Living In A Rural Community:determinants And Consequences Of Mental Health And Wellbeing.
Funder
National Health and Medical Research Council
Funding Amount
$729,415.00
Summary
Th e proposed study will investigate individual, family and community factors associated with the mental health and wellbeing of residents in rural communties of NSW. It will also examine rural residents' perceptions of their mental health needs and their access and utilisation of health services. The study will be conducted in 3 rural Area Health Services in NSW (Greater Western,Hunter New England and North Coast) comprising 70% of the rural population of NSW. These health regions encompass rur ....Th e proposed study will investigate individual, family and community factors associated with the mental health and wellbeing of residents in rural communties of NSW. It will also examine rural residents' perceptions of their mental health needs and their access and utilisation of health services. The study will be conducted in 3 rural Area Health Services in NSW (Greater Western,Hunter New England and North Coast) comprising 70% of the rural population of NSW. These health regions encompass rural, remote and coastal NSW. We aim to conduct the mail and telephone survey on adults residing in 4000 households across the 3 regions. Unique aspects of the study include: i) Examination of a diverse range of rural communities which will provide the opportunity to investigate the influence and interaction of specific community characteristics on mental health. These community factors will include social and economic factors, severity of rural environmental stress (eg drought), and the levels of access to health and other services. ii) Focus on the household and its members so as to examine the mental health needs of family groups in rural communities. This cross-sectional study will form the baseline for a longitudinal study investigating the changes experienced by rural families over time and the impact of such change on mental health outcomes.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
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
Alcohol Use Disorders In Young Adults: Youthful Epidemic Or Diagnostic Bias?
Funder
National Health and Medical Research Council
Funding Amount
$198,874.00
Summary
Epidemiological studies show that 1 in 5 Australians aged 18-24 are diagnosed as having an alcohol use disorder. However, there is evidence to suggest that young adults may interpret the diagnostic criteria differently to older adults. The current study aims to validate the alcohol use disorder criteria in younger populations through the use of novel cognitive interviewing techniques.
Enhanced Treatment For Social Phobia Through The Incorporation Of Attentional Re-training.
Funder
National Health and Medical Research Council
Funding Amount
$465,162.00
Summary
Social phobia is a serious difficulty that can cause tremendous interference in an individual's life. Social phobia can interfere with an individual's social and romantic life, work and study aspirations, and even increase medical and other psychological problems. Psychological programs to help individuals manage their anxiety have been developed and shown to lead to relatively strong positive outcomes. Recent theoretical understanding has suggested that one maintaining factor in social phobia m ....Social phobia is a serious difficulty that can cause tremendous interference in an individual's life. Social phobia can interfere with an individual's social and romantic life, work and study aspirations, and even increase medical and other psychological problems. Psychological programs to help individuals manage their anxiety have been developed and shown to lead to relatively strong positive outcomes. Recent theoretical understanding has suggested that one maintaining factor in social phobia may be these people's tendency to focus onto negative information. In some exciting developments, several researchers have shown that simply training people with social phobia to focus their attention away from negative information, with no other treatment components, can produce a marked change in their fears. Therefore it makes sense that incorporating these methods into current standard treatment packages, may increase their effectiveness. The current study aims to compare the current best practice treatment package for social phobia with a combination of this package plus the recent attention re-training methods. It is expected that incorporating attention re-training into standard treatment with significantly improve its effects.Read moreRead less
Does Inpatient Weight Restoration Prior To Outpatient Family Therapy Improve Outcomes In Adolescent Anorexia Nervosa?
Funder
National Health and Medical Research Council
Funding Amount
$552,283.00
Summary
This study examines the effect of length of hospital admission for refeeding, prior to manualised outpatient family therapy on outcomes for patients with anorexia nervosa. Subjects will include sixty children and adolescents aged 10 to 18 years admitted to the Children's Hospital at Westmead for medical management of anorexia nervosa. This study aims to randomly allocate and compare outcomes between adolescents with anorexia nervosa admitted for medical stabilisation followed by outpatient famil ....This study examines the effect of length of hospital admission for refeeding, prior to manualised outpatient family therapy on outcomes for patients with anorexia nervosa. Subjects will include sixty children and adolescents aged 10 to 18 years admitted to the Children's Hospital at Westmead for medical management of anorexia nervosa. This study aims to randomly allocate and compare outcomes between adolescents with anorexia nervosa admitted for medical stabilisation followed by outpatient family therapy versus adolescents admitted for full weight restoration followed by outpatient family therapy. Physical and psychological outcomes will be measured at admission to hospital, at the end of the hospital treatment and at the completion of outpatient family therapy and 6 and 12 months after the completion of treatment.Read moreRead less
The Beyondblue Schools Research Initiative: A Two-year Follow-up.
Funder
National Health and Medical Research Council
Funding Amount
$827,285.00
Summary
The prevalence of Depressive Disorders among children and adolescents was estimated in the Australian National Child and Adolescent Mental Health Survey to be 3.7%. This means that at any single point of time, approximately 138,000 Australian children and adolescents are experiencing a Depressive Disorder. Furthermore, the National Survey found that less than half (46%) of those with a Depressive Disorder received any help over a 6 month period prior to the survey, with only 8% attending a menta ....The prevalence of Depressive Disorders among children and adolescents was estimated in the Australian National Child and Adolescent Mental Health Survey to be 3.7%. This means that at any single point of time, approximately 138,000 Australian children and adolescents are experiencing a Depressive Disorder. Furthermore, the National Survey found that less than half (46%) of those with a Depressive Disorder received any help over a 6 month period prior to the survey, with only 8% attending a mental health clinic, and only 4% attending a hospital-based Department of Psychiatry. These findings emphasise the importance of finding alternative approaches to help the large number of young people with depression who do not receive help from professional services. This application seeks funding to evaluate the beyondblue Schools Research Initiative. The key features of the initiative are the development of a strong partnership between the health and education sectors and a focus on both individual-level and school-level risk factors. This has enabled us to provide a much longer duration of intervention than previous studies, to test the intervention in several different Australian States, and to utilise a broadly based intervention that includes a range of approaches, each of which have the potential to help reduce adolescent depression. The significance of the project lies in its potential to identify effective interventions which can reduce rates of depression experienced by adolescents, and the quality of the ongoing research partnership we have established across the education and health sectors. We anticipate that this partnership will be utilised for ongoing research in this area.Read moreRead less
Integrating Treatment For Alcohol Use Problems And Comorbid PTSD
Funder
National Health and Medical Research Council
Funding Amount
$658,073.00
Summary
Comorbid alcohol use problems and posttraumatic stress disorder (PTSD) are common mental health problems that cause disability and distress. Despite this, there are few randomized controlled trials of interventions. The proposed study is the first Australian randomised controlled trial in this field to address the question of whether treating PTSD and alcohol use problems is superior to treating alcohol use problems alone. The study compares the relative efficacy of a manual guided treatment for ....Comorbid alcohol use problems and posttraumatic stress disorder (PTSD) are common mental health problems that cause disability and distress. Despite this, there are few randomized controlled trials of interventions. The proposed study is the first Australian randomised controlled trial in this field to address the question of whether treating PTSD and alcohol use problems is superior to treating alcohol use problems alone. The study compares the relative efficacy of a manual guided treatment for alcohol use disorder alone with a simultaneous treatment for alcohol use and PTSD. This study improves on the methodological limitations described in the two existing studies reported in the published literature. Two-hundred and sixty four participants will be recruited from mutiple sites (media, GPs, specialist clinics) and treated in the community at two sites in Sydney. Participants will be eligible if they consume harmful levels of alcohol (NHMRC risky or high risk levels) and have a concurrent diagnosis of PTSD based on recognised diagnostic criteria. Treatment will consist of 16 sessions of manual guided individual psychological therapy that has been found to be very efficacious with each problem alone. The efficacy of treatment will be determined on the basis of reductions in harmful drinking (above NHMRC low risk levels) and in symptoms of PTSD. Participants will be followed up by an independent, blind, clinician three and six months after treatment completion. The findings of this study have the potential to provide valuable information regarding the treatment needs of people with these complex presentations to clinicians and policy developers alike.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
Risk Factors For The Development Of Eating Disorder Phenotypes And Endophenotypes In Adolescent Twins
Funder
National Health and Medical Research Council
Funding Amount
$266,500.00
Summary
The overall aim of the project is to develop a better understanding of how environment, temperament and genes work together to cause disordered eating and eating disorders. Eating disorders, including anorexia nervosa and bulimia nervosa, are an extremely difficult and costly condition to treat, and are associated with high mortality. Eating disorders in adolescence lead to increased risk for anxiety disorders, chronic fatigue, chronic pain, depressive disorders, infectious diseases, suicide att ....The overall aim of the project is to develop a better understanding of how environment, temperament and genes work together to cause disordered eating and eating disorders. Eating disorders, including anorexia nervosa and bulimia nervosa, are an extremely difficult and costly condition to treat, and are associated with high mortality. Eating disorders in adolescence lead to increased risk for anxiety disorders, chronic fatigue, chronic pain, depressive disorders, infectious diseases, suicide attempts, and limitation in activities due to poor health in adulthood. Full- and partial-syndrome eating disorders affect around 10% of adolescent girls. Given the seriousness of the consequences of eating disorders, and the large number of Australians affected, a better understanding of what causes the development of eating disorders is required. The current research investigates identical and non-identical adolescent female twins aged 13-15 years. As well as examining their eating, this study will look at the sort of environments and temperaments that may increase genetic susceptibility to develop eating problems. The types of environment to be examined include media influence, weight related peer teasing, parental dieting, and pre- and pernatal complications. Twin temperament will also be examined, including perfectionism, sense of ineffectiveness, body dissatisfaction and depression. Parental anxiety and novelty seeking will also be examined for impact on the development of disordered eating in their children. The twins will be followed up over a 2-year period, the peak risk age for onset of eating problems. By comparing the identical and non-identical twins, we can define the characteristics of those most at risk of developing eating problems. The results of this project can be used to formulate specific prevention strategies.Read moreRead less