ORCID Profile
0000-0003-2733-3326
Current Organisation
Flinders University
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Publisher: Springer Science and Business Media LLC
Date: 06-09-2022
DOI: 10.1007/S12310-022-09540-3
Abstract: Perfectionism has adverse impacts on mental health and academic outcomes. We evaluated a 5-lesson classroom intervention for young adolescents delivered by teachers for impact on perfectionism, well-being, self-compassion, academic motivation and negative affect, at post-intervention and 3-month follow-up. Classes ( N = 636 students, M age = 13.68, SD = 0.60) were randomized to intervention ( n = 343) or classes as usual ( n = 293). Data were analyzed using linear mixed models adjusted for baseline observation and clustering. At post-intervention no differences were found between the groups. At 3-month follow-up, anxiety showed a significant increase in the control group with no increase in the intervention group ( d = 0.23 95% CI: 0.05, 0.40) females in the control group had a significant decrease in well-being from post-intervention to 3 month follow-up compared to the intervention group ( d = 0.33 95% CI: 0.08, 0.58) students with high levels of perfectionistic concerns in the intervention had significantly lower perfectionistic strivings at 3 month follow-up than the control group (( d = 0.34, 95% CI: 0.19, 0.49). This intervention shows promising results when delivered by teachers. Australian New Zealand Clinical Trials Registry (ANZCTR) Trial Number: ACTRN12621000457842 (April 19, 2021).
Publisher: Wiley
Date: 22-03-2019
DOI: 10.1111/EIP.12801
Abstract: It is unclear how adult mindfulness-based interventions (MBIs) should be modified for youth, and at what ages programmes should be implemented for optimal impact. Recent non-replication with a 9-week programme in early adolescence suggested abbreviated programme content might be insufficient and/or that this age group are less receptive. This controlled quasi-experimental design tested a more intensive 8-week MBI (longer meditation and session duration, plus inquiry) in Year 8 (M Within this format students rated the content as agreeable, and school staff deemed content developmentally appropriate, across both age bands. Efficacy was tested in a small subs le (N = 90) to provide an estimate of effect size. Linear mixed modelling demonstrated significant between-group differences in depression (Cohen's d = 0.61 95% CI = 0.19 to 1.03) and anxiety (d = 0.52 95% CI = 0.10 to 0.94) at 4-month follow-up, but not immediately post-intervention. An MBI more closely modelled on adult curricula was acceptable to students, although session duration was harder to timetable by schools. Promising effect sizes support further investigation in a larger s le.
Publisher: Elsevier BV
Date: 05-2003
DOI: 10.1016/S1356-689X(02)00155-8
Abstract: Twenty asymptomatic volunteers (mean age 33 years, range 26 - 54 years) underwent investigation using duplex Doppler ultrasound with real-time imaging and colour flow enhancement. With the subjects seated, peak velocity at C1-2 and volume flow rate at C5-6 were measured in the artery contralateral to the direction of rotation, in the four positions of neutral, 45 degrees and end range rotation, plus a subsequent neutral position. No change in peak velocity at C1-2 between the initial neutral measurement and the measurements at 45 degrees and end range rotation was found (P>0.05). Peak velocity was less in both vertebral arteries on return to the neutral position as compared with end range rotation, however the difference was significant for the left vertebral artery only (P=0.005). This lends support for the rest period, which is taken between cervical movement tests when conducting pre-manipulative testing, to allow for any latent effect on blood flow of the tests themselves. There was no change in volume flow rate between any of the test positions (P=0.349). There was no indication of a cumulative effect of the test procedure (P>0.05).
Publisher: Wiley
Date: 12-05-2022
DOI: 10.1002/EAT.23732
Abstract: The rate of screening for eating disorders (EDs) by general practitioners (GPs) in primary health care is low. We examined an approach to increase screening and the impact on referrals. Low cost assessment/treatment pathways were established in February 2019 for patients with an ED. Between October 2020 and June 2021 information was sent to GP practices about screening for EDs, along with provision of an online screening tool and training. Of the 44 GP practices invited to participate in the screening initiative, 42 (95.5%) agreed. Only 12 (27%) had referred patients before the initiative, 53 patients over 19 months (2.8/month). Over the 10‐month initiative 90 patients were referred and started treatment from 50% of the practices (8.2/month) 73 (81%) had an ED and six had disordered eating but not an ED. Qualitative feedback from GPs suggested they would not screen for a condition if there were no readily identifiable treatment pathway available. Results suggest that the three elements of the initiative (provision of assessment and treatment pathways, access to a screening tool, provision of information on screening) increased the likelihood that GPs would use a screening tool, leading to an almost three‐fold increase in referrals. An initiative used to translate screening for an eating disorder to treatment in primary health care had three components. First, provision of an easy referral process to assessment as well as treatment. Second, screening tools were made available on computer desktops. Third, information and training provided to GPs was used to support their clinical observation and increase confidence in initiating screening. Adoption of this initiative almost tripled referrals for assessment.
Publisher: Cambridge University Press (CUP)
Date: 22-11-2021
DOI: 10.1017/S0033291721004621
Abstract: Web-based interventions are increasingly used for the prevention, treatment and aftercare of mental disorders. A crucial factor to the efficacy of such online programmes is adherence to the intervention content and procedure. It has been frequently suggested that adherence in web-based interventions is low and little is known about which factors influence adherence. To increase intervention uptake and completion, studies increasingly include interventions with some form of guidance. Guided interventions have been shown to have higher efficacy, however, evidence for the impact on adherence is limited and mixed. This meta-analysis explored the impact of human guidance on intervention completion in web-based mental health interventions. A total of 22 studies were included with interventions primarily targeting symptoms of depression and anxiety disorders. Results showed that guidance significantly increases the average amount of intervention completion [ g = 0.29, 95% confidence interval (CI) 0.18–0.40] and the proportion of intervention completers [ log odds ratio (OR) = 0.50, 95% CI 0.34–0.66] with small effects. On average, full completion rates were 12% higher in guided intervention groups. This meta-analysis demonstrated that guidance in web-based mental health interventions does increase adherence, but more research is required to better understand the specific mechanisms between guidance, adherence and outcomes.
Publisher: Elsevier BV
Date: 10-2017
Publisher: Springer Science and Business Media LLC
Date: 04-08-2021
Publisher: American Psychological Association (APA)
Date: 03-2017
DOI: 10.1037/PAS0000342
Abstract: Mindfulness-based interventions show consistent benefits in adults for a range of pathologies, but exploration of these approaches in youth is an emergent field, with limited measures of mindfulness for this population. This study aimed to investigate whether multifactor scales of mindfulness can be used in adolescents. A series of studies are presented assessing the performance of a recently developed adult measure, the Comprehensive Inventory of Mindfulness Experiences (CHIME) in 4 early adolescent s les. Study 1 was an investigation of how well the full adult measure (37 items) was understood by youth (N = 292). Study 2 piloted a revision of items in child friendly language with a small group (N = 48). The refined questionnaire for adolescents (CHIME-A) was then tested in Study 3 in a larger s le (N = 461) and subjected to exploratory factor analysis and a range of external validity measures. Study 4 was a confirmatory factor analysis in a new s le (N = 498) with additional external validity measures. Study 5 tested temporal stability (N = 120). Results supported an 8-factor 25-item measure of mindfulness in adolescents, with excellent model fit indices and sound internal consistency for the 8 subscales. Although the CFA supported an overarching factor, internal reliability of a combined total score was poor. The development of a multifactor measure represents a first step toward testing developmental models of mindfulness in young people. This in turn will aid construction of evidence based interventions that are not simply downward derivations of adult mindfulness programs. (PsycINFO Database Record
Publisher: Elsevier BV
Date: 02-2000
Publisher: Elsevier BV
Date: 10-2023
Publisher: Springer Science and Business Media LLC
Date: 17-11-2022
DOI: 10.1186/S40337-022-00695-7
Abstract: Many people with eating disorders (EDs) either do not access treatment, access it well after symptoms first start, or drop out of treatment. This study evaluated ways to improve early access to evidence-based interventions for those with EDs in a non-specialist community setting. In an Australian regional community, links were formed between general medical practitioners and treatment providers (psychologists, mental health social workers and dietitians), who received ongoing training, feedback and support. Service users had access to 20–40 subsidised treatment sessions. Data were collected from 143 patients over 18 months. Our outcomes are reported according to the RE-AIM implementation framework: Reach (we measured uptake and treatment completion) Effectiveness (impact on disordered eating cognitions, body mass index, remission, and moderators of effectiveness including illness duration, previous treatment, presence of comorbidities, presence of a normative level of disordered eating, presence of any ED behaviours, weighing in treatment, multidisciplinary case conferencing, number of dietetic sessions) Adoption (drop-out and predictors) Implementation (barriers encountered) Maintenance (subsequent activity designed to embed new practices). Treatment was completed by 71% significant large decreases in eating disorder cognitions were achieved remission was obtained by 37% (intent-to-treat). Treatment completion was predicted by lower baseline levels of disordered eating, uptake of ≥ 3 dietetic sessions, and ≥ 2 team case conferences. Greater improvement over time was predicted by regular case conferencing and in-session weighing. Implementation of this model in a regional community setting produced completion rates and outcomes comparable to those found in specialist clinical trials of ED treatments. Service providers identified care coordination as the most important factor to connect users to services and help navigate barriers to ongoing treatment. Trial Registration: This research was an invited evaluation of a project implemented by the Australian Department of Health. The project did not introduce any new clinical practice but sought to improve access to evidence-based multidisciplinary treatment for people with EDs by removing four known systemic barriers: securing an accurate diagnosis, availability of multidisciplinary treatment, cost of treatment, and intensity of treatment. As such, the project did not require trial registration. Notwithstanding, this evaluation obtained ethics approval (Bellberry Human Research Ethics Committee, Application No: 2018-09-728-FR-1).
Publisher: Wiley
Date: 25-04-2018
DOI: 10.1002/EAT.22872
Abstract: While randomized controlled trials (RCTs) inform the efficacy and effectiveness of treatments, we need to understand that even RCTs can be associated with sub-optimal execution. This is of special pertinence to eating disorders given the majority of treatment studies involving cognitive behaviour therapy are of poor quality with respect to managing risk of bias adequately. The current paper outlines the components of a good RCT for psychotherapy, and examines ways to improve the conduct, interpretation, and usefulness of RCTs. This includes managing reporting bias, recognizing the limits of randomization, applicability, and ethical considerations. We highlight a number of strategies for future research, including issues related to utilizing a variety of designs to examine treatment outcomes, integrity, openness and reproducibility.
Publisher: Wiley
Date: 05-10-2019
DOI: 10.1111/EIP.12490
Abstract: Despite widespread enthusiasm to adopt universal mindfulness-based interventions (MBIs) for youth, high-quality evidence is still lacking. It remains unknown how best to modify the successful adult curricula to render them accessible for young people but still effective. Specifically, it is unclear whether particular elements of mindfulness are key ingredients. The aim of this research was to identify the relation between aspects of baseline mindfulness and longitudinal trajectories related to well-being in adolescence. We examined associations between eight aspects of mindfulness at baseline and longitudinal trajectories of depression, anxiety, well-being, weight concern and shape concern over a 12-month period in early adolescents (N = 499 46% female M We found a transdiagnostic protective effect for those high in Accepting and Nonjudgmental Orientation, Decentering and Nonreactivity and Acting with Awareness, with effect sizes across the variables ranging from small to large (Cohen's d = .29-1.26) although this benefit reduced over time, especially for weight and shape concerns in girls. This natural but waning protective effect strengthens the case for MBIs in youth. The isolation of three key elements is an important preliminary step in identifying ways to improve the effectiveness of current adolescent curricula. Of the three, the current study suggests that teaching young adolescents to respond to their mistakes with kindness and non-judgement should be a prime focus.
Publisher: Wiley
Date: 19-07-2022
DOI: 10.1002/EAT.23781
Abstract: Eating disorders (EDs) often emerge in late adolescence. Schools are ideal settings for prevention programs however, cost and time limit implementation. Microinterventions may overcome these challenges. This study adapted two microinterventions (cognitive dissonance, self‐compassion) and assessed feasibility and acceptability among mid‐adolescents to provide proof‐of‐concept for further investigation. Feedback from staff ( n = 5) and student ( n = 15) focus groups contributed iteratively to the adaptation of intervention materials. Students in Grade 10 and 11 ( N = 101, M age = 15.80, SD = 0.68) were then randomly allocated by class to a 20‐min video‐based cognitive‐dissonance or self‐compassion intervention, accessed on their school devices. ED risk and protective factors were assessed at baseline, immediate postintervention (state outcomes), and 1‐week follow‐up (trait outcomes). Acceptability items were included at both timepoints. Implementation was deemed feasible. Girls generally reported greater acceptability than boys. Among girls, the self‐compassion intervention demonstrated greater acceptability. Among boys, some aspects of acceptability (e.g., lesson endorsement, utilization of techniques) were rated higher in the cognitive dissonance group whereas other aspects (e.g., understanding, interest) were greater in the self‐compassion group. All groups exhibited favorable changes in most state outcomes, however trait outcome change was varied. Microinterventions provide a feasible way of implementing prevention strategies in a time‐poor educational context. Future large‐scale evaluation is warranted to determine efficacy, following modifications based on current findings. This study shows promising feasibility and acceptability of two brief, self‐guided video‐based lessons (microinterventions) for adolescents in school classrooms, that use psychological techniques to target appearance pressures as a key risk factor for eating disorders. Such interventions are easier to implement in school settings than longer, facilitator‐led interventions, to encourage greater uptake and ongoing use. Findings support further research to evaluate effectiveness, to ultimately provide accessible and gender‐inclusive tools for busy schools.
Location: Australia
Start Date: 2018
End Date: 2020
Funder: Channel 7 Children's Research Foundation
View Funded ActivityStart Date: 2018
End Date: 2019
Funder: Flinders University
View Funded Activity