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
- Full Text: false
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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.
Risk factors for paternal perinatal depression and anxiety: A systematic review and meta-analysis
- Authors: Chhabra, Jasleen , McDermott, Brett , Li, Wendy
- Date: 2020
- Type: Text , Journal article
- Relation: Psychology of men & masculinity Vol. 21, no. 4 (2020), p. 593-611
- Full Text: false
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- Description: This article aims to identify the risk factors associated with paternal perinatal depression and anxiety. Studies published between January 1950 and December 2017 that report paternal depression and anxiety in the perinatal period were obtained from 5 different databases. In total, 84 studies were included in the systematic review, and 31,310 participants from 45 studies were included in the final meta-analysis. Risk factors obtained were classified based on the frequency of distribution of factors. Maternal depression is an important risk factor for fathers in the postnatal period (odds ratio [OR] = 3.34, 95% confidence interval [CI 2.51, 4.46]). Marital distress was also linked to a twofold increase in the likelihood of paternal depression in the postnatal period (OR = 2.16, 95% CI [1.47, 3.19]). Parenting stress as a risk factor was strongly and significantly associated with paternal anxiety in perinatal period (OR = 14.38, 95% CI [7.39, 27.97]). The findings suggest that maternal depression, marital distress, and parental stress are important risk factors for fathers' mental health in the perinatal period. The current meta-analysis also identifies gender role stress, domestic violence, and mismatched expectancies from pregnancy and childbirth as the risk factors that are unique to fathers only in the perinatal period. Future intervention programs should screen and target fathers with no previous children, or a depressed partner, and aim to enhance relationship satisfaction. Public Significance Statement Like women, men also show signs and symptoms of depression and anxiety in the perinatal period. Meta-analysis revealed that partner's depression, marital distress, and parenting stress are significant risk factors to fathers' mental health in perinatal period. Counteracting these risk factors may reduce the risk of depression and anxiety in fathers in the perinatal period.
The effectiveness of massage for reducing pregnant women's anxiety and depression; systematic review and meta-analysis
- Authors: Hall, Helen , Cant, Robyn , Munk, Niki , Carr, Bethany , Tremayne, Anne , Weller, Carolina , Fogarty, Sarah , Lauche, Romy
- Date: 2020
- Type: Text , Journal article , Review
- Relation: Midwifery Vol. 90, no. (2020), p.
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- Description: Objective: To critically appraise and synthesize the best available evidence on the effectiveness of massage to reduce antenatal women's anxiety and/ or depression. Design: Systematic review with meta-analysis Participants, interventions: Pregnant women over the age of 18 years who receive massage interventions. Measurements and findings: Eight studies were included in the review; seven were randomized controlled trials. Data were collected via pregnant women's self-reported ratings of anxiety or depression using validated tools. Meta-analysis of four studies revealed a moderate effect of massage therapy on women's depressive symptoms as measured by the Center for Epidemiologic Studies Depression Scale (CES-D) (MD = -5.95, 95%CI = -8.11 to -3.80, I2 = 0%) compared with usual care. A moderate effect of massage interventions on women's anxiety were also found based on five studies using various measures (SMD = -0.59, 95%CI = -1.06 to -0.12, I2 = 75%) when compared with usual care. However, none of the trials had a low risk of bias. Key conclusions: Non-pharmacologic treatments for mental health symptoms are an important option for women to use during pregnancy. As shown in meta-analysed data, massage therapy might be more effective in reducing pregnant women's anxiety and depression than usual care, although the current results may be prone to bias. Further high-quality research is required to fully evaluate the impact of massage therapy on pregnant women's mental health symptoms in the immediate and also longer term. Implications for practice: Massage therapy may be an acceptable and feasible approach for pregnant women to employ to reduce their anxiety and depressive symptoms. More research evidence examining the safety and effectiveness of massage is required before practice recommendations can be made. © 2020 Elsevier Ltd
Depression, anxiety and stress among Australian nursing and midwifery undergraduate students during the COVID-19 pandemic : A cross-sectional study
- Authors: Wynter, Karen , Redley, Bernice , Holton, Sara , Manias, Elizabeth , McDonall, Jo , McTier, Lauren , Hutchinson, Alison , Kerr, Debra , Lowe, Grainne , Phillips, Nicole , Rasmussen, Bodil
- Date: 2021
- Type: Text , Journal article
- Relation: International Journal of Nursing Education Scholarship Vol. 18, no. 1 (2021), p.
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- Description: Objectives: To assess depression, anxiety and stress among undergraduate nursing and midwifery students during the COVID-19 pandemic, and identify socio-demographic and educational characteristics associated with higher depression, anxiety and stress scores. Methods: Cross-sectional study during August-September 2020, using an anonymous, online, self-administered survey. E-mail invitations with a survey link were sent to 2,907 students enrolled in the Bachelor of Nursing suite of courses, offered across four campuses of a single university in Victoria, Australia. Depression, anxiety and stress were assessed using the DASS-21. Data on socio-demographic and educational characteristics, self-rated physical health and exposure to COVID-19 were also collected. DASS-21 subscale scores were compared with existing data for various pre-pandemic and COVID-19 samples. Multiple regression was used to investigate factors associated with higher scores on depression, anxiety and stress subscales. Results: The response rate was 22% (n=638). Mean scores on all DASS-21 subscales were significantly higher (p<0.001) than means from all comparative sample data. The proportions of students reporting moderate to severe symptoms of depression, anxiety and stress were 48.5%, 37.2% and 40.2% respectively. Being a woman, being younger, having completed more years of study and having poorer self-rated general health were all significantly associated (p<0.05) with higher scores on at least one DASS-21 subscale. Conclusions: Almost half of participants reported at least moderate symptoms of depression; more than a third reported at least moderate symptoms of anxiety or stress. Poor psychological wellbeing can impact students' successful completion of their studies and therefore, has implications for nursing and midwifery workforce recruitment and retention. During and after pandemics, universities should consider screening undergraduate students not only for anxiety and stress, but also for depression. Clear, low-cost referral pathways should be available, should screening indicate that further diagnosis or treatment is required. © 2021 Walter de Gruyter GmbH, Berlin/Boston.
Fetal programming pathway from maternal mental health to infant cortisol functioning: The role of placental 11β-HSD2 mRNA expression
- Authors: Galbally, Megan , Watson, Stuart , Lappas, Martha , de Kloet, E. , van Rossum, Elisabeth , Wyrwoll, Caitlin , Mark, Peter , Lewis, Andrew
- Date: 2021
- Type: Text , Journal article
- Relation: Psychoneuroendocrinology Vol. 127, no. (2021), p. 105197-105197
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- Description: Placental 11β-HSD2 has been a focus of research for understanding potential fetal programming associated with maternal emotional disorders. This study examined the pathway from antenatal mental health via placental 11β-HSD2 mRNA to cortisol regulation in the infant offspring. This study reports on data obtained from 236 participants in the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS). At term, placental tissue was collected within 30 min of birth from 52 participants meeting current criteria for a depressive disorder, and 184 control participants. Depressive disorders were diagnosed using the SCID-IV. In addition, antidepressant use, depressive and anxiety symptoms were measured in early and late pregnancy. Placental 11β-HSD2 mRNA expression was measured using qRT-PCR. Infant salivary cortisol samples were taken at 12 months of age. Women on antidepressant medication and with higher trait anxiety had higher placental 11β-HSD2 expression compared to women not taking medication. Furthermore, the offspring of women taking an antidepressant and who also had a current depressive disorder and high trait anxiety had high cortisol reactivity at 12 months of age and this was mediated through 11β-HSD2 mRNA expression. In contrast, offspring of women not taking antidepressant medication with depressive disorder and high anxiety there was low cortisol reactivity observed. Our findings suggest that the relationship between maternal antenatal depression and anxiety and infant cortisol reactivity is mediated through placental 11β-HSD2 mRNA expression. Furthermore, the direction differed for women taking antidepressants, where infant cortisol reactivity was high whereas when compared to those with unmedicated depression and anxiety, where infant cortisol reactivity was low. •There has been substantial research understanding placental role in fetal programming pathways for maternal mental health.•Placental 11β-HSD2 has one area of focus given the role in cortisol regulation across the placenta.•Placental 11β-HSD2 mRNA expression in this study was found to be lower in those with depression and anxiety.•This study also found that antidepressant use increased placental 11β-HSD2 mRNA expression.•Infant cortisol reactivity was mediated through 11β-HSD2 mRNA expression and this differed by mental health and antidepressants use.
Maternal mental health and partner-delivered massage : a pilot study
- Authors: Hall, Helen , Munk, Niki , Carr, Bethany , Fogarty, Sarah , Cant, Robyn , Holton, Sara , Weller, Carolina , Lauche, Romy
- Date: 2021
- Type: Text , Journal article
- Relation: Women and Birth Vol. 34, no. 3 (2021), p. e237-e247
- Full Text: false
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- Description: Background: Anxiety and depression affects many pregnant women. Massage may be beneficial for supporting mental wellbeing during this time. The aim of this study was to assess the feasibility and acceptability of a partner-delivered relaxation massage program for pregnant women, and its impact on symptoms of antenatal anxiety, stress and depression. Methods: A feasibility randomised controlled trial was conducted to compare partner-delivered relaxation massage (intervention) with self-directed stress management (control). Women attended an initial workshop at 28–32 weeks gestation followed by completion of a self-directed massage or stress management program. Qualitative data about the feasibility and acceptability (primary outcomes) were collected via online participant diaries and post-birth interviews. Anxiety, depression and stress symptoms (secondary outcomes) were assessed using the Depression and Anxiety Stress Scale (DASS-21). Birth outcomes were collected at the post- birth interview. Results: A total of 14 women/partner dyads in the massage group and 13 women in the self-directed stress management group, attended the initial workshops. When interviewed, participants from both groups reported that the programs were feasible and acceptable. Women's mean scores on all subscales of the DASS-21significantly decreased over time in both the intervention and the control group. Conclusion: Pregnant women found the partner-delivered massage program to be feasible and acceptable. Both programs decreased women's symptoms of anxiety, depression and stress with no significant differences identified between the two groups. An adequately powered experimental study with a large representative sample is needed to determine whether partner-delivered relaxation massage reduces pregnant women's symptoms of anxiety, depression and stress. © 2020 Australian College of Midwives
Nurses’ experience of caring for patients with delirium: Systematic review and qualitative evidence synthesis
- Authors: Thomas, Nissy , Coleman, Mardhie , Terry, Daniel
- Date: 2021
- Type: Text , Journal article
- Relation: Nursing Reports Vol. 11, no. 1 (2021), p. 164-174
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- Description: Delirium is an acute deterioration in attention, conscious state, perception, and cognition of a person. While nurses possess the theoretical understanding of the condition, they lack insight into its early recognition and management. This systematic review aims to understand what factors influence nurses as they care for patients with delirium, and to identify best practices to improve overall clinical care. The Qualitative Evidence Synthesis (QES), as a strategy process to identify gaps in research, formulate new models or strategies for care, underpinned the review. In addition to specific inclusion and exclusion criteria, a methodological assessment, data were analysed using QES, as informed by the Joanna Briggs Institute Review process. Ten studies were identified and synthesised to generate four key themes. The themes included (1) nurse's knowledge deficit (2) increased workload and stress (3) safety concerns among nurse when caring for patients with delirium and (4) strategies used when caring for patients with delirium. Overall, the review has highlighted the need for increased delirium education and coping strategies among nurses to effectively care for patients with delirium. This may be augmented through regular education sessions to provide nurses with the confidence and competence to care for the acutely confused person.
Does a disaster worsen anxiety when you are already anxious? Psychological consequences following exposure to a M7.1 earthquake in an outpatient anxiety disorder population
- Authors: Kannis-Dymand, Lee , Colhoun, Helen , Huntley, Monique , Woolcock, Colette , Chambers, Ron , Compte, Dianne Le , Macleod, Juliet , Gilbert, Claire , Statham, Dixie , Jones, Monique , Sullivan, Clare , Alexander, Jane , Love, Steven , Bell, Caroline
- Date: 2022
- Type: Text , Journal article
- Relation: Australasian journal of disaster and trauma studies Vol. 26, no. 1 (2022), p. 3
- Full Text: false
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- Description: Research of clinical patients with a pre-existing psychological disorder involved in a disaster is limited. This study investigated relationships between pre-and post-earthquake psychopathology (i.e., anxiety, depression, and posttraumatic stress), peritraumatic distress, work and social impairment, perceived support post-earthquake, and personality dimensions in an outpatient, anxiety disorder population. Thirty-seven patients with pre-existing anxiety disorders completed standard clinical assessments pre-earthquake. They then completed a second set of questionnaires 3 months after exposure to the 2010 Christchurch, Aotearoa New Zealand, earthquake. Bivariate correlations on the variables determined what relationships were present, and paired samples t-tests assessed differences in pre- and post-earthquake anxiety, depression, and alcohol and drug consumption as well as relationships with peritraumatic distress, posttraumatic stress, and personality variables. Significant relationships were found between pre-earthquake psychopathology, peritraumatic distress, post-earthquake psychopathology, and impairment. Paired samples t-tests demonstrated anxiety and depression scores were significantly lower post-earthquake. However, prior anxiety and depression, as well as peritraumatic distress, were significantly associated with post-earthquake psychopathology, including posttraumatic stress and impaired work and social functioning. There were no differences between pre- and post-event alcohol and drug consumption. The personality dimensions of harm avoidance, self-directedness, and persistence significantly associated with post-disaster anxiety and depression. Promisingly, post-earthquake perceived support was significantly negatively correlated with depression and posttraumatic stress. Keywords: Anxiety, depression, posttraumatic stress, peritraumatic distress, personality temperament, earthquake
Partner delivered relaxation massage to support mild antenatal anxiety; views of participants
- Authors: Hall, Helen , Lauche, Romy , Fogarty, Sarah , Kloester, Joy , Carr, Bethany , Munk, Niki
- Date: 2022
- Type: Text , Journal article
- Relation: Midwifery Vol. 105, no. (2022), p.
- Full Text: false
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- Description: Background: Approximately one-fifth of pregnant women suffer from anxiety and/or depression. These mental health conditions are associated with increased infant and maternal morbidity. Relaxation massage has the potential to improve mental health and may provide a vaulable option for pregnant women. This paper reports on participants’ experiences of partner delivered massage as a technique to manage mild antenatal anxiety. Methods: We conducted a feasibility study with 44 pregnant women who self-assessed as mildly anxious. The women were randomised into massage therapy (14 women/partner dyads) or to an active control group (13 women). 4–6 weeks after the birth of their baby, massage group participants were invited to be interviewed about their experiences; twelve women and four partners agreed. The qualitative data was analysed using reflective thematic analysis. Results: Four themes emerged from the data; Supporting mental health, Connecting, Useful and adaptable and Making it happen. Partner delivered massage was an accessible and practical method to manage mild anxiety for pregnant women in this study. The massage program also provided useful skills for participants to apply in their lives after the birth of their child, which has the potential to continue to support maternal mental health as well as partner connection. Conclusion: Partner delivered massage offers low-cost, accessible option for pregnant women to manage their mild anxiety. These findings have particular relevance in the context of the COVID-19 pandemic, where anecdotal reports indicate that antenatal stress is increasing and women may have limited access to healthcare services. © 2021 Elsevier Ltd
Predictive factors for depression and anxiety in men during the perinatal period: A mixed methods study
- Authors: Chhabra, Jasleen , Li, Wendy , McDermott, Brett
- Date: 2022
- Type: Text , Journal article
- Relation: American Journal of Men's Health Vol. 16, no. 1 (2022), p. 15579883221079489-15579883221079489
- Full Text: false
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- Description: The purpose of this study was to identify the risk factors associated with paternal perinatal mental distress in a sample of Australian men. A mixed-methods design was used. The qualitative component (N = 13) using thematic analysis identified maternal depression, marital distress, masculine gender role stress, unplanned pregnancy, work–family conflict, and sleep disturbance as risk factors for paternal perinatal mental distress. The quantitative component (N = 525) expanded on the qualitative findings and examined the associations between the identified risk factors and mental distress of fathers in the perinatal period measured by Edinburgh postnatal depression scale. Hierarchical multiple regression analysis revealed six significant predictors of paternal perinatal mental distress with masculine gender role stress being the most significant risk factor for paternal perinatal mental distress. The results from this study provide an insight into how masculine gender role may affect the expression and experience of mental distress in fathers within the perinatal period. Implications of research findings are discussed.
The role of internet gaming in the association between anxiety and depression : a preliminary cross-sectional study
- Authors: Stavropoulos, Vasileios , Vassallo, Jeremy , Burleigh, Tyrone , Gomez, Rapson , Colder Carras, Michelle
- Date: 2022
- Type: Text , Journal article
- Relation: Asia-Pacific Psychiatry Vol. 14, no. 2 (2022), p.
- Full Text: false
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- Description: Background: Disordered Internet gaming is thought to be perpetuated by one's need to escape their real-life distress or mental health symptoms, which may in turn generate depressive feelings. Nevertheless, moderate engagement with Internet games has also been suggested to provide relief, thus improving one's mood. This study aspires to clarify the contribution of Internet gaming and gender in the association between anxiety and depression. Methods: A large sample of Internet gamers (N = 964) were recruited online. Disordered Internet gaming was assessed with the Internet Gaming Disorder Scale, 9 Items Short Form (IGD9S-SF). Anxiety and depression symptoms were assessed using the Depression, Anxiety and Stress Scale, 21 items (DASS-21). Results: Regression, moderation and moderated moderation analyses accounting for the effects of gender on the relationship between disordered gaming, anxiety, and depression found a significant effect for anxiety symptoms on depression symptoms and a significant interaction between anxiety and Internet gaming disorder on depression symptoms. Findings support the theory that although anxious gamers bear a higher depression risk, this is buffered with lower and exacerbated with higher disordered gaming symptoms. Conclusion: Findings suggest a dual role of Internet gaming in the association between anxiety and depression, depending on the intensity of one's disordered gaming symptoms. Depression prevention and intervention protocols should be optimized by considering the effects of Internet gaming among anxious gamers by focusing on the intensity of a gamer's involvement and any gaming disorder symptoms. Further research should include clinical samples to better understand this interaction. © 2021 John Wiley & Sons Australia, Ltd.
Students coping with change in higher education : an overview
- Authors: Co, Mary , Hamadeh Kerbage, Samira , Willetts, Georgina , Garvey, Loretta , Bhattacharya, Ananya , Croy, Glen , Mitchell, Bruce
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Educational Research Review Vol. 38, no. (2023), p.
- Full Text: false
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- Description: Higher education institutions implement purposeful change to improve their performance or impose changes in response to their external environments. To deal with these changes, students are expected to develop their coping capacity – the emotional and cognitive ability to manage the demands of adverse situations. Student coping is composed of four interdependent core elements – self-efficacy, engagement, resilience and anxiety. This article synthesizes the evidence on the effect of higher education changes on student's ability to cope. Using Polanin et al.’s (2017) overview process, our search generated 551 articles, and after three rounds of screening, the remaining 12 reviews were analyzed using the narrative descriptive synthesis approach. We found that the quality assessment within the included reviews were inconsistent and, sometimes not clearly defined. From the analysis of the reviews, four key themes emerged: (1) change is complex; (2) the nature of change is varied; (3) there is an interdependent relationship between the coping elements; and (4) the measurement of change is not sophisticated. Our findings highlight the need for higher education institutions to adopt a principle-based approach to purposefully develop students' coping capacity, by improving their self-efficacy, engagement, and resilience, and reducing anxiety. Limitations and future research directions are outlined. © 2023 Elsevier Ltd
Video chat therapist assistance in an adaptive digital intervention for anxiety and depression : reflections from participants and therapists
- Authors: Andrews, Brooke , Klein, Britt , Corboy, Denise , McLaren, Suzanne , Watson, Shaun
- Date: 2023
- Type: Text , Journal article
- Relation: Professional psychology, research and practice Vol. 54, no. 6 (2023), p. 418-429
- Full Text: false
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- Description: The purpose of this article is to qualitatively explore participant and therapist experiences of the therapeutic alliance, perceived benefits, challenges, and areas for improvement when using video chat as a mode of therapist assistance within an adaptive digital mental health intervention. In total, 74 semistructured interviews were completed with participants and therapists who participated in an adaptive clinical trial. The participant interviews explored experiences of attending a clinical assessment via video chat and experiences of receiving low- or high-intensity therapist assistance via video chat. Interviews completed with therapists explored their experience of administrating a clinical assessment tool and delivering therapist assistance, both via video chat. Reflexive thematic analysis identified four themes: using video chat, characteristics of therapeutic relationships, task-specific experiences, and utility and adoption of video chat. Both participants and therapists were able to adapt to the modality of video chat and develop positive therapeutic alliances. They reported satisfaction with video chat for conducting clinical assessments and delivering therapist assistance. Concerns were identified by both participants and therapists with low-intensity therapist assistance. This study identified elements of task-specific experiences and human characteristics as more influential in participant and therapist experience than the modality of video chat technology. Implications for assessing suitability for the modality of video chat and low- and high-intensity models of therapist assistance are discussed. (PsycInfo Database Record (c) 2023 APA, all rights reserved) (Source: journal abstract)