Resilience-based multifactorial model of depression among people who lost an only-child in China
- Authors: Wang, Anni , Zhang, Wen , Guo, Yufang , Cross, Wendy , Plummer, Virginia , Lam, Louisa , Zhang, Jingping
- Date: 2021
- Type: Text , Journal article
- Relation: Zhong nan da xue xue bao. Yi xue ban = Journal of Central South University. Medical sciences Vol. 46, no. 1 (2021), p. 75-83
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- Description: Objective: There are almost one million families who lost their only child in China, and 65.6% of them had severe and long lasting depression and needed timely psychointervention. This study aims to explore the relationship among resilience and its influential factors, and to compare their effect on depression. Methods: A total of 212 only-child loss person in 9 administrative regions in Changsha were assessed by using Connor-Davidson Resilience Scale, Zung Self-rating Depression Scale, Simplified Coping Style Questionnaire, Simplified Eysenck Personality Questionnaire, Social Support Rating Scale, and General Self-efficacy Scale. A hypothetical model was tested based on Kumpfer resilience framework and stress-coping theory. Results: The influential factors of resilience were: positive coping (the total effect value was 0.480), support utilization (the total effect value was 0.359), neuroticism (the total effect value was -0.326), negative coping (the total effect value was 0.279), extraversion (the total effect value was 0.219), and objective support (the total effect value was 0.077). The process of individual-environment interaction showed a greater impact on resilience, which had a direct effect on depression (the total effect value was −0.344, 67.1%), and also indirect effect through self-efficacy (the total effect value was −0.169). The total effect of resilience accounted for 20.1% of the total effect of all variables. Conclusion: Resilience mainly impacts depression directly, and can negatively predict depression in only-child loss parents. Resilience, located before self-efficacy, is a significant stress mediating variables. Personality traits and support utilization indirectly impact resilience via negative and positive coping. The key to promote the reorganization of resilience is the process of individual-environmental interaction, involving support utilization, positive coping, and some sorts of negative coping strategies, which plays an important role in developing a resilience intervention program and can improve the depression of the only-child loss person.
The relationships between self-compassion, rumination, and depressive symptoms among older adults : the moderating role of gender
- Authors: Hodgetts, Jessica , McLaren, Suzanne , Bice, Bridget , Trezise, Alexandra
- Date: 2021
- Type: Text , Journal article
- Relation: Aging and Mental Health Vol. 25, no. 12 (2021), p. 2337-2346
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- Description: Objectives: Depression is a significant mental health issue for older adults. Rumination is a key risk factor for depressive symptoms, and self-compassion is a protective factor. The aim of the current study was to test the processes by which self-compassion might act as a protective factor among older adults by investigating a mediation model, and whether the model is conditional on gender. It was hypothesised that self-compassion and its six components (self-kindness, common humanity, mindfulness, self-judgement, isolation, and over-identification) would be indirectly associated with depressive symptoms via rumination. Method: A sample of 135 older Australian women and 106 older Australian men aged between 65 and 89 years completed the Centre for Epidemiologic Studies Depression Scale, the Ruminative Thought Style Questionnaire, and the Self-Compassion Scale. Results: Results supported the mediation models for self-compassion for both men and women, however, support for the models involving the individual components of self-compassion varied according to gender. The mediation effects were stronger for women than men. Conclusion: Interventions aimed at increasing self-compassion might have benefits for older adults. Future research investigating whether tailoring interventions according to gender of participants is efficacious is needed. © 2020 Informa UK Limited, trading as Taylor & Francis Group.
Cognitive behaviour therapy for insomnia and depression : qualitative reflections from older adults who participated in a randomised controlled trial
- Authors: Sadler, Paul , McLaren, Suzanne , Klein, Britt , Jenkins, Megan
- Date: 2020
- Type: Text , Journal article
- Relation: Aging and Mental Health Vol. 24, no. 6 (2020), p. 932-938
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- Description: Objectives: To explore the experiences of older adults who participated in a randomised controlled trial (RCT) that tested cognitive behaviour therapy for insomnia and depression. Methods: Focus groups were conducted post treatment for older adults (M age = 75 years; 61% female) who participated in a RCT that tested two experiential interventions targeting comorbid insomnia and depression (cognitive behaviour therapy for insomnia, CBT-I; cognitive behaviour therapy for insomnia plus positive mood strategies, CBT-I+). Six semi-structured focus group interviews (N = 31) were analysed using a qualitative thematic analysis. Results: Interview data were transcribed into 424 sentences and 60 codes were extracted. Thirty-four initial themes emerged, which were transformed into 3 themes and 10 subthemes. The three primary themes were (1) positive experiences, (2) negative experiences, and (3) suggested modifications. The positive subthemes were (1a) therapists, (1b) togetherness, (1c) use of strategies reduced symptoms, and (1d) acceptance. The negative subthemes were (2a) persistent symptoms, (2b) program too condensed, and (2c) attendance obstacles. The suggested modifications were (3a) lengthen program, (3b) multi-dimensional learning, and (3c) multi-modal delivery options. Conclusion: The experiences and suggestions identified in this study strengthen the foundation to advance therapeutic program development for older adults with comorbid insomnia and depression. Future CBT-I programs for older adults may be improved by increasing the length of therapy (e.g. 8 sessions to 12 sessions), adding multi-dimensional learning opportunities (e.g. visual/audio/mentorship), and offering various modes of treatment delivery (e.g. group, individual, internet, telephone). © 2019, © 2019 Informa UK Limited, trading as Taylor & Francis Group.
- Description: Federation University Australia and the Australian Government Research Training Program Scholarship
Sleep and mental health among paramedics from Australia and Saudi Arabia : a comparison study
- Authors: Khan, Wahaj , Conduit, Russell , Kennedy, Gerard , Alslamah, Ahmed , Alsuwayeh, Mohammad , Jackson, Melinda
- Date: 2020
- Type: Text , Journal article
- Relation: Clocks & Sleep Vol. 2, no. 2 (JUN 2020), p. 246-257
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- Description: Paramedics face many challenges while on duty, one of which is working different types of shifts. Shift work has been linked to a number of health issues such as insomnia, depression, and anxiety. Besides shift work, Saudi paramedics, a group that has not been investigated for sleep or mental health issues previously, may be facing more demands than Australian paramedics due to lower numbers of paramedics in comparison to the general population. The aim of this study was to investigate the prevalence of sleep and mental health disorders among paramedics in Saudi Arabia and Australia. Paramedics were invited to complete a survey to assess stress, post-traumatic stress disorder (PTSD), depression, anxiety, daytime sleepiness, insomnia, sleep quality, shift work disorder, obstructive sleep apnoea, fatigue, and general health. A total of 104 males Saudi paramedics (M age = 32.5 +/- 6.1 years) and 83 males paramedics from Australia (M age = 44.1 +/- 12.1 years) responded to the survey. Significantly higher rates of depression, PTSD, insomnia, and fatigue, along with significantly poorer physical functioning were observed among Saudi paramedics in comparison with Australian paramedics. However, Australian paramedics reported significantly poorer sleep quality and general health in comparison to Saudi paramedics. After removing the effect of driving and working durations, outcomes were no longer significant. The higher burden of depression and PTSD among Saudi paramedics may be explained by longer hours spent driving and longer work durations reported by this group. Taking into consideration the outcomes reported in this study, more investigations are needed to study their possible effects on paramedics' cognition, performance, and safety.
The relationship between phobic anxiety and 2-year readmission after Acute Coronary Syndrome : What is the role of heart rate variability?
- Authors: O'Neil, Adrienne , Taylor, Barr , Hare, David , Thomas, Emma , Toukhsati, Samia , Oldroyd, John , Scovelle, Anna , Oldenburg, Brian
- Date: 2019
- Type: Text , Journal article
- Relation: Journal of Affective Disorders Vol. 247, no. (2019), p. 73-80
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- Description: Objective: Phobic anxiety is a risk factor for poor prognosis following Acute Coronary Syndrome (ACS). A psychophysiological marker of vagal function, autonomic dysfunction may play a critical role in this relationship. The aim of the study was two-fold: to assess whether phobic anxiety was characterised by autonomic dysfunction (heart rate variability) in the short (1-month) and longer term (12-months) following ACS, and (ii) to quantify the extent to which HRV parameters modified the effect of phobic anxiety on all-cause hospital readmission over 2 years. Methods: The ADVENT study followed 416 ACS patients. At 1-month following discharge (T0), phobic anxiety and autonomic functioning were assessed using the Crown Crisp Index (CCI) and 11 indices of heart rate variability (HRV), respectively. HRV was measured again at 12-months (T1) (n = 359). Hospital readmission (all cause) was derived from an audit of hospital records by two medically trained research fellows. Generalised linear modelling (GLM) was used to first determine the association between CCI score at T0 and HRV parameters at T0 and T1. Binary logistic regression was used to measure the relationship between CCI scores and readmission (yes/no) and the extent to which HRV parameters modified this effect. Results: CCI scores were associated with 7 of the 11 indices of HRV: Average RR (ms), SDRR (ms), RMSSD (ms), SDSD (ms), pRR50 (%), LF Powers (ms2) and HF Powers (ms2) at T0 but not T1. CCI scores at T0 significantly predicted likelihood of readmission to hospital in the subsequent 2 year period. No parameter of HRV at T0 modified this effect. Limitations: We were unable to provide adjudicated major adverse coronary events outcome data, or account for changes in medication adherence, diet or physical activity. Conclusions: While phobic anxiety is associated with both reduced vagal function in the short term after an ACS event and 2 year all cause readmission, HRV does not appear to be the pathway by which phobic anxiety drives this outcome.
Cognitive behavior therapy for older adults with insomnia and depression : A randomized controlled trial in community mental health services
- Authors: Sadler, Paul , McLaren, Suzanne , Klein, Britt , Harvey, Jack , Jenkins, Megan
- Date: 2018
- Type: Text , Journal article
- Relation: Sleep Vol. 41, no. 8 (2018), p. 1-12
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- Description: Study Objectives: To investigate whether cognitive behavior therapy was effective for older adults with comorbid insomnia and depression in a community mental health setting, and explore whether an advanced form of cognitive behavior therapy for insomnia produced better outcomes compared to a standard form of cognitive behavior therapy for insomnia. Methods: An 8-week randomized controlled clinical trial was conducted within community mental health services, Victoria, Australia. Seventy-two older adults (56% female, M age 75 ± 7 years) with diagnosed comorbid insomnia and depression participated. Three conditions were tested using a group therapy format: cognitive behavior therapy for insomnia (CBT-I, standard), cognitive behavior therapy for insomnia plus positive mood strategies (CBT-I+, advanced), psychoeducation control group (PCG, control). The primary outcomes were insomnia severity (Insomnia Severity Index) and depression severity (Geriatric Depression Scale). Primary and secondary measures were collected at pre (week 0), post (week 8), and follow-up (week 20). Results: CBT-I and CBT-I+ both generated significantly greater reductions in insomnia and depression severity compared to PCG from pre to post (p < .001), which were maintained at follow-up. Although the differences between outcomes of the two treatment conditions were not statistically significant, the study was not sufficiently powered to detect either superiority of one treatment or equivalence of the two treatment conditions. Conclusion: CBT-I and CBT-I+ were both effective at reducing insomnia and depression severity for older adults. Mental health services that deliver treatment for comorbid insomnia with cognitive behavior therapy may improve recovery outcomes for older adults with depression. Trial Registration: Australian and New Zealand Clinical Trials Registry (ANZCTR); URL: https://www.anzctr.org.au; Trial ID: ACTRN12615000067572; Date Registered: December 12, 2014.
Resiliency among older adults : Dispositional hope as a protective factor in the insomnia–depressive symptoms relation
- Authors: Trezise, Alexandra , McLaren, Suzanne , Gomez, Rapson , Bice, Bridget , Hodgetts, Jessica
- Date: 2018
- Type: Text , Journal article
- Relation: Aging and Mental Health Vol. 22, no. 8 (2018), p. 1088-1096
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- Description: Objectives: Depression is a significant mental health issue among older Australian adults. Research has indicated that insomnia is a key risk factor for the development of depressive symptoms in older adults, and that dispositional hope may be protective against the development of depressive symptoms in this population. This study examined whether dispositional hope and its dimensions, agency and pathways, moderated the relationship between insomnia symptoms and depressive symptoms among older Australian adults. Method: A community sample of 88 men (Mage = 71.11, SDage = 5.54) and 111 women (Mage = 70.25, SDage = 4.64), aged 65–94 years, completed the Insomnia Severity Index, Adult Dispositional Hope Scale, and Centre of Epidemiologic Studies Depression Scale. Results: After controlling for gender, age, relationship status, education level, method of participation, and perceived physical health, results supported the moderation models. The insomnia–depressive symptoms relation was significant for older adults with low and average (but not high) levels of dispositional hope, agency, and pathways. The Johnson–Neyman analyses indicated that the insomnia–depressive symptoms relation was significant for older adults who scored below 27.10 on dispositional hope, below 13.73 on agency, and below 13.49 and above 15.64 on pathways. Conclusion: The results of this study imply that interventions aimed at increasing dispositional hope, agency, and pathways among older adults who experience symptoms of insomnia may reduce their depressive symptoms. A cautionary note, however, is that very high scores on pathways among older adults who experience insomnia symptoms may be detrimental to their mental health.
The first 30 months of the MindSpot Clinic: Evaluation of a national e-mental health service against project objectives
- Authors: Titov, Nickolai , Dear, Blake , Staples, Lauren , Bennett-Levy, James , Klein, Britt , Rapee, Ronald , Andersson, Gerhard , Purtell, Carol , Bezuidenhout, Greg , Nielssen, Olav
- Date: 2016
- Type: Text , Journal article
- Relation: Australian & New Zealand Journal of Psychiatry Vol. , no. (2016), p. 1-13
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- Description: OBJECTIVE: The MindSpot Clinic provides online mental health services to Australian adults with anxiety and depression. This paper describes users of MindSpot between January 2013 and June 2015. Outcomes are considered against three key objectives: improving access to mental health services, improving public awareness of how to access services and providing evidence-based treatments. METHOD: Website traffic data were examined to determine patterns of use. Demographic characteristics, past service utilisation and reasons for contacting MindSpot were analysed. Outcomes for patients enrolled in a MindSpot treatment course were also analysed. Primary outcomes were scores on the 9-Item Patient Health Questionnaire, Generalised Anxiety Disorder 7-Item, Yale-Brown Obsessive Compulsive Scale and Post-Traumatic Stress Disorder Checklist-Civilian Version, administered at assessment, post-treatment and 3-month follow-up. RESULTS: The website was visited by almost 500,000 Australians, of which 33,990 adults started assessments, and 25,469 people completed assessment and were eligible for analysis. Mean age was 36.4 years (standard deviation = 13.3 years; range = 18-94 years), and 72% were female. The proportion living in rural or remote regions and who identified as Aboriginal and Torres Strait Islander closely matched national statistics. The majority (82%) reported that they were not currently in contact with mental health services. Most patients sought an assessment, information about treatment options, or referral to another service, and only 24% of those completing an assessment commenced a MindSpot treatment course. Of these, large clinical effects (d: 0.7-2.4; average symptom reductions: 25.5% to 61.6%) were found from assessment to follow-up on all outcome measures. Deterioration ranged from 1.0% to 4.3%. CONCLUSION: Based on the number of website visits, completed assessments and treatment outcomes, MindSpot achieved its three programme objectives. This model of service provision has considerable value as a complement to existing services, and is proving particularly important for improving access for people not using existing services.
A psychological pathway from insomnia to depression among older adults
- Authors: Sadler, Paul , McLaren, Suzanne , Jenkins, Megan
- Date: 2013
- Type: Text , Journal article
- Relation: International Psychogeriatrics Vol. 25, no. 8 (2013), p. 1375-1383
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- Description: Background: Higher levels of insomnia predict greater depression severity among older adults; however. The psychological mechanisms underlying this relationship are unclear. This study tested a path model that explored whether dysfunctional beliefs about sleep and hopelessness mediate. The relationship from insomnia to depression. It was hypothesized that insomnia would predict depression, both directly and indirectly, via dysfunctional beliefs about sleep and hopelessness. Methods: A community sample of 218 independent-living Australian older adults aged from 65 to 96 years completed a self-report questionnaire package. From the initial 218 participants, 171 completed a measure of depression three months later. Results: Path analysis demonstrated that maladaptive sleep beliefs and hopelessness partly explained how insomnia influenced depression, irrespective of the presence of obstructive sleep apnea and/or restless legs syndrome. Conclusions: An older adult's beliefs about sleep and sense of hopelessness were important psychological factors that helped explain how insomnia related to depression. © 2013 International Psychogeriatric Association.
- Description: 2003011128
Housing type and depressive symptoms among older adults: a test of sense of belonging as a mediating and moderating variable
- Authors: McLaren, Suzanne , Turner, Jayne , Gomez, Rapson , McLachlan, Angus , Gibbs, Petah
- Date: 2013
- Type: Text , Journal article
- Relation: Aging & Mental Health Vol. 17, no. 8 (November 2013), p. 1023-1029
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- Description: Objectives: Higher levels of depression have been documented among older adults who reside in an assisted living facility, compared with those who remain in their own homes. The aims of the current study were to test whether the relationship between housing type and depressive symptoms was mediated by a sense of belonging and whether housing type and sense of belonging interact to influence the depressive symptoms among older adults (moderation model).Method: A sample of 257 older adults who lived in their own homes and 166 older adults who lived in an assisted living facility completed the psychological subscale of the Sense of Belonging Instrument and the Center for Epidemiologic Studies Depression Scale.Results: Results showed that a sense of belonging partially mediated the relationship between housing type and depressive symptoms, such that living in a nursing home was associated with lower levels of belonging, and lower levels of belonging were, in turn, associated with higher levels of depressive symptoms. Residing in an assisted living facility was associated with depressive symptoms at low and average levels of belonging.Conclusion: Results highlight the need for more research on the role of sense of belonging as an influencing factor on depressive symptoms among institutionalised older adults for both theoretical and treatment goals.
- Description: C1