Buffering the fear of COVID-19 : social connectedness mediates the relationship between fear of COVID-19 and psychological wellbeing
- Authors: Humphrey, Ashley , March, Evita , Lavender, Andrew , Miller, Kyle , Alvarenga, Marlies , Mesagno, Christopher
- Date: 2022
- Type: Text , Journal article
- Relation: Behavioral Sciences Vol. 12, no. 3 (2022), p.
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- Description: Social connections are crucial for an individual’s health, wellbeing, and overall effective functioning. During the COVID-19 pandemic, one major preventative effort for reducing the spread of COVID-19 involved restricting people’s typical social interactions through physical distancing and isolation. The current cross-sectional study, conducted during the COVID-19 pandemic, explored the relationship among fear of COVID-19, social connectedness, resilience, depressive symptomologies, and self-perceived stress. Participants (N = 174) completed an anonymous, online questionnaire, and results indicated that social connectedness mediated the relationship between fear of COVID-19 and psychological wellbeing. In contrast, the relationship between fear of COVID-19 and psychological wellbeing was not mediated by resilience. These findings highlight the important role that social connections and resilience play in buffering against negative psychological wellbeing outcomes, especially during a pandemic. © 2022 by the authors. Licensee MDPI, Basel, Switzerland.
The cardiac distress inventory : a new measure of psychosocial distress associated with an acute cardiac event
- Authors: Jackson, Alun , Grande, Michael , Rogerson, Michelle , Ski, Chantal , Amerena, John , Smith, Julian , Hoover, Valerie , Alvarenga, Marlies , Higgins, Rosemary , Thompson, David , Murphy, Barbara
- Date: 2022
- Type: Text , Journal article
- Relation: BMC Cardiovascular Disorders Vol. 22, no. 1 (2022), p.
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- Description: Background: Many challenges are posed by the experience of a heart attack or heart surgery which can be characterised as ‘cardiac distress’. It spans multiple psychosocial domains incorporating patients’ responses to physical, affective, cognitive, behavioural and social symptoms and experiences related to their cardiac event and their recovery. Although some measures of the psychological and emotional impacts of a cardiac event exist, none provides a comprehensive assessment of cardiac distress. To address this gap, the study aimed to develop a Cardiac Distress Inventory (CDI) using best practice in instrument design. Method: An item pool was generated through analysis of cognate measures, mostly in relation to other health conditions and through focus group and individual review by a multidisciplinary development team, cardiac patients, and end-users including cardiac rehabilitation co-ordinators. The resulting 144 items were reduced through further reviews to 74 for testing. The testing was carried out with 405 people recruited from three hospitals, through social media and by direct enrolment on the study website. A two-stage psychometric evaluation of the 74 items used exploratory factor analysis to extract the factors followed by Rasch analysis to confirm dimensionality within factors. Results: Psychometric analysis resulted in the identification of 55 items comprising eight subscales, to form the CDI. The subscales assess fear and uncertainty, disconnection and hopelessness, changes to roles and relationships, overwhelm and depletion, cognitive challenges, physical challenges, health system challenges, and death concerns. Validation against the Kessler 6 supports the criterion validity of the CDI. Conclusion: The CDI reflects a nuanced understanding of cardiac distress and should prove to be a useful clinical assessment tool, as well as a research instrument. Individual subscales or the complete CDI could be used to assess or monitor specific areas of distress in clinical practice. Development of a short form screening version for use in primary care, cardiac rehabilitation and counselling services is warranted. © 2022, The Author(s).
Unraveling the complexity of cardiac distress : a study of prevalence and severity
- Authors: Jackson, Alun , Rogerson, Michelle , Amerena, John , Smith, Julian , Hoover, Valerie , Alvarenga, Marlies , Higgins, Rosemary , Grande, Michael , Ski, Chantal , Thompson, David , Murphy, Barbara
- Date: 2022
- Type: Text , Journal article
- Relation: Frontiers in Psychiatry Vol. 13, no. (2022), p.
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- Description: Introduction: While much research attention has been paid to anxiety and depression in people who have had a recent cardiac event, relatively little has focused on the broader concept of cardiac distress. Cardiac distress is a multidimensional construct that incorporates but extends beyond common mood disorders such as anxiety and depression. In the present study we assessed the prevalence, severity and predictors of a broad range of physical, affective, cognitive, behavioral and social symptoms of cardiac distress. This is the first study to investigate cardiac distress in this comprehensive way. Method: A sample of 194 patients was recruited from two hospitals in Australia. Eligible participants were those who had recently been hospitalized for an acute cardiac event. Data were collected at patients' outpatient clinic appointment ~8 weeks after their hospital discharge. Using a questionnaire developed through a protocol-driven 3-step process, participants reported on whether they had experienced each of 74 issues and concerns in the past 4 weeks, and the associated level of distress. They also provided sociodemographic and medical information. Regression analyses were used to identify risk factors for elevated distress. Results: Across the 74 issues and concerns, prevalence ratings ranged from a high of 66% to a low of 6%. The most commonly endorsed items were within the domains of dealing with symptoms, fear of the future, negative affect, and social isolation. Common experiences were “being physically restricted” (66%), “lacking energy” (60%), “being short of breath” (60%), “thinking I will never be the same again” (57%), and “not sleeping well” (51%). While less prevalent, “not having access to the health care I need,” “being concerned about my capacity for sexual activity,” and “being unsupported by family and friends” were reported as highly distressing (74, 64, and 62%) for those experiencing these issues. Having a mental health history and current financial strain were key risk factors for elevated distress. Conclusion and Implications: Specific experiences of distress appear to be highly prevalent in people who have had a recent cardiac event. Understanding these specific fears, worries and stressors has important implications for the identification and management of post-event mental health and, in turn, for supporting patients in their post-event cardiac recovery. Copyright © 2022 Jackson, Rogerson, Amerena, Smith, Hoover, Alvarenga, Higgins, Grande, Ski, Thompson and Murphy.
Emerging approaches to the treatment of depression in patients with cardiovascular disease
- Authors: Alvarenga, Marlies , Murphy, Barbara , Jackson, Alun
- Date: 2021
- Type: Text , Journal article
- Relation: British Journal of Cardiac Nursing Vol. 16, no. 9 (2021), p. 1-4
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- Description: The authors discuss transcranial magnetic stimulation as a possible treatment for patients with cardiovascular disease and treatment-resistant depression.
Enhancing the appeal of cardiac rehabilitation for women: development and pilot testing of a women-only yoga cardiac rehabilitation programme
- Authors: Murphy, Barbara , Zaman, Sarah , Tucker, Kim , Alvarenga, Marlies , Morrison-Jack, Jenni , Higgins, Rosemary , Le Grande, Michael , Nasis, Arthur , Jackson, Alun
- Date: 2021
- Type: Text , Journal article
- Relation: European Journal Cardiovascular Nursing Vol. 20, no. 7 (2021), p. 633-640
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- Description: Despite its demonstrated benefits, cardiac rehabilitation (CR) attendance, and completion is suboptimal, particularly in women. The aims of this study were (i) to develop and pilot test a women-only yoga-based CR programme (the Women's Yoga CR Programme WYCRP) (ii) to investigate programme acceptability and (iii) to investigate attendance and completion of the WYCRP and continuation to Phase III community-based CR. Women eligible for CR at a tertiary hospital in Melbourne, Australia were recruited. Over a 6-month period in 2019, they were offered the WYCRP or usual CR. The WYCRP involved attendance at a 1-h yoga session following the usual 1-h mixed-sex education session, over a 7-week period. Participants completed pre- and post-programme questionnaires and attended focus groups to assess programme acceptability. Rates of attendance, completion, and continuation for the WYCRP were recorded and compared to those for the standard CR programme offered in 2018. In total, 27 women were eligible for the study and attended the initial CR assessment. Of those, 22 (81%) attended the WYCRP, 1 (4%) attended usual CR, and 4 (15%) did not attend CR. Ratings of programme acceptability were consistently positive qualitative comments highlighted both physical and emotional benefits. While attendance at the WYCRP was not significantly higher than for usual CR the previous year (81% vs. 76% P = 0.40), CR completion, and continuation were (95% vs. 56% P = 0.02, and 72% vs. 12% P < 0.001, respectively). This pilot study has demonstrated that women-only yoga-based CR is appealing to women and can improve women's CR completion and continuation. These preliminary findings support further development of women-only and yoga-based CR options.
The adrenal medulla in cardiovascular medicine: an untold story
- Authors: Esler, Murray , Jennings, Garry , Schlaich, Markus , Lambert, Gavin , Thompson, Jane , Lambert, Elisabeth , Guo, Ling , Alvarenga, Marlies , Esler, Danielle , Eikelis, Nina , Kaye, David
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of Hypertension Vol. 39, no. 5 (2021), p. 819-829
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- Description: Unlike noradrenaline, the sympathetic neurotransmitter which overflows to the circulation, adrenaline (ADR) is a secreted hormone, with a low plasma concentration, and plasma concentration for biological action a log order lower than that of noradrenaline. The venous drainage of the left adrenal medulla into the left renal vein does expose this vein to uniquely high plasma ADR concentrations and possible risk of thrombosis at high rates of ADR secretion. There is typically a different timeframe for adrenal medullary and sympathetic nervous system responsesADR release is short term in contrast with sympathetic activation persisting for years in heart failure and hypertension. The historic view of Walter Cannon, subject to recent review, that the sympathoadrenal system is a unified biological system, was deconstructed further with demonstration of frequent mismatching of adrenal medullary and sympathetic nervous responses. Under gravity stimulation with standing, there is prompt sympathetic activation without ADR release. In many diseases, notably obesity, hypertension, heart failure and depressive illness, an activated sympathetic nervous system and silent adrenal medulla coexist. The therapeutic corollary of this is that ADR blockade is much less commonly needed clinically than pharmacological antagonism of the sympathetic nervous system.
Anxiety and Depression After a Cardiac Event: Prevalence and Predictors
- Authors: Murphy, Barbara , Le Grande, Michael , Alvarenga, Marlies , Worcester, Marian , Jackson, Alun
- Date: 2020
- Type: Text , Journal article
- Relation: Frontiers in Psychology Vol. 10, no. (2020), p.
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- Description: Introduction: Patients who are anxious or depressed after an acute cardiac event are at increased risk of a subsequent event and premature death. It is therefore important to identify these patients early in order to initiate supportive or even preventive measures. In the present study, we report on the prevalence of anxiety and depression during the first 12 months after an acute cardiac event, and the patient characteristics predictive of increased anxiety and depression risk in early and late convalescence. Methods: We recruited a sample of 911 patients with acute myocardial infarction (AMI), acute coronary syndrome (ACS), and/or unstable angina (UA), and/or undergoing coronary artery bypass graft surgery (CABGS). Patients completed the Hospital Anxiety and Depression Scale (HADS) close to the time of their event, and again during early (2–4 months post-event) and late (6–12 months post-event) convalescence. Using HADS-A and HADS-D cut-offs of 8+, prevalence rates for anxiety, depression, and comorbid anxiety and depression were determined for each timepoint. Chi-square tests and odds ratios were used to identify baseline patient characteristics associated with increased anxiety and depression risk over 12 months. Results: Anxiety rates were 43, 28, and 27% at the time of the event, early, and late convalescence. Depression rates were 22, 17, and 15%, respectively. Factors consistently associated with increased anxiety and depression risk were history of depression, financial strain, poor self-rated health, low socioeconomic status, younger age (<55 years), and smoking. Obesity, diabetes, and social isolation (living alone or being unpartnered) were identified as important albeit less significant risk factors. Neither sex nor event type were predictive of anxiety or depression. Conclusion: This large patient sample provided the opportunity to identify rates of anxiety and depression during the 12 months after a cardiac event and key patient characteristics for increased risk. These risk factors are easily identifiable at the time of the event, and could be used to guide the targeting of support programs for patients at risk. © Copyright © 2020 Murphy, Le Grande, Alvarenga, Worcester and Jackson.
Mood disorders
- Authors: Wilhelm, Kay , Alvarenga, Marlies
- Date: 2020
- Type: Text , Book chapter
- Relation: Mental health and collaborative community practice : An Australian perspective Chapter 4 p. 628-661
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- Description: Mental Health in Australia is the go-to reference on mental health for students, academics and practitioners. With a new four part structure, the book thoroughly covers the current context of mental health, clinical practice principles, and the assessment and management of mental health disorders. Taking a cross-disciplinary approach, Mental Health in Australia reflects a wide range of opinions and perspectives in the field of mental health care. This approach also allows the text to be used throughout a degree and into professional practice. Authoritative and up-to-date, Mental Health in Australia is the most comprehensive Australian book on mental health on the market.
Protocol for the development and validation of a measure of persistent psychological and emotional distress in cardiac patients : the cardiac distress inventory
- Authors: Jackson, Alun , Rogerson, Michelle , Le Grande, Michael , Thompson, David , Ski, Chantal , Alvarenga, Marlies , Amerena, John , Higgins, Rosemary , Raciti, Michela , Murphy, Barbara
- Date: 2020
- Type: Text , Journal article
- Relation: BMJ Open Vol. 10, no. 6 (2020), p.
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- Description: Introduction Distress is experienced by the majority of cardiac patients, yet no cardiac-specific measure of distress exists. The aim of this project is to develop and validate the Cardiac Distress Inventory (CDI). Using the CDI, health professionals will be able to identify key clusters of psychological, emotional and social concern to address with patients, postcardiac event. Methods and analysis An item pool will be generated through: identification of items by a multidisciplinary group of clinician researchers; review of generic and condition-specific distress measures; focus group testing with cardiac rehabilitation professionals; feedback from patients. The COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) criteria will be used to inform the development of the methodology for determining the CDI's psychometric properties. The item pool will be tested with 400 cardiac patients and responses subjected to exploratory factor analysis, Rasch analysis, construct validity testing and latent class analysis. Receiver operating characteristic analysis will be used to identify the optimal CDI cut-off score for distinguishing whether a person experiences clinically significant distress. Ethics and dissemination Approved by the Monash Health Human Research Ethics Committee (approval number - RES-19-0000631L-559790). The CDI will be made available to clinicians and researchers without charge. The CDI will be translated for use internationally. Study findings will be shared with cardiac patient support groups; academic and medical communities via publications and presentations; in the training of cardiac secondary prevention professionals; and in reports to funders. Authorship for publications will follow the uniform requirements for manuscripts submitted to biomedical journals. © Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
Anxiety and cardiovascular disease: Epidemiology and proposed mechanisms
- Authors: Alvarenga, Marlies , Byrne, Don
- Date: 2016
- Type: Text , Book chapter
- Relation: Handbook of Psychocardiology Chapter 10 p.
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- Description: Anxiety disorders tend to be highly prevalent in heart disease, particularly amongst patients recovering from acute cardiac events. Yet, the role of anxiety in heart disease has not received as much attention in the literature as has depression. Epidemiologic studies indicate that there is an increased risk of sudden death and myocardial infarction in patients experiencing panic anxiety. Pathophysiologic correlates of anxiety appear to contribute to an increased cardiac risk, leading to the appreciation that anxiety disorders might in fact constitute a risk to life as exemplified by the cardiovascular disease link. Explanatory mechanisms of cardiac risk point to a link between anxiety and heart disease being mediated by stress giving way to increased cardiac sensitivity and reactivity. The present chapter reviews the psychobiological link between anxiety and heart disease. It also supports an integrative approach for the analysis of psychogenic heart disease, that cardiac patients can benefit from cardiologists educating them about the influence of psychosocial factors on their cardiac conditions and that further research is required on the development of specific psychologically based therapies which tap into the proposed pathophysiological mechanisms associated with the mind-heart nexus.
Handbook of Psychocardiology
- Authors: Alvarenga, Marlies , Byrne, Don
- Date: 2016
- Type: Text , Book
- Relation: Springer Nature Living Reference
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- Description: This handbook brings togetherthe full weight of contemporary evidence bearing on what is now commonly termed "psycho-cardiology". It focuses on the role of psycho-social factors in the genesis and clinical management of cardiovascular disease (CVD). The book constitutes a critically reviewed compendium of current knowledge in the area, coupled with guides to evidence-based best practice in the field of psycho-cardiology. The following categories are covered:Social/demographic risk for CVD, Personality and CVD risk, Stress and CVD risk, Psychopathology (particularly affective disorders) and CVD risk, The psychological management of those with clinical CVD, Psychology in the prevention of CVD. The book integrates the evidence into a compelling argument that clinicians, researchers and those in public health will discount the role of psychological factors in regard to CVD at their own peril. And importantly for clinicians charged with the care of patients with CVD, the bookposes the argument that failure to recognize the links between psychological factors and CVD may well be at the considerable peril of those patients under their care.
An analysis of autonomic nervous system fuctioning in panic disorder and its relation to negative affect / Marles E. Alvarenga
- Authors: Alvarenga, Marlies
- Date: 2002
- Type: Text , Thesis , PhD
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- Description: "The present studies investigated the issue of potential explanatory mechanisms for the observed association between panic disorder (PD) and the development of cardiovascular disease (CVD). Specifically, this research aimed to elucidate more clearly the contribution of psychological variables. physical processes and social relations to the onset of cardiopathology."
- Description: Doctor of Clinical Psychology
Extension and replication of an internet-based treatment program for panic disorder
- Authors: Richards, Jeffrey , Alvarenga, Marlies
- Date: 2002
- Type: Text , Journal article
- Relation: Cognitive Behaviour Therapy Vol. 31, no. 1 (2002), p. 41-47
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- Description: This study describes an internet-based intervention for people with panic disorder that consisted of a 5-module program. Participants accessed the program for 5-8 weeks and were then re-assessed 3 months later. Use of the program was associated with reductions in severity of panic disorder and in catastrophic misinterpretation of ambiguous panic body sensations in 9 people with this anxiety disorder. There were also non-significant trends for body vigilance to decrease over the course of the study. Further investigations of the efficacy of this medium for the treatment of panic disorder and the associated mechanisms of change are warranted.
- Description: 2003000077
Interpretation of ambiguous interoceptive stimuli in panic disorder and nonclinical panic
- Authors: Richards, Jeffrey , Austin, David , Alvarenga, Marlies
- Date: 2001
- Type: Text , Journal article
- Relation: Cognitive Therapy and Research Vol. 25, no. 3 (2001), p. 235-246
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- Description: Cognitive bias in the misinterpretation of ambiguous interoceptive stimuli has been demonstrated in panic disorder. This study investigated whether this cognitive bias also occurs in people with nonclinical panic who are at risk of developing panic disorder. The responses of 25 people with nonclinical panic were compared to those of 20 people with panic disorder and 69 nonpanic controls on a measure of interpretive bias, the Brief Body Sensations Interpretation Questionnaire. There was evidence for interpretive cognitive bias for ambiguous interoceptive stimuli among the nonclinical panickers which did not differ from that of the people with panic disorder, but which differed from the nonpanic controls. High anxiety sensitivity predicted interpretive bias toward both interoceptive and external stimuli. Results therefore suggest that interpretive cognitive bias for ambiguous interoceptive stimuli may be a risk factor for the development of panic disorder.
Serum lipids and their relationships with angry affect and behaviours in men
- Authors: Richards, Jeffrey , Hof, Alexandra , Alvarenga, Marlies
- Date: 2001
- Type: Text , Journal article
- Relation: Australian Journal of Psychology Vol. 53, no. (2001), p. 171-171
- Full Text: false
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