked posttraumatic stress disorder (PTSD) symptoms to the performance of a nontraumatized control group, and examined the relationships between EF deficits and functional status in traumatized preadolescent children. Fifty-one preadolescent children who had witnessed a death at school 30 months prior (26 with marked PTSD symptoms and 25 without) and 30 healthy controls who had not been traumatized participated. EFs were examined using the Comprehensive Attention Test (CAT). The functional state of traumatized children was measured by the Parent Report Form-Children's Health and Illness Profile-Children's Edition (PRF-CHIP-CE). The traumatized children, regardless of status of PTSD symptomatology, showed poorer working memory performance than nontraumatized healthy controls. The traumatized children with marked PTSD symptoms performed more poorly on measures of interference control compared to those children without marked PTSD symptoms. Lower levels of EFs were associated with lower risk avoidance and diminished academic achievement in traumatized children. These results indicate that an inhibitory control deficit is specifically associated with the current PTSD symptoms but not with trauma exposure per se.
Publisher: Elsevier BV
Date: 2021
DOI: 10.1016/J.PSYNEUEN.2020.104903
Abstract: Cortisol is the primary glucocorticoid produced by the activation of the hypothalamic pituitary adrenal (HPA) axis after a psychological or physiological stressor. The dysregulation of the HPA axis by chronic stress has been associated with psychiatric disorders. Although hair is currently the main validated source of chronic cortisol concentrations, cortisol is also bound to human nails, another keratinised matrix. Therefore, nail cortisol has the potential to be an alternative retrospective chronic measure of HPA activation. The aim of this systematic review was to assess the temporal resolution, methodological issues, HPA correlates, and target populations in nail cortisol investigations. A qualitative synthesis was performed to assess current literature exploring cortisol concentrations from human nails. A total of 18 eligible human studies extracted from Medline (PubMed and Ovid), ProQuest (PsycINFO), and Scopus found that immunoassays and mass spectrometry were the two primarily methods of analysis. However, methodological variability remained evident between studies. Nail cortisol correlated with saliva and hair in some studies and was investigated across multiple developmental periods. Finally, when applied as an outcome measure in health disorders, higher nail cortisol concentrations have been shown to be associated with acute coronary syndrome and depression. In conclusion, nail cortisol may serve as a retrospective biomarker of chronic stress however, the ability to track how much cortisol is accumulating within nail clippings is complex and may represent a large timespan. Further, very few studies have reported effect sizes and investigated the effects of covariates, such as age, sex, ethnicity, and nail characteristics, which limits the validation of this measure. Further studies are required to validate the utility of nail cortisol as a biomarker of chronic stress across the human lifespan.
Publisher: MDPI AG
Date: 14-11-2022
DOI: 10.3390/AGRICULTURE12111914
Abstract: Undigested neutral detergent fiber (uNDF) is becoming more widely recognized as an important fiber fraction in forage quality assessment because it explains a portion of NDF that is inaccessible to digestion in the ruminant digestive system and is, thus, important in modeling the digestion kinetics of the potentially degradable component of NDF. In experiment 1, uNDF was determined in several forage species in order to compare the accuracy of two reference methods: (1) a long-term in vitro ruminal fermentation (240 h) using an Ankom DaisyII incubator and (2) a multi-step enzymatic method without ruminal fluid. The objective of experiment 2 was to construct predictive equations for uNDF estimation using acid detergent lignin (ADL) and near-infrared reflectance spectroscopy (NIRS) in a pool (n = 264) of alfalfa hay, timothy hay, and tall fescue straw, using the most accurate reference method selected in experiment 1. Partial least squares regression analysis was used to calibrate the reference values against NIRS spectra. Several indicators were used to assess the performance of validation results, including standard error of cross-validation (SECrV), coefficient of determination of cross-validation (R2CrV), and ratio percentage deviation (RPD). The findings of experiment 1 suggested that, relative to the in vitro ruminal methodology, the enzymatic approach overestimated uNDF concentration of forages. Repeatability coefficient was also greater when uNDF was determined using the in vitro versus enzymatic procedure, potentially disqualifying the enzymatic method for the uNDF analysis in forages. In experiment 2, a poor relationship was established between ADL and uNDF (R2 0.60), suggesting the inadequacy of ADL parameter to represent the uNDF pool size in these forages. The best predictive equation using NIRS was obtained for alfalfa hay (R2CrV = 0.92 SECrV = 1.16 RPD = 3.57), using the in vitro fermentation as a reference method. The predictive equations were moderately accurate for timothy hay (R2CrV = 0.80 SECrV = 1.31 RPD = 2.08) and tall fescue straw (R2CrV = 0.79 SECrV = 1.38 RPD = 2.18). Our findings suggested the inadequacy of the enzymatic procedure in accurately determining uNDF concentration of forages as compared with the in vitro rumen fermentation protocol. Although the NIRS equations developed using the alfalfa hay dataset were more accurate than that of timothy hay and tall fescue straw, the validation results verified applicability of the equations as a fast screening tool for qualitative prediction of uNDF in these forages, which is important in commercial settings.
Publisher: Wiley
Date: 02-2015
DOI: 10.1002/JTS.21987
Abstract: This study investigated parents' satisfaction with postdisaster school-based screening and whether satisfaction was related to follow-through with screening recommendations. From among 1,268 there were 224 children, ages 7-18 years (M = 10.97, SD = 2.44 years) screened for emotional distress 4 months after a flood and 130 parents who completed the screening evaluation. Of the 44 children who showed severe emotional distress, less than 50% of their parents reported concerns and only 29.5% had sought assistance. Following screening, 86.7% of these children completed treatment. Overall satisfaction ratings by parents were high, with 99.2% very or mostly satisfied.
Publisher: Wiley
Date: 11-2001
DOI: 10.1002/EAT.1081
Abstract: To compare the bone density of adolescent patients with anorexia nervosa with adolescent patients with other dieting disorders and to evaluate risk factors for low bone density in these patients. Sixty-nine consecutive female patients referred to an adolescent eating disorders clinic were studied by interview, blood s ling, body composition, and lumbar spine bone density measurement using dual energy X-ray absorptiometry. Although patients with anorexia nervosa were more malnourished, their bone density was similar to other dieting patients. Patients were ided into a low and normal bone density group irrespective of psychiatric diagnosis. Patients with low bone density had dieted for longer, had lower lean body mass, more often had not achieved menarche, and had longer duration of secondary amenorrhea and lower estrogen levels. Irrespective of clinical diagnosis, adolescents with dieting disorders have increased risk of low bone density when malnutrition commences early in puberty and is associated with reduced lean body mass and impaired ovarian function.
Publisher: SAGE Publications
Date: 25-10-2020
Abstract: To investigate the rate of attendance at Alcohol Tobacco and Other Drug Services (ATODS) for patients discharged from an acute mental health unit with a primary/secondary diagnosis of substance use disorder (SUD) and describe factors, demographics, diagnoses and service provision that relate to their attendance. All inpatients between 1 November 2016 and 31 October 2017 with a diagnosis of SUD were compared for their attendance at ATODS within 30 days of discharge. Other measures included their admission data (e.g. demographics, diagnosis), and indices of their illness severity. Of 1295 admissions for a total of 900 patients, 32.4% of patients had an SUD diagnosis. Only 10.3% of these patients attended ATODS. There were no significant differences by gender, age, indigenous status, illness severity or dual diagnosis intervention during their inpatient stay on attendance. Relative to the SUD-only group, in iduals with any psychiatric comorbidity were three–four times less likely to attend ATODS. Despite the ongoing emphasis on dual diagnosis treatment, the rate of engagement with ATODS remains low. Further review is needed to determine whether enhanced information sharing or case management models may improve attendance rates.
Publisher: SAGE Publications
Date: 10-07-2014
Abstract: This study examines how often depression and anxiety, in patients with diabetes, are detected by health professionals and whether detection is influenced by patient characteristics (age, gender), illness factors (duration of illness, diabetes control), and self-reported levels of depression and anxiety. Prevalence rates of clinically significant depression and anxiety were high (57% and 36%, respectively) however, of those identified, only 44 and 36 per cent, respectively, were detected by staff as depressed or anxious. The only significant predictors of detection were severity of depressive and anxious symptoms. Patient and illness characteristics did not influence whether professionals identified emotional problems in their patients.
Publisher: SAGE Publications
Date: 08-2002
DOI: 10.1046/J.1440-1614.2002.01043.X
Abstract: Objective: To investigate parent and self-report of family dysfunction in children and adolescents with eating disorders. Further, to investigate family functioning differences across the eating disorders diagnostic groups anorexia nervosa, eating disorders not otherwise specified (EDNOS) and bulimia nervosa, and between the restricting and binge-purge eating disorders behavioural subtypes. Methods: The Family Adjustment Device General Functioning Scale (FAD-GFS) was administered to 100 children and their parents who presented consecutively at an eating disorders assessment clinic. DSM-IV eating disorders diagnoses in this group included 42 children diagnosed with anorexia nervosa, 26 with EDNOS, 12 with bulimia nervosa and 20 diagnosed as having no eating disorder. Results: Both the parent and child FAD-GFS report demonstrated high internal consistency supporting the suitability of this instrument for research with this s le. Parent and child reports were moderately positively correlated. Total scores for all eating disorders diagnostic categories were significantly higher than community norms. Anorexia nervosa, EDNOS and bulimia nervosa groups did not significantly differ on parent or child reports. FAD-GFS profiles for restricters and binge-purgers suggest higher levels of family dysfunction in the families of binge purgers. Conclusions: The FAD-GFS has suitable psychometric properties for use as a summary instrument with young people diagnosed with an eating disorder. However, more informative instruments assaying a greater range of constructs, especially in the impulsive, dyscontrol domain, are required to investigate differences among eating disorders diagnostic groups and behavioural subtypes.
Publisher: Wiley
Date: 30-04-2014
DOI: 10.1111/JCPP.12241
Abstract: We investigated the distinct longitudinal trajectories of posttraumatic stress symptoms in a s le of 167 children, who witnessed death of two mothers of their schoolmates. The cohort was followed-up at 2 days (T1), 2 months (T2), 6 months (T3), and 30 months (T4) after the traumatic event. The children's posttraumatic stress symptoms (T1-T4), depression (T1, T3 and T4), state anxiety (T1, T3 and T4), and quality of life (T4) were assessed, along with parental stress related to child rearing (T4). Different trajectory patterns of the children's posttraumatic stress symptoms were identified using growth mixture modeling (GMM). Four different patterns of symptom change were identified, which were consistent with the prototypical model, and were named Recovery (19.9%), Resilience (72.7%), Chronic Dysfunction (1.8%), and Delayed Reactions (5.6%). Significant differences were found in depression and anxiety scores, children's quality of life, and parental rearing stress according to the distinct longitudinal trajectories of posttraumatic stress symptoms. The present study suggests that in idual differences should be taken into account in the clinical course and outcome of children exposed to psychological trauma. The two most common trajectories were the Resilience and the Recovery types, together suggesting that over 90% of children were evidenced with a favorable 30-month outcome. The latent classes were associated with significant mean differences in depression and anxiety scores, supporting the clinical validity of the distinct trajectories.
Publisher: SAGE Publications
Date: 2008
DOI: 10.1080/00048670802050587
Abstract: Objective: Aggressive behaviour is common in young people admitted to child and adolescent inpatient services. Little is known about how physical aggression during admission influences patient outcomes. The aim of the present study was to identify predictors of aggression in a child and adolescent inpatient unit and examine differences in clinical outcomes between aggressive and non-aggressive patients. Method: Episodes of aggression occurring within a child and adolescent inpatient unit were prospectively documented between October 2004 and December 2005. Patient factors (demographics, diagnoses, clinical history) were examined as predictors of aggression. Outcomes for admissions in which more than one episode of physical aggression occurred were compared to those in which no aggression occurred. Outcomes assessed were changes in symptom severity (as rated by the Health of the Nation Outcome Scales for Children and Adolescents) length of stay, and initiation of medications. Results: A total of 134 patients were admitted during the study period (61.9% female, mean age=13.8years, SD=2.9) 31 patients (23.1%) exhibited physical aggression during admission and 20 of these exhibited more than one episode of physical aggression. Factors that predicted persistent physical aggression included history of aggression, use of medications at presentation and absence of self-harm. Persistent aggression was also associated with increased length of stay, but did not compromise improvements in clinical symptom ratings between admission and discharge or lead to increased medication prescribing Conclusion: Contrary to hypotheses and existing research, aggression during admission does not appear to be a barrier to clinical improvement. Further research is necessary to clarify how aggressive children can receive the most benefit from inpatient admission while minimizing the risks to the patient and those around them.
Publisher: Springer Science and Business Media LLC
Date: 31-03-2006
DOI: 10.1007/S00787-006-0532-9
Abstract: To identify utilisation rates of prn (pro re nata) sedation in children and adolescents receiving inpatient psychiatric treatment, and to compare correlates of prn prescribing and administration. A retrospective chart review examined 122 medical charts from a child and youth mental health inpatient service. 71.3% of patients were prescribed prn sedation and 50.8% were administered prn sedation. Patients received an average of 8.0 doses of prn sedation, with 9.8% receiving 10 or more doses. Chlorpromazine and diazepam were the most commonly utilised agents. Prescribing of prn sedation was only related to use of regular medications (p < 0.01), and non-parent carers (p < 0.01). In contrast, administration of prn sedation was associated with multiple diagnoses (p < 0.01), pervasive development disorder (p < 0.01), mental retardation (p < 0.01) ADHD (p < 0.01), longer hospital admission (p < 0.01), use of atypical antipsychotics (p < 0.01) and polypharmacy (p < 0.01). Despite lack of data to inform practice, prn sedation is widely utilised, especially in complex patients. Future research in this area needs to incorporate nurses and examine whether patients benefit from prn sedation, which drugs and dosing patterns optimise safety and efficacy, and what is the role of prn sedation in the context of other medication.
Publisher: Elsevier BV
Date: 02-2020
Publisher: Informa UK Limited
Date: 15-01-2023
Publisher: SAGE Publications
Date: 06-2005
Abstract: All staff members of a child and adolescent mental health service were invited to participate in a survey about the use of email. Sixty-two of the 105 staff members responded to the survey, a participation rate of 59%. Of the respondents, 32 were allied health staff, 10 were nurses, seven were administrative staff, six were medical staff, three were operational staff and four were acting in a combination of these roles. The respondents reported extensive work-related email usage and considered that they were confident in using email despite low levels of training. However, they did not feel that they understood the legal and ethical issues involved. Furthermore, there was limited incorporation of email into standard record keeping. The majority of respondents thought that increased use of email would lead to a greater workload, a consequence they considered would probably increase over time. Many commented on the quick and practical use of this medium, but were wary about using email with in iduals outside the service organization, especially if it were to contain clinical material. There was low use of email directly with clients, and clinicians were ambivalent about incorporating email into therapy. The results suggest that it is timely to consider the utility and appropriateness of email communication with clients and external service providers, and to formulate guidelines and procedures to ensure the confidentiality of client information and the safety of clients and staff.
Publisher: Physicians Postgraduate Press, Inc
Date: 15-05-2012
DOI: 10.4088/JCP.11M07348
Publisher: American Psychiatric Association Publishing
Date: 2002
Abstract: The study investigated the settings in which children and adolescents were treated to determine whether clinicians assigned in iduals who had greater needs to more intensive treatment. Subjects were 603 children four to 16 years of age who visited a mental health treatment facility in Western Australia, where, as is the case throughout Australia, universal publicly funded health care is provided. DSM-IV criteria were used to make diagnoses, and clinicians assessed each child's level of impairment. The clinicians assigned the children to inpatient treatment, day treatment, or outpatient treatment, or they saw the child only for a psychiatric consultation. Measures included parents' and children's reports of children's psychopathology and parents' reports of family functioning, family life events, and parental mental health symptoms and treatment. Clinicians' ratings of impairment were highest for children assigned to the inpatient and day treatment settings. Parents' ratings of total psychopathology and of internalizing and externalizing symptoms were highest for children in the inpatient and day treatment settings. Parents' reports also indicated that family dysfunction and parental alcohol problems were most severe in the inpatient group. No differences in parents' mental health problems were found across treatment settings. Children with more severe psychopathology and more severe family dysfunction and parental problems were more likely to be provided treatment in the most costly and time-intensive treatment settings. The results provide empirical evidence for what many clinicians consider best clinical practice-to assign children and families to treatment settings appropriate to their level of impairment.
Publisher: Korean Society of Animal Science and Technology
Date: 2023
Publisher: SAGE Publications
Date: 04-06-2020
Abstract: The primary aims were to compare the characteristics and health outcomes of consumers entering a regional mental health service compared with a city service. A retrospective audit was undertaken of consumers aged 18 and over from a regional town and city mental health service. Consumer demographics, diagnoses and outcomes were compared between the two services. The data analysis plan utilised descriptive statistics. For between-clinic comparisons, relevant inferential statistics was used. Regional service patients had a significantly greater proportion of substance use disorder diagnoses. Outcome rating scales were higher (worse) for regional consumers. There was significantly less overall service utilisation for regional service consumers including shorter duration of episodes of care, less hospitalisations and less people treated under the Mental Health Act. There were a broader range of patient presentations in the regional town. Regional practitioners may specifically need more training and skills in treating substance use disorders.
Publisher: Mary Ann Liebert Inc
Date: 02-2014
Abstract: Recent research suggests that not only parental psychopathology, but also parenting practices, have a role to play in the development of child posttraumatic stress symptoms (PTSS) following a natural disaster. The current study aimed to investigate the relationship between parents' perceptions of their parenting in the aftermath of a natural disaster, and child PTSS. A cross-sectional design was used to explore the associations among child PTSS, parents' perceptions of altered (more anxious) parenting, and parental disaster-related distress (altered cognitions and behaviors) in 874 elementary school children (ages 8-12 years) and their parents following a severe storm of cyclonic proportions. With parental consent, school-based screening was conducted in impacted communities 3 months after the storm. Children completed a screening questionnaire consisting of the Child Trauma Screening Questionnaire (CTSQ used for identifying children at risk for posttraumatic stress disorder [PTSD]), as well as a range of questions assessing disaster exposure and threat perception. Parents completed questions relating to their perceptions of changes in their parenting since the storm, as well as two items relating to their own disaster-related distress. Independent of other significant associations with child PTSS (such as age, gender, and disaster exposure), a high level of parent-perceived altered parenting appeared to put children at increased risk for PTSS 3 months after the disaster. However, when the s le was stratified for the presence or absence of altered parent cognitions and behaviors following the storm, altered parenting was found to have a unique relationship with child PTSS only when parents reported altered disaster-related cognitions and behaviors. When parents report disaster-related cognitions and behaviors, their perception of altered parenting practices (becoming more protective, less granting of autonomy, and communicating a sense of current danger) is associated with child PTSS. Although it is not possible to draw conclusions about the direction of these relationships, this study identifies parenting practices that may constitute important targets for intervention.
Publisher: Springer Science and Business Media LLC
Date: 22-01-2009
DOI: 10.1007/S00787-008-0723-7
Abstract: Cognitive behavior therapy delivered by trained clinicians has been shown to be an effective treatment for childhood anxiety. However, the prevalence of anxiety disorders in children and adolescents, combined with the practical and psychological obstacles that often prevent families from accessing professional help, mean that alternative ways of reaching prospective clients must be explored. This pilot study aims to compare the relative efficacy of two different modes of delivering a family-focused, cognitive-behavioral intervention for children with an anxiety disorder. The two modalities compared were: a parent-delivered program (bibliotherapy) and a clinician-delivered program (in idual therapy). Twenty-seven children aged between 7 and 14, together with their parents, were randomly assigned to one of the two conditions listed above. Results at post-treatment showed a significant improvement for children in both treatment conditions in terms of diagnostic status, number of diagnoses and severity of primary diagnosis at follow-up. Children in the bibliotherapy condition demonstrated a significant improvement over time in terms of child- and parent-reported anxiety levels. No differences were found between the two treatment conditions on any outcome measure. These results were maintained at 3- and 6-month follow-up. Although a pilot study, these data suggest that a bibliotherapy format of the intervention described may have potential merit. The implications for service delivery are discussed, as are the limitations of this research.
Publisher: Wiley
Date: 06-1998
DOI: 10.1046/J.1440-1754.1998.00215.X
Abstract: To document the health status, comorbidity and functional impairments experienced by a group of psychiatrically disturbed children and adolescents. A detailed study of consecutive admissions to a residential unit over a two-year period was undertaken. All admissions had a comprehensive paediatric, speech pathology and psychiatric assessment. Compared to the general population, there was a significant history of developmental delay and low birthweight, but only a slightly greater prevalence of antenatal problems. Clumsiness (37%), severe speech and language disorder (32%), and hearing loss (15%) were prominent. Only 25% had no history of comorbid medical or neurological disorders. Children and adolescents presenting with moderate to severe mental health morbidity may have pre-existing comorbid medical problems, as well as unrecognised difficulties and impairments in other skills areas. Multidisciplinary assessment and intervention should be an integral part of the residential programme.
Publisher: SAGE Publications
Date: 10-07-2016
Abstract: Repeated retelling of trauma narratives within Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) assists participants to habituate to experiences that have precipitated symptoms of post-traumatic stress. In this study, the narratives produced by children and adolescents, who developed post-traumatic stress disorder following a natural disaster, and who were treated with a manualized TF-CBT intervention, were examined. The first author developed a coding system utilizing three major concepts (coherence, elaboration, and evaluation) to identify changes in the narratives as they were retold at each therapeutic session. Analysis using this coding system identified that the internal logic of the stories was maintained as the detail diminished, and that the level of evaluation increased. Compression emerged as a major pattern, alongside the reduction in participant distress over the course of the treatment. Although requiring replication, these trial concepts, developed by the coding system, have potential analyzing trauma narratives and enhancing clinician observations.
Publisher: Wiley
Date: 05-2010
DOI: 10.1111/J.1465-3362.2009.00152.X
Abstract: Gender differences have been reported in adult substance users, but little research has examined gender differences in adolescents presenting to treatment services. This study aimed to explore gender differences in adolescents presenting to a withdrawal service. All presentations to a withdrawal service between March 2000 and September 2004 were identified. For each presentation, the following information was extracted from clinical databases: sociodemographics, drug use, risk-taking behaviour, mental health symptoms, reasons and context of drug use. Significant gender differences identified at bivariate analysis were then incorporated into multivariate models exploring predictors of heroin use, cannabis use and sharing injecting equipment. A total of 262 young people were admitted during the study period (53% male, mean age 16.8 years SD 1.13). Bivariate analysis indicated that girls were more likely to report: being homeless, using a greater number of substances, using heroin and hetamines, higher rates of injecting, sharing injecting equipment and using with a partner. Multivariate analysis identified that being female was an independent predictor of heroin use and that being male was an independent predictor of cannabis use. Significant predictors of sharing injecting equipment were using with a partner and current use of heroin the effect of gender was not significant after controlling for other factors. Our findings indicate that male and female adolescents presenting to a withdrawal treatment service exhibit differences in substance use characteristics. Future research should examine the role of gender in determining optimal treatment approaches in substance-using adolescents.
Publisher: Mary Ann Liebert Inc
Date: 05-2021
Publisher: SAGE Publications
Date: 26-06-2013
Abstract: Our aim is to critique Australian child maltreatment policy, outline abuse trends and provide data on family risk factors. We identified policy gaps and reviewed family profiles within selective child maltreatment databases. Data sources included international and Australian literature, Queensland Department of Child Safety reports and a research clinical database. Data reviewed suggest that a pattern of co-occurring complex multiple system family problems characterize substantiated abuse cases. The presence of multiple family problems suggests the need for a new treatment paradigm. Multisystemic Therapy for child physical abuse and neglect is an evidence-based intervention that matches the therapeutic needs of such families.
Publisher: Springer Science and Business Media LLC
Date: 21-09-2022
DOI: 10.1038/S41586-022-05071-8
Abstract: Fast radio bursts (FRBs) are highly dispersed, millisecond-duration radio bursts
Publisher: SAGE Publications
Date: 08-2002
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 07-2005
Publisher: SAGE Publications
Date: 2021
DOI: 10.1177/11795735211063985
Abstract: This paper describes pseudo-seizure as an atypical presentation of attention-deficit hyperactivity disorder (ADHD) in an adolescent female in the context of psychosocial difficulties. We present the case, which explains the clinical dilemma in such situations, along with selective literature review. An adolescent female, who is an academic high achiever, living with parents, presented with unresponsive spells which were initially treated with antiepileptics by the paediatrician without any significant improvement. Later, after further assessments and revision of her diagnosis to conversion disorder, she was referred to the child and youth mental health service team. Further evaluation revealed her symptoms to be a result of multiple psychosocial stressors in the context of her having undiagnosed ADHD. In idual therapy, treatment with stimulant, resulted in significant improvement in her school and home adjustments. This case demonstrates the diagnostic challenges that high-functioning girls with ADHD coloured by psychosocial stressors can pose and raises the need for reviewing our diagnostic approaches in these situations.
Publisher: Mary Ann Liebert Inc
Date: 06-2006
Abstract: This study aimed to identify rates and correlates of psychotropic drug utilization in children and adolescents in inpatient and outpatient settings. A retrospective chart review examined 122 inpatient and 126 outpatient charts from a metropolitan child and youth mental health service in Brisbane, Australia. Inpatients received more psychotropic medication than outpatients (71% vs. 25% p < 0.01). Patients receiving medication were older, had longer hospital admissions, and more complex presentations, including history of abuse or suicide attempts and more diagnoses (all p < 0.01). Selective serotonin reuptake inhibitors (SSRIs) were the most frequently used drug class (44% inpatients 14% outpatients), primarily indicated for mood disorders (31%). SSRIs and newer antidepressants (ADs) were used more frequently in patients with a high suicide risk (p 1 concurrent drug), with up to four drugs used at one time. Rates of polypharmacy were highest among patients receiving antipsychotics. Use of psychotropic medication is frequent in this population. Future research should initially focus on inpatients and intensive treatment settings and examine both safety and efficacy of interventions for depression in young people, atypical antipsychotics for behavioral disturbances, and polypharmacy.
Publisher: SAGE Publications
Date: 02-2012
Abstract: Objective: The aim of this study was to investigate a new social connectedness factor and Posttraumatic Stress Disorder (PTSD) in children who experienced a cyclone disaster. Method: Three months post-disaster school-based screening for PTSD was conducted. 804 children (mean age=10.22 years, SD=1.24) participated. 12.0% of children reported severe or very severe PTSD symptoms. Results: Low connected children, adjusted for age, gender and independent of cyclone exposure and threat perception, were 3.96 times more likely to experience severe to very severe PTSD. A structural model of child PTSD indicated that connectedness was the most important factor explaining variance in children’s symptomatology. The final model accounted for 60% of the variance of child PTSD scores. Conclusions: We conclude that child connectedness is a new, significant, independent factor in a model of post-disaster child PTSD. Connectedness may represent a vulnerability factor that can be targeted preventatively in children in disaster-prone regions. Conversely, a pre-disaster intervention that helps children develop high connectedness may have the potential to confer resilience.
Publisher: SAGE Publications
Date: 03-2005
DOI: 10.1177/070674370505000302
Abstract: To report on the use of the Post Traumatic Stress Disorder Reaction Index (PTSD-RI) and the Strengths and Difficulties Questionnaire (SDQ) in identifying children and adolescents who may require psychological interventions following exposure to a wildfire disaster. Six months after a wildfire disaster, we conducted a school-based program to screen for wildfire-related events, such as exposure to and perception of threat, posttraumatic stress disorder (PTSD), and general psychopathology. The screening battery was completed by 222 children (mean age 12.5 years, SD 2.48 range 8 to 18 years). Severe or very severe PTSD was reported by 9.0% of students, while 22.6% scored in the abnormal range on the Emotional Symptoms subscale of the SDQ. Younger children and in iduals with greater exposure to and perception of threat experienced higher levels of PTSD and general psychopathology. Female students reported a greater perception of threat but did not report higher levels of PTSD or other symptoms. Screening was well received by students, parents, and staff and proved feasible in the postdisaster environment. The PTSD-RI and SDQ demonstrated different in idual risk associations and functioned as complementary measures within the screening battery. The identification of children at greatest risk of mental health morbidity enabled service providers to selectively target limited mental health resources.
Publisher: Frontiers Media SA
Date: 05-01-2023
DOI: 10.3389/FPSYT.2022.976140
Abstract: The cumulative burden of chronic stress and life events has been termed allostatic load. Elevated allostatic load indices are associated with different mental health conditions in adulthood. To date, however, the association between elevated allostatic load in childhood and later development of mental health conditions has not been investigated. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), we will calculate allostatic load indices using biomarkers representing the cardiovascular, metabolic, immune, and neuroendocrine systems, at the ages of 9 and 17 years. Bivariate and multivariable logistic regression models will be used to investigate the association between allostatic load and psychiatric disorders in adulthood. Furthermore, the role of adverse childhood experiences as a modifier will be investigated. This protocol describes a strategy for investigating the association between elevated allostatic load indices in childhood at the age of 9 years old and psychiatric disorders in adulthood at 24 years old.
Publisher: Elsevier BV
Date: 03-2000
DOI: 10.1097/00004583-200003000-00021
Abstract: The frequency of laxative use in adolescents with anorexia nervosa is poorly described. This study of adolescents with anorexia nervosa examined self-report and biochemical screening methods for the detection of laxative use, the pattern of laxative use in this population over time, and the associated medical complications and psychopathology. Forty-three consecutive patients with anorexia nervosa were studied. Initial assessment encompassed psychiatric history, medical examination, and administration of the Eating Disorders Examination, Child Behavior Checklist, and Youth Self-Report. Biochemical investigations, including random urinary laxative screening, were performed at assessment and follow-up. The frequency of laxative use from self-report alone was 12% combined with urine screening it was 19%. The frequency of laxative use increased to 32% with prospective follow-up. Medical complications were associated with laxative use at follow-up. Laxative use was associated with longer duration of disease and with higher scores on the Eating Disorders Examination subscale Eating Concern. Laxative use is common among adolescents with anorexia nervosa, and the risk of associated medical complications increases over time. Biochemical screening will improve detection of laxative use. Longer duration of illness and greater Eating Concern scores are associated with increased risk of laxative use, and monitoring patients at increased risk is important.
Publisher: Elsevier BV
Date: 05-2017
Publisher: SAGE Publications
Date: 08-2011
DOI: 10.3109/10398562.2011.601311
Abstract: Objective: The aim of this study was to investigate patterns of child and adolescent admissions to an acute adult psychiatric unit in a rural city. Correlates of admissions were then considered in terms of service reform for this vulnerable, under-resourced group. Method: The study reviewed consecutive clinical records of children and adolescents who were admitted to an acute general psychiatric inpatient unit over a 6 year period (N = 332). Results: Patients generally experienced numerous pre-admission psychosocial stressors there were many abuse histories and/or juvenile justice involvement. The principal diagnosis was varied and comorbidity was common. Maori patients were over-represented. The majority of admissions occurred out of working hours and more than half came from rural areas. There was high usage of the Mental Health Act on admission. Common causes of admission were self-harm and suicidal behaviour. The majority of the admitted adolescents required follow up by child and adolescent mental health services after discharge. Conclusion: We identified several reform possibilities, including up-skilling emergency and adult mental health staff in child and adolescent mental health, exploration of alternatives to admissions and specialist service coverage.
Publisher: Elsevier BV
Date: 2020
DOI: 10.1016/J.NEUBIOREV.2019.12.020
Abstract: Health risk behaviours (HRB) across the lifespan have been associated with higher cumulative physiological burden as measured by allostatic load (AL). This study examines the contribution of HRB and their effects on multisystem biological risk associated with morbidity and early mortality. We systematically reviewed the literature to assess the links between HRB and AL. Twenty-six eligible human studies were included in our assessment of the current literature investigating the association of different HRB that included overeating/obesity, alcohol, smoking, drug use, physical inactivity and sleep impairments in relation to AL. We found that 50 % of obesity and substance abuse, 75 % of sleep and 62.5 % of combined HRB studies showed a significant association with AL. Lifestyle coping behaviours therefore have a significant contribution to AL. This study is among the first to explore multiple domains of HRB in relation to AL. Further research should focus on evaluating lifestyle factors that adapt HRB as a strategy to cope with chronic stress to help decrease AL and resulting long-term negative health consequences.
Publisher: Wiley
Date: 02-2010
Publisher: Wiley
Date: 12-2007
DOI: 10.1038/OBY.2007.369
Publisher: SAGE Publications
Date: 2009
DOI: 10.1080/00048670902721095
Abstract: Objective: The primary purpose of the present study was to examine changes in utilization of pro re nata (PRN ‘as required’) sedation over time within a child and adolescent psychiatric inpatient unit. The secondary purpose was to assess whether changes in PRN sedation were related to changing patient characteristics. Methods: A retrospective chart review examined 257 medical charts from a child and youth mental health inpatient service over two time periods (wave I, n = 122 wave II, n = 135) and collected data on PRN sedation, patient characteristics and routine medications. Results: Over time a significant reduction was observed in the proportion of patients prescribed PRN sedation from 70% to 54% (p 0.01), and a reduction in the proportion of patients given PRN sedation from 46% to 26% (p 0.01). The most commonly administered drug was chlorpromazine in wave I, and diazepam in wave II. Multivariate analysis indicated that reductions in PRN sedation occurred independently of changes in patient characteristics. Conclusions: High utilization rates of PRN sedation are not inevitable in a child and adolescent psychiatric inpatient unit and may be reduced over time. Changing utilization of PRN sedation occurred independently from changing patient characteristics. More treatment outcome studies are required to optimize use of PRN sedation in young people.
Publisher: SAGE Publications
Date: 18-11-2009
Abstract: The present study investigated the efficacy of four EMDR sessions in comparison to a six-week wait-list control condition in the treatment of 27 children (aged 6 to 12 years) suffering from persistent PTSD symptoms after a motor vehicle accident. An effect for EMDR was identified on primary outcome and process measures including the Child Post-Traumatic Stress — Reaction Index, clinician rated diagnostic criteria for PTSD, Subjective Units of Disturbance and Validity of Cognition scales. All participants initially met two or more PTSD criteria. After EMDR treatment, this decreased to 25% in the EMDR group but remained at 100% in the wait-list group. Parent ratings of their child’s PTSD symptoms showed no improvement, nor did a range of non-trauma child self-report and parent-reported symptoms. Treatment gains were maintained at three and 12 month follow-up. These findings support the use of EMDR for treating symptoms of PTSD in children, although further replication and comparison studies are required.
Publisher: Elsevier BV
Date: 08-2006
DOI: 10.1016/J.EATBEH.2005.08.006
Abstract: This study aimed to compare the attitudes and psychopathology of eating disorders of Asian and Caucasian university students using a survey method. The study also investigated the relationship between acculturation, attitudes and psychopathology of eating disorders in sub-groups of Asian girls. There were 130 Asian and 110 Caucasian adolescent girls, aged 18-24 who were screened using the Eating Attitudes Test (EAT-26), the Eating Disorders Inventory (EDI-2) and an Acculturation Index. The Asian group did not have higher mean EAT score than the Caucasian group, but had higher mean score in some sub-scales of the EDI-2. Eating disordered attitudes and psychopathology was not significantly different in the low compared to the high accultured Asian girls. This study suggests that Asian and Caucasian university students in Western Australia are equally susceptible to eating disorders, and that the level of acculturation does not modify the susceptibility of Asian students for eating disorders.
Publisher: SAGE Publications
Date: 03-05-2021
DOI: 10.1177/10398562211009268
Abstract: Classification systems and their practical implications have become increasingly important in child and adolescent psychiatry. This paper presents the evolution and practical applications of a multiaxial classification system for children and adolescents presenting to mental health services. Included are some worked ex les demonstrating both the complexity of many presentations and how broadening the use of the multiaxial system can help in identifying appropriate interventions. Classification systems in child and adolescent psychiatry have largely remained uniaxial in nature. A multiaxial system encapsulates the broader biopsychosocial aspects of the presenting child or adolescent, and orders complex data in a concise manner. This approach can be used to concisely communicate with other treating clinicians, and assist with case reviews, formulation and teaching.
Publisher: SAGE Publications
Date: 20-07-2016
Abstract: There is a critical need for evaluation of the pharmacotherapies used in conduct disorder (CD), due to the high incidence of off-label prescribing. The aim of this review was to identify concerns associated with the safety, efficacy and impact on quality of life (QOL) that pharmacotherapy has in children and adolescents with CD. A systematic review was undertaken using pre-defined search criteria and four databases, including reference searches. We assessed these studies using the Strength of Recommendation Taxonomy, Grading of Recommendations Assessment, Development and Evaluation, and Review Manager Risk of Bias (RevMan®) tools. There were 12 randomised controlled trials that met our inclusion criteria. Studies included: antipsychotics, atomoxetine, lithium, clonidine, alproex sodium and psychostimulants. The antipsychotics demonstrated efficacy, but were associated with adverse effects. Other agents demonstrated mixed responses, highlighting the lack of clinical significance and increased incidence of adverse effects. The management of related adverse effects was addressed to assist with clinical gaps. Overall, there is limited evidence regarding the role of pharmacotherapy in CD. More research is needed that takes into account the heterogeneity of CD and analysis of pharmacotherapy in pure CD.
Publisher: Springer Science and Business Media LLC
Date: 03-2011
DOI: 10.1007/S10567-010-0075-Y
Abstract: Research indicates that parents and other family members often grieve their child or relative's mental illness. This grief appears resultant from a profound sense of loss, which has been described as complicated and nonfinite (e.g., Atkinson in Am J Psychiatry 151(8):1137-1139, 1994 Davis and Schultz in Soc Sci Med 46(3):369-379, 1998 Jones in Br J Soc Work 34:961-979, 2004 MacGregor in Soc Work 39(2):160-166, 1994 Osborne and Coyle in Couns Psychol Q 15(4):307-323, 2002 Ozgul in Aust N Z J Fam Ther 25(4):183-187, 2004 Tuck et al. in Arch Psychiatric Nurs 11(3):118-125, 1997). This paper reviews existent research in this emerging field, with a focus on parents' grief experience in relation to their adult child's mental disorder. Studies that explore parents' and family members' grief, using both qualitative and quantitative methodologies, are considered. Research evidence for the association between parents' and family members' grief and other outcomes are discussed. Findings concerning the prediction of grief in parents and family members who have a child or relative with a mental disorder will be reviewed. Finally, this paper considers methodological and theoretical issues associated with existent research and presents options for further study.
Publisher: Wiley
Date: 08-09-2000
DOI: 10.1017/S0012162200000049
Abstract: To test the hypothesis that children with suboptimal fetal growth have significantly poorer mental health outcomes than those with optimal growth, a population random s le survey of children aged 4 to 16 years in Western Australia in 1993 was conducted. The Child Behavior Checklist (Achenbach 1991a) and the Teacher Report Form (Achenbach 1991b) were used to define mental health morbidity. Survey data for 1775 children aged 4 to 13 years were available for linkage with original birth information. The percentage of expected birthweight (PEBW) was used as the measure of fetal growth. Children below the 2nd centile of PEBW who had achieved only 57% to 72% of their expected birthweight given their gestation at delivery were at significant risk of a mental health morbidity (OR 2.9, 95% CI 1.18, 7.12). In addition, they were more likely to be rated as academically impaired (OR 6.0, 95% CI 2.25, 16.06) and to have poor general health (OR 5.1, 95% CI 1.69, 15.52).
Publisher: SAGE Publications
Date: 27-08-2021
DOI: 10.1177/00048674211041917
Abstract: This paper describes the development of the third edition of the National Health and Medical Research Australian Guidelines for the Prevention and Treatment of Acute Stress Disorder, posttraumatic stress disorder and Complex posttraumatic stress disorder, highlighting key changes in scope, methodology, format and treatment recommendations from the previous 2013 edition of the Guidelines. Systematic review of the international research was undertaken, with GRADE methodology used to assess the certainty of the evidence, and evidence to decision frameworks used to generate recommendations. The Guidelines are presented in an online format using MAGICApp. Key changes since the publication of the 2013 Guidelines include a new conditional recommendation for Child and Family Traumatic Stress Intervention for children and adolescents with symptoms within the first 3 months of trauma, and a strong recommendation for trauma-focused cognitive behaviour therapy for the child alone or with a caregiver, for those with diagnosed posttraumatic stress disorder. For adults with posttraumatic stress disorder, strong recommendations are made for specific types of trauma-focused cognitive behaviour therapy and conditional recommendations are made for five additional psychological interventions. Where medication is indicated for adults with posttraumatic stress disorder, venlafaxine is now conditionally recommended alongside sertraline, paroxetine or fluoxetine. These Guidelines, based on systematic review of the international literature, are intended to guide decision making for practitioners, service planners, funders and those seeking treatment for trauma related mental health concerns. For an Australian Guideline, a critical limitation is the absence of research on the treatment of Australian Aboriginal and Torres Strait Islander peoples. The new online format of the Australian posttraumatic stress disorder Guidelines means that they can be updated as sufficient new evidence becomes available.
Publisher: SAGE Publications
Date: 12-2015
Publisher: AMPCo
Date: 02-2012
DOI: 10.5694/MJA12.10112
Publisher: Springer Science and Business Media LLC
Date: 10-07-2012
Publisher: SAGE Publications
Date: 10-1997
DOI: 10.3109/00048679709062681
Abstract: Objective: The scientific literature has not kept pace with the evolution of child and adolescent psychiatric inpatient units, including their nature, patient profile, philosophical orientation and efficacy. This study aims to establish a comprehensive, mul-timodal description of the population served by an inpatient psychiatric treatment facility for children and adolescents. Method: A multidisciplinary assessment regime including psychiatric, medical, speech and language examination, observer rating and patient self-report of psy-chopathology was used to assess 58 consecutive patients over a 20-month period. Results: In addition to a prevalence of disruptive behaviour disorders of 67% and a high rate of comorbidity with other psychiatric conditions, a breadth of impairment was demonstrated in many areas. Significantly decreased measures of socialisation, communication, daily living skills, self-esteem, intelligence and physical health are reported. Moderate to severe language handicap was found in 40% of patients. Conclusions: The inpatient population of children and adolescents exhibited not only a high rate of disruptive behaviour disorders, frequently cornorbid with other psychiatric conditions, but also high levels of physical, speech, language and living skills impairment. This finding supports the need for multimodal, multidisciplinary evaluation and treatment in this population. Outcome research evaluating treatment effectiveness must also account for the wide-ranging disabilities of these children and adolescents.
Publisher: Informa UK Limited
Date: 10-2010
DOI: 10.5172/JAMH.9.2.148
Publisher: Elsevier BV
Date: 02-2021
No related grants have been discovered for Brett McDermott.