ORCID Profile
0000-0001-5453-5316
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Publisher: Elsevier BV
Date: 11-2022
DOI: 10.1016/J.JPAINSYMMAN.2022.08.002
Abstract: Psycho-existential symptoms are common yet often missed or neglected in palliative care. Screening can be an effective way to recognize and respond to this need. We aimed to implement routine use of the Psycho-existential Symptom Assessment Scale (PeSAS) as a screening tool in Australian palliative care services and discern the symptom prevalence identified. In a multi-site rolling design, we established implementation site committees and embarked on experiential workshops to train clinicians in the tool's efficient use. Patient symptom prevalence data were collected to compare uptake across sites. Descriptive statistics were applied. Over one year, we trained 216 clinicians across six palliative care services in the use of the PeSAS as a screening tool and collected data from 1405 patients. Clinicians reported significant growth in their sense of efficacy in assessing psycho-existential wellness. Services using electronic records implemented most easily. Psycho-existential symptoms with clinically significant prevalence (scores ≥ 4/10) included anxiety 41.1%, discouragement 37.6%, hopelessness 35.8%, pointlessness 26.9%, depression 30.3%, and the wish to die 17%. The precision of measurement within 3% was found for severe ratings (score ≥ 8/10) including anxiety 10.6%, depression 10.2%, the wish to die 7.6%, and confusion 3.6%. Clinicians can be trained to screen with the Psycho-existential Symptom Assessment Scale, which serves as a valuable measure to better recognize symptoms of psycho-existential distress among palliative care patients. Implementation barriers included the prior ethos of the service, confidence in talking about these themes, electronic data entry, and perceived time pressures.
Publisher: SAGE Publications
Date: 21-04-2021
DOI: 10.1177/0192513X211010206
Abstract: Alexithymia, fear of intimacy, attachment security, and mood variables were examined as predictors of satisfaction in couple relationships after accounting for age, sex, relationship length, and marital status. Participants were 158 adults (52% women and 48% men) in an ongoing couple relationship for 1-19 years. They completed validated measures of the variables of interest online. Bivariate correlations were significant for all predicted associations. Multiple mediation modelling examined the hypothesis that the low relationship satisfaction reported by those with alexithymia can be explained by fear of intimacy, insecure attachment, and negative affect, after accounting for relevant covariates. Mediation was indicated for fear of intimacy and negative affect. Such factors may merit particular attention by clinicians working with alexithymic clients in couples therapy.
Publisher: Informa UK Limited
Date: 03-2020
DOI: 10.1111/AJPY.12258
Publisher: Wiley
Date: 08-03-2019
DOI: 10.1002/JCLP.22772
Abstract: A developmental model of alexithymia in relation to alcohol-related risk was examined. Validated indices of parental bonding, adult attachment, alexithymia, theory of mind (ToM), alcohol-related risk, and mood were administered to a nonclinical s le of 286 alcohol-using men and women. Hierarchical regression incorporating demographic and psychosocial variables accounted for 44% of the variance in alexithymia. Modeling indicated a significant path from dysfunctional maternal bonding to insecure adult attachment to alexithymia to risky drinking a separate path indicated an indirect effect of alexithymia in association between the deficient ToM and risky drinking. Findings were consistent with a developmental model where dysfunctional parental bonding in childhood manifests in adulthood as insecure attachment and alexithymia, the latter reflecting the insufficient acquisition of emotion regulation skills alexithymia, in turn, increases the risk of problematic drinking as an emotion regulation strategy.
No related grants have been discovered for Katarina Needham.