Social relationships as predictors of depression and suicidal ideation in older adults
- Vanderhorst, Renee, McLaren, Suzanne
- Authors: Vanderhorst, Renee , McLaren, Suzanne
- Date: 2005
- Type: Text , Journal article
- Relation: Aging and Mental Health Vol. 9, no. 6 (2005), p. 517-525
- Full Text: false
- Reviewed:
- Description: The prevalence of depression and suicidal ideation among older adults is considered to be a major mental health concern among this age group. The present study investigated the human relatedness variables of marital status, social support resources and sense of belonging as predictors of depression and suicidal ideation in older adults. A community sample of 110 older adults (M age 76.67 years, SD = 8.11) completed the Social Support Subscale of the Coping Resources Inventory, the Sense of Belonging Instrument, the Zung Depression Inventory and the Suicide Subscale of the General Health Questionnaire. Results indicated that fewer social support resources were associated with higher levels of depression and suicidal ideation. Sense of belonging to the community was not an additional predictor of mental health. The results of the present study suggest that enhancing social support resources in older adults could reduce depression and suicidal ideation. © 2005 Taylor & Francis.
- Description: C1
- Description: 2003001227
The relationship between internalised homophobia, sense of belonging to specific communities and depressive symptoms among self-identified gay men
- Authors: Davidson, Kenneth
- Date: 2011
- Type: Text , Thesis , PhD
- Full Text:
- Description: This study explored depressive symptoms among gay men. Gay men who internalised anti-gay attitudes experienced more depressive symptoms, where as gay men who reported a sense of belonging to gay friends and the general community reported fewer depressive symptoms.
- Description: Doctor of Psychology (Clinical)
- Authors: Davidson, Kenneth
- Date: 2011
- Type: Text , Thesis , PhD
- Full Text:
- Description: This study explored depressive symptoms among gay men. Gay men who internalised anti-gay attitudes experienced more depressive symptoms, where as gay men who reported a sense of belonging to gay friends and the general community reported fewer depressive symptoms.
- Description: Doctor of Psychology (Clinical)
Emotional functioning in children and adolescents with elevated depressive symptoms
- Hughes, Elizabeth, Gullone, Eleonora, Watson, Shaun
- Authors: Hughes, Elizabeth , Gullone, Eleonora , Watson, Shaun
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Psychopathology and Behavioral Assessment Vol. 33, no. 3 (2011), p. 335-345
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- Description: Difficulties with emotion and its regulation are of central importance to the etiology and course of depression. The current study investigated these constructs in relation to childhood and adolescence by comparing the emotional functioning of 170 9- to 15-year-olds reporting high levels of depressive symptoms (HD) to a matched sample of 170 children and adolescents reporting low levels of depressive symptoms (LD). Compared to LD, HD participants reported significantly greater shame proneness, poorer functioning on emotion regulation competencies (emotional control, self-awareness and situational responsiveness), less healthy emotion regulation strategy use (less reappraisal and greater suppression), and lower levels of guilt proneness. Empathic concern did not differ between the two groups. The findings enhance current knowledge by providing a more comprehensive profile of the emotional difficulties experienced by children and adolescents with elevated depressive symptoms. © 2011 Springer Science+Business Media, LLC.
- Authors: Hughes, Elizabeth , Gullone, Eleonora , Watson, Shaun
- Date: 2011
- Type: Text , Journal article
- Relation: Journal of Psychopathology and Behavioral Assessment Vol. 33, no. 3 (2011), p. 335-345
- Full Text:
- Reviewed:
- Description: Difficulties with emotion and its regulation are of central importance to the etiology and course of depression. The current study investigated these constructs in relation to childhood and adolescence by comparing the emotional functioning of 170 9- to 15-year-olds reporting high levels of depressive symptoms (HD) to a matched sample of 170 children and adolescents reporting low levels of depressive symptoms (LD). Compared to LD, HD participants reported significantly greater shame proneness, poorer functioning on emotion regulation competencies (emotional control, self-awareness and situational responsiveness), less healthy emotion regulation strategy use (less reappraisal and greater suppression), and lower levels of guilt proneness. Empathic concern did not differ between the two groups. The findings enhance current knowledge by providing a more comprehensive profile of the emotional difficulties experienced by children and adolescents with elevated depressive symptoms. © 2011 Springer Science+Business Media, LLC.
A psychological pathway from insomnia to depression among older adults
- Sadler, Paul, McLaren, Suzanne, Jenkins, Megan
- Authors: Sadler, Paul , McLaren, Suzanne , Jenkins, Megan
- Date: 2013
- Type: Text , Journal article
- Relation: International Psychogeriatrics Vol. 25, no. 8 (2013), p. 1375-1383
- Full Text: false
- Reviewed:
- 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
The Relationships Between Sense of Belonging to the Gay Community, Body Image Dissatisfaction, and Self-Esteem Among Australian Gay Men
- Kousari-Rad, Pantea, McLaren, Suzanne
- Authors: Kousari-Rad, Pantea , McLaren, Suzanne
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Homosexuality Vol. 60, no. 6 (2013), p. 927-943
- Full Text:
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- Description: Body image dissatisfaction has been linked to belonging to the gay community and poor self-esteem among gay men. This study was designed to explore the applicability of a moderation model and a mediation model in explaining the relations between sense of belonging to the gay community, body image dissatisfaction and self-esteem among 90 self-identified Australian gay men. Participants completed the psychological subscale of the Sense of Belonging Instrument, the Body Satisfaction Scale, and the Rosenberg Self-Esteem Scale. Results supported the moderation model; the relation between body image dissatisfaction and self-esteem was found to be statistically significant only at average and high levels of belonging to the gay community. The mediation model was also supported; body image dissatisfaction partially mediated the sense of belonging-self-esteem relation. Educating gay men and health professionals about the possible negative outcomes of "belonging" to an appearance-oriented community is important. © 2013 Copyright Taylor and Francis Group, LLC.
- Description: 2003011102
- Authors: Kousari-Rad, Pantea , McLaren, Suzanne
- Date: 2013
- Type: Text , Journal article
- Relation: Journal of Homosexuality Vol. 60, no. 6 (2013), p. 927-943
- Full Text:
- Reviewed:
- Description: Body image dissatisfaction has been linked to belonging to the gay community and poor self-esteem among gay men. This study was designed to explore the applicability of a moderation model and a mediation model in explaining the relations between sense of belonging to the gay community, body image dissatisfaction and self-esteem among 90 self-identified Australian gay men. Participants completed the psychological subscale of the Sense of Belonging Instrument, the Body Satisfaction Scale, and the Rosenberg Self-Esteem Scale. Results supported the moderation model; the relation between body image dissatisfaction and self-esteem was found to be statistically significant only at average and high levels of belonging to the gay community. The mediation model was also supported; body image dissatisfaction partially mediated the sense of belonging-self-esteem relation. Educating gay men and health professionals about the possible negative outcomes of "belonging" to an appearance-oriented community is important. © 2013 Copyright Taylor and Francis Group, LLC.
- Description: 2003011102
- Hadjistavropoulos, Heather, Pugh, Nicole, Nugent, Marcie, Hesser, Hugo, Andersson, Gerhard, Ivanov, Max, Butz, Cory, Marchildon, Gregory, Asmundson, Gordon, Klein, Britt, Austin, David
- Authors: Hadjistavropoulos, Heather , Pugh, Nicole , Nugent, Marcie , Hesser, Hugo , Andersson, Gerhard , Ivanov, Max , Butz, Cory , Marchildon, Gregory , Asmundson, Gordon , Klein, Britt , Austin, David
- Date: 2015
- Type: Text , Journal article
- Relation: Journal of Anxiety Disorders Vol. 28, no. 8 (2015), p. 884-893
- Full Text: false
- Reviewed:
- Description: This dissemination study examined the effectiveness of therapist-assisted Internet-delivered Cognitive Behavior Therapy (ICBT) when offered in clinical practice. A centralized unit screened and coordinated ICBT delivered by newly trained therapists working in six geographically dispersed clinical settings. Using an open trial design, 221 patients were offered 12 modules of ICBT for symptoms of generalized anxiety (. n=. 112), depression (. n=. 83), or panic (. n=. 26). At baseline, midpoint and post-treatment, patients completed self-report measures. On average, patients completed 8 of 12 modules. Latent growth curve modeling identified significant reductions in depression, anxiety, stress and impairment (. d=. .65-.78), and improvements in quality of life (. d=. .48-.66). Improvements in primary symptoms were large (. d=. .91-1.25). Overall, therapist-assisted ICBT was effective when coordinated across settings in clinical practice, but further attention should be given to strategies to improve completion of treatment modules.
- Titov, Nickolai, Dear, Blake, Ali, Shehzad, Zou, Judy, Lorian, Carolyn, Johnston, Luke, Terides, Matthew, Kayrouz, Rony, Klein, Britt, Gandy, Milena, Fogliati, Vincent
- Authors: Titov, Nickolai , Dear, Blake , Ali, Shehzad , Zou, Judy , Lorian, Carolyn , Johnston, Luke , Terides, Matthew , Kayrouz, Rony , Klein, Britt , Gandy, Milena , Fogliati, Vincent
- Date: 2015
- Type: Text , Journal article
- Relation: Behavior Therapy Vol. 46, no. 2 (2015), p. 193-205
- Full Text: false
- Reviewed:
- Description: Depression is a common and significant health problem among older adults. Unfortunately, while effective psychological treatments exist, few older adults access treatment. The aim of the present randomized controlled trial (RCT) was to examine the efficacy, long-term outcomes, and cost-effectiveness of a therapist-guided internet-delivered cognitive behavior therapy (iCBT) intervention for Australian adults over 60. years of age with symptoms of depression. Participants were randomly allocated to either a treatment group (n= 29) or a delayed-treatment waitlist control group (n=. 25). Twenty-seven treatment group participants started the iCBT treatment and 70% completed the treatment within the 8-week course, with 85% of participants providing data at posttreatment. Treatment comprised an online 5-lesson iCBT course with brief weekly contact with a clinical psychologist, delivered over 8. weeks. The primary outcome measure was the Patient Health Questionnaire-9 Item (PHQ-9), a measure of symptoms and severity of depression. Significantly lower scores on the PHQ-9 (Cohen's d=. 2.08; 95% CI: 1.38 - 2.72) and on a measure of anxiety (Generalized Anxiety Disorder-7 Item) (Cohen's d=. 1.22; 95% CI: 0.61 - 1.79) were observed in the treatment group compared to the control group at posttreatment. The treatment group maintained these lower scores at the 3-month and 12-month follow-up time points and the iCBT treatment was rated as acceptable by participants. The treatment group had slightly higher Quality-Adjusted Life-Years (QALYs) than the control group at posttreatment (estimate: 0.012; 95% CI: 0.004 to 0.020) and, while being a higher cost (estimate $52.9. l 95% CI: -. 23.8 to 128.2), the intervention was cost-effective according to commonly used willingness-to-pay thresholds in Australia. The results support the potential efficacy and cost-effectiveness of therapist-guided iCBT as a treatment for older adults with symptoms of depression. © 2014 Association for Behavioral and Cognitive Therapies.
A Case study illustrating therapist-assisted internet cognitive behavior therapy for depression
- Pugh, Nicole, Hadjistavropoulos, Heather, Klein, Britt, Austin, David
- Authors: Pugh, Nicole , Hadjistavropoulos, Heather , Klein, Britt , Austin, David
- Date: 2014
- Type: Text , Journal article
- Relation: Cognitive and Behavioral Practice Vol. 21, no. 1 (2014), p. 64-77
- Full Text: false
- Reviewed:
- Description: Randomized controlled trials show that therapist-assisted Internet cognitive behavior therapy (ICBT) is efficacious in the treatment of depression. Given that this is a novel way of delivering cognitive behavior therapy, however, clinical service providers may have questions about how to provide therapist-assisted ICBT in clinical practice, particularly with respect to therapist assistance. To exemplify this approach, we present a case study of an older adult male who received 12 modules of therapist-assisted ICBT for depression over the course of 5. months. Highlights of the therapeutic exchanges that occurred over email are provided to illustrate the type of information clients may share with therapists and the nature of therapist assistance. Treatment progress was assessed via self-report questionnaires measuring depression, anxiety, and adjustment. Consistent with the research evidence, significant improvement was observed on all symptom measures at posttreatment. Satisfaction with the therapist-assisted ICBT program and a strong therapeutic alliance was also reported. The case will expand clinician understanding of therapist-assisted ICBT and may serve to stimulate clinician interest in the provision of therapist-assisted ICBT. Future research directions stemming from this case are presented. © 2013.
Psychometric properties of the center for epidemiological studies-depression scale (CES-D) - Greek Version
- Moore, Kathleen, Alexi, Nektarios, Argyrides, Marios
- Authors: Moore, Kathleen , Alexi, Nektarios , Argyrides, Marios
- Date: 2016
- Type: Text , Journal article
- Relation: Hellenic Journal of Psychology Vol. 13, no. 1 (2016), p. 74-87
- Full Text:
- Reviewed:
- Description: A Greek translation of the Center for Epidemiological Studies-Depression Scale (CES-D) was examined in a sample of 221 Greek-Cypriots (M age 24.82 years). Results provide partial support for Radloff's original factor structure, the factors' internal reliability and independence, and the comparability of total scalemeans to the scale's normative data.Women scored higher on the total scale scores thanmen and also higher on the depressed, interpersonal and somatic factors, but not the positive factor, than men. The incidence of depression using Radloff's cut-point of 16 was lower in this Greek-Cypriot sample but aligned with Kessler's (2003) estimate of the incidence of depression in the general community.
- Authors: Moore, Kathleen , Alexi, Nektarios , Argyrides, Marios
- Date: 2016
- Type: Text , Journal article
- Relation: Hellenic Journal of Psychology Vol. 13, no. 1 (2016), p. 74-87
- Full Text:
- Reviewed:
- Description: A Greek translation of the Center for Epidemiological Studies-Depression Scale (CES-D) was examined in a sample of 221 Greek-Cypriots (M age 24.82 years). Results provide partial support for Radloff's original factor structure, the factors' internal reliability and independence, and the comparability of total scalemeans to the scale's normative data.Women scored higher on the total scale scores thanmen and also higher on the depressed, interpersonal and somatic factors, but not the positive factor, than men. The incidence of depression using Radloff's cut-point of 16 was lower in this Greek-Cypriot sample but aligned with Kessler's (2003) estimate of the incidence of depression in the general community.
The effects of playing Nintendo Wii on depression, sense of belonging and social support in Australian aged care residents : a protocol study of a mixed methods intervention trial
- Chesler, Jessica, McLaren, Suzanne, Klein, Britt, Watson, Shaun
- Authors: Chesler, Jessica , McLaren, Suzanne , Klein, Britt , Watson, Shaun
- Date: 2015
- Type: Text , Journal article
- Relation: BMC Geriatrics Vol. 15, no. 1 (2015), p. 1-8
- Full Text:
- Reviewed:
- Description: Background: The proportion of people aged 65 or older is the fastest growing age group worldwide. Older adults in aged care facilities have higher levels of depression, and lower levels of social support and sense of belonging compared with older adults living in the community. Research has begun to assess the effectiveness of interventions to improve the mental health of residents and has found both cognitive and physical benefits of video game playing. The benefits of playing these games in a group may also lead to greater social interaction and decreased loneliness. The current study aims to investigate an intervention program designed to foster relationships among older adults in care based on shared interests. Residents will be assessed on the effectiveness of a 6 week program of playing Wii bowling in comparison to a control group. Method/Design: Participants will be allocated to the intervention (Wii bowling) or the control group based on their place of residence. Participants in the intervention group will be invited to participate in Wii bowling twice weekly, with up to three other residents for a period of 6 weeks. Residents in both conditions will be assessed for depression, social support, sense of belonging, and current self-rated mood at pre-intervention (0 weeks), post-intervention (6 weeks), and at 2-month follow up (14 weeks). Qualitative data on social interaction between group members will also be collected at weeks 1, 3, and 6. Both groups will receive a Wii console after week 6 to establish if residents and staff engage with the Wii without intervention. Discussion: The Wii provides a user friendly platform for older adults to use video games, and it incorporates both social and competitive aspects in the game play. Existing research has not extensively investigated the social aspects of using this type of technology with older adults. If found to be effective, incorporating Wii games into an activity schedule may benefit the mental health of older adults living in care by establishing an intervention that is fun, economical, and easy to use. Trial Registry: Australian New Zealand Clinical Trials Registry: ACTRN12614000445673. © 2015 Chesler et al.
- Authors: Chesler, Jessica , McLaren, Suzanne , Klein, Britt , Watson, Shaun
- Date: 2015
- Type: Text , Journal article
- Relation: BMC Geriatrics Vol. 15, no. 1 (2015), p. 1-8
- Full Text:
- Reviewed:
- Description: Background: The proportion of people aged 65 or older is the fastest growing age group worldwide. Older adults in aged care facilities have higher levels of depression, and lower levels of social support and sense of belonging compared with older adults living in the community. Research has begun to assess the effectiveness of interventions to improve the mental health of residents and has found both cognitive and physical benefits of video game playing. The benefits of playing these games in a group may also lead to greater social interaction and decreased loneliness. The current study aims to investigate an intervention program designed to foster relationships among older adults in care based on shared interests. Residents will be assessed on the effectiveness of a 6 week program of playing Wii bowling in comparison to a control group. Method/Design: Participants will be allocated to the intervention (Wii bowling) or the control group based on their place of residence. Participants in the intervention group will be invited to participate in Wii bowling twice weekly, with up to three other residents for a period of 6 weeks. Residents in both conditions will be assessed for depression, social support, sense of belonging, and current self-rated mood at pre-intervention (0 weeks), post-intervention (6 weeks), and at 2-month follow up (14 weeks). Qualitative data on social interaction between group members will also be collected at weeks 1, 3, and 6. Both groups will receive a Wii console after week 6 to establish if residents and staff engage with the Wii without intervention. Discussion: The Wii provides a user friendly platform for older adults to use video games, and it incorporates both social and competitive aspects in the game play. Existing research has not extensively investigated the social aspects of using this type of technology with older adults. If found to be effective, incorporating Wii games into an activity schedule may benefit the mental health of older adults living in care by establishing an intervention that is fun, economical, and easy to use. Trial Registry: Australian New Zealand Clinical Trials Registry: ACTRN12614000445673. © 2015 Chesler et al.
Cognitive behaviour therapy for older adults experiencing insomnia and depression in a community mental health setting: Study protocol for a randomised controlled trial
- Sadler, Paul, McLaren, Suzanne, Klein, Britt, Jenkins, Megan, Harvey, Jack
- Authors: Sadler, Paul , McLaren, Suzanne , Klein, Britt , Jenkins, Megan , Harvey, Jack
- Date: 2015
- Type: Text , Journal article
- Relation: Trials Vol. 16, no. 1 (2015), p.1-12
- Full Text:
- Reviewed:
- Description: Background: Cognitive behaviour therapy for insomnia (CBT-I) is a well-established treatment; however, the evidence is largely limited to homogenous samples. Although emerging research has indicated that CBT-I is also effective for comorbid insomnia, CBT-I has not been tested among a complex sample of older adults with comorbid insomnia and depression. Furthermore, no study has explored whether modifying CBT-I to target associated depressive symptoms could potentially enhance sleep and mood outcomes. Therefore, this study aims to report a protocol designed to test whether an advanced form of CBT for insomnia and depression (CBT-I-D) is more effective at reducing insomnia and depressive symptoms compared to a standard CBT-I and psychoeducation control group (PCG) for older adults in a community mental health setting. Methods/Design: We aim to recruit 150 older adults with comorbid insomnia who have presented to community mental health services for depression. Eligible participants will be randomly allocated via block/cluster randomisation to one of three group therapy conditions: CBT-I, CBT-I-D, or PCG. Participants who receive CBT-I will only practice strategies designed to improve their sleep, whereas participants who receive CBT-I-D will practice additional strategies designed to also improve their mood. This trial will implement a mixed-methods design involving quantitative outcome measures and qualitative focus groups. The primary outcome measures are insomnia and depression severity, and secondary outcomes are anxiety, hopelessness, beliefs about sleep, comorbid sleep conditions, and health. Outcomes will be assessed at pre-intervention (week 0), post-intervention (week 8), and 3-month follow-up (week 20). Discussion: This CBT study protocol has been designed to address comorbid insomnia and depression for older adults receiving community mental health services. The proposed trial will determine whether CBT-I is more effective for older adults with comorbid insomnia and depression compared to a PCG. It will also establish whether an advanced form of CBT-I-D generates greater reductions in insomnia and depression severity compared to standard CBT-I. The results from the proposed trial are anticipated to have important clinical implications for older adults, researchers, therapists, and community mental health services. Trial registration: Australian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN: 12615000067572 , Date Registered 12 December 2014. © 2015 Sadler et al.
- Authors: Sadler, Paul , McLaren, Suzanne , Klein, Britt , Jenkins, Megan , Harvey, Jack
- Date: 2015
- Type: Text , Journal article
- Relation: Trials Vol. 16, no. 1 (2015), p.1-12
- Full Text:
- Reviewed:
- Description: Background: Cognitive behaviour therapy for insomnia (CBT-I) is a well-established treatment; however, the evidence is largely limited to homogenous samples. Although emerging research has indicated that CBT-I is also effective for comorbid insomnia, CBT-I has not been tested among a complex sample of older adults with comorbid insomnia and depression. Furthermore, no study has explored whether modifying CBT-I to target associated depressive symptoms could potentially enhance sleep and mood outcomes. Therefore, this study aims to report a protocol designed to test whether an advanced form of CBT for insomnia and depression (CBT-I-D) is more effective at reducing insomnia and depressive symptoms compared to a standard CBT-I and psychoeducation control group (PCG) for older adults in a community mental health setting. Methods/Design: We aim to recruit 150 older adults with comorbid insomnia who have presented to community mental health services for depression. Eligible participants will be randomly allocated via block/cluster randomisation to one of three group therapy conditions: CBT-I, CBT-I-D, or PCG. Participants who receive CBT-I will only practice strategies designed to improve their sleep, whereas participants who receive CBT-I-D will practice additional strategies designed to also improve their mood. This trial will implement a mixed-methods design involving quantitative outcome measures and qualitative focus groups. The primary outcome measures are insomnia and depression severity, and secondary outcomes are anxiety, hopelessness, beliefs about sleep, comorbid sleep conditions, and health. Outcomes will be assessed at pre-intervention (week 0), post-intervention (week 8), and 3-month follow-up (week 20). Discussion: This CBT study protocol has been designed to address comorbid insomnia and depression for older adults receiving community mental health services. The proposed trial will determine whether CBT-I is more effective for older adults with comorbid insomnia and depression compared to a PCG. It will also establish whether an advanced form of CBT-I-D generates greater reductions in insomnia and depression severity compared to standard CBT-I. The results from the proposed trial are anticipated to have important clinical implications for older adults, researchers, therapists, and community mental health services. Trial registration: Australian and New Zealand Clinical Trials Registry (ANZCTR): ACTRN: 12615000067572 , Date Registered 12 December 2014. © 2015 Sadler et al.
- Titov, Nickolai, Dear, Blake, Staples, Lauren, Bennett-Levy, James, Klein, Britt, Rapee, Ronald, Andersson, Gerhard, Purtell, Carol, Bezuidenhout, Greg, Nielssen, Olav
- 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
- Full Text: false
- Reviewed:
- 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.
The effects of playing Nintendo Wii on depression, sense of belonging, social support, and mood among Australian aged care residents : A pilot study
- Authors: Chesler, Jessica
- Date: 2015
- Type: Text , Thesis , Masters
- Full Text:
- Description: Adults aged 65 years or older constitute the fastest growing age group worldwide, leading to greater numbers of people requiring care in residential facilities. Adults in these facilities have higher levels of depression, lower levels of social support, and lower levels of sense of belonging compared with older adults living in the community. Research has begun to assess the effectiveness of interventions aimed at improving the mental health of aged care residents. Within this population, cognitive and physical benefits of playing video games have been documented in the literature, as well as greater social interaction, and decreased loneliness. The aim of the current study was to investigate the effectiveness of playing Wii bowling twice weekly, with up to 3 other residents, for 6 weeks. An Australian sample of 31 women and 8 men between the ages of 65 and 95 years (Mean age = 85.68, SD = 9.62) were randomised to either a treatment or control group based on their place of residence. The residents completed demographic information, The Veterans Affairs Saint Louis University Mental Status Exam, the Geriatric Depression Scale Short Form, the Social Provisions Scale, and three visual analogue scales to measure sense of belonging and mood. These scales were completed pre-intervention (0 weeks), postintervention (6 weeks), and at 2-month follow up (14 weeks). Qualitative data on social interaction between group members was also collected at weeks 1, 3, and 6. Results did not support the use of the Wii to improve residents’ self-reported levels of depression, social support, sense of belonging, or mood. Social interaction increased over the 6 weeks, as measured by interaction analyses and also residents’ comments. Overall, findings indicate that Wii bowling may be a useful intervention as part of a comprehensive care program to increase social interaction within aged care. Pervasive environmental problems associated with aged care, as well as participant characteristics, may have reduced the effectiveness of the intervention program.
- Description: Master of Applied Science by Research (Psychology)
- Authors: Chesler, Jessica
- Date: 2015
- Type: Text , Thesis , Masters
- Full Text:
- Description: Adults aged 65 years or older constitute the fastest growing age group worldwide, leading to greater numbers of people requiring care in residential facilities. Adults in these facilities have higher levels of depression, lower levels of social support, and lower levels of sense of belonging compared with older adults living in the community. Research has begun to assess the effectiveness of interventions aimed at improving the mental health of aged care residents. Within this population, cognitive and physical benefits of playing video games have been documented in the literature, as well as greater social interaction, and decreased loneliness. The aim of the current study was to investigate the effectiveness of playing Wii bowling twice weekly, with up to 3 other residents, for 6 weeks. An Australian sample of 31 women and 8 men between the ages of 65 and 95 years (Mean age = 85.68, SD = 9.62) were randomised to either a treatment or control group based on their place of residence. The residents completed demographic information, The Veterans Affairs Saint Louis University Mental Status Exam, the Geriatric Depression Scale Short Form, the Social Provisions Scale, and three visual analogue scales to measure sense of belonging and mood. These scales were completed pre-intervention (0 weeks), postintervention (6 weeks), and at 2-month follow up (14 weeks). Qualitative data on social interaction between group members was also collected at weeks 1, 3, and 6. Results did not support the use of the Wii to improve residents’ self-reported levels of depression, social support, sense of belonging, or mood. Social interaction increased over the 6 weeks, as measured by interaction analyses and also residents’ comments. Overall, findings indicate that Wii bowling may be a useful intervention as part of a comprehensive care program to increase social interaction within aged care. Pervasive environmental problems associated with aged care, as well as participant characteristics, may have reduced the effectiveness of the intervention program.
- Description: Master of Applied Science by Research (Psychology)
Duration perception versus perception duration : A proposed model for the consciously experienced moment
- Authors: Kent, Lachlan
- Date: 2019
- Type: Text , Journal article
- Relation: Timing and Time Perception Vol. 7, no. 1 (2019), p. 1-14
- Full Text:
- Reviewed:
- Description: Duration perception is not the same as perception duration. Time is an object of perception in its own right and is qualitatively different to exteroceptive or interoceptive perception of concrete objects or sensations originating within the self. In reviewing evidence for and against the experienced moment, White (2017, Psychol. Bull., 143, 735-756) proposed a model of global integration of information dense envelopes of integration. This is a valuable addition to the literature because it supposes that, like Tononi's (2004, BMC Neurosci., 5, 42) Integrated Information Theory, consciousness is an integral step above perception of objects or the self. Consciousness includes the perception of abstract contents such as time, space, and magnitude, as well as post-perceptual contents drawn from memory. The present review takes this logic a step further and sketches a potential neurobiological pathway through the salience, default mode, and central executive networks that culminates in a candidate model of how duration perception and consciousness arises. Global integration is viewed as a process of Bayesian Prediction Error Minimisation according to a model put forward by Hohwy, Paton and Palmer (2016, Phenomenol. Cogn. Sci., 15, 315-335) called 'distrusting the present'. The proposed model also expresses global integration as an intermediate stage between perception and memory that spans an approximate one second duration, an analogue of Wittmann's (2011, Front. Integr. Neurosci., 5, 66) experienced moment.
- Authors: Kent, Lachlan
- Date: 2019
- Type: Text , Journal article
- Relation: Timing and Time Perception Vol. 7, no. 1 (2019), p. 1-14
- Full Text:
- Reviewed:
- Description: Duration perception is not the same as perception duration. Time is an object of perception in its own right and is qualitatively different to exteroceptive or interoceptive perception of concrete objects or sensations originating within the self. In reviewing evidence for and against the experienced moment, White (2017, Psychol. Bull., 143, 735-756) proposed a model of global integration of information dense envelopes of integration. This is a valuable addition to the literature because it supposes that, like Tononi's (2004, BMC Neurosci., 5, 42) Integrated Information Theory, consciousness is an integral step above perception of objects or the self. Consciousness includes the perception of abstract contents such as time, space, and magnitude, as well as post-perceptual contents drawn from memory. The present review takes this logic a step further and sketches a potential neurobiological pathway through the salience, default mode, and central executive networks that culminates in a candidate model of how duration perception and consciousness arises. Global integration is viewed as a process of Bayesian Prediction Error Minimisation according to a model put forward by Hohwy, Paton and Palmer (2016, Phenomenol. Cogn. Sci., 15, 315-335) called 'distrusting the present'. The proposed model also expresses global integration as an intermediate stage between perception and memory that spans an approximate one second duration, an analogue of Wittmann's (2011, Front. Integr. Neurosci., 5, 66) experienced moment.
Exercise, mood, self-efficacy, and social support as predictors of depressive symptoms in older adults : Direct and interaction effects
- Miller, Kyle, Mesagno, Christopher, McLaren, Suzanne, Grace, Fergal, Yates, Mark, Gomez, Rapson
- Authors: Miller, Kyle , Mesagno, Christopher , McLaren, Suzanne , Grace, Fergal , Yates, Mark , Gomez, Rapson
- Date: 2019
- Type: Text , Journal article
- Relation: Frontiers in Psychology Vol. 10, no. (2019), p. 1-11
- Full Text:
- Reviewed:
- Description: Background: Depression is a chronic condition that affects up to 15% of older adults. The healthogenic effects of regular exercise are well established, but it is still unclear which exercise-related variables characterise the antidepressant effects of exercise. Thus, the purpose of this study was to examine the extent to which exercise-related variables (exercise behaviour, exercise-induced mood, exercise self-efficacy, and social support) can predict depressive symptoms in a cohort of community-dwelling older adults. Methods: This study employed a cross-sectional analysis of questionnaire data from a sample of 586 community-dwelling older Australians aged 65 to 96 years old. Participants completed the Center for Epidemiologic Studies Depression Scale, modified CHAMPS Physical Activity Questionnaire for Older Adults, Four-Dimension Mood Scale, Self-Efficacy for Exercise Scale, and Social Provisions Scale - Short Form. Bivariate correlations were performed, and hierarchical multiple regression was subsequently used to test the regression model. Results: Exercise behaviour, exercise-induced mood, exercise self-efficacy, and social support were all negatively associated with depressive symptoms (r = -0.20 to -0.56). When the variables were entered as predictors into the hierarchical multiple regression model, social support was the strongest predictor of depressive symptoms (beta = -0.42), followed by exercise-induced mood (beta = -0.23), and exercise self-efficacy (beta = -0.07). Exercise behaviour did not explain any additional variance in depressive symptoms. A modest interaction effect was also observed between exercise-induced mood and social support. Conclusion: These findings indicate that social support is the strongest predictor of depressive symptomology in community-dwelling older adults, particularly when combined with positive exercise-induced mood states. When addressing the needs of older adults at risk of depression, healthcare professionals should consider the implementation of exercise programmes that are likely to benefit older adults by improving mood, enhancing self-efficacy, and building social support.
- Authors: Miller, Kyle , Mesagno, Christopher , McLaren, Suzanne , Grace, Fergal , Yates, Mark , Gomez, Rapson
- Date: 2019
- Type: Text , Journal article
- Relation: Frontiers in Psychology Vol. 10, no. (2019), p. 1-11
- Full Text:
- Reviewed:
- Description: Background: Depression is a chronic condition that affects up to 15% of older adults. The healthogenic effects of regular exercise are well established, but it is still unclear which exercise-related variables characterise the antidepressant effects of exercise. Thus, the purpose of this study was to examine the extent to which exercise-related variables (exercise behaviour, exercise-induced mood, exercise self-efficacy, and social support) can predict depressive symptoms in a cohort of community-dwelling older adults. Methods: This study employed a cross-sectional analysis of questionnaire data from a sample of 586 community-dwelling older Australians aged 65 to 96 years old. Participants completed the Center for Epidemiologic Studies Depression Scale, modified CHAMPS Physical Activity Questionnaire for Older Adults, Four-Dimension Mood Scale, Self-Efficacy for Exercise Scale, and Social Provisions Scale - Short Form. Bivariate correlations were performed, and hierarchical multiple regression was subsequently used to test the regression model. Results: Exercise behaviour, exercise-induced mood, exercise self-efficacy, and social support were all negatively associated with depressive symptoms (r = -0.20 to -0.56). When the variables were entered as predictors into the hierarchical multiple regression model, social support was the strongest predictor of depressive symptoms (beta = -0.42), followed by exercise-induced mood (beta = -0.23), and exercise self-efficacy (beta = -0.07). Exercise behaviour did not explain any additional variance in depressive symptoms. A modest interaction effect was also observed between exercise-induced mood and social support. Conclusion: These findings indicate that social support is the strongest predictor of depressive symptomology in community-dwelling older adults, particularly when combined with positive exercise-induced mood states. When addressing the needs of older adults at risk of depression, healthcare professionals should consider the implementation of exercise programmes that are likely to benefit older adults by improving mood, enhancing self-efficacy, and building social support.
A 12-month prospective cohort study of symptoms of common mental disorders among professional rugby players
- Gouttebarge, Vincent, Hopley, Philip, Kerkhoffs, Gino, Verhagen, Evert, Viljoen, Wayne, Wylleman, Paul, Lambert, Mike
- Authors: Gouttebarge, Vincent , Hopley, Philip , Kerkhoffs, Gino , Verhagen, Evert , Viljoen, Wayne , Wylleman, Paul , Lambert, Mike
- Date: 2018
- Type: Text , Journal article
- Relation: European Journal of Sport Science Vol. 18, no. 7 (2018), p. 1004-1012
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- Reviewed:
- Description: The primary aims were to determine the 12-month incidence (and comorbidity) of symptoms of common mental disorders (CMD) among male professional rugby players and to explore their association with potential stressors. A secondary aim was to explore the view of male professional rugby players about the consequences of symptoms of CMD and related medical support/needs. An observational prospective cohort study with three measurements over a 12-month period was conducted among male professional rugby players from several countries. Symptoms of CMD (distress, anxiety/depression, sleep disturbance, eating disorders and adverse alcohol use) and stressors (adverse life events, rugby career dissatisfaction) were assessed through validated questionnaires. A total of 595 players (mean age of 26 years; mean career duration of 6 years) were enrolled, of which 333 completed the follow-up period. The incidence of symptoms of CMD were: 11% for distress, 28% for anxiety/depression, 12% for sleep disturbance, 11% for eating disorders and 22% for adverse alcohol use (13% for two simultaneous symptoms of CMD). Professional rugby players reporting recent adverse life events or career dissatisfaction were more likely to report symptoms of CMD but statistically significant associations were not found. Around 95% of the participants stated that symptoms of CMD can negatively influence rugby performances, while 46% mentioned that specific support measures for players were not available in professional rugby. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve not only awareness and psychological resilience of rugby players but also their rugby performance and quality-of-life. © 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
- Authors: Gouttebarge, Vincent , Hopley, Philip , Kerkhoffs, Gino , Verhagen, Evert , Viljoen, Wayne , Wylleman, Paul , Lambert, Mike
- Date: 2018
- Type: Text , Journal article
- Relation: European Journal of Sport Science Vol. 18, no. 7 (2018), p. 1004-1012
- Full Text:
- Reviewed:
- Description: The primary aims were to determine the 12-month incidence (and comorbidity) of symptoms of common mental disorders (CMD) among male professional rugby players and to explore their association with potential stressors. A secondary aim was to explore the view of male professional rugby players about the consequences of symptoms of CMD and related medical support/needs. An observational prospective cohort study with three measurements over a 12-month period was conducted among male professional rugby players from several countries. Symptoms of CMD (distress, anxiety/depression, sleep disturbance, eating disorders and adverse alcohol use) and stressors (adverse life events, rugby career dissatisfaction) were assessed through validated questionnaires. A total of 595 players (mean age of 26 years; mean career duration of 6 years) were enrolled, of which 333 completed the follow-up period. The incidence of symptoms of CMD were: 11% for distress, 28% for anxiety/depression, 12% for sleep disturbance, 11% for eating disorders and 22% for adverse alcohol use (13% for two simultaneous symptoms of CMD). Professional rugby players reporting recent adverse life events or career dissatisfaction were more likely to report symptoms of CMD but statistically significant associations were not found. Around 95% of the participants stated that symptoms of CMD can negatively influence rugby performances, while 46% mentioned that specific support measures for players were not available in professional rugby. Supportive and preventive measures directed towards symptoms of CMD should be developed to improve not only awareness and psychological resilience of rugby players but also their rugby performance and quality-of-life. © 2018, © 2018 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
Time dilation and acceleration in depression
- Kent, Lachlan, Van Doorn, George, Klein, Britt
- Authors: Kent, Lachlan , Van Doorn, George , Klein, Britt
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Acta Psychologica Vol. 194, no. (2019), p. 77-86
- Full Text: false
- Reviewed:
- Description: Background: A recent meta-analysis left open a significant question regarding altered time perception in depression: Why do depressed people overproduce short durations and under-produce longer durations if their present experience is that time flows slowly? Experience and judgement of time do not seem to accord with one another. Analysis: By excluding two of the six studies on methodological grounds from a previous meta-analysis of medium-length interval productions, and re-analysing the remaining four studies, the present paper finds that subjective time accelerates from initial dilation within present experience (approximately 1 s duration) to subsequent acceleration within working memory (approximately 30 s duration) when depressed. Proposals: It is proposed that depressive time dilation and acceleration refer to the default mode and central executive networks, respectively. The acceleration effect is suggested to occur due to mood congruency between long intervals, boredom, and depression. This mood congruency leads to the automatic recall of intrusive, negative, and non-specific autobiographical long-term memories used to judge intervals from previous experience. Acceleration in working memory then occurs according to the contextual change model of duration estimation. Limitations: The meta-analysis is limited to four studies only, but provides a potential link between time experience and judgement within the same explanatory model. Conclusions: Similarities between psychological time dilation/acceleration and physical time dilation/acceleration are discussed.
- Razani, Jill, Corona, Roberto, Quilici, Jill, Matevosyan, Adelina, Funes, Cynthia, Larco, Andrea, Miloyan, Beyon, Avila, Justina, Chang, Julia, Goldberg, Hope, Lu, Po
- Authors: Razani, Jill , Corona, Roberto , Quilici, Jill , Matevosyan, Adelina , Funes, Cynthia , Larco, Andrea , Miloyan, Beyon , Avila, Justina , Chang, Julia , Goldberg, Hope , Lu, Po
- Date: 2014
- Type: Text , Journal article
- Relation: Clinical Gerontologist Vol. 37, no. 3 (2014), p. 235-252
- Full Text: false
- Reviewed:
- Description: The degree to which changes in caregiver burden over a one-year period can be predicted by functioning of dementia patients and caregiver psychological stress was examined. The Direct Assessment of Functional Status (DAFS) was administered to 44 patients and the Caregiver Burden Inventory and the Brief Symptom Inventory were administered to their next-of-kin caregivers. All patients and caregivers were assessed at baseline and again in approximately one year with the same measures. Hierarchical regression revealed that baseline patient functioning predicted overall changes in caregiver burden, but that increases in psychological symptoms of caregivers such as depression, anxiety, and hostility were the best predictors for specific types of increased caregiver burden, such as social, developmental, or physical burden. These results suggest that interventions should target reduction of particular psychological symptoms in order to reduce caregiver burden over time.
Cognitive behaviour therapy for insomnia and depression among older adults : A mixed methods randomised controlled clinical trial
- Authors: Sadler, Paul
- Date: 2018
- Type: Text , Thesis , PhD
- Full Text:
- Description: Background A strong relationship exists between insomnia and depression, particularly among older adults (aged 65 years and older). Recently experts in the field of behavioural sleep medicine established cognitive behaviour therapy (CBT) was an effective treatment for comorbid insomnia, however, it was unknown whether cognitive behaviour therapy for insomnia (CBT-I) benefitted older adults with co-occurring depression (literature review published in Cognitive Behaviour Therapy). A mixed-methods randomised controlled clinical trial (RCT) was warranted within a community mental health setting to investigate the efficacy of CBT-I for older adults with comorbid insomnia and depression. Furthermore, no study had tested whether an advanced form of CBT-I that included additional positive mood-enhancing strategies produced better outcomes compared to a standard form of CBT-I that only targeted insomnia. It was anticipated that the results from such a trial could influence the evolution of treatment for older adults with these highly prevalent comorbid conditions. Methodology An RCT was conducted between 2014 and 2016 across Victoria, Australia, through Latrobe Regional Hospital‟s and Peninsula Health‟s Community Mental Health Services (protocol published in Trials). Seventy-two older adults with diagnosed comorbid insomnia and depression were randomly assigned to one of three group therapy conditions: cognitive behaviour therapy for insomnia (CBT-I, standard), cognitive behaviour 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). Participants who completed the experiential conditions were invited to provide feedback in the form of semi- xvii structured focus groups following the final session of treatment. Thirty-one participants from six groups reflected on their experiences of participating in CBT-I and CBT-I+. Results Quantitative analyses demonstrated the experiential CBT conditions both generated significantly greater reductions in insomnia and depression severity compared to PCG from pre to post, which were maintained at follow-up. The standard and advanced conditions showed similar reductions on insomnia and depression severity at post and follow up. These results were also consistent for the secondary measures across conditions. Both active treatments demonstrated large effect sizes, high retention, and strong remission rates for older adults with insomnia and depression (published in journal SLEEP). A qualitative analysis was also conducted to explore the participants‟ experiences of treatment. Interview data from the reflective focus groups was transcribed into 424 sentences and 60 codes were extracted. Thirty-four initial themes emerged, which were finally transformed into 3 themes and 10 subthemes. The three 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 (manuscript under review in Aging and Mental Health). Conclusion This is the first RCT to demonstrate that specifically treating comorbid insomnia with CBT has an additional positive effect of improving depression for older adults with multiple comorbidities. Both CBT programs were effective at reducing insomnia and depression severity for older adults with comorbidity. Replication of this study is necessary with a larger sample size to conclusively establish whether the two interventions have different or equivalent effects. It was suggested mental health services that deliver treatment for comorbid insomnia with CBT may improve recovery outcomes for older adults with 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).
- Description: Doctor of Philosophy
- Authors: Sadler, Paul
- Date: 2018
- Type: Text , Thesis , PhD
- Full Text:
- Description: Background A strong relationship exists between insomnia and depression, particularly among older adults (aged 65 years and older). Recently experts in the field of behavioural sleep medicine established cognitive behaviour therapy (CBT) was an effective treatment for comorbid insomnia, however, it was unknown whether cognitive behaviour therapy for insomnia (CBT-I) benefitted older adults with co-occurring depression (literature review published in Cognitive Behaviour Therapy). A mixed-methods randomised controlled clinical trial (RCT) was warranted within a community mental health setting to investigate the efficacy of CBT-I for older adults with comorbid insomnia and depression. Furthermore, no study had tested whether an advanced form of CBT-I that included additional positive mood-enhancing strategies produced better outcomes compared to a standard form of CBT-I that only targeted insomnia. It was anticipated that the results from such a trial could influence the evolution of treatment for older adults with these highly prevalent comorbid conditions. Methodology An RCT was conducted between 2014 and 2016 across Victoria, Australia, through Latrobe Regional Hospital‟s and Peninsula Health‟s Community Mental Health Services (protocol published in Trials). Seventy-two older adults with diagnosed comorbid insomnia and depression were randomly assigned to one of three group therapy conditions: cognitive behaviour therapy for insomnia (CBT-I, standard), cognitive behaviour 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). Participants who completed the experiential conditions were invited to provide feedback in the form of semi- xvii structured focus groups following the final session of treatment. Thirty-one participants from six groups reflected on their experiences of participating in CBT-I and CBT-I+. Results Quantitative analyses demonstrated the experiential CBT conditions both generated significantly greater reductions in insomnia and depression severity compared to PCG from pre to post, which were maintained at follow-up. The standard and advanced conditions showed similar reductions on insomnia and depression severity at post and follow up. These results were also consistent for the secondary measures across conditions. Both active treatments demonstrated large effect sizes, high retention, and strong remission rates for older adults with insomnia and depression (published in journal SLEEP). A qualitative analysis was also conducted to explore the participants‟ experiences of treatment. Interview data from the reflective focus groups was transcribed into 424 sentences and 60 codes were extracted. Thirty-four initial themes emerged, which were finally transformed into 3 themes and 10 subthemes. The three 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 (manuscript under review in Aging and Mental Health). Conclusion This is the first RCT to demonstrate that specifically treating comorbid insomnia with CBT has an additional positive effect of improving depression for older adults with multiple comorbidities. Both CBT programs were effective at reducing insomnia and depression severity for older adults with comorbidity. Replication of this study is necessary with a larger sample size to conclusively establish whether the two interventions have different or equivalent effects. It was suggested mental health services that deliver treatment for comorbid insomnia with CBT may improve recovery outcomes for older adults with 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).
- Description: Doctor of Philosophy
Yes : The symptoms of OCD and depression are discrete and not exclusively negative affectivity
- Moore, Kathleen, Howell, Jacqui
- Authors: Moore, Kathleen , Howell, Jacqui
- Date: 2017
- Type: Text , Journal article
- Relation: Frontiers in Psychology Vol. 8, no. MAY (2017), p. 1-10
- Full Text:
- Reviewed:
- Description: Although Obsessive-Compulsive Disorder (OCD) and Depression are classified as separate disorders, the high incidence of co-morbidity and the strong correlations between measures of each has led to debate about the nature of their relationship. Some authors have proposed that OCD is in fact a mood disorder while others have suggested that the two disorders are grounded in negative affectivity. A third proposition is that depression is an essential part of OCD but that OCD is a separate disorder from depression. The aim in this study was to investigate these diverse propositions in a non-clinical sample and also to determine whether factors implicated in each, that is anxious and depressive cognitions, hopelessness, and self-criticism, would demonstrate commonality as predictors of the symptoms of OCD and of depression. Two hundred participants (59% female) (M age = 34 years, SD = 16) completed the Padua Inventory, Carroll Rating Scale, Cognitions Checklist, Self-Criticism Scale, Beck Hopelessness Scale, Buss-Durkee Hostility Inventory-Revised and a Negative Affectivity Schedule. Results indicated a strong correlation between OCD and depression, depression, and negative affectivity but a weaker relationship between OCD and negative affectivity. Path analyses revealed that both anxious and depressive cognitions, as well as hostility predicted both disorders but the Beta-weights were stronger on OCD. Self-criticism predicted only depression while hopelessness failed to predict either disorder but was itself predicted by depressive cognitions. Depression was a stronger indicator of negative affect than OCD and while OCD positively predicted depression, depression was a negative indicator of OCD. These results support the hypothesis that OCD and depression are discrete disorders and indicate that while depression is implicated in OCD, the reverse does not hold. While both disorders are related to negative affectivity, this relationship is much stronger for depression thus failing to confirm that both are subsumed by a common factor, in this case, negative affectivity. The proposition that depression is part of OCD but that OCD is not necessarily implicated in depression and is, in fact, a separate disorder, is supported by the current model. Further research is required to support the utility of the model in clinical samples. © 2017 Moore and Howell.
- Authors: Moore, Kathleen , Howell, Jacqui
- Date: 2017
- Type: Text , Journal article
- Relation: Frontiers in Psychology Vol. 8, no. MAY (2017), p. 1-10
- Full Text:
- Reviewed:
- Description: Although Obsessive-Compulsive Disorder (OCD) and Depression are classified as separate disorders, the high incidence of co-morbidity and the strong correlations between measures of each has led to debate about the nature of their relationship. Some authors have proposed that OCD is in fact a mood disorder while others have suggested that the two disorders are grounded in negative affectivity. A third proposition is that depression is an essential part of OCD but that OCD is a separate disorder from depression. The aim in this study was to investigate these diverse propositions in a non-clinical sample and also to determine whether factors implicated in each, that is anxious and depressive cognitions, hopelessness, and self-criticism, would demonstrate commonality as predictors of the symptoms of OCD and of depression. Two hundred participants (59% female) (M age = 34 years, SD = 16) completed the Padua Inventory, Carroll Rating Scale, Cognitions Checklist, Self-Criticism Scale, Beck Hopelessness Scale, Buss-Durkee Hostility Inventory-Revised and a Negative Affectivity Schedule. Results indicated a strong correlation between OCD and depression, depression, and negative affectivity but a weaker relationship between OCD and negative affectivity. Path analyses revealed that both anxious and depressive cognitions, as well as hostility predicted both disorders but the Beta-weights were stronger on OCD. Self-criticism predicted only depression while hopelessness failed to predict either disorder but was itself predicted by depressive cognitions. Depression was a stronger indicator of negative affect than OCD and while OCD positively predicted depression, depression was a negative indicator of OCD. These results support the hypothesis that OCD and depression are discrete disorders and indicate that while depression is implicated in OCD, the reverse does not hold. While both disorders are related to negative affectivity, this relationship is much stronger for depression thus failing to confirm that both are subsumed by a common factor, in this case, negative affectivity. The proposition that depression is part of OCD but that OCD is not necessarily implicated in depression and is, in fact, a separate disorder, is supported by the current model. Further research is required to support the utility of the model in clinical samples. © 2017 Moore and Howell.