ORCID Profile
0000-0001-5879-442X
Current Organisation
The University of Sydney The Matilda Centre for Research in Mental Health and Substance Use
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Publisher: Australia’s Mental Health Think Tank
Date: 2021
DOI: 10.25910/MC0G-V929
Publisher: Cambridge University Press (CUP)
Date: 04-2023
DOI: 10.1017/BEC.2023.3
Abstract: The COVID-19 pandemic dramatically altered social determinants of health including work, education, social connections, movement, and perceived control and loneliness was commonly experienced. This longitudinal study examined how social determinants at the personal (micro), community (meso), and societal (macro) levels predicted loneliness during the pandemic. Participants were 2056 Australian adults surveyed up to three times over 18 months in 2020 and 2021. Multi-level mixed-effect regressions were conducted predicting loneliness from social determinants at baseline and two follow-ups. Loneliness was associated with numerous micro determinants: male gender, lifetime diagnosis of a mental health disorder, experience of recent stressful event(s), low income, living alone or couples with children, living in housing with low natural light, noise, and major building defects. Lower resilience and perceived control over health and life were also associated with greater loneliness. At the meso level, reduced engagement with social groups, living in inner regional areas, and living in neighbourhoods with low levels of belongingness and collective resilience was associated with increased loneliness. At the macro level, increased loneliness was associated with State/Territory of residence. Therapeutic initiatives must go beyond psychological intervention, and must recognise the social determinants of loneliness at the meso and macro levels.
Publisher: SAGE Publications
Date: 25-02-2023
DOI: 10.1177/00048674221080406
Abstract: Physical inactivity, sugar sweetened beverage consumption, alcohol use, smoking, poor sleep and excessive recreational screen time (the ‘Big 6’ lifestyle risk behaviours) often co-occur and are key risk factors for psychopathology. However, the best fitting latent structure of the Big 6 is unknown and links between multiple lifestyle risk behaviours and hierarchical dimensions of psychopathology have not been explored among adolescents. This study aimed to address these gaps in the literature. Confirmatory factor analysis, latent class analysis and factor mixture models were conducted among 6640 students ( M age = 12.7 years) to identify the latent structure of the Big 6 lifestyle risk behaviours. Structural equation models were then used to examine associations with psychopathology. A mixture model with three classes, capturing mean differences in a single latent factor indexing overall risk behaviours, emerged as the best fitting model. This included relatively low-risk (Class 1: 30%), moderate-risk (Class 2: 67%) and high-risk (Class 3: 3%) classes. Students high on externalizing demonstrated significantly greater odds of membership to the high-risk class (odds ratio = 8.75, 99% confidence interval = [3.30, 23.26]) and moderate-risk class (odds ratio = 2.93, 99% confidence interval = [1.43, 5.97]) in comparison to the low-risk class. Similarly, students high on internalizing demonstrated significantly higher odds of membership to the high-risk class (odds ratio = 1.89, 99% confidence interval = [1.06, 3.37]) and the moderate-risk class (odds ratio = 1.66, 99% confidence interval = [1.03, 2.67]) in comparison to the low-risk class. Associations between lower order factors of psychopathology and lifestyle risk behaviours were mostly accounted for by the more parsimonious higher order factors. Classes representing differences in probabilities of the Big 6 lifestyle risk behaviours relate to varying levels of hierarchical dimensions of psychopathology, suggesting multiple health behaviour change and transdiagnostic intervention approaches may be valuable for reducing risk of psychopathology.
Publisher: Center for Open Science
Date: 02-12-2021
Abstract: The COVID-19 pandemic, as well as the recent bushfires and flash floods, have resulted in significant and unprecedented mental health impacts in Australia. Despite the known impacts, there is a paucity of research directly asking Australian community members about their mental health experiences and what they perceive to be the most important mental health issues in the context of the pandemic. This study utilises qualitative data from Alone Together, a longitudinal mixed-methods study investigating the effects of COVID-19 on mental health in an Australian community s le (N = 2,056). Of the 1,350 participants who completed the first follow-up survey, a total of 1,037 participants, who ranged in sex (69.9% female), age (M = 40-49 years), state/territory of residence, and socioeconomic status, shared responses to two open-ended questions regarding the most important issues for mental health in Australia and the impact of COVID-19 on their in idual mental health. Responses were analysed using thematic analysis. Participants described COVID-19 as primarily impacting their mental health through the disruption it posed to their social world and financial stability. A key concern for participants who reported having poor mental health was the existence of multiple competing barriers to accessing good mental health care. According to participant responses, the pandemic had pressurized an already over-burdened mental health service system, leaving many without timely, appropriate support. Further absent or stigmatising rhetoric around mental health, at both a political and community level, also prevented participants from seeking help. Insights gained from the present research provide opportunities for policymakers and health practitioners to draw on the expertise of Australians’ lived experience and address priority issues through targeted policy planning. This could ultimately support a more responsive, integrated and effective mental health system, during and beyond the COVID-19 pandemic.
Publisher: Frontiers Media SA
Date: 08-03-2023
DOI: 10.3389/FPSYT.2023.1107560
Abstract: The mental health impacts of the COVID-19 pandemic remain a public health concern. High quality synthesis of extensive global literature is needed to quantify this impact and identify factors associated with adverse outcomes. We conducted a rigorous umbrella review with meta-review and present (a) pooled prevalence of probable depression, anxiety, stress, psychological distress, and post-traumatic stress, (b) standardised mean difference in probable depression and anxiety pre-versus-during the pandemic period, and (c) comprehensive narrative synthesis of factors associated with poorer outcomes. Databases searched included Scopus, Embase, PsycINFO, and MEDLINE dated to March 2022. Eligibility criteria included systematic reviews and/or meta-analyses, published post-November 2019, reporting data in English on mental health outcomes during the COVID-19 pandemic. Three hundred and thirty-eight systematic reviews were included, 158 of which incorporated meta-analyses. Meta-review prevalence of anxiety symptoms ranged from 24.4% (95%CI: 18–31%, I 2 : 99.98%) for general populations to 41.1% (95%CI: 23–61%, I 2 : 99.65%) in vulnerable populations. Prevalence of depressive symptoms ranged from 22.9% (95%CI: 17–30%, I 2 : 99.99%) for general populations to 32.5% (95%CI: 17–52%, I 2 : 99.35) in vulnerable populations. Prevalence of stress, psychological distress and PTSD/PTSS symptoms were 39.1% (95%CI: 34–44% I 2 : 99.91%), 44.2% (95%CI: 32–58% I 2 : 99.95%), and 18.8% (95%CI: 15–23% I 2 : 99.87%), respectively. Meta-review comparing pre-COVID-19 to during COVID-19 prevalence of probable depression and probable anxiety revealed standard mean differences of 0.20 (95%CI = 0.07–0.33) and 0.29 (95%CI = 0.12–0.45), respectively. This is the first meta-review to synthesise the longitudinal mental health impacts of the pandemic. Findings show that probable depression and anxiety were significantly higher than pre-COVID-19, and provide some evidence that that adolescents, pregnant and postpartum people, and those hospitalised with COVID-19 experienced heightened adverse mental health. Policymakers can modify future pandemic responses accordingly to mitigate the impact of such measures on public mental health.
Publisher: Elsevier BV
Date: 05-2023
Publisher: Public Library of Science (PLoS)
Date: 19-05-2022
DOI: 10.1371/JOURNAL.PONE.0268824
Abstract: The COVID-19 pandemic has resulted in significant and unprecedented mental health impacts in Australia. However, there is a paucity of research directly asking Australian community members about their mental health experiences, and what they perceive to be the most important mental health issues in the context of the pandemic. This study utilises qualitative data from Alone Together , a longitudinal mixed-methods study investigating the effects of COVID-19 on mental health in an Australian community s le (N = 2,056). A total of 1,037 participants, ranging in sex (69.9% female), age (M = 40–49 years), state/territory of residence, and socioeconomic status, shared responses to two open-ended questions in the first follow up survey regarding their mental health experiences and priorities during COVID-19. Responses were analysed using thematic analysis. Participants described COVID-19 as primarily impacting their mental health through the disruption it posed to their social world and financial stability. A key concern for participants who reported having poor mental health was the existence of multiple competing barriers to accessing high quality mental health care. According to participant responses, the pandemic placed additional pressures on an already over-burdened mental health service system, leaving many without timely, appropriate support. Absent or stigmatising rhetoric around mental health, at both a political and community level, also prevented participants from seeking help. Insights gained from the present research provide opportunities for policymakers and health practitioners to draw on the expertise of Australians’ lived experience and address priority issues through targeted policy planning. This could ultimately support a more responsive, integrated, and effective mental health system, during and beyond the COVID-19 pandemic.
Publisher: Wiley
Date: 07-11-2022
DOI: 10.5694/MJA2.51333
Publisher: Elsevier BV
Date: 02-2023
Publisher: BMJ
Date: 07-2020
DOI: 10.1136/BMJOPEN-2019-035662
Abstract: Lifestyle risk behaviours, including alcohol use, smoking, poor diet, physical inactivity, poor sleep (duration and/or quality) and sedentary recreational screen time (‘the Big 6’), are strong determinants of chronic disease. These behaviours often emerge during adolescence and co-occur. School-based interventions have the potential to address risk factors prior to the onset of disease, yet few eHealth school-based interventions target multiple behaviours concurrently. This paper describes the protocol of the Health4Life Initiative , an eHealth school-based intervention that concurrently addresses the Big 6 risk behaviours among secondary school students. A multisite cluster randomised controlled trial will be conducted among year 7 students (11–13 years old) from 72 Australian schools. Stratified block randomisation will be used to assign schools to either the Health4Life intervention or an active control (health education as usual). Health4Life consists of (1) six web-based cartoon modules and accompanying activities delivered during health education (once per week for 6 weeks), and a smartphone application (universal prevention), and (2) additional app content, for students engaging in two or more risk behaviours when they are in years 8 and 9 (selective prevention). Students will complete online self-report questionnaires at baseline, post intervention, and 12, 24 and 36 months after baseline. Primary outcomes are consumption of sugar-sweetened beverages, moderate-to-vigorous physical activity, sleep duration, sedentary recreational screen time and uptake of alcohol and tobacco use. This study has been approved by the University of Sydney (2018/882), NSW Department of Education (SERAP no. 2019006), University of Queensland (2019000037), Curtin University (HRE2019-0083) and relevant Catholic school committees. Results will be presented to schools and findings disseminated via peer-reviewed journals and scientific conferences. This will be the first evaluation of an eHealth intervention, spanning both universal and selective prevention, to simultaneously target six key lifestyle risk factors among adolescents. Australian New Zealand Clinical Trials Registry (ACTRN12619000431123), 18 March 2019.
Publisher: Center for Open Science
Date: 14-01-2022
Abstract: Background: The mental health impacts of the COVID-19 pandemic remain a public health concern. High quality synthesis of extensive global literature is needed to quantify this impact and identify factors associated with adverse outcomes. Methods: We conducted a rigorous umbrella review with meta-review and present a) pooled prevalence of probable depression, anxiety, stress, psychological distress, and post-traumatic stress, b) standardised mean difference in probable depression and anxiety pre-versus-during the pandemic period, and c) comprehensive narrative synthesis of factors associated with poorer outcomes. Databases searched included Scopus, Embase, PsycINFO, and MEDLINE dated to March 2022. Eligibility criteria included systematic reviews and/or meta-analyses, published post-November 2019, reporting data in English on mental health outcomes during the COVID-19 pandemic. Findings: Three hundred and thirty-eight systematic reviews were included, 158 of which incorporated meta-analyses. Meta-review prevalence of anxiety symptoms ranged from 24.4% (95%CI: 18-31%, I2: 99.98%) for general populations to 41.1% (95%CI: 23-61%, I2: 99.65%) in vulnerable populations. Prevalence of depressive symptoms ranged from 22.9% (95%CI: 17-30%, I2: 99.99%) for general populations to 32.5% (95%CI: 17-52%, I2: 99.35) in vulnerable populations. Prevalence of stress, psychological distress and PTSD/PTSS symptoms were 39.1% (95%CI: 34%-44% I2: 99.91%), 44.2% (95%CI: 32%-58% I2: 99.95%), and 18.8% (95%CI: 15%-23% I2: 99.87%), respectively. Meta-review comparing pre-COVID-19 to during COVID-19 prevalence of probable depression and probable anxiety revealed standard mean differences of 0.20 (95%CI=0.07-0.33) and 0.29 (95%CI=0.12-0.45), respectively. Conclusions: This is the first meta-review to synthesise the longitudinal mental health impacts of the pandemic. Findings show that probable depression and anxiety were significantly higher than pre-COVID-19, and provide some evidence that that adolescents, pregnant and postpartum people, and those hospitalised with COVID-19 experienced heightened adverse mental health. Policymakers can modify future pandemic responses accordingly to mitigate the impact of such measures on public mental health. The final authenticated published version is available online at: 0.3389/fpsyt.2023.1107560
Publisher: SAGE Publications
Date: 10-04-2023
DOI: 10.1177/00048674231165201
Abstract: Research shows highly palatable foods can elicit addictive eating behaviours or ‘food addiction’. Early adolescence is theorised to be a vulnerable period for the onset of addictive eating behaviours, yet minimal research has examined this. This study explored the prevalence and correlates of addictive eating behaviours in a large early adolescent s le. 6640 Australian adolescents (M age = 12.7 ± 0.5, 49%F) completed an online survey. Addictive eating was measured with the Child Yale Food Addiction Scale (YFAS-C). Negative-binomial generalised linear models examined associations between addictive eating symptoms and high psychological distress, energy drink consumption, sugar-sweetened beverage (SSB) consumption, alcohol use, and cigarette use. Mean YFAS-C symptom criteria count was 1.36 ± 1.47 (of 7). 18.3% of participants met 3+ symptoms, 7.5% endorsed impairment and 5.3% met the diagnostic threshold for food addiction. All examined behavioural and mental health variables were significantly associated with addictive eating symptoms. Effects were largest for high psychological distress and cigarette use with those exhibiting high psychological distress meeting 0.65 more criteria (95%CI = 0.58–0.72, p 0.001) and those who smoked a cigarette meeting 0.51 more criteria (95%CI = 0.26–0.76, p 0.001). High psychological distress and consumption of SSB and energy drinks remained significant when modelling all predictors together. In this large adolescent study, addictive eating symptoms were common. Further research should establish directionality and causal mechanisms behind the association between mental ill-health, alcohol and tobacco use, and addictive eating behaviours. Cross-disciplinary prevention initiatives that address shared underlying risk factors for addictive eating and mental ill-health may offer efficient yet substantial public health benefits.
Publisher: MDPI AG
Date: 12-2022
DOI: 10.3390/BS12120488
Abstract: Adolescence is considered an important period of neurodevelopment. It is a time for the emergence of psychosocial vulnerabilities, including symptoms of depression, eating disorders, and increased engagement in unhealthy eating behaviours. Food addiction (FA) in adolescents is an area of study where there has been substantial growth. However, to date, limited studies have considered what demographic characteristics of adolescents may predispose them to endorse greater symptoms of FA. Studies have found a variety of factors that often cluster with and may influence an adolescent’s eating behaviour such as sleep, level of self-control, and parenting practices, as well as bullying. Therefore, this study investigated a range of socio-demographic, trait, mental health, and lifestyle-related profiles (including self-control, parenting, bullying, and sleep) as proximal factors associated with symptoms of FA, as assessed via the Yale Food Addiction Scale for Children (YFAS-C) in a large s le of Australian adolescents. Following data cleaning, the final analysed s le included 6587 students (age 12.9 years ± 0.39 range 10.9–14.9 years), with 50.05% identifying as male (n = 3297), 48.5% as female (n = 3195), 1.02% prefer not to say (n = 67), and 0.43% as non-binary (n = 28). Self-control was found to be the most significant predictor of total FA symptom score, followed by female gender, sleep quality, and being a victim of bullying. Universal prevention programs should therefore aim to address these factors to help reduce the prevalence or severity of FA symptoms within early adolescent populations.
Location: Australia
No related grants have been discovered for Scarlett Smout.