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
The Neurochemical Basis Of Behavioural Control: Relevance For Addiction, OCD And Tourette Syndrome.
Funder
National Health and Medical Research Council
Funding Amount
$375,225.00
Summary
Both the control of voluntry responses over reflexive habits, and the ability to direct voluntary responses appropriately when there are conflicting choices present in the world, are thought to be important in mental disorders such as drug addiction, tic disorders such as Tourette syndrome and obsessive compulsive disorder. This project will examine the brain neurochemistry that underpins our ability to control voluntary responses, providing insight into potential pharmacological interventions.
Acute Stress Disorder And Posttraumatic Stress Disorder In Injured Children
Funder
National Health and Medical Research Council
Funding Amount
$125,000.00
Summary
The aim of this project is to develop the means to identify acute reactions to trauma that will predict chronic posttraumatic stress disorder (PTSD) in children after a traumatic injury. This project will conduct the first prospective analysis of acute stress disorder and chronic traumatic stress symptoms in children, develop diagnostic guidelines to identify acutely traumatized children who are at risk of PTSD, and identify biological, cognitive, and familial factors that mediate PTSD developme ....The aim of this project is to develop the means to identify acute reactions to trauma that will predict chronic posttraumatic stress disorder (PTSD) in children after a traumatic injury. This project will conduct the first prospective analysis of acute stress disorder and chronic traumatic stress symptoms in children, develop diagnostic guidelines to identify acutely traumatized children who are at risk of PTSD, and identify biological, cognitive, and familial factors that mediate PTSD development following trauma. Two hundred children (aged 7 - 12 years) who are admitted to hospital following a traumatic injury will be assessed for acute disorder within one month of the accident. They will be also be assessed for heart rate, blood pressure, memory patterns, and family responses during the initial assesment. Parents will also be assessed for their trauma reactions. All participants will be re-assessed at 6-months posttrauma, and again at 18-months posttrauma. These findings will establish the means to identify acutely traumatized children who are at risk of PTSD and open up opportunities for early intervention and prevention of PTSD.Read moreRead less
Enhancing Treatment Effectiveness In Acute Stress Disorder
Funder
National Health and Medical Research Council
Funding Amount
$235,330.00
Summary
Posttraumatic stress disorder (PTSD) is the most common psychiatric condition to develop after trauma. Early intervention of PTSD following a trauma is indicated because chronic PTSD can be resistant to treatment. Early intervention is possible because acute stress disorder immediately after a trauma identifies those people who will develop chronic PTSD. Although cognitive behaviour therapy of acute stress disorder can effectively prevent PTSD in many cases, many people do not benefit from this ....Posttraumatic stress disorder (PTSD) is the most common psychiatric condition to develop after trauma. Early intervention of PTSD following a trauma is indicated because chronic PTSD can be resistant to treatment. Early intervention is possible because acute stress disorder immediately after a trauma identifies those people who will develop chronic PTSD. Although cognitive behaviour therapy of acute stress disorder can effectively prevent PTSD in many cases, many people do not benefit from this treatment because this treatment involves exposure to distressing memories and emotions, and this contributes to many people dropping out of treatment. This project aims to extend the utility of early intervention following trauma by assessing approaches that can be used by most trauma survivors. The project compares early intervention with either exposure, cognitive therapy, combined exposure and cognitive therapy, or supportive counseling. All therapy will be conducted in the initial four weeks and will comprise 6 sessions. Assessments will be conducted posttreatment, six-months follow-up, and one-year follow-up. The outcomes of this project will have significant public health benefits because they will lead to increased treatment effectiveness for acutely traumatized people, and will markedly reduce the incidence of PTSD in the community.Read moreRead less
Panic Disorder: Neurobiology And Mechanisms Of Cardiac Risks
Funder
National Health and Medical Research Council
Funding Amount
$414,375.00
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 diagnosis of panic disorder. It has until recently been felt that although panic disorder was distressing and disabling, it did not constitute a risk to life. Sufferers often fear that they have heart disease, be ....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 diagnosis of panic disorder. It has until recently been felt that although panic disorder was distressing and disabling, it did not constitute a risk to 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 of heart risk in patients with panic disorder. Our hypotheses in this research are as follows: That panic disorder is characterised by increased release of the brain chemical messenger, serotonin, which is reversed by drug treatment with the most widely used class of drugs for this disorder, selective serotonin reuptake blockers That changes in an automatic stimulatory part of the nervous system, has primary importance in the disorder, in both genetically predisposing to panic disorder, and in mediating heart risk. That weight gain during therapy, a very common problem, is due to inhibition of brain serotonin release. We will test all these propositions 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. Our study of the mechanisms of cardiac risk should provide this. We will also provide very direct, valid measurements of chemical messenger release in the brain of panic disorder sufferers, using our unique methods. These should give a new understanding of the brain chemistry abnormalities of panic disorder, and the mechanism of action of the selective serotonin reuptake inhibitors.Read moreRead less
Attention Deficit Hyperactivity Disorder: Genes, Cognition And Brain Activity
Funder
National Health and Medical Research Council
Funding Amount
$428,602.00
Summary
Attention deficit hyperactivity disorder (ADHD) is a common psychiatric disorder of childhood that is marked by age-inappropriate levels of inattention and-or hyperactivity-impulsivity. The disorder appears genetic with a number of different genes likely contributing risk for ADHD. I will use a multi-modal (genetic, cognitive, neurochemical, physiological) approach to increase our understanding of the biological mechanisms leading from gene to disorder in ADHD.
Solving The Jigsaw! Understanding Biological And Environmental Effects On ADHD Through Discordant Mononozygotic Twins
Funder
National Health and Medical Research Council
Funding Amount
$557,500.00
Summary
The recent Child and Adolescent component of the National Mental Health Survey identified Attention Deficit Hyperactivity Disorder(ADHD) as the most common behavioural problem among Australian children. Since 1991 our Australian Twin ADHD Project (ATAP) has developed as one of the world's largest programs on the genetics of ADHD, and in 2001 we published the first text on this topic. In this grant we turn the focus onto environmental influences with the question Why can one identical twin have A ....The recent Child and Adolescent component of the National Mental Health Survey identified Attention Deficit Hyperactivity Disorder(ADHD) as the most common behavioural problem among Australian children. Since 1991 our Australian Twin ADHD Project (ATAP) has developed as one of the world's largest programs on the genetics of ADHD, and in 2001 we published the first text on this topic. In this grant we turn the focus onto environmental influences with the question Why can one identical twin have ADHD, while the other twin has no difficulties? Using the unique resources of the Australian Twin Registry and the WA Twin Child Health Study, we shall work across the country to find over 100 identical twin pairs who are very different in ADHD. In this way, each ADHD affected twin has an unaffected 'control twin', offering a powerful means for comparing the two. Such a study is really only possible in Australia, as no other country has such twin resources for research. The questions we want to consider with these children include the following 1- Twins have a more difficult time before and at birth. To what extent do these problems contribute to differences between the twins? 2- Are there differences in specific aspects of brain functioning? 3- Is it that one twin grows out of their ADHD but the other does not? If so, what distinguishes the children? 4- What is it like growing up with a twin who has ADHD, when you have no difficulties yourself? 5- When one twin has ADHD symptoms, is the family more likely to seek help, as they can see how different this child is form the other twin? Obviously identical twins in wehich only one has ADHD are a very unique group. By covering all aspects of development, from brain functioning to service utilisation, the hope is that this study will provide invaluable insights into this common condition which will help all children and families where the diagnosis of ADHD has been made.Read moreRead less
A Randomised Controlled Trial Of Internet-based Therapy For Panic Disorder.
Funder
National Health and Medical Research Council
Funding Amount
$202,575.00
Summary
Approximately 9.7% of the adult population have an anxiety disorder with one of the more common, panic disorder, often with agoraphobia, afflicting 2.4% of the community. Around 8% of patients consulting a GP also have panic disorder (PD). A further 10% of the community experience spontaneous panic, but do not have full PD (termed non-clinical panic). People with PD frequently experience clinical depression, about 15% abuse alcohol and non-prescription drugs and PD is associated with an increase ....Approximately 9.7% of the adult population have an anxiety disorder with one of the more common, panic disorder, often with agoraphobia, afflicting 2.4% of the community. Around 8% of patients consulting a GP also have panic disorder (PD). A further 10% of the community experience spontaneous panic, but do not have full PD (termed non-clinical panic). People with PD frequently experience clinical depression, about 15% abuse alcohol and non-prescription drugs and PD is associated with an increased risk of suicide. Over time people with PD appear to have an increased risk of heart problems. They also have substantial financial burdens through multiple attendances at doctors' rooms and through restricted employment opportunities. Only just over one in four people with an anxiety disorder consults a health professional for their problems, with most going to their GP. It has been estimated that less than 10% of these people seek the services of a mental health specialist such as a clinical psychologist or psychiatrist. Therefore because of blocks to do with access, cost or embarrassment, many people with mental health problems do not seek face-to-face specialised mental health treatment. People in rural and regional Australia are particularly disadvantaged by limited access to these specialists. We have developed an internet-based treatment program on panic and anxiety for people in the community, and particularly in regional Australia. Early evaluation of this program has found it is more effective than other types of therapist-assisted self-help treatment. The aim of this research project is to compare it to best-practice face-to-face psychological and pharmacological treatment for PD. If the effectiveness of our internet-based treatment is comparable to best-practice face-to-face treatment, its availability will assist the many Australians who suffer from debilitating panic but who are unable to access specialised mental health assistance.Read moreRead less
Depression, Anxiety And Somatic Distress: Syndromal Structure And Relationship To Onset Of Clinical Disorder
Funder
National Health and Medical Research Council
Funding Amount
$224,085.00
Summary
The project aims to identify the principal dimensions or syndromes underlying symptoms of psychological distress (negative emotional states such as depression, anxiety, stress and fatigue). We plan to use an intensive longitudinal design to examine how these syndromes develop into episodes of clinical disorder. We expect that episodes of disorder will be predicted not only by closely related syndromes, but also by other causally related syndromes - for example, a period of increased anxiety and ....The project aims to identify the principal dimensions or syndromes underlying symptoms of psychological distress (negative emotional states such as depression, anxiety, stress and fatigue). We plan to use an intensive longitudinal design to examine how these syndromes develop into episodes of clinical disorder. We expect that episodes of disorder will be predicted not only by closely related syndromes, but also by other causally related syndromes - for example, a period of increased anxiety and stress may precipitate a depressive disorder. This information is important for understanding the aetiology of clinical disorders, for refining diagnostic criteria, and for the prediction and prevention of disorder. We also plan to collect information about the degree of disability that people suffer and the type of health services they access at various levels of severity of each syndrome. We expect that subclinical levels of some syndromes will be associated with substantial impairment and service usage, but that for other syndromes impairment will be minimal until clinical levels of severity are reached. This information will give a more complete picture of the community-wide burden of emotional distress, and will be directly relevant to health planning and policy.Read moreRead less
Structural And Diffusion Tensor Neuroimaging In Twins Concordant And Discordant For Psychosis.
Funder
National Health and Medical Research Council
Funding Amount
$477,375.00
Summary
Measures from specialised brain scans i.e. MRI's (Magnetic Resonance Imaging) have suggested that several areas in the brain are different in those individuals who suffer from psychosis compared to those who don't. Evaluations of these brain differences have helped us better understand the nature of these illnesses. For example, frontal lobe dysfunction has been linked with the loss of ability to plan and organize information, seen in those who have schizophrenia. These measures may also help cl ....Measures from specialised brain scans i.e. MRI's (Magnetic Resonance Imaging) have suggested that several areas in the brain are different in those individuals who suffer from psychosis compared to those who don't. Evaluations of these brain differences have helped us better understand the nature of these illnesses. For example, frontal lobe dysfunction has been linked with the loss of ability to plan and organize information, seen in those who have schizophrenia. These measures may also help clarify the relationship between the genetic and environmental factors contributing to the development of these disorders. One of the best ways to investigate this relationship is the use of a twin study design. The Australian study of twins with psychosis will recruit dizygotic (DZ) and monozygotic (MZ) twin pairs in which at least one twin is affected by a psychotic disorder, plus control twin pairs matched for age, sex and zygosity. Measures derived from MRI scans will be collected in an attempt to further define specific brain regions reported to be different in psychosis. In addition Diffusion Tensor Imaging (DTI) will be used to visualize white matter tracts in the brain. The twin study design will allow us to differentiate genetic and environmental factors associated with these brain measures and help evaluate the potential for these measures to genetically define sub-groups of individuals with psychotic disorders. The identification of these subgroups would facilitate the search for susceptibility genes. Additionally, this study will help clarify the possible clinical overlap between affective (i.e. bipolar affective disorder) and non-affective (i.e. schizophrenia) psychotic disorders. The information obtained from this study has the potential to greatly improve our understanding of caustive factors in psychosis, which may also lead to earlier diagnosis and treatment, thereby improving prognosis.Read moreRead less