The Role Of Learning In The Development, Maintenance, And Treatment Of Paediatric Obsessive-Compulsive Disorder
Funder
National Health and Medical Research Council
Funding Amount
$189,604.00
Summary
Obsessive-compulsive disorder (OCD) in children is a severely debilitating mental health problem affecting between 0.5 and 1% of the population at any point in time. Children with OCD frequently experience high functional impairment as a result of their symptoms, including deteriorating school performance and poor peer relationships. Family life is often disrupted, causing significant distress and hardship to parents and siblings. However, little research attention has been paid to how families ....Obsessive-compulsive disorder (OCD) in children is a severely debilitating mental health problem affecting between 0.5 and 1% of the population at any point in time. Children with OCD frequently experience high functional impairment as a result of their symptoms, including deteriorating school performance and poor peer relationships. Family life is often disrupted, causing significant distress and hardship to parents and siblings. However, little research attention has been paid to how families affect and are affected by this disabling condition. This research examines the role of learning in the development, maintenance and treatment of OCD. Specifically, the study aims to: 1. explore the way in which children with OCD process threatening information 2. investigate the influence of parents on children's processing of OCD-relevant information 3. develop and implement the world's first randomised control trial of cognitive-behavioural plus parent training (CBT + PT) for childhood OCD 4. evaluate parent-assisted treatment in comparison to a standard cognitive-behavioural treatment (CBT) and a placebo control 5. examine the long-term maintenance of each type of treatment The outcomes of this project will be: 1. an improved understanding of OCD in children, and their families 2. an increased knowledge of the relationship between parenting processes and OCD symptomatology 3. the development and dissemination of an evidence-based treatment for childhood OCDRead moreRead less
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
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
It is known that about 10% of patients over the age of 55 have difficulty with cognition and thinking 3 months after surgery and anaesthesia. Over 2 million operations involving anaesthesia are administered in Australia every year and increasingly the patients are elderly and thus exposed to the risk of cognitive decline after surgery. We have preliminary data showing that people who have mild changes in cognitive function before the surgery (known as mild cognitive impairment) are susceptible t ....It is known that about 10% of patients over the age of 55 have difficulty with cognition and thinking 3 months after surgery and anaesthesia. Over 2 million operations involving anaesthesia are administered in Australia every year and increasingly the patients are elderly and thus exposed to the risk of cognitive decline after surgery. We have preliminary data showing that people who have mild changes in cognitive function before the surgery (known as mild cognitive impairment) are susceptible to further cognitive decline after anaesthesia and surgery. In order to explore the relationship between preoperative cognitive function and postoperative cognitive decline we plan to measure cognition in patients scheduled for elective hip replacement surgery. This is done by asking patients to complete a standard battery of cognitive tests. We will be then able to identify those patients who already have mild cognitive impairment before surgery and by repeated testing after the operation will be able to demonstrate if preoperative cognitive status is a determinant of postoperative cognitive dysfunction. The primary aim of the research is to test whether cognitive impairment before surgery leads to cognitive deficit after surgery in patients over the age of 65 undergoing total hip replacement surgery. The study will also establish the prevalence of pre-operative mild cognitive impairment and the magnitude of postoperative cognitive dysfunction after surgery in this patient group. The study will explore the relationship between preoperative cognitive status and postoperative cognitive deficit , providing information about the incidence, natural history and risk factors of postoperative cognitive deficit. This work will enable further research to isolate specific causative factors and identify therapeutic and prophylactic strategies.Read moreRead less
Cardiac Intervention, Surgery And Cognitive Outcome (CISCO) Study
Funder
National Health and Medical Research Council
Funding Amount
$367,739.00
Summary
We propose to investigate the association between the presence of coronary artery disease and changes in brain function after therapeutic interventions. Patients undergoing surgery for coronary heart disease are prone to experience changes in mental function and higher level thought processes (cognition) after surgery, especially if they are elderly. As the population ages this is becoming a more significant problem. There is some limited evidence that this particular group of patients has a hig ....We propose to investigate the association between the presence of coronary artery disease and changes in brain function after therapeutic interventions. Patients undergoing surgery for coronary heart disease are prone to experience changes in mental function and higher level thought processes (cognition) after surgery, especially if they are elderly. As the population ages this is becoming a more significant problem. There is some limited evidence that this particular group of patients has a higher incidence of cognitive impairment than the normal population even before they present for surgery, because cardiovascular disease has also been shown to be associated with changes in cognition. To investigate this, we will measure cognitive status in patients over the age of 55 who have coronary artery disease and are being investigated with coronary angiography. This will provide an indication of the baseline cognitive status in patients presenting with coronary vascular disease. We will use validated neuropsychological tests that have been used to assess potsoperative cognitive decline. These tests are sufficiently sensitive to detect subtle changes in a number of areas of thought processing (cognitive domains) and thus identify those subjects who have cognitive impairment. Patients will then go on to be treated by surgery or angioplasty. We will continue to test these patients at time intervals for 3 months in order to track the changes in cognition in each treatment group. Thus we will be in the position to compare how these modalities of treatment for heart disease impact on patients mental function and cognition. In addition we will be able to tell whether a 'recovery' period might be of benefit following coronary angiography. If we are able to demonstrate different cognitive outcomes from different treatments and also an association with pre-existing cognition, this will guide clinical decision making to minimise harm to the brain.Read moreRead less
The Cognitive Impact Of Opioids During Chronic Administration
Funder
National Health and Medical Research Council
Funding Amount
$416,024.00
Summary
Many people are now being prescribed opioid drugs for long periods of time, mainly for the treatment of chronic pain. These drugs can adversely affect the person's ability to drive a car, hold down a job, and perform normal functions of daily living. This project will investigate what types of impairment are produced by these drugs and how the drugs can best be used so as to minimise the effects on patients.
Effects Of Oestrogen On Mood, Memory And Quality Of Life Of Women Aged 70 Years Or Over
Funder
National Health and Medical Research Council
Funding Amount
$170,990.00
Summary
Oestrogen has a number of actions that extend well beyond the regulation of the reproductive cycle and sexual behaviour. The results of recent studies indicate that oestrogen may influence mood and a number of intellectual abilities such as memory and language. In addition, oestrogen replacement therapy seems to reduce the risk of Alzheimer's disease (the most frequent cause of dementia in Western societies) amongst postmenopausal women. The present study aims to: (1) investigate the association ....Oestrogen has a number of actions that extend well beyond the regulation of the reproductive cycle and sexual behaviour. The results of recent studies indicate that oestrogen may influence mood and a number of intellectual abilities such as memory and language. In addition, oestrogen replacement therapy seems to reduce the risk of Alzheimer's disease (the most frequent cause of dementia in Western societies) amongst postmenopausal women. The present study aims to: (1) investigate the association of depression and memory performance with physiological levels of oestrogen in women aged 70 years or over; and (2) investigate the evolution of depression and memory scores in old women treated with oestrogen replacement therapy as compared to placebo. The results of the present study may have important implications in the prevention and management of two of the most relevant mental health disorders of later life: depression and Alzheimer's disease.Read moreRead less
What Is The Burden Of Dementia In Urban Dwelling Indigenous Australians?
Funder
National Health and Medical Research Council
Funding Amount
$1,571,527.00
Summary
The main aim of this research project is to determine what proportion of Aboriginal people aged 45 years and older who live in urban areas of NSW, have dementia. We hope to establish what types of dementia occur amongst Aboriginal people, what the causes are, and how we can best measure dementia. We will also focus on what types of problems dementia causes for both people with the condition and their carers. What is the meaning of dementia for Aboriginal people themselves?
The ability to monitor one's cognitive performance deteriorates with normal ageing, and is particularly affected in a range of clinical conditions of older age, such as Parkinson's Disease, where it is a predictor of a poor prognostic outcome. This project aims to clarify the effects of age on cognitive and neural processes underlying performance monitoring, as an important first step to improving interventions for age-related impairments, including those accompanying neurodegenerative diseases.