Childhood Cognitive Antecedents Of Adult Psychopathology: Follow-up Of The Port Pirie Lead Cohort Into Adulthood
Funder
National Health and Medical Research Council
Funding Amount
$587,263.00
Summary
The role of childhood factors in the development of adult psychiatric disorder is an important public health concern. Indvividuals identified before birth and followed across the life course offer the most powerful means of establishing predictors for particular types of psychiatric disorder. Not only do these studies enable researchers to more clearly determine the exact age of onset of disorder but they also give us insight into the background and hence possible risk factors that may have lead ....The role of childhood factors in the development of adult psychiatric disorder is an important public health concern. Indvividuals identified before birth and followed across the life course offer the most powerful means of establishing predictors for particular types of psychiatric disorder. Not only do these studies enable researchers to more clearly determine the exact age of onset of disorder but they also give us insight into the background and hence possible risk factors that may have lead to the development of that disorder. Early identification of disorder can significantly reduce public health cost and reduce the burden on the community by enabling individuals to get help before their symptoms become too severe and unmanageable. Few long-term studies have investigated the combined role of pre-natal, developmental, parental characteristics, biological and childhood cognitive risk factors in the development of adult psychiatric dysfunction. Even fewer studies have examinined this interrelationship in a group of individuals who have been exposed to an environmental toxin such as lead. This study will follow-up 723 adults from the lead smelting city of Port Pirie who were originally recruited between 1979 and 1982. All adults were exposed to lead to some degree in childhood and have been followed over various time points over the course their lives. This project will be conducted 27 years since they were first involved, and will hence be one of the longest studies to be conducted in this field. The extensive information already collected on this group of individuals will enable us to create a very comprehensive picture of risk and protective factors for various types of adult disorder.Read moreRead less
Panic Disorder: Neurobiology And Mechanisms Of Cardiac Risk
Funder
National Health and Medical Research Council
Funding Amount
$456,657.00
Summary
Some people are subject to episodes of recurring, often inexplicable anxiety which are very unpleasant and accompanied by physical symptoms such as sweating, palpitations, tremor and a sensation of suffocation. Recurring attacks over a period of months, or years, forms the basis for the diagnostic of panic disorder. It has until recently been felt that although panic disorder was distressing and disabling, it did not constitute a risk of life. Sufferers often fear that they have heart disease, b ....Some people are subject to episodes of recurring, often inexplicable anxiety which are very unpleasant and accompanied by physical symptoms such as sweating, palpitations, tremor and a sensation of suffocation. Recurring attacks over a period of months, or years, forms the basis for the diagnostic of panic disorder. It has until recently been felt that although panic disorder was distressing and disabling, it did not constitute a risk of life. Sufferers often fear that they have heart disease, because of the nature of their symptoms, but have been reassured that this is not the case. Recent epidemiological studies, however, indicate that there is an increased risk in patients with panic disorder. Our hypotheses in this research project are as follow: That some specific genes predispose to the development of panic disorder - through actions on the nervous system and blood vessels That drug treatment (selective serotonin uptake blockers) and psychological treatment (cognitive behaviour therapy, CBT) reduce cardiac risk in panic disorder We will test these hypothesis using state of the art clinical scientific methods. Panic disorder has an important cardiological dimension which needs to be better understood for cardiac protection to be achieved in panic disorder patients.Read moreRead less
Evaluation Of Internet-based, Cognitive Behaviour Therapy For The Treatment Of Anxiety Disorders In Adolescents
Funder
National Health and Medical Research Council
Funding Amount
$570,750.00
Summary
Anxiety disorders affect around 5-10% of adolescents and are associated with a range of adverse consequences if left untreated. The majority of young people with anxiety disorders do not seek nor receive treatment. This may be due partly to the perceived stigma of attending a mental health clinic and logistic problems of attending therapy. A challenge is to identify ways in which treatment can be made more accessible to adolescents in need, particularly those in rural and remote areas. Contrary ....Anxiety disorders affect around 5-10% of adolescents and are associated with a range of adverse consequences if left untreated. The majority of young people with anxiety disorders do not seek nor receive treatment. This may be due partly to the perceived stigma of attending a mental health clinic and logistic problems of attending therapy. A challenge is to identify ways in which treatment can be made more accessible to adolescents in need, particularly those in rural and remote areas. Contrary to original beliefs, evidence shows that the internet can be used to deliver effective psychological therapies for a range of mental health problems, including anxiety disorders. So far this research has focused on adults, but adolescents may be in a particularly strong position to benefit from these forms of therapy, being experienced users of internet resources. This research investigates the effectiveness of internet-based cognitive-behaviour therapy (CBT) in the treatment for anxiety disorders in adolescents. Recently we have piloted CBT for anxious children that combines clinic and internet therapy, with half the therapy sessions in the clinic and half over the internet. Pilot data show that clinic + internet therapy produced significant reductions in anxiety and is almost as effective full clinic-based therapy. The proposed research builds on our pilot work by evaluating the effectiveness of a more extensive internet-based therapy in which all sessions are completed using the internet and with an older age group. The research also examines the factors that predict which young people will respond most positively to the intervention so that the treatment can be matched to those most likely to benefit from it in the future. The aim is to develop an effective internet-based treatment for adolescents with anxiety disorders that is easily accessed and suitable for use in rural and remote populations, requiring minimal face-to-face therapist contact.Read moreRead less
Maternal Anxiety In Pregnancy And Infant Bio-behavioural Regulation: Testing The Fetal Programming Hypothesis
Funder
National Health and Medical Research Council
Funding Amount
$577,896.00
Summary
Recent research shows that maternal anxiety in pregnancy is associated with emotional and behaviour problems in childhood. This project examines the impact of anxiety during pregnancy on infant capacity to regulate behaviour, sleep and physiological response to stress and also considers possible genetic contributions. Findings address the earliest origins of mood and behaviour disorders in children and will inform evidence-based interventions during the perinatal period.
Autism and its milder forms affect approximately 6 per 1,000 children. The biological basis of the disorder is unknown, so considerable research is being invested in identifying cognitive processes that are atypical in children with autism because this may help identify key areas of the brain affected by the disorder. This research has established that children with autism often outperform their typically developing peers on tasks that require detailed analysis of visual information. In contrast ....Autism and its milder forms affect approximately 6 per 1,000 children. The biological basis of the disorder is unknown, so considerable research is being invested in identifying cognitive processes that are atypical in children with autism because this may help identify key areas of the brain affected by the disorder. This research has established that children with autism often outperform their typically developing peers on tasks that require detailed analysis of visual information. In contrast, visual tasks that require integrating information often reveal impaired performance in children with autism. Human vision is achieved through two pathways in the brain - a dorsal pathway most responsive to changing (e.g. moving or flickering) stimuli and a ventral pathway most responsive to enduring stimulus features (e.g. colour, pattern). Increasingly complex visual processing is achieved at higher levels in each pathway through integrating information from lower levels. One objective of our work is to identify which levels of processing in each of the dorsal and ventral pathways show atypical functioning (either enhanced or impaired) in autism. We will do this using tasks designed to establish thresholds for different perceptual judgements, such as identifying patterns in a field of dots. Children with autism will be compared to typically developing children and also to children with Specific Language Impairment (SLI). This will enable us to establish whether the same profile of strengths and weaknesses in perception and cognition are observed in autism and SLI, or whether they can be distinguished on this basis. The significance of the work is that it will advance considerably the understanding of atypical visual processing in autism and SLI. Also, by identifying perceptual and cognitive differences in children with autism, we may be able to develop tests to identify infants affected by the disorder and commence remediation at an early age.Read moreRead less
A Double Blind Placebo Randomised Controlled Trial Of Sativex In The Management Of Cannabis Withdrawal
Funder
National Health and Medical Research Council
Funding Amount
$245,626.00
Summary
Cannabis is the most commonly used illicit drug in Australia with an estimated 300,000 individuals with cannabis use disorder in Australia. Treatment presentations for cannabis have more than doubled over the last 10 years, yet there is still no medication to help with withdrawal. This proposal will test pure active ingredients in cannabis in a preparation sprayed in the mouth, to wean individuals from cannabis. This will assist them to complete cannabis withdrawal.
A Prospective Study Of Concussion In Children And Adolescents: Diagnosis, Recovery And Risk Factors For Poor Outcome.
Funder
National Health and Medical Research Council
Funding Amount
$277,000.00
Summary
Concussion is one of the most common neurological injuries and represents a significant public health issue in Australia. The most common consequences of concussive injuries are reduced attention, slowed response speeds and memory impairment. These cognitive processes are critical for performing common day-to-day activities in childhood and adolescence (e.g. acquiring new knowledge and skills, attending to school work). Approximately 20% of concussive injuries occur during participation in organ ....Concussion is one of the most common neurological injuries and represents a significant public health issue in Australia. The most common consequences of concussive injuries are reduced attention, slowed response speeds and memory impairment. These cognitive processes are critical for performing common day-to-day activities in childhood and adolescence (e.g. acquiring new knowledge and skills, attending to school work). Approximately 20% of concussive injuries occur during participation in organised sport. In adult populations, there are now evidence-based guidelines for the diagnosis and management of concussion in sport. Few well-controlled studies exist to identify the frequency and outcome of such injuries in child and adolescent populations, and there are currently no guidelines for diagnosis and management of concussion in children. Further, the academic and social consequence of concussion for the child remains unknown. This study will investigate the cognitive and behavioural outcomes of concussion in young children and adolescents and will use this information to modify and validate currently available adult concussion diagnosis and management paradigms for application with this population. This study will also investigate risk factors for poor outcome following concussion in children and adolescents, and provide age-appropriate data for use in the medical, behavioural and educational management of concussed children and adolescents. A total of 3000 children aged between 10 and 18 years will be recruited to participate in this study. All participants will undergo a baseline evaluation consisting of memory and attention tests, a behavioural rating scale, and measures of educational ability. Participants parents will also provide general health and demographic information. Children who are concussed during the year will be re-assessed within 48 hours of injury and again at 5 days, 10 days and 30 days post-injury to track recovery.Read moreRead less
A Longitudinal Study Of Depression, Anxiety, Substance Use And Cognitive Change: PATH Through Life Wave 3
Funder
National Health and Medical Research Council
Funding Amount
$2,068,954.00
Summary
The PATH Through Life study is a longitudinal study of depression, anxiety, alcohol and drug use. It is also a study of normal cognitive development, mild cognitive impairment and dementia. PATH involves three cohorts of adults who were aged 20-24, 40-44 and 60-64 at baseline. They are followed up at four yearly intervals. This application seeks funding for Wave 3 of the study, which will allow for 8 years of follow-up of the baseline sample to be conducted. The key aims are to discover the rela ....The PATH Through Life study is a longitudinal study of depression, anxiety, alcohol and drug use. It is also a study of normal cognitive development, mild cognitive impairment and dementia. PATH involves three cohorts of adults who were aged 20-24, 40-44 and 60-64 at baseline. They are followed up at four yearly intervals. This application seeks funding for Wave 3 of the study, which will allow for 8 years of follow-up of the baseline sample to be conducted. The key aims are to discover the relationships between biological and psychological processes in depression, anxiety, substance abuse and cognitive ageing; to identify the socio-demographic factors contributing to these disorders, and to quantify more fully the range of social and economic consequences of mental illness and cognitive decline. Such consequences include reduced workforce participation, relationship breakdown, family and carer burden, suicide attempts, use of health services and need for social welfare. Wave 3 will also focus on transitions into parenthood, fertility and mental health, menopause, and retirement. Factors in early and mid-adulthood that influence healthy ageing and cognitive decline in late life will be identified. Information is obtained on physical health, health habits , social networks, employment and work stress, lifestyle activities, personality, family structure, physical function and cognitive performance. DNA has also been obtained and a sub-sample of the oldest cohort also participate in a study of brain MRIs. Longitudinal analysis is the only means of distinguishing the causes of disorders and tracking their development within individuals. PATH is unique in its narrow age-group design and breadth of measures, allowing for detailed understanding of the pathways to mental health and illness, and for identification of how to prevent mental illness and dementia.Read moreRead less
Assessing Naltrexone Implant Or Methadone Maintenance Treatment On Mental And Physical Health Outcomes In Heroin Users
Funder
National Health and Medical Research Council
Funding Amount
$216,200.00
Summary
The WA hospital data linkage system (DLS) will be used to assess differences in the mental and physical health of dependent heroin users prior to and post naltrexone implant or methadone maintenance treatment (MMT). MMT is the best established pharmacotherapy for the management of heroin dependence but oral naltrexone is gaining some acceptance. Currently funded by NHMRC, we are looking at outcomes with oral naltrexone using DLS data. Although effective in blocking heroin, management via oral na ....The WA hospital data linkage system (DLS) will be used to assess differences in the mental and physical health of dependent heroin users prior to and post naltrexone implant or methadone maintenance treatment (MMT). MMT is the best established pharmacotherapy for the management of heroin dependence but oral naltrexone is gaining some acceptance. Currently funded by NHMRC, we are looking at outcomes with oral naltrexone using DLS data. Although effective in blocking heroin, management via oral naltrexone has proved problematic, with medicine non compliance and relapse common. Surgical insertion of subcutaneous implants is an alternative method of naltrexone delivery. 441 heroin users have received naltrexone implants (3.4g) under Special Access in WA. Although naltrexone implants have yet to be comprehensively assessed, early results are encouraging. Pilot study data has shown a significant reduction in hospital emergency department (ED) attendance for accidental overdose, and mental health events following implant. The aim of this study is to more rigorously assess outcomes associated with implants compared to heroin dependent persons treated by MMT . The DLS collates general hospital and mental health admissions plus mortality data for individuals. This allows the health of an individual to be monitored over time. An electronic version of hospital ED data has recently become available. The study will validate these records by comparing the electronic data against hospital ED records for the implant group. We will then combine the electronic ED and DLS data. Morbidity and mortality rates for heroin users are significantly greater than those for the general population. If the preliminary findings are replicated, naltrexone implants may offer significant benefits over current pharmacotherapies in reducing general and psychiatric morbidity in dependent heroin users.Read moreRead less
Multi-site Randomised Controlled Trial Of Fluoxetine In Children And Adolescents With Autism.
Funder
National Health and Medical Research Council
Funding Amount
$499,482.00
Summary
Fluoxetine is a medication that is increasingly used in children with autism in an attempt to control repetitive behaviours, which substantially interfere with daily functioning and quality of life. However clinicians working in the field of autism and goverment regulatory bodies (such as the TGA) require evidence of the efficacy of fluoxetine for this indication. This study aims to determine this, thereby addressing an important gap in clinical knowledge.