Behavioural Management Of The Triggers Of Recurrent Headache: Avoidance Versus Coping
Funder
National Health and Medical Research Council
Funding Amount
$503,233.00
Summary
The traditional approach to headache management is to advise that the best way to prevent headaches is to avoid the trigger factors. This approach has never been systematically evaluated, however, and it may lead to headache sufferers losing tolerance for the factors that could precipitate a headache. This study will be the first to evaluate the traditional approach, and will also evaluate an innovative approach that includes techniques designed to desensitise people to headache triggers.
The Effectiveness Of Mindfulness Practices In Reducing Distress In Children Diagnosed With Cancer And Their Parents.
Funder
National Health and Medical Research Council
Funding Amount
$22,019.00
Summary
This research project aims to investigate the effectiveness of mindfulness based cognitive therapy, an intervention using specific meditation and thought techniques, to reduce psychological distress in children who have been diagnosed with cancer and their parents. Specifically, symptoms of depression, anxiety and stress related to the experience of the illness will be targeted.
The Role Of Allostatic Load As A Mediator Between Chronic Stress And Poor Health For Dementia Caregivers
Funder
National Health and Medical Research Council
Funding Amount
$237,321.00
Summary
The potential risk to caregivers of dementia patients of poor health outcomes is well documented. The burden imposed by caregiving is most often described in terms of chronic stress. While it is apparent that some stress-relieving social interventions (e.g. respite) may have short-term benefits, it is also clear that many caregivers are unable or unwilling to avail themselves of such programs. The way in which chronic stress leads to poor health is not well understood. Our study of spouse caregi ....The potential risk to caregivers of dementia patients of poor health outcomes is well documented. The burden imposed by caregiving is most often described in terms of chronic stress. While it is apparent that some stress-relieving social interventions (e.g. respite) may have short-term benefits, it is also clear that many caregivers are unable or unwilling to avail themselves of such programs. The way in which chronic stress leads to poor health is not well understood. Our study of spouse caregivers seeks to identify the groups of physiological systems that suffer cumulative wear and tear as a result of chronic stress. This wear and tear is called allostatic load, and is thought to lead to poor health. It is expected that caregivers in our study will have greater allostatic load than people who are not caregivers. Should this be the case, our results will provide the basis for the design of tailored interventions to maintain caregivers in good health. The potential of such preventive health measures is to reduce caregivers' health care costs and reliance on community support, and to help caregivers to continue providing care for their spouses at home.Read moreRead less
Enhancing Efficacy Of Bibliotherapy For Rural Children With Anxiety Disorders Using Child-therapist Contact
Funder
National Health and Medical Research Council
Funding Amount
$482,798.00
Summary
Many Australian children suffering severe anxiety live in areas where access to qualified therapists is limited. In previous research we developed an outreach program in which parents were taught to help their own child overcome their anxiety through a mixture of printed materials and remote access to a therapist. In the current project we aim to extend these results by incorporating the child into the remote treatment, and in doing so improving the number of children who benefit from treatment
Selective Attention And Fear Avoidance In The Maintenance And Management Of Pain Associated With Rheumatoid Arthritis
Funder
National Health and Medical Research Council
Funding Amount
$195,660.00
Summary
Despite advances in the treatment of RA, the condition continues to have a chronic course for the majority of patients. Research has established that the way in which people think about pain and illness influences their responses to symptoms. In turn, these factors can impinge on quality of life and disability. For people with chronic pain problems, those who are fearful of pain and concentrate on symptoms have a poorer outcome in the long-term. In RA, striking a balance between rest and exercis ....Despite advances in the treatment of RA, the condition continues to have a chronic course for the majority of patients. Research has established that the way in which people think about pain and illness influences their responses to symptoms. In turn, these factors can impinge on quality of life and disability. For people with chronic pain problems, those who are fearful of pain and concentrate on symptoms have a poorer outcome in the long-term. In RA, striking a balance between rest and exercise is thought to be crucial. As such, ignoring the pain can lead to overactivity and subsequent joint damage and may be as unhelpful as underactivity. This project aims to investigate the relationship between people's fear of pain and the degree to which they attend to pain. It is suggested that those with very high or very low levels of fear towards the pain will either over-attend or under-attend to pain in comparison to healthy controls and patients with a moderate level of fear. Optimum levels of fear avoidance are expected to be associated with less disability and improved joint function. These findings have implications for the management of RA. Psychological treatments for patients with RA have been found to be effective in reducing pain, disability and improving mood. Treatments usually focus on a combination of changing people's attitudes and behaviours. However, whether strategies that aim to change attitudes or those targeting behaviour are more successful or have specific treatment effects is unknown. The present project will compare a treatment targeting behaviours associated with RA and encouraging a balanace between rest and exercise, with a treatment targeting patient's beliefs about the illness. It is expected that the treatments will have specific effects, which may better allow tailoring of psychological management to patient's individual needs.Read moreRead less
Acquisition And Extinction Of Headache-eliciting Properties Of Trigger Factors
Funder
National Health and Medical Research Council
Funding Amount
$91,082.00
Summary
Standard advice in the clinical management of headaches is to counsel headache sufferers to avoid any factors that could trigger a headache. There is a compelling logic to this approach but is there a danger that it amounts to being over-protective in the sense that it encourages headache sufferers to 'cocoon' themselves from situations that could give rise to headaches, ultimately resulting in them losing their ability to cope with such situations. Certainly, avoiding situations that elicit anx ....Standard advice in the clinical management of headaches is to counsel headache sufferers to avoid any factors that could trigger a headache. There is a compelling logic to this approach but is there a danger that it amounts to being over-protective in the sense that it encourages headache sufferers to 'cocoon' themselves from situations that could give rise to headaches, ultimately resulting in them losing their ability to cope with such situations. Certainly, avoiding situations that elicit anxiety leads to a sensitisation process whereby the situations elicit greater anxiety. And the converse is true, exposure to anxiety-eliciting situations results in a desensitisation process whereby the situations elicit less anxiety. Whether avoidance or exposure is more appropriate in the management of headache disorders depends on the processes by which sensitivity to trigger factors is gained and lost. Two studies will be completed that test different models of these processes. The expected outcome of these studies is that they will support the theory that stimuli acquire the capacity to elicit headaches as a function of individuals trying to avoid or escape from any factor that they believe could trigger a headache. This sensitisation process can be reversed by prolonged exposure to headache trigger factors. Such results would suggest that the established practice of counselling headache sufferers to avoid triggers is counterproductive as it may lead to a reduction of headaches in the short-term but may also lead to an insidious sensitisation process that ultimately results in an increase in headaches. Given that headaches are so common and associated with such high direct and indirect costs, changes in clinical management arising from these findings could have major benefits to individuals, families and society.Read moreRead less
A Randomised Trial Of A Decision Aid For Women At Increased Risk For Ovarian Cancer
Funder
National Health and Medical Research Council
Funding Amount
$115,110.00
Summary
Epithelial ovarian cancer is the leading cause of death from gynaecological malignancy in Australia. The majority of women with ovarian cancer are diagnosed with advanced disease, and the chance of cure is low. The strongest risk factor for ovarian cancer identified to date is a family history of ovarian cancer, and up to 5% of all ovarian cancers are thought to be due to dominantly inherited mutations in a small number of ovarian-cancer-related genes. National guidelines on surveillance and pro ....Epithelial ovarian cancer is the leading cause of death from gynaecological malignancy in Australia. The majority of women with ovarian cancer are diagnosed with advanced disease, and the chance of cure is low. The strongest risk factor for ovarian cancer identified to date is a family history of ovarian cancer, and up to 5% of all ovarian cancers are thought to be due to dominantly inherited mutations in a small number of ovarian-cancer-related genes. National guidelines on surveillance and prophylactic strategies have recently been ratified. These are largely based on expert opinion. Because of the uncertain efficacy of ovarian cancer screening and the high mortality associated with ovarian cancer, prophylactic oophorectomy is considered an option for women at high risk. Decisions about optimal care are difficult for both women and their doctors. Efforts to improve services for women who are trying to make informed decisions about screening and prophylactic strategies under conditions of uncertainty must be informed by sound knowledge of the efficacy of educational interventions. Decision aids have been developed as adjuncts to practitioners' counselling to prepare patients for decision-making. The proposed randomised controlled trial will compare the efficacy of a general educational pamphlet and that of a tailored decision aid. A total of 120 women at risk for ovarian cancer who are attending one of five familial cancer clinics will be included in the trial to determine the efficacy of different educational interventions in preparing women for decision-making about screening and prophylactic options.Read moreRead less