ORCID Profile
0000-0003-0609-9219
Current Organisation
Australian College of Applied Professions
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Publisher: American Psychological Association (APA)
Date: 05-2013
DOI: 10.1037/A0031617
Publisher: Wiley
Date: 21-11-2013
DOI: 10.1002/J.1532-2149.2012.00241.X
Abstract: This study aimed to investigate the efficacy of mindfulness training in comparison with relaxation training on pain, threshold and tolerance during the cold pressor task. Undergraduate psychology students (n = 140) were randomly assigned to receive reassuring or threatening information about the cold pressor. Participants were then re-randomized to receive mindfulness or a control intervention: relaxation training. Analyses confirmed that the threat manipulation was effective in increasing worry, fear of harm and expectations of pain, and reducing coping efficacy. Interaction effects revealed that mindfulness was effective in increasing curiosity and reducing decentring under conditions of high threat but not low threat. Other interactions on cognitive variables (attentional bias to pain and self-focus) confirmed that mindfulness and relaxation appeared to exert influences under different conditions (i.e. mindfulness: high threat and relaxation: low threat). Despite these cognitive effects being discerned under different conditions, there were no differences between mindfulness and relaxation on pain, tolerance or threshold in either threat group. These results show that a single, brief session of mindfulness based on body scanning is not sufficient to change the way in which in iduals approach an experimental pain task in comparison with relaxation, which has previously been shown to be ineffective.
Publisher: Informa UK Limited
Date: 07-2015
DOI: 10.1111/CP.12066
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2012
DOI: 10.1016/J.PAIN.2011.12.014
Abstract: Potential applications of attention bias modification (ABM) for acute and chronic pain patients are investigated. In study 1, 54 acute back pain patients (46 of whom completed the study) were recruited at their initial physiotherapy session and randomised to receive 1 session of ABM or placebo. Patients were followed up 3 months later. Participants who were randomised to receive ABM reported less average (P=0.001) and current pain (P=0.008) and experienced pain for fewer days (P=0.01) than those who received placebo. In study 2, 34 chronic pain patients were recruited and randomly assigned to receive either 4 sessions of ABM (n=22) or placebo (n=12), followed by 8 sessions of cognitive behavioural treatment (CBT). After ABM, there was a significant group-by-time effect for disability. By 6-month follow-up, differences had emerged between the 2 training groups, such that the ABM group had shown greater reductions in anxiety sensitivity and disability than the placebo group. Although the results of these studies show that there is potential in the application of ABM to pain conditions, the mechanisms of treatment could not be established. Neither group showed an initial bias towards the word stimuli or a training effect, and only in the acute pain group were changes in biases related to outcome. Nonetheless, the fact that 2 independent s les showed a positive effect of ABM on clinical outcomes suggests that ABM is worthy of future study as an intervention for pain patients.
Publisher: Wiley
Date: 04-2011
Publisher: Elsevier BV
Date: 11-2012
DOI: 10.1016/J.JAD.2011.11.039
Abstract: People with epilepsy (PWE) have a high chance of experiencing depression and anxiety disorders over their lifetime. However, those most at risk are unknown. Psychosocial variables have been suggested as potentially important risk factors. A systematic review was conducted in order to critically assess available evidence regarding the psychosocial predictors of depression and anxiety in adults with epilepsy. Electronic databases searched were MEDLINE, PsycINFO and Web of Science. Studies were included if they assessed depressive or anxiety symptoms using a validated questionnaire, and controlled for the role of potentially important epilepsy factors. Eleven studies were identified and assessed for research standards using the Quality Index Scale (QIS). Ten of the eleven studies found at least one significant predictor of depression and all six studies that assessed anxiety found one or more significant predictors. Overall QIS score was only 7.5 out of 15, indicating significant design limitations of many included studies. There was also large variability between studies in measures used to assess psychosocial variables. Studies did not support the importance of attributional theory and stigma in the development of depression in epilepsy. There was inconsistent support for the role of illness representations but likely support for the role of stress and self-efficacy. Consistent support was found for the role of coping strategies and perceived social support. Given that psychosocial factors are potentially modifiable, a better understanding of their role in the development of depression in people with epilepsy is urgently needed to guide effective treatments.
Publisher: Informa UK Limited
Date: 02-01-2014
Publisher: Informa UK Limited
Date: 2011
DOI: 10.3109/09638288.2010.524276
Abstract: This article seeks to outline the design and implementation of cognitive behavioural pain management programmes (PMPs) for people with spinal cord injury (SCI), illustrated by the experiences in a recently evaluated programme (SpinalADAPT). It is hoped that this will provide an easily accessible account of the relevant design and implementation issues for those who seek to deliver such programmes to persons with a SCI. A collaborative team of pain and SCI professionals developed a modified version of a standard cognitive behavioural pain management programme (ADAPT) based upon experiences of those with SCI who had previously attempted ADAPT. A number of structural and content elements of the programme were identified that required modification in order to accommodate the particular needs of those with SCI. The modified programme was subsequently successfully delivered by a combination of SCI and pain health professionals. Three groups of in iduals completed the SpinalADAPT, and an evaluation of outcomes compared to standard care are reported elsewhere (Nicholson Perry et al., Clin J Pain 2010 :206-216). It appears feasible to appropriately modify standard PMPs for participants with SCI, and that such programmes may offer benefits in terms of improved quality of life. Further revision and evaluation of such programmes is required.
Publisher: Informa UK Limited
Date: 18-03-2014
DOI: 10.1080/16506073.2014.892530
Abstract: This study compared a 9-week in idualised Cognitive Behaviour Therapy (CBT) programme for people with epilepsy (PWE), with a wait-list control. Fifty-nine PWE were randomised and 45 (75%) completed post-treatment outcomes. People with lower quality of life (QoL), particularly for cognitive functioning, were more likely to drop out. Analyses based on treatment completers demonstrated significant improvements on the Neurological Depressive Disorders Inventory for Epilepsy (p = .045) and Hospital Anxiety Depression Scale-Depression subscale (p = .048). Importantly, CBT significantly reduced the likelihood of clinical depressive symptoms (p = .014) and suicidal ideation (p = .005). Improvements were not observed for anxiety, QoL or maintained overtime for depression. Results suggest that CBT was effective, however, and could be improved to increase patient retention and long-term outcomes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 06-2013
DOI: 10.1016/J.PAIN.2013.03.005
Abstract: The present study evaluated the efficacy of a clinician-guided Internet-delivered cognitive behaviour therapy (iCBT) program, the Pain Course, to reduce disability, anxiety, and depression associated with chronic pain. Sixty-three adults with chronic pain were randomised to either a Treatment Group or waitlist Control Group. Treatment consisted of 5 iCBT-based lessons, homework tasks, additional resources, weekly e-mail or telephone contact from a Clinical Psychologist, and automated e-mails. Twenty-nine of 31 Treatment Group participants completed the 5 lessons during the 8-week program, and posttreatment and 3-month follow-up data were collected from 30/31 and 29/31 participants, respectively. Treatment Group participants obtained significantly greater improvements than Control Group participants in levels of disability, anxiety, depression, and average pain levels at posttreatment. These improvements corresponded to small to large between-groups effect sizes (Cohen's d) at posttreatment for disability (d = .88), anxiety (d = .38), depression (d = .66), and average pain (d = .64), respectively. These outcomes were sustained at follow-up and participants rated the program as highly acceptable. Overall, the clinician spent a total mean time of 81.54 minutes (SD 30.91 minutes) contacting participants during the program. The results appear better than those reported in iCBT studies to date and provide support for the potential of clinician-guided iCBT in the treatment of disability, anxiety, and depression for people with chronic pain.
Publisher: Elsevier BV
Date: 11-1995
Publisher: Springer Science and Business Media LLC
Date: 19-09-2018
DOI: 10.1007/S00520-017-3891-5
Abstract: To examine differences in distress and unmet needs between bereaved adolescent and young adult (AYA) offspring who accessed support before and after being bereaved by parental cancer, and to explore aspects of their cancer experience that influenced their help-seeking. Phase 1: Surveys completed by AYAs (11-26 years) bereaved by parental cancer were subjected to analysis of covariance examining differences in distress and unmet needs between those who accessed support before (n = 159) and after (n = 212) parental bereavement. Phase 2: Semi-structured interviews explored the cancer experiences of bereaved offspring (n = 8) and factors that influenced their decision to seek support. Phase 1: There were no significant group differences in distress and unmet needs however, older and female AYAs reported higher levels of distress and unmet needs. Interestingly, in iduals who accessed support pre-bereavement were older on average (M = 17.35 years, SD = 3.26) than those who accessed support post-bereavement (M = 15.73 years, SD = 3.26). Phase 2: Three themes emerged centred on socio-emotional developmental changes during and after the cancer trajectory. These related to: participants' meaning-making and changes in understanding of the cancer experience, changing relationships and desires to fit in, and understanding of their own emotional needs. While no differences were found in unmet needs and distress between those who sought support pre- or post-bereavement, those seeking support pre-bereavement were older on average. Social and emotional development impacts how bereaved offspring access psychosocial support. Awareness of these issues can assist in improving support by ensuring services are age appropriate and families are sufficiently supported.
Publisher: Elsevier BV
Date: 02-2017
DOI: 10.1016/J.SEIZURE.2016.12.007
Abstract: The aim of this meta-analysis is to evaluate and synthesize the available evidence from the previous 20 years regarding the utility of psychological interventions in the management of psychogenic non-epileptic seizures (PNES). Studies were retrieved from MEDLINE via OvidSP and PsychINFO. Selection criteria included controlled and before-after non-controlled studies including case series, using seizure frequency as an outcome measurement. Studies were required to assess one or more types of psychological intervention for the treatment of PNES in adults. Data from 13 eligible studies was pooled to examine the effectiveness of psychological interventions in treating PNES on two primary outcomes: seizure reduction of 50% or more and seizure freedom. A meta-analysis was conducted with data extracted from 228 participants with PNES. Interventions reviewed in the analysis included CBT, psychodynamic therapy, paradoxical intention therapy, mindfulness and psychoeducation and eclectic interventions. Meta-analysis synthesized data from 13 studies with a total of 228 participants with PNES, of varied gender and age. Results showed 47% of people with PNES are seizure free upon completion of a psychological intervention. Additional meta-analysis synthesized data from 10 studies with a total of 137 participants with PNES. This analysis found 82% of people with PNES who complete psychological treatment experience a reduction in seizures of at least 50%. The studies identified for this analysis were erse in nature and quality. The findings highlight the potential for psychological interventions as a favorable alternative to the current lack of treatment options offered to people with PNES.
Publisher: American Psychological Association (APA)
Date: 2015
DOI: 10.1037/REP0000052
Abstract: To examine change in resilience in people with spinal cord injury (SCI) when group cognitive behavior therapy (GCBT) was added to routine psychosocial rehabilitation (RPR). A prospective repeated-measures cohort design was used to determine the efficacy of the addition of GCBT (n = 50). The control group consisted of in iduals receiving RPR, which included access to in idual CBT (ICBT) when required (n = 38). Groups were assessed on 3 occasions: soon after admission, within 2 weeks of discharge, and 6-months postdischarge. Measures included sociodemographic, injury, and psychosocial factors. The outcome variable was resilience, considered an important outcome measure for recovery. To adjust for baseline differences in self-efficacy, depressive mood and anxiety between the 2 groups, these factors were entered into a repeated measures multivariate analysis of covariance (MANCOVA) as covariates. Latent class analysis was used to determine the best-fitting model of resilience trajectories for both groups. The MANCOVA indicated that the addition of GCBT to psychosocial rehabilitation did not result in improved resilience compared with the ICBT group. Trajectory data indicated over 60% were demonstrating acceptable resilience irrespective of group. Changes in resilience mean scores suggest the addition of GCBT adds little to resilience outcomes. Latent class modeling indicated both groups experienced similar trajectories of improvement and deterioration. Results highlight the importance of conducting multivariate modeling analysis that isolates subgroups of related cases over time to understand complex trajectories. Further research is needed to clarify in idual differences in CBT intervention preference as well as other factors which impact on resilience.
Publisher: Elsevier BV
Date: 03-2013
DOI: 10.1016/J.JPSYCHORES.2012.11.001
Abstract: Despite considerable effort to identify correlates of psychopathology in people with epilepsy (PWE), research has yet to identify consistent predictors. We tested the association between factors predicted by a model of adjustment to illness and psychopathology in PWE. In 123 PWE recruited from a tertiary referral centre, we examined the cross-sectional relationship between psychosocial factors (illness representations, coping, self-illness enmeshment and self-efficacy) with depression and suicide risk, while controlling for condition-related and demographic factors. Multivariate analyses confirmed previous findings showing that condition-related and demographic variables did not consistently account for unique variance in depression although employment status was found to be a significant predictor of suicide risk. In multivariate analyses escape-avoidance coping and the illness consequences subscale of the illness representation questionnaire predicted unique variance in both depression and suicide risk. The results provided partial support for a model of adjustment to illness. Specifically, those who believed epilepsy was serious and coped through avoidance were more likely to be depressed and report a current level of suicide risk. These results suggest that interventions that target coping strategies and illness representations may be warranted for PWE with psychopathology.
Publisher: Informa UK Limited
Date: 04-2017
DOI: 10.1111/AP.12268
Publisher: Informa UK Limited
Date: 18-04-2013
DOI: 10.3109/09638288.2013.782356
Abstract: Pain is commonly experienced in those with cerebral palsy (CP), and previous research suggests an increase in behavioural and emotional problems in children experiencing pain and pain anxiety. Therefore, it was hypothesised that pain intensity and pain anxiety would predict behavioural and emotional problems in children with CP. Parents or guardians of 61 children (38 boys, 23 girls) with CP, aged 5-15 years completed an online questionnaire on pain intensity, pain anxiety and behavioural and emotional problems. Correlation and a multiple linear regression analyses were conducted to examine whether pain intensity and/or pain anxiety predicts behavioural and emotional problems. A total of 59% of participants reported that their children with CP currently experiences pain. Multiple regression analyses revealed that pain intensity (p = 0.038) and pain anxiety (p < 0.001) both made a significant and independent contributions in predicting anxiety in children, however, pain anxiety was the only predictor that made a significant and independent contribution to the depression (p = 0.001) and the behavioural and emotional problems measure (p = 0.004). Whilst pain intensity appears to be associated with behavioural and emotional problems in children, pain anxiety may be more strongly associated still.
Publisher: Wiley
Date: 05-2009
DOI: 10.1016/J.EJPAIN.2008.06.003
Abstract: Although psychological aspects of SCI-related pain have been investigated in those with chronic pain, little data is available regarding these factors in those early in the course of the injury. Using a s le admitted for SCI rehabilitation, this paper describes the relationships between usual pain intensity, mood, disability and both pain and SCI-related psychological factors. The s le were largely similar to other s les of in iduals with SCI-related chronic pain in terms of mood, but were noted to be less catastrophic in their thinking about pain than a comparative pain clinic s le. They also reported SCI self-efficacy and acceptance scores consistent with other SCI s les. Compared with other SCI populations there were mixed findings in relation to physical disability. Consistent with previous findings in chronic pain SCI s les, usual pain intensity was found to have a strong relationship with symptoms of anxiety and depression, and pain-related life interference. SCI acceptance was significantly negatively associated with depression scores, pain catastrophizing was significantly positively associated with both anxiety and depression scores, and SCI self-efficacy was significantly negatively associated with both anxiety and depression scores. SCI self-efficacy was also significantly positively associated with physical function scores. These findings suggest that pain-related psychological factors may have importance even early in the clinical course following SCI, but that it is important, however, to consider more general SCI-related psychological factors alongside them. In addition, these findings suggest the possibility that early interventions based upon the cognitive behavioural treatment of pain may be integrated into SCI rehabilitation programmes.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2015
Publisher: Elsevier BV
Date: 08-2015
DOI: 10.1016/J.APMR.2015.02.027
Abstract: To conduct a prospective study of the occurrence of psychological disorders and comorbidities after spinal cord injury (SCI), determine psychotropic medication usage, and establish predictors of psychological disorders after transition to the community. Longitudinal design with multiple measures. Assessment occurred in SCI units and the community. Adults with SCI (N=88) admitted over a period of 32 months into 3 SCI units. Participants completed inpatient rehabilitation for an acute SCI. Longitudinal assessment occurred up to 6 months postdischarge. Measures were chosen that had a theoretical and clinical foundation for contributing to recovery after SCI. The Mini International Neuropsychiatric Interview, a structured diagnostic psychiatric interview, was conducted to determine the presence of psychological disorders. Medical measures included severity of secondary conditions or complications. Psychological measures included measures of anxiety and depressive mood, resilience, pain catastrophization, self-efficacy, and cognitive capacity. Rates of psychological disorders of 17% to 25% were substantially higher than rates found in the Australian community. The occurrence of psychological disorder comorbidities was also very high. Anxiety was significantly elevated in those with a psychological disorder. Psychotropic medications were prescribed to more than 36% of the s le, with most being antidepressants. Factors predictive of psychological disorders included years of education, premorbid psychiatric sychological treatment, cognitive impairment, secondary complications, resilience, and anxiety. SCI can have a substantial negative impact on mental health that does not change up to 6 months postdischarge. Findings suggest a substantial minority experience increased psychosocial distress after the injury and after transitioning into the community. Additional resources should be invested in improving the mental health of adults with SCI.
Publisher: Wiley
Date: 21-12-2005
DOI: 10.1002/PON.887
Publisher: Elsevier BV
Date: 09-1999
Publisher: Wiley
Date: 08-2000
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2010
Publisher: Springer Science and Business Media LLC
Date: 31-05-2018
DOI: 10.1038/S41393-018-0146-3
Abstract: Single-group feasibility clinical trial. This study examined the feasibility and outcomes of a modified version of a validated internet-delivered pain management programme, the Pain Course, for adults with SCI. Nationwide in Australia. Sixty-eight adults participated in the programme, which comprises five online lessons and homework tasks that are systematically released over 8 weeks. Participants were supported through the course with weekly contact from a clinical psychologist. Eighty-five percent of participants provided data at post-treatment and 76% of participants completed all five lessons of the course. High levels of satisfaction were observed and relatively little clinician time (M = 93.16 min SD = 52.76 min) was required per participant to provide the course. Preliminary evidence of clinical improvements in pain-related disability (ds ≥ 0.53. avg. improvement ≥ 20% Mdiff ≥ 7.77), depression (ds ≥ 0.44. avg. improvement ≥ 24% Mdiff ≥ 2.44), anxiety (ds ≥ 0.41. avg. improvement ≥ 26% Mdiff ≥ 1.8) and average pain intensity (ds ≥ 0.46. avg. improvement ≥ 13% Mdiff ≥ 0.71) were observed at post-treatment, which were maintained or further improved to 3-month follow-up. These improvements were reflected in overall improvements in self-reported satisfaction with life (ds ≥ 0.31 avg. improvement ≥ 25% Mdiff ≥ 2.16) CONCLUSION: These findings highlight the potential of carefully developed internet-delivered interventions as an approach for overcoming barriers and increasing access to psychosocial care for adults with SCI. iCare Lifetime Care and Support Authority and the Australian National Health and Medical Research Council.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 09-2010
DOI: 10.1016/J.PAIN.2010.05.027
Abstract: This study aimed to investigate the efficacy of an attention training technique (ATT) on pain ratings, threshold and tolerance during the cold pressor task. One hundred and three undergraduate students were randomly assigned to receive either threat-alleviating or threat-inducing information about the task. Participants were then re-randomized to receive either ATT or progressive muscle relaxation (PMR). Hence, the present study had a 2 (threat expectancy: high vs. low)x2 (training: ATT vs. PMR) design. Analyses confirmed that the threat manipulation was effective in increasing the harm associated with the task. ATT resulted in a relative reduction in hypervigilance to sensory pain words compared to PMR. ATT was also associated with a lower degree of focus on internal sensations, but not mindfulness or difficulty disengaging from pain words. Results showed that, relative to relaxation training, those receiving ATT reported pain less quickly than those receiving relaxation, although there were no differences between the training groups for tolerance or pain ratings. These results show that ATT changes the cognitive processes of internal/external focus and hypervigilance towards sensory pain words, but not difficulty disengaging or mindfulness. Although ATT changed threshold, the fact that neither pain ratings nor tolerance was affected suggests that a single, brief session of ATT may not be sufficient to affect broader change. Nonetheless, this study shows that ATT can change cognitive processes thought to be associated with heightened perception of pain and that this changes how quickly pain is registered and is therefore worthy of further investigation.
Publisher: Oxford University Press
Date: 21-11-2012
DOI: 10.1093/OXFORDHB/9780199733989.013.0023
Abstract: Issues of education and training are fundamental to the conceptualization and development of the specialty of applied rehabilitation psychology, as they are in all areas of professional health service psychology. A specialty is shaped by the preparation of its practitioners, including its selection of trainees, the structures and processes of its training programs, and the competencies expected of successful trainees. In considering education and training in rehabilitation psychology, this chapter discusses a conceptual space, based on the definition of the specialty and its relevance to important world health issues conceptual elements, based on existing training guidelines and expected practitioner competencies and data about what actually occurs in preparing practitioners for work in rehabilitation psychology. Recommendations are made for improving education and training in rehabilitation psychology.
Publisher: Frontiers Media SA
Date: 14-10-2021
DOI: 10.3389/FPSYG.2021.721238
Abstract: Increasing prevalence rates of mental health problems among adolescents is an issue of growing concern. Surf therapy is a novel intervention that may provide tangible benefits to address this problem. Congruent with the ecological dynamics perspective (EDP), the existing research postulates that surf therapy yields psychological benefits in part due to the unique affordances of immersion in a blue space such as the ocean. Evidence worldwide has validated the use of surfing as a therapeutic mediator to achieve positive change, however, no such research has been conducted on Australian adolescents. The current study aimed to evaluate the impact of the Waves of Wellness (WOW) Foundation's 8 week surf therapy program on mental health outcomes in Australian at-risk youth. The study employed a mixed-methods design to examine the experiences of participants. Nine adolescents ( M age = 14.9 SD = 1.2 8 female) participated in the quantitative stage, with four completing the qualitative interview. Results indicated positive changes in resilience, self-esteem, social connectedness, and depressive symptoms post-intervention, however, improvements were not maintained at follow-up. Participants unanimously agreed that the program normalised their experiences with mental health through the unique leaning environment and fostered personal growth through mastery experiences and the development of healthy relationships. The EDP provided the most compelling explanation of the results denoting that benefits arise from the reciprocal relationship between in idual, task, and environment. Despite the small and heterogenous s le, the findings provided preliminary evidence of the efficacy of surf therapy among Australian youth and offer a potential starting point for further research utilising larger more erse s les.
Publisher: Springer Science and Business Media LLC
Date: 09-2018
Publisher: Elsevier BV
Date: 02-2015
DOI: 10.1016/J.JPSYCHORES.2014.12.002
Abstract: Anxiety disorders and symptoms are highly prevalent and problematic comorbidities in people with epilepsy (PWE), yet they remain poorly understood and often go undetected. This research aimed to further our understanding about anxiety in PWE. Study 1 assessed the effectiveness of the commonly utilised yet unvalidated measure (Hospital Anxiety Depression Scale-Anxiety subscale HADS-A) to identify DSM-IV anxiety disorders in 147 adult epilepsy outpatients. This study found that although the HADS-A had reasonable specificity (75%), its poor sensitivity (61%) and inadequate area under the curve (.68) deemed it unreliable as a screener for anxiety disorders in this population. Study 2 aimed to further our understanding of the relationship between anxiety disorders, as defined by clinical interview, and psychosocial correlates in PWE. One hundred and twenty-two participants from Study 1 completed a battery of psychosocial measures. Multivariate analysis revealed that the presence of an anxiety disorder was associated with unemployment, which was found to be the only independent predictor. That is, despite the fact that psychosocial factors together contributed to the variance in anxiety disorders none were revealed to be significant independent predictors. These findings add to the literature indicating that the HADS may indicate distress, but does not adequately identify people with anxiety disorders and highlights the urgent need for the development of a reliable anxiety screening measure for PWE. Further, the results suggest that anxiety disorders in PWE are likely to be multiply determined with respect to psychosocial factors and require further investigation.
Publisher: Elsevier BV
Date: 09-1999
Publisher: Informa UK Limited
Date: 02-09-2021
Publisher: BMJ
Date: 09-2021
DOI: 10.1136/BMJOPEN-2021-048658
Abstract: We aimed to analyse the degree of carer burden and depressive symptoms in family carers of persons with age-related macular degeneration (AMD) and explore the factors independently associated with carer burden and depressive symptoms. Cross-sectional study using self-administered and interviewer-administered surveys, involving 96 family carer–care recipient pairs. Participants were identified from tertiary ophthalmology clinics in Sydney, Australia, as well as the Macular Disease Foundation of Australia database. Logistic regression, Pearson and Spearman correlation analyses were used to investigate associations of explanatory factors (family caregiving experience, carer fatigue, carer quality of life and care-recipient level of dependency) with study outcomes—carer burden and depressive symptoms. Over one in two family carers reported experiencing mild or moderate-severe burden. More than one in five and more than one in three family carers experienced depressive symptoms and substantial fatigue, respectively. High level of care-recipient dependency was associated with greater odds of moderate-severe and mild carer burden, multivariable-adjusted OR 8.42 (95% CI 1.88 to 37.60) and OR 4.26 (95% CI 1.35 to 13.43), respectively. High levels of fatigue were associated with threefold greater odds of the carer experiencing depressive symptoms, multivariable-adjusted OR 3.47 (95% CI 1.00 to 12.05). A substantial degree of morbidity is observed in family carers during the caregiving experience for patients with AMD. Level of dependency on the family carer and fatigue were independently associated with family carer burden and depressive symptoms. The trial registration number is ACTRN12616001461482. The results presented in this paper are Pre-results stage.
Publisher: Informa UK Limited
Date: 07-07-2014
DOI: 10.1080/13548506.2014.933852
Abstract: Adherence to treatment for hepatitis C virus (HCV) infection is associated with the successful eradication of infection. However, patients often have difficulty adhering to HCV treatment because of factors such as the psychiatric side effects of regimens and social disadvantage. Commonly, health professionals including specialist physicians, nurses, social workers and psychologists work together under a multidisciplinary model of shared-care to support patients' adherence to HCV treatment. In some HCV treatment clinics, shared-care is not always available, or only partially implemented and this has implications for patient adherence. To explore the facilitators of adherence, an interview-based study was conducted in 2012 with a purposive s le of Australian physicians and nurses (N = 20). The findings reveal that when comprehensive shared-care was limited or unavailable, physicians and nurses filled in the gaps by assuming roles outside of their expertise to help patients adhere to HCV treatment. Physicians and nurses applied instrumental support strategies based on psychosocial interventions, namely patient advocacy, pragmatic problem-solving, treatment engagement and emotional support. These strategies were provided by dedicated physicians and nurses to address shortfalls in multidisciplinary shared-care. Although these interventions were reported to assist adherence, there is an increased risk of complications when physicians and nurses move beyond the bounds of their disciplinary training, for ex le, to assess and manage patients' psychiatric side effects or advocate on their behalf for social services. Future research should measure the effectiveness of instrumental support strategies on HCV treatment adherence, and explore the costs associated with physicians and nurses providing instrumental support in the absence of comprehensive multidisciplinary shared-care.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 11-07-2012
Publisher: Elsevier BV
Date: 2013
DOI: 10.1016/J.YEBEH.2012.10.023
Abstract: Despite recent research into the impact of seizure control on mood disorders in epilepsy, it is often assumed that rates of psychiatric disorders are higher in people with refractory rather than well-controlled epilepsy. We assessed the point prevalence of mood and anxiety disorders and suicide risk using the Mini International Neuropsychiatric Interview (MINI) in a consecutive s le of epilepsy outpatients from a tertiary referral center. One hundred and thirty patients, whose epilepsy was categorized as well-controlled versus drug-treatment-refractory epilepsy (69 53% well-controlled epilepsy) were recruited. High rates of mood disorders (n = 34 26%), anxiety disorders (n = 37 29%) and suicide risk (n = 43 33%) were found. However, there was no difference in rates of disorders or suicide risk for those with refractory versus well-controlled epilepsy. These results underscore the importance of assessment and management of psychopathology in all people with epilepsy, regardless of their seizure control.
Publisher: Journal of Rehabilitation Research & Development
Date: 2009
Publisher: American Psychological Association (APA)
Date: 12-2015
DOI: 10.1111/CPSP.12123
Publisher: Elsevier BV
Date: 07-2017
DOI: 10.1016/J.JPAIN.2017.02.431
Abstract: Chronic pain is prevalent in people with spinal cord injury (SCI). We investigated how chronic pain intensity and catastrophizing varies in adults with SCI during inpatient rehabilitation up to 12 months postinjury after transitioning into the community. Eighty-eight participants with SCI were assessed for pain intensity and catastrophizing, depressive mood states, and cognitive performance. Participants were ided into subgroups of clinically elevated depressive mood and anxiety versus those with normal mood state levels. The rate of clinically elevated pain catastrophizing was 22.5% at 12 months postinjury. Participants with elevated anxiety reported significantly higher pain intensity 12 months postinjury. Participants with clinically elevated depressive mood and anxiety reported significantly elevated pain catastrophizing 12 month postinjury. Findings indicate those with elevated depressive mood states will be more likely to have high levels of pain and engage in cognitive appraisals involving pain-related catastrophizing. Importantly, however, risk of increased pain intensity and catastrophizing occurred only after transitioning into the community, when personal resources will be severely challenged. Implications of these results for models of pain catastrophizing are discussed and it is concluded there is a need for ongoing support in the community to develop self-management skills and strategies that strengthen social support networks. We studied pain catastrophizing and negative mood states in adults with SCI. Catastrophizing was higher in those with depression, but only after discharge from hospital into the community. Results provide direction for improving treatment of pain catastrophizing in adults with SCI who are depressive and anxious.
Publisher: Wiley
Date: 02-06-2015
DOI: 10.1111/BJHP.12143
Abstract: Spinal cord injury (SCI) is a catastrophic event that may result in diminished physical, social, and mental health. The main objective of this research was to establish inpatient factors that contribute to social participation following discharge into the community. Prospective longitudinal design with measures taken three times, soon after admission to rehabilitation (N = 88), at discharge from the inpatient phase (N = 81) and 6 months following discharge (N = 71). Participants included adults with SCI admitted into three SCI units over a 33-month period. Assessment included demographic, injury, and psychosocial health measures. Adjustment was defined by the extent of social re-integration or participation post-discharge after 6 months in the community. Social participation was measured by the Impact on Participation and Autonomy Questionnaire (IPAQ). Logistic regression models were used to establish inpatient factors that significantly predicted social participation 6 months post-discharge. Six months after discharge, around 55% of the s le had difficulties with social participation. The odds against being employed for an adult with poor social participation was found to be 8.4 to 1. Factors that predicted social participation included a younger age, having less severe secondary medical complications like bladder and bowel dysfunction, having a higher cognitive capacity, perceiving one has control (self-efficacy) over one's life and environment, and having greater perceived social support. These results provide direction for enhancing existing psychosocial health strategies within SCI rehabilitation, affording an opportunity for every person who sustains a permanent SCI to have optimal capacity for social participation. Statement of contribution What is already known on this subject? Spinal cord injury (SCI) is associated with significant challenges to wellbeing, including a high risk of secondary chronic illnesses, risk of co-morbid mental health problems, financial insecurity and social isolation. Research has shown poor social participation can lead to problems in re-integration into society following discharge from inpatient rehabilitation. Research to date has examined various factors related to poor social participation, but the majority of this research has been survey based with convenience s les. What does this study add? This study adds results of prospective longitudinal research on adjustment following SCI, where adjustment was defined by the rate of social participation when living in the community. About one-third of SCI participants were found to have very poor social participation, and only one-third had found some form of employment 6 months after discharge. Multiple factors were found to predict and contribute to poor social participation, including older age when injured, more severe medical complications, cognitive deficits, poor perceptions of control or self-efficacy, and poor social support.
Publisher: Wiley
Date: 03-09-2013
DOI: 10.1111/EPI.12345
Abstract: Cognitive behavioral therapy (CBT) is a recommended treatment for depression in people with epilepsy (PWE) however, a recent Cochrane review found that there was insufficient evidence that any psychological therapy is effective. This conclusion provides little help to clinicians who provide interventions for depressed PWE. The aim of this review was to systematically and qualitatively review the literature on the efficacy of CBT for depression in PWE based on randomized controlled trials (RCTs) and case series. We aim to determine patterns in the literature to inform the type of CBT, if any, that should be offered to PWE who are depressed. Databases MEDLINE, PsycINFO, and the Cochrane EBM Reviews were searched via OVID. Selection criteria included the following: (1) participants with epilepsy (2) use of CBT (3) valid depression outcome measure and (4) published in peer-reviewed journal in English. Inclusions of studies were assessed by two independent researchers. We identified 14 outcome papers for 13 CBT trials including 6 randomized controlled trials (RCTs) and 7 case series. Positive effects of CBT on depression were reported in three of six RCTs. A review of their content revealed that all effective RCTs specifically tailored CBT to improve depression. Conversely, two of three RCTs that failed to find depression-related effects focused on improving seizure-control. This pattern was also observed in the case series. Although limited in number and having methodologic limitations, the treatment studies included in our review suggest that interventions tailored toward improving depression are possibly efficacious, whereas those that focus on improving seizure control do not appear to be. However, this review highlights that there is need for further RCTs in this area in order to confirm the possible efficacy of CBT for depression in PWE.
Publisher: Wiley
Date: 13-04-2016
DOI: 10.1002/EJP.853
Abstract: Patients face numerous challenges adopting skills taught within pain self-management programmes. The present study reports the acceptability and preliminary outcomes of supplementing an Internet-delivered cognitive behavioural therapy (iCBT) course for chronic pain, the Pain Course, with brief automated short message service (SMS) prompts that encourage skills practice. Participants were recruited from the Waitlist Control Group of a large randomized controlled trial and provided access to the Pain Course over 8 weeks, with the addition of SMS prompts. Fifteen SMS prompts were created to encourage the use of self-management skills during the course. Participants were sent one random SMS prompt each business day. The acceptability of the SMS was assessed and clinical outcomes of participants who received prompts (n = 56) compared with a historical group who previously received the course without prompts (n = 139). SMS prompts were rated highly with 85% reporting them to be very helpful or helpful and that they would recommend them to others. Clinical improvements for those receiving SMS, at post-treatment and 3-month follow-up (disability, d = 0.44 0.58 anxiety d = 0.50 0.51 depression, d = 0.78 0.79 and average pain d = 0.49 0.54), were consistent with participant who had received the course previously without SMS (ps >0.05). Brief automated SMS prompts were an acceptable adjunct to iCBT for chronic pain but did not result in any additional clinical benefit. Further research is needed to systematically evaluate the potential of SMS prompts to increase skills practice and facilitate treatment outcomes. WHAT DOES THIS STUDY ADD?: Automated short message service (SMS) messages are an acceptable means of prompting skills practice during iCBT for chronic pain. SMS prompts did not improve clinical outcomes of an established clinician-supported iCBT programme.
Publisher: Elsevier BV
Date: 05-2000
DOI: 10.1016/S0002-9343(00)00330-2
Abstract: Epidemiological studies have suggested that cholesterol lowering could affect psychological functioning. This study was designed to test whether cholesterol-lowering diets adversely affect mood and cognitive function.5.2 mM [198 mg/dL]) to either a low-fat diet, a Mediterranean diet, or a waiting-list control. Cholesterol levels, psychological well-being (depression, anxiety, hostility), and cognitive function were assessed at baseline, 6 weeks, and 12 weeks. Total serum cholesterol levels fell significantly more in the intervention groups (8.2% reduction) than in the control group (P <0.001). All three groups showed a modest improvement in psychological well-being during the 12-week treatment period, but there were no differences among the groups. There were no between-group differences on three measures of cognitive function, but for a fourth measure, which involved the task with the greatest processing load, the two intervention groups did significantly worse (P <0.001) than the control group. The change in performance was correlated with the change in total serum cholesterol level (r = 0. 21, P = 0.01). Two dietary interventions that successfully lowered serum cholesterol levels had no adverse effect on mood. There was some evidence for a relative impairment in cognitive function in the treated groups in one of four cognitive tests, but additional studies will be required to determine the relevance of this finding.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 10-2015
Publisher: Wiley
Date: 14-04-2013
DOI: 10.1111/LIV.12138
Abstract: To increase cure rates for Hepatitis C, barriers to treatment adherence and completion must be identified and overcome. This study systematically reviewed evidence on the psychological, lifestyle and social determinants of achieving viral eradication with antiviral therapy. An electronic search strategy was used to identify relevant studies that examined psychological, lifestyle and social factors related to achieving a sustained virological response (SVR). Thirty-four studies that matched our criteria were identified. Of the factors that predict response to treatment, Asian ethnicity was an independent predictor of SVR. We found an indirect relationship between diet and SVR, with non-responders to treatment consuming more polyunsaturated fatty acids, fats and carbohydrates than those who attained SVR. The effect of alcohol consumption relied on the amount consumed fewer than 30 grams daily had no effect on SVR, whereas >70 grams daily had an adverse impact on a patient's ability to achieve SVR, with termination rates up to 44% in those who drank >2 drinks a day. Patients with psychiatric illnesses had comparable SVR rates to controls if they continued psychological therapy (average 42%), although discontinuation rates were high with 11 studies reporting rates from 14 to 48%. There are major gaps in current knowledge of the impact of variables such as diet, exercise, attitudes and coping skills on cure rates in chronic Hepatitis C. Those who drink limited amounts of alcohol or have psychiatric disorders should be offered treatment for their disease, with adjunctive education and support to improve treatment completion.
No related grants have been discovered for Kathryn Nicholson Perry.