Engaging youth with major depression in an exercise intervention with motivational interviewing
- Nasstasia, Yasmina, Baker, Amanda, Lewin, Terry, Halpin, Sean, Hides, Leanne
- Authors: Nasstasia, Yasmina , Baker, Amanda , Lewin, Terry , Halpin, Sean , Hides, Leanne
- Date: 2019
- Type: Text , Journal article
- Relation: Mental Health and Physical Activity Vol. 17, no. (2019), p.
- Full Text: false
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- Description: Background: Exercise has beneficial effects on depression; however, research is constrained by low program adherence. This paper investigates: 1) whether there are improvements in stage of change (exercise readiness) and exercise self-efficacy from before to after a brief motivational interviewing (MI) intervention designed to enhance program engagement among youth with major depressive disorder (MDD); and 2) any prospective association between baseline stage of change (exercise readiness) category and exercise program participation, retention and treatment outcomes. Methods: Selected pre- versus post-intervention and related secondary analyses based on pooled data from an initial pilot (n = 14) and subsequent two-armed RCT (n = 68). Participants were aged 15–25 years and met diagnostic criteria for MDD. Following psychological and physical fitness assessments, participants in the active treatment condition received a brief MI intervention followed by a supervised 12-week multi-modal exercise intervention. Results: Higher initial exercise readiness was significantly related to baseline weekly exercise participation and self-efficacy, with trend-level associations with behavioural activation. There was a trend level differential improvement in exercise readiness post MI, and a significant increase in self-efficacy among the intervention group. Post MI self-efficacy was also correlated with increased exercise participation. Clear post-intervention benefits were detected for most outcome measures; however, these were not differential by baseline stage of change category. Conclusion: Early MI based interventions increase exercise readiness and enhance self-efficacy, which may promote increased engagement and exercise adherence. Integrating MI as a prelude to exercise intervention shows promise as an effective engagement and treatment strategy among youth with MDD. © 2019 Elsevier Ltd. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Yasmina Nasstasi” is provided in this record**
Evaluating the efficacy of an integrated motivational interviewing and multi-modal exercise intervention for youth with major depression: Healthy Body, Healthy Mind randomised controlled trial protocol
- Nasstasia, Yasmina, Baker, Amanda, Halpin, Sean, Hides, Leanne, Lewin, Terry, Kelly, Brian, Callister, Robin
- Authors: Nasstasia, Yasmina , Baker, Amanda , Halpin, Sean , Hides, Leanne , Lewin, Terry , Kelly, Brian , Callister, Robin
- Date: 2018
- Type: Text , Journal article
- Relation: Contemporary Clinical Trials Communications Vol. 9, no. (2018), p. 13-22
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- Description: Background Recent meta-analytic reviews suggest exercise can reduce depression severity among adults with major depressive disorder (MDD); however, efficacy studies with depressed youth are limited. Few studies have investigated the efficacy of multi-modal exercise interventions in this population, addressed treatment engagement, or explored the differential effects of exercise on depressive symptom profiles. Objectives This paper describes the study protocol and recruitment pattern for an assessor blinded, two-arm randomised controlled trial investigating the efficacy of an integrated motivational interviewing (MI) and multi-modal exercise intervention in youth diagnosed with MDD. Associations between depressive symptom profiles (cognitive, somatic and affective) and psychological, physiological (fitness), and biological (blood biomarker) outcomes will also be examined. Methods Participants aged 15–25 years with current MDD were recruited. Eligible participants were randomised and stratified according to gender and depression severity to either an immediate or delayed (control) group. The immediate group received a brief MI intervention followed by a 12-week small group exercise intervention (3 times per week for 1 h), all delivered by personal trainers. The delayed control group received the same intervention 12-weeks later. Both groups were reassessed at mid-treatment or mid-control, post-treatment or post-control, and follow-up (12 weeks post-treatment). Results 68 participants were recruited and randomly allocated to an intervention group. Conclusion This trial will increase our understanding of the efficacy of multi-modal exercise interventions for depression and the specific effects of exercise on depressive symptom profiles. It also offers a novel contribution by addressing treatment engagement in exercise efficacy trials in youth with MDD. © 2017 The Authors
- Authors: Nasstasia, Yasmina , Baker, Amanda , Halpin, Sean , Hides, Leanne , Lewin, Terry , Kelly, Brian , Callister, Robin
- Date: 2018
- Type: Text , Journal article
- Relation: Contemporary Clinical Trials Communications Vol. 9, no. (2018), p. 13-22
- Full Text:
- Reviewed:
- Description: Background Recent meta-analytic reviews suggest exercise can reduce depression severity among adults with major depressive disorder (MDD); however, efficacy studies with depressed youth are limited. Few studies have investigated the efficacy of multi-modal exercise interventions in this population, addressed treatment engagement, or explored the differential effects of exercise on depressive symptom profiles. Objectives This paper describes the study protocol and recruitment pattern for an assessor blinded, two-arm randomised controlled trial investigating the efficacy of an integrated motivational interviewing (MI) and multi-modal exercise intervention in youth diagnosed with MDD. Associations between depressive symptom profiles (cognitive, somatic and affective) and psychological, physiological (fitness), and biological (blood biomarker) outcomes will also be examined. Methods Participants aged 15–25 years with current MDD were recruited. Eligible participants were randomised and stratified according to gender and depression severity to either an immediate or delayed (control) group. The immediate group received a brief MI intervention followed by a 12-week small group exercise intervention (3 times per week for 1 h), all delivered by personal trainers. The delayed control group received the same intervention 12-weeks later. Both groups were reassessed at mid-treatment or mid-control, post-treatment or post-control, and follow-up (12 weeks post-treatment). Results 68 participants were recruited and randomly allocated to an intervention group. Conclusion This trial will increase our understanding of the efficacy of multi-modal exercise interventions for depression and the specific effects of exercise on depressive symptom profiles. It also offers a novel contribution by addressing treatment engagement in exercise efficacy trials in youth with MDD. © 2017 The Authors
Evaluation of various support intensities of digital mental health treatment for reducing anxiety and depression in adults : protocol for a mixed methods, adaptive, randomized clinical trial
- Andrews, Brooke, Klein, Britt, McLaren, Suzanne, Watson, Shaun, Corboy, Denise
- Authors: Andrews, Brooke , Klein, Britt , McLaren, Suzanne , Watson, Shaun , Corboy, Denise
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Research Protocols Vol. 12, no. (2023), p.
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- Description: Background: Anxiety and depression are leading causes of disease worldwide, requiring timely access to evidence-based treatment. Digital mental health (dMH) interventions increase accessibility to evidence-based psychological services delivered in a variety of web-based formats (eg, self-help and therapist-assisted interventions). Robust and rigorous studies of adaptive web-based intervention designs are scarce. No identified randomized clinical trial has investigated the efficacy of a 2-stage adaptive design, whereby the program-only condition or no support dMH treatment program is augmented by either low or high therapist assistance, if a participant does not improve or engage in the program-only condition. Objective: The primary objective is to assess whether low or high therapist-assisted support delivered via video chat is more effective in reducing anxiety and depressive symptoms compared with a dMH program–only condition. The secondary objective is to evaluate the role of motivation; self-efficacy; and preferences in participant engagement, adherence, and clinical outcomes (anxiety and depression symptoms) among the 3 treatment conditions (program only, low-intensity therapist assistance, and high-intensity therapist assistance). A mixed methods analysis of factors affecting participant attrition, participant reasons for nonengagement and withdrawal, and therapist training and implementation of dMH interventions will be completed. Qualitative data regarding participant and therapist experiences and satisfaction with video chat assessment and treatment will also be analyzed. Methods: Australian adults (N=137) with symptoms or a diagnosis of anxiety or depression will be screened for eligibility and given access to the 8-module Life Flex dMH treatment program. On day 15, participants who meet the augmentation criteria will be stepped up via block randomization to receive therapist assistance delivered via video chat for either 10 minutes (low intensity) or 50 minutes (high intensity) per week. This adaptive trial will implement a mixed methods design, with outcomes assessed before the intervention (week 0), during the intervention (weeks 3 and 6), after the intervention (week 9), and at the 3-month follow-up (week 21). Results: The primary outcome measures are for anxiety (Generalized Anxiety Disorder–7) and depression severity (Patient Health Questionnaire–9). Measures of working alliance, health status, health resources, preferences, self-efficacy, and motivation will be used for secondary outcomes. Qualitative methods will be used to explore participant and therapist experiences of video chat assessment and treatment, participant reasons for withdrawal and nonengagement, and therapist training and implementation experiences. Data collection commenced in November 2020 and was completed at the end of March 2022. Conclusions: This is the first mixed methods adaptive trial to explore the comparative efficacy of different intensity levels of self-help and a therapist-assisted dMH intervention program delivered via video chat for adults with anxiety or depression. Anticipated results may have implications for the implementation of dMH interventions. © Brooke Andrews, Britt Klein, Suzanne McLaren, Shaun Watson, Denise Corboy. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 28.04.2023.
- Authors: Andrews, Brooke , Klein, Britt , McLaren, Suzanne , Watson, Shaun , Corboy, Denise
- Date: 2023
- Type: Text , Journal article
- Relation: JMIR Research Protocols Vol. 12, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Anxiety and depression are leading causes of disease worldwide, requiring timely access to evidence-based treatment. Digital mental health (dMH) interventions increase accessibility to evidence-based psychological services delivered in a variety of web-based formats (eg, self-help and therapist-assisted interventions). Robust and rigorous studies of adaptive web-based intervention designs are scarce. No identified randomized clinical trial has investigated the efficacy of a 2-stage adaptive design, whereby the program-only condition or no support dMH treatment program is augmented by either low or high therapist assistance, if a participant does not improve or engage in the program-only condition. Objective: The primary objective is to assess whether low or high therapist-assisted support delivered via video chat is more effective in reducing anxiety and depressive symptoms compared with a dMH program–only condition. The secondary objective is to evaluate the role of motivation; self-efficacy; and preferences in participant engagement, adherence, and clinical outcomes (anxiety and depression symptoms) among the 3 treatment conditions (program only, low-intensity therapist assistance, and high-intensity therapist assistance). A mixed methods analysis of factors affecting participant attrition, participant reasons for nonengagement and withdrawal, and therapist training and implementation of dMH interventions will be completed. Qualitative data regarding participant and therapist experiences and satisfaction with video chat assessment and treatment will also be analyzed. Methods: Australian adults (N=137) with symptoms or a diagnosis of anxiety or depression will be screened for eligibility and given access to the 8-module Life Flex dMH treatment program. On day 15, participants who meet the augmentation criteria will be stepped up via block randomization to receive therapist assistance delivered via video chat for either 10 minutes (low intensity) or 50 minutes (high intensity) per week. This adaptive trial will implement a mixed methods design, with outcomes assessed before the intervention (week 0), during the intervention (weeks 3 and 6), after the intervention (week 9), and at the 3-month follow-up (week 21). Results: The primary outcome measures are for anxiety (Generalized Anxiety Disorder–7) and depression severity (Patient Health Questionnaire–9). Measures of working alliance, health status, health resources, preferences, self-efficacy, and motivation will be used for secondary outcomes. Qualitative methods will be used to explore participant and therapist experiences of video chat assessment and treatment, participant reasons for withdrawal and nonengagement, and therapist training and implementation experiences. Data collection commenced in November 2020 and was completed at the end of March 2022. Conclusions: This is the first mixed methods adaptive trial to explore the comparative efficacy of different intensity levels of self-help and a therapist-assisted dMH intervention program delivered via video chat for adults with anxiety or depression. Anticipated results may have implications for the implementation of dMH interventions. © Brooke Andrews, Britt Klein, Suzanne McLaren, Shaun Watson, Denise Corboy. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 28.04.2023.
- Galbally, Megan, Watson, Stuart, Spigset, Olav, Lappas, Martha, Walker, Susan, Lewis, Andrew
- Authors: Galbally, Megan , Watson, Stuart , Spigset, Olav , Lappas, Martha , Walker, Susan , Lewis, Andrew
- Date: 2022
- Type: Text , Journal article
- Relation: Placenta Vol. 119, no. (2022), p. 44-51
- Full Text: false
- Reviewed:
- Description: Placental dysfunction and inefficiency, is important in understanding fetal growth restriction and low birth weight. Two recent studies have examined the relationship between antidepressant use in pregnancy and placental weight ratios one found lower placental weight ratio associated with antidepressant use and the other found a higher ratio. This study examined 342 women recruited in early pregnancy, including 75 taking antidepressants, 29 with current depression and 238 controls. Antidepressant use was measured through self-report in early and late pregnancy, hospital records at delivery and drug concentrations in umbilical cord and maternal blood obtained at delivery. Maternal depression was measured using the Structured Clinical Interview for the DSM IV (SCID) at recruitment. Placentas were collected at delivery and weighed, and infant birth weight recorded. Placental efficiency was measured using standardised placental weight residuals and included as the outcome in general linear models (ANOVA/ANCOVA) to test hypotheses. While placental weight was higher for those on antidepressants compared to controls (z=.30 c.f. Z=-0.08, p=.012), there were no significant differences between the three groups after adjusting for maternal body mass index at recruitment. When comparing antidepressant groups separately there were small-to-moderate positive associations between (SSRI) concentrations and placental weight (rho's > 0.20, p's > 0.05), which did not reach significance. Antidepressant use in pregnancy was not associated with significant changes in placental efficiency after adjustment for confounding variables. Future research should expand on this to examine other aspects of placental function and include a wide range of potential confounding variables to draw clinically meaningful conclusions. •Birth weight to placental weight ratio is often used as a proxy for placental dysfunction.•Placental dysfunction may underlie the association between antenatal antidepressant use and low infant birth weight.•Two studies found the opposite relationship between antidepressants and placental weight but did not adjust for confounders.•We found placental weight, when adjusted for confounders, was not significantly different for those on antidepressants.
- Dear, Blake, Zou, Judy, Ali, Shehzad, Lorian, Carolyn, Johnston, Luke, Terides, Matthew, Staples, Lauren, Gandy, Milena, Fogliati, Vincent, Klein, Britt, Titov, Nickolai
- Authors: Dear, Blake , Zou, Judy , Ali, Shehzad , Lorian, Carolyn , Johnston, Luke , Terides, Matthew , Staples, Lauren , Gandy, Milena , Fogliati, Vincent , Klein, Britt , Titov, Nickolai
- Date: 2015
- Type: Text , Journal article
- Relation: Internet Interventions Vol. 2, no. (2015), p. 17-23
- Full Text: false
- Reviewed:
- Description: Self-guided internet-delivered cognitive behavior therapy (iCBT) has considerable public health potential for treating anxiety and depression. However, no research has examined the use of self-guided iCBT, that is, treatment without contact with a clinician, specifically for older adults. The aim of the present study was to undertake a preliminary examination of the acceptability, efficacy and health economic impact of two entirely self-guided iCBT programs for adults over 60. years of age with anxiety and depression. Two separate single-group feasibility open trials of self-guided iCBT were conducted, the Anxiety Trial (n. =. 27) and the Depression Trial (n. =. 20), using the control groups of two randomized controlled trials. The online treatment packages consisted of five online educational lessons, which were delivered over 8. weeks without clinical contact. Participants rated the interventions as acceptable with more than 90% reporting the course was worth their time and more than 70% of participants completing at least 3 of the 5 lessons within the eight weeks. Significant reductions on measures of anxiety (Generalized Anxiety Disorder 7-item; GAD-7) and depression (Patient Health Questionnaire 9-item; PHQ-9) were observed from pre-treatment to post-treatment in both the Anxiety Trial (GAD-7 Cohen's d=. 1.17; 95% CI: 0.55 to 1.75) and the Depression Trial (PHQ-9 Cohen's d=. 1.06; 95% CI: 0.33 to 1.73). The economic analyses indicated that there was statistically significant improvement in health-related quality of life compared to baseline and marginally higher costs associated with treatment for both the Anxiety Trial ($69.84; 95% CI: $4.24 to $135.45) and the Depression Trial ($54.98; 95% CI: $3.84 to $106.12). The results provide preliminary support for the potential of entirely self-guided iCBT for older adults with anxiety and depression and indicate larger scale and controlled research trials are warranted.
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
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- 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.
- Galbally, Megan, Watson, Stuart, Lappas, Martha, de Kloet, E., van Rossum, Elisabeth, Wyrwoll, Caitlin, Mark, Peter, Lewis, Andrew
- 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
- Full Text: false
- Reviewed:
- 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.
- Miloyan, Beyon, Pachana, Nancy, Suddendorf, Thomas
- Authors: Miloyan, Beyon , Pachana, Nancy , Suddendorf, Thomas
- Date: 2017
- Type: Text , Journal article
- Relation: Gerontologist Vol. 57, no. 4 (2017), p. 619-625
- Full Text: false
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- Description: Anxiety and mood disorders in later life are the focus of an increasing amount of intervention research, however basic mechanisms and paradigms explaining etiology and maintenance warrant further exploration. Research on future-oriented thought patterns associated with anxiety and depression in this age group may prove useful, as these disorders are both characterized by a tendency to generate and fixate on threat-related future scenarios that may or may not materialize. Additionally, depression is associated with a reduced expectancy of positive future events. In this paper, we review the literature relevant to future thinking in anxiety and depression in older adults. We focus on the mental construction and anticipation of negative future events, and their underlying neurocognitive mechanisms. We then consider clinical and research implications of anxious and depressive future-oriented thought patterns for older adults. We believe that more research investigating future-oriented thought patterns associated with emotional disorders in later life could improve conceptualization, measurement, and perhaps potential treatments for late-life anxiety and depression. © 2016 The Author.
General practice nurse-led screening for anxiety in later life in Australian primary care settings
- Hills, Sharon, Robinson, Tracy, Northam, Holly, Hungerford, Catherine
- Authors: Hills, Sharon , Robinson, Tracy , Northam, Holly , Hungerford, Catherine
- Date: 2019
- Type: Text , Journal article
- Relation: Australasian Journal on Ageing Vol. 38, no. 4 (Dec 2019), p. E121-E126
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- Description: Objective To test the feasibility of general practice nurse (GPN)-led screening for clinically significant symptoms of anxiety (CSSA) in older people and to estimate the prevalence of CSSA. Methods General practice nurse-led screening for CSSA was undertaken in eight general practices by integrating the five-item Geriatric Anxiety Inventory-Short Form (GAI-SF) into the annual 75 years and older health assessment (75+ HA). Prevalence rates were calculated, and field notes were analysed. Results Over 30 months, 736 patients were screened for CSSA, with a detected prevalence rate of 20.1%. The application of the GAI-SF into the 75+ HA was feasible and readily accepted by patients. Conclusions The five-item GAI-SF is an age-appropriate screening tool for CSSA in general practice settings. Further research is warranted, particularly in relation to the development and implementation of evidence-informed, general practice-based interventions for CSSA that can be effectively delivered to meet the needs of older people.
- Authors: Hills, Sharon , Robinson, Tracy , Northam, Holly , Hungerford, Catherine
- Date: 2019
- Type: Text , Journal article
- Relation: Australasian Journal on Ageing Vol. 38, no. 4 (Dec 2019), p. E121-E126
- Full Text:
- Reviewed:
- Description: Objective To test the feasibility of general practice nurse (GPN)-led screening for clinically significant symptoms of anxiety (CSSA) in older people and to estimate the prevalence of CSSA. Methods General practice nurse-led screening for CSSA was undertaken in eight general practices by integrating the five-item Geriatric Anxiety Inventory-Short Form (GAI-SF) into the annual 75 years and older health assessment (75+ HA). Prevalence rates were calculated, and field notes were analysed. Results Over 30 months, 736 patients were screened for CSSA, with a detected prevalence rate of 20.1%. The application of the GAI-SF into the 75+ HA was feasible and readily accepted by patients. Conclusions The five-item GAI-SF is an age-appropriate screening tool for CSSA in general practice settings. Further research is warranted, particularly in relation to the development and implementation of evidence-informed, general practice-based interventions for CSSA that can be effectively delivered to meet the needs of older people.
Growth mixture modeling of depression symptoms following traumatic brain injury
- Gomez, Rapson, Skilbeck, Clive, Thomas, Matt, Slatyer, Mark
- Authors: Gomez, Rapson , Skilbeck, Clive , Thomas, Matt , Slatyer, Mark
- Date: 2017
- Type: Text , Journal article
- Relation: Frontiers in Psychology Vol. 8, no. AUG (2017), p. 1-14
- Full Text:
- Reviewed:
- Description: Growth Mixture Modeling (GMM) was used to investigate the longitudinal trajectory of groups (classes) of depression symptoms, and how these groups were predicted by the covariates of age, sex, severity, and length of hospitalization following Traumatic Brain Injury (TBI) in a group of 1074 individuals (696 males, and 378 females) from the Royal Hobart Hospital, who sustained a TBI. The study began in late December 2003 and recruitment continued until early 2007. Ages ranged from 14 to 90 years, with a mean of 35.96 years (SD = 16.61). The study also examined the associations between the groups and causes of TBI. Symptoms of depression were assessed using the Hospital Anxiety and Depression Scale within 3 weeks of injury, and at 1, 3, 6, 12, and 24 months post-injury. The results revealed three groups: low, high, and delayed depression. In the low group depression scores remained below the clinical cut-off at all assessment points during the 24-months post-TBI, and in the high group, depression scores were above the clinical cut-off at all assessment points. The delayed group showed an increase in depression symptoms to 12 months after injury, followed by a return to initial assessment level during the following 12 months. Covariates were found to be differentially associated with the three groups. For example, relative to the low group, the high depression group was associated with more severe TBI, being female, and a shorter period of hospitalization. The delayed group also had a shorter period of hospitalization, were younger, and sustained less severe TBI. Our findings show considerable fluctuation of depression over time, and that a non-clinical level of depression at any one point in time does not necessarily mean that the person will continue to have non-clinical levels in the future. As we used GMM, we were able to show new findings and also bring clarity to contradictory past findings on depression and TBI. Consequently, we recommend the use of this approach in future studies in this area. © 2017 Gomez, Skilbeck, Thomas and Slatyer.
- Authors: Gomez, Rapson , Skilbeck, Clive , Thomas, Matt , Slatyer, Mark
- Date: 2017
- Type: Text , Journal article
- Relation: Frontiers in Psychology Vol. 8, no. AUG (2017), p. 1-14
- Full Text:
- Reviewed:
- Description: Growth Mixture Modeling (GMM) was used to investigate the longitudinal trajectory of groups (classes) of depression symptoms, and how these groups were predicted by the covariates of age, sex, severity, and length of hospitalization following Traumatic Brain Injury (TBI) in a group of 1074 individuals (696 males, and 378 females) from the Royal Hobart Hospital, who sustained a TBI. The study began in late December 2003 and recruitment continued until early 2007. Ages ranged from 14 to 90 years, with a mean of 35.96 years (SD = 16.61). The study also examined the associations between the groups and causes of TBI. Symptoms of depression were assessed using the Hospital Anxiety and Depression Scale within 3 weeks of injury, and at 1, 3, 6, 12, and 24 months post-injury. The results revealed three groups: low, high, and delayed depression. In the low group depression scores remained below the clinical cut-off at all assessment points during the 24-months post-TBI, and in the high group, depression scores were above the clinical cut-off at all assessment points. The delayed group showed an increase in depression symptoms to 12 months after injury, followed by a return to initial assessment level during the following 12 months. Covariates were found to be differentially associated with the three groups. For example, relative to the low group, the high depression group was associated with more severe TBI, being female, and a shorter period of hospitalization. The delayed group also had a shorter period of hospitalization, were younger, and sustained less severe TBI. Our findings show considerable fluctuation of depression over time, and that a non-clinical level of depression at any one point in time does not necessarily mean that the person will continue to have non-clinical levels in the future. As we used GMM, we were able to show new findings and also bring clarity to contradictory past findings on depression and TBI. Consequently, we recommend the use of this approach in future studies in this area. © 2017 Gomez, Skilbeck, Thomas and Slatyer.
- McLaren, Suzanne, Turner, Jayne, Gomez, Rapson, McLachlan, Angus, Gibbs, Petah
- Authors: McLaren, Suzanne , Turner, Jayne , Gomez, Rapson , McLachlan, Angus , Gibbs, Petah
- Date: 2013
- Type: Text , Journal article
- Relation: Aging & Mental Health Vol. 17, no. 8 (November 2013), p. 1023-1029
- Full Text: false
- Reviewed:
- Description: Objectives: Higher levels of depression have been documented among older adults who reside in an assisted living facility, compared with those who remain in their own homes. The aims of the current study were to test whether the relationship between housing type and depressive symptoms was mediated by a sense of belonging and whether housing type and sense of belonging interact to influence the depressive symptoms among older adults (moderation model).Method: A sample of 257 older adults who lived in their own homes and 166 older adults who lived in an assisted living facility completed the psychological subscale of the Sense of Belonging Instrument and the Center for Epidemiologic Studies Depression Scale.Results: Results showed that a sense of belonging partially mediated the relationship between housing type and depressive symptoms, such that living in a nursing home was associated with lower levels of belonging, and lower levels of belonging were, in turn, associated with higher levels of depressive symptoms. Residing in an assisted living facility was associated with depressive symptoms at low and average levels of belonging.Conclusion: Results highlight the need for more research on the role of sense of belonging as an influencing factor on depressive symptoms among institutionalised older adults for both theoretical and treatment goals.
- Description: C1
Investigating cumulative effects of preperformance routine interventions in beach volleyball serving
- Wergin, Vanessa, Beckmann, Jurgen, Gröpel, Peter, Mesagno, Christopher
- Authors: Wergin, Vanessa , Beckmann, Jurgen , Gröpel, Peter , Mesagno, Christopher
- Date: 2020
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 15, no. 1 (2020), p.
- Full Text:
- Reviewed:
- Description: Pre-performance routines (PPRs) can be used in certain sports to minimize the effects of choking under pressure. This study aimed to investigate the cumulative effectiveness of PPR interventions on the accuracy of beach volleyball serves. Fifty-four beach volleyball players were randomly assigned to one of three PPR intervention groups or a control group. Participants performed 10 serves at a target on the opposite side of the beach volleyball court (pretest), were educated on a PPR intervention, and then completed 10 serves at the target under pressure that was induced through videotaping and ego-relevant instructions (posttest). The results indicated no difference in post-test serving accuracy among the intervention groups and the wait-list control group and no difference in effectiveness between cumulative and isolated PPR use. A possible explanation may be the inefficiency of the pressure manipulation. However, the null results related to isolated and cumulative PPR use under general (i.e., no pressure) conditions are still an important research finding. Future research should investigate the effectiveness of cumulative and other PPRs in other sports in general and under pressure. © 2020 Wergin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Investigating cumulative effects of preperformance routine interventions in beach volleyball serving
- Authors: Wergin, Vanessa , Beckmann, Jurgen , Gröpel, Peter , Mesagno, Christopher
- Date: 2020
- Type: Text , Journal article
- Relation: PLoS ONE Vol. 15, no. 1 (2020), p.
- Full Text:
- Reviewed:
- Description: Pre-performance routines (PPRs) can be used in certain sports to minimize the effects of choking under pressure. This study aimed to investigate the cumulative effectiveness of PPR interventions on the accuracy of beach volleyball serves. Fifty-four beach volleyball players were randomly assigned to one of three PPR intervention groups or a control group. Participants performed 10 serves at a target on the opposite side of the beach volleyball court (pretest), were educated on a PPR intervention, and then completed 10 serves at the target under pressure that was induced through videotaping and ego-relevant instructions (posttest). The results indicated no difference in post-test serving accuracy among the intervention groups and the wait-list control group and no difference in effectiveness between cumulative and isolated PPR use. A possible explanation may be the inefficiency of the pressure manipulation. However, the null results related to isolated and cumulative PPR use under general (i.e., no pressure) conditions are still an important research finding. Future research should investigate the effectiveness of cumulative and other PPRs in other sports in general and under pressure. © 2020 Wergin et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Managing depression with complementary and alternative medicine therapies: a scientometric analysis and visualization of research activities
- Zhao, Fei-Yi, Xu, Peijie, Zheng, Zhen, Conduit, Russell, Xu, Yan, Yue, Li-Ping, Wang, Hui-Ru, Wang, Yan-Mei, Li, Yuan-Xin, Li, Chun-Yan, Zhang, Wen-Jing, Fu, Qiang-Qiang, Kennedy, Gerard
- Authors: Zhao, Fei-Yi , Xu, Peijie , Zheng, Zhen , Conduit, Russell , Xu, Yan , Yue, Li-Ping , Wang, Hui-Ru , Wang, Yan-Mei , Li, Yuan-Xin , Li, Chun-Yan , Zhang, Wen-Jing , Fu, Qiang-Qiang , Kennedy, Gerard
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Psychiatry Vol. 14, no. (2023), p.
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- Description: Background: Complementary and Alternative Medicine (CAM) interventions may prove to be an attractive option for the treatment of depression. The aim of this scientometric analysis is to determine the global scientific output of research regarding managing depression with CAM and identify the hotspots and frontiers within this theme. Methods: Publications regarding the utilization of CAM for treating depression were collected from the Web of Science Core Collection from 1993 to 2022, and analyzed and visualized by Bibliometrix R-package, VOSviewer, and CiteSpace. Results: A total of 1,710 publications were acquired. The number of annual publications showed an overall rapid upward trend, with the figure peaking at 179 in 2021. The USA was the leading research center. Totally 2,323 distinct institutions involving 7,638 scholars contributed to the research theme. However, most of the cooperation was limited to within the same country, institution or research team. The Journal of Alternative and Complementary Medicine was the most productive periodical. The CAM therapies of most interest to researchers were acupuncture and body–mind techniques, such as yoga, meditation and mindfulness. Systematic review and meta-analysis are commonly used methods. “Inflammation,” “rating scale” and “psychological stress” were identified as the most studied trend topics recently. Conclusion: Managing depression with evidence-based CAM treatment is gaining attention globally. Body–mind techniques and acupuncture are growing research hotspots or emerging trending topics. Future studies are predicted to potentially investigate the possible mechanisms of action underlying CAM treatments in reducing depression in terms of modulation of psychological stress and inflammation levels. Cross-countries/institutes/team research collaborations should be encouraged and further enhanced. Copyright © 2023 Zhao, Xu, Zheng, Conduit, Xu, Yue, Wang, Wang, Li, Li, Zhang, Fu and Kennedy.
- Authors: Zhao, Fei-Yi , Xu, Peijie , Zheng, Zhen , Conduit, Russell , Xu, Yan , Yue, Li-Ping , Wang, Hui-Ru , Wang, Yan-Mei , Li, Yuan-Xin , Li, Chun-Yan , Zhang, Wen-Jing , Fu, Qiang-Qiang , Kennedy, Gerard
- Date: 2023
- Type: Text , Journal article
- Relation: Frontiers in Psychiatry Vol. 14, no. (2023), p.
- Full Text:
- Reviewed:
- Description: Background: Complementary and Alternative Medicine (CAM) interventions may prove to be an attractive option for the treatment of depression. The aim of this scientometric analysis is to determine the global scientific output of research regarding managing depression with CAM and identify the hotspots and frontiers within this theme. Methods: Publications regarding the utilization of CAM for treating depression were collected from the Web of Science Core Collection from 1993 to 2022, and analyzed and visualized by Bibliometrix R-package, VOSviewer, and CiteSpace. Results: A total of 1,710 publications were acquired. The number of annual publications showed an overall rapid upward trend, with the figure peaking at 179 in 2021. The USA was the leading research center. Totally 2,323 distinct institutions involving 7,638 scholars contributed to the research theme. However, most of the cooperation was limited to within the same country, institution or research team. The Journal of Alternative and Complementary Medicine was the most productive periodical. The CAM therapies of most interest to researchers were acupuncture and body–mind techniques, such as yoga, meditation and mindfulness. Systematic review and meta-analysis are commonly used methods. “Inflammation,” “rating scale” and “psychological stress” were identified as the most studied trend topics recently. Conclusion: Managing depression with evidence-based CAM treatment is gaining attention globally. Body–mind techniques and acupuncture are growing research hotspots or emerging trending topics. Future studies are predicted to potentially investigate the possible mechanisms of action underlying CAM treatments in reducing depression in terms of modulation of psychological stress and inflammation levels. Cross-countries/institutes/team research collaborations should be encouraged and further enhanced. Copyright © 2023 Zhao, Xu, Zheng, Conduit, Xu, Yue, Wang, Wang, Li, Li, Zhang, Fu and Kennedy.
Maternal attachment state of mind and perinatal emotional wellbeing : findings from a pregnancy cohort study
- Galbally, Megan, Watson, Stuart, Lewis, Andrew, Power, Josephine, Buus, Niels, van Ijzendoorn, Marinus
- Authors: Galbally, Megan , Watson, Stuart , Lewis, Andrew , Power, Josephine , Buus, Niels , van Ijzendoorn, Marinus
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Affective Disorders Vol. 333, no. (2023), p. 297-304
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- Description: Objectives: Maternal attachment state of mind is an important potential predictor of risk and resilience to perinatal emotional wellbeing and early parenting. To explore maternal attachment in relation to perinatal depression and emotional wellbeing. Methods: This study drew on data collected within an ongoing cohort from 170 women recruited in early pregnancy, including 67 who met criteria for Major Depression. Maternal attachment state of mind was assessed with the Adult Attachment Interview (AAI) in pregnancy. Additional measures included the Structured Clinical Interview for the DSM (SCID), at 12 months the Strange Situation Procedure (SSP), Child Trauma Questionnaire (CTQ), Parenting Stress Index, and antenatal maternal hair cortisol concentrations (HCC). Limitations: Sample size to be able to undertake all analyses using the 4 way classifications, cortisol measurement is limited to hair only and there is no prospectively collected measure of childhood trauma in mothers. Conclusions: This study found that maternal attachment, specifically the Non-Autonomous states of mind, adjusted for clinical depression, was associated with higher cortisol in pregnancy and higher depressive symptoms across pregnancy and the postpartum. Furthermore, separately those with depression and Non-Autonomous states of mind also had higher postpartum parenting stress. There was no significant intergenerational concordance between AAI and SSP attachment classifications. Our findings support future research exploring the role of maternal attachment state of mind in understanding perinatal depression and emotional wellbeing. © 2023 The Author(s)
- Authors: Galbally, Megan , Watson, Stuart , Lewis, Andrew , Power, Josephine , Buus, Niels , van Ijzendoorn, Marinus
- Date: 2023
- Type: Text , Journal article
- Relation: Journal of Affective Disorders Vol. 333, no. (2023), p. 297-304
- Full Text:
- Reviewed:
- Description: Objectives: Maternal attachment state of mind is an important potential predictor of risk and resilience to perinatal emotional wellbeing and early parenting. To explore maternal attachment in relation to perinatal depression and emotional wellbeing. Methods: This study drew on data collected within an ongoing cohort from 170 women recruited in early pregnancy, including 67 who met criteria for Major Depression. Maternal attachment state of mind was assessed with the Adult Attachment Interview (AAI) in pregnancy. Additional measures included the Structured Clinical Interview for the DSM (SCID), at 12 months the Strange Situation Procedure (SSP), Child Trauma Questionnaire (CTQ), Parenting Stress Index, and antenatal maternal hair cortisol concentrations (HCC). Limitations: Sample size to be able to undertake all analyses using the 4 way classifications, cortisol measurement is limited to hair only and there is no prospectively collected measure of childhood trauma in mothers. Conclusions: This study found that maternal attachment, specifically the Non-Autonomous states of mind, adjusted for clinical depression, was associated with higher cortisol in pregnancy and higher depressive symptoms across pregnancy and the postpartum. Furthermore, separately those with depression and Non-Autonomous states of mind also had higher postpartum parenting stress. There was no significant intergenerational concordance between AAI and SSP attachment classifications. Our findings support future research exploring the role of maternal attachment state of mind in understanding perinatal depression and emotional wellbeing. © 2023 The Author(s)
- MacMillan, Kelli, Lewis, Andrew, Watson, Stuart, Galbally, Megan
- Authors: MacMillan, Kelli , Lewis, Andrew , Watson, Stuart , Galbally, Megan
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Affective Disorders Vol. 266, no. (2020), p. 678-685
- Full Text: false
- Reviewed:
- Description: •Perinatal depression has been associated with poorer quality mother-infant interaction.•Emotional availability (EA) is an observable aspect of the mother-infant interaction.•Of the maternal depression and EA studies, few utilise both symptomatic and diagnostic measures.•Symptoms but not diagnosis of depression in early pregnancy were associated with lower EA.•Neither diagnosis of depression or late pregnancy or postnatal symptoms were linked to reduced EA. Existing research suggests maternal depression may reduce the quality of early mother-infant interaction and this might increase our understanding of how maternal mental health impacts on child development outcomes. However, most studies recruit from community samples and few include both a diagnostic measure of maternal depression together with an observational measure of the quality of the mother-infant relationship. Data was drawn from 210 women recruited in early pregnancy until 6 months postpartum within an Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study. Those women who at six months postpartum were video recorded interacting with their infant for at least 40-minutes were included in this study, with the quality of those interactions assessed using the Emotional Availability Scales coding system. Depression was measured using the Structured Clinical Interview for the DSM-IV-TR Clinician Version and the Edinburgh Postnatal Depression Scale, and covariates included maternal age and education. Whilst results showed a small negative association between antenatal depressive symptoms in trimester one of pregnancy and maternal EA, there was no effect of maternal depression diagnosis or of maternal depressive symptoms in later pregnancy or postpartum. This study focuses exclusively on mothers and does not account for the role of partners. Maternal depression might have a smaller effect on maternal EA then some existing research implies, with that effect most prevalent in early pregnancy. Clinical intervention might not be necessary for all mother-infant dyads experiencing depressive symptomology, but instead be directed to those with additional risk factors.
Maternal mental health and partner-delivered massage : a pilot study
- Hall, Helen, Munk, Niki, Carr, Bethany, Fogarty, Sarah, Cant, Robyn, Holton, Sara, Weller, Carolina, Lauche, Romy
- 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
- Reviewed:
- 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
- Galbally, Megan, Watson, Stuart, Keelan, Jeff, MacMillan, Kelli, Power, Josephine, Ijzendoorn, Marinus van, Lewis, Andrew
- Authors: Galbally, Megan , Watson, Stuart , Keelan, Jeff , MacMillan, Kelli , Power, Josephine , Ijzendoorn, Marinus van , Lewis, Andrew
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Psychiatric Research Vol. 130, no. (2020), p. 247-253
- Full Text: false
- Reviewed:
- Description: Oxytocin has been a hormone of interest in understanding both depression and parenting. Here, the role of oxytocin has been explored in understanding the interaction between perinatal depression, history of trauma and subsequent longer-term child socio-emotional outcomes. Data were obtained from 203 pregnant women from the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS), a pregnancy cohort study with data collected across pregnancy, postpartum and until 4 years for mother and child. Maternal antenatal depression was measured using the Structured Clinical Interview for DSM-IV (SCID-IV) together with the Childhood Trauma Questionnaire to measure maternal trauma history. Maternal oxytocin levels were measured by enzyme immunoassay following extraction at four time points across pregnancy and the postpartum. The offspring consisted of 203 children followed up from birth until 4 years of age when they were assessed for DSM 5 depression and anxiety disorders (emotional disorders) using the Preschool Age Psychiatric Assessment. Maternal oxytocin levels increased over pregnancy and the postpartum in both control and depressed women with no difference between groups. Maternal childhood trauma and antenatal antidepressant use was also not associated with maternal oxytocin levels. Lower gestational age, maternal depression and early childhood trauma, and late pregnancy oxytocin concentrations were associated with later childhood emotional disorders together they predicted 10% of variance for emotional disorders. Oxytocin is a hormone whose role in understanding intergenerational risk from pregnancy to child emotional disorders is dependent on relational context. Future research can expand on understanding these important early predictors of childhood mental health.
- MacMillan, Kelli, Lewis, Andrew, Watson, Stuart, Power, Josephine, Galbally, Megan
- Authors: MacMillan, Kelli , Lewis, Andrew , Watson, Stuart , Power, Josephine , Galbally, Megan
- Date: 2020
- Type: Text , Journal article
- Relation: Infant behavior & development Vol. 61, no. (2020), p. 101505
- Full Text: false
- Reviewed:
- Description: •Lower emotional availability at 6 months is associated with mothers more likely using a pacifier.•Women with depression were no more likely to use a pacifier during the interaction.•Women with childhood trauma history were no more likely to use a pacifier during the interaction. The prevalence of pacifier use is high but when it occurs outside of the recommended sleep context, it becomes more controversial. Using 211 mother-infant dyads recorded as part of the Mercy Pregnancy and Emotional Wellbeing Study, we examined the maternal psychosocial predictors of pacifier use within an interaction task (i.e., ten minutes face-to-face followed by 30-minutes unstructured play). Predictors included maternal emotional availability measured with the Emotional Availability Scales depression measured by the Structured Clinical Interview for the DSM-IV-TR Clinician Version and maternal history of childhood trauma measured by the Childhood Trauma Questionnaire. An unadjusted odds ratio demonstrated that women classified as non-emotionally available to their infants were three-and-a-half-times more likely to use a pacifier. Multivariate logistic regression including all maternal psychosocial predictors demonstrated that even when adjusting for cessation of breastfeeding, maternal emotional availability remained the only significant predictor of pacifier use. This is the first time that predictors of pacifier use have been examined with a sample of clinically depressed women, as well as women with childhood trauma history. The results provide preliminary evidence that women who are not emotionally available might be more likely to rely on a pacifier during mother-infant interaction.
- MacMillan, Kelli, Lewis, Andrew, Watson, Stuart, Bourke, Declan, Galbally, Megan
- Authors: MacMillan, Kelli , Lewis, Andrew , Watson, Stuart , Bourke, Declan , Galbally, Megan
- Date: 2021
- Type: Text , Journal article
- Relation: Journal of affective disorders Vol. 292, no. (2021), p. 757-765
- Full Text: false
- Reviewed:
- Description: •Maternal depression in pregnancy was not predictive of postpartum maternal emotional availability (EA).•Maternal depression in pregnancy was not associated with perceived social support.•Depressive symptoms negatively predict maternal EA when partner support is low.•Depressive symptoms negatively predict maternal EA when family support is low.•Support from friends is not a moderator between depressive symptoms and maternal EA. Social support theory suggests that parental social support may influence the nature of early parenting behaviours and specifically the mother-infant relationship. This study examines whether support from a partner, friends or family is associated with differences in quality of mother-infant interactions in the context of maternal depression. 210 women were followed from early pregnancy to six months postpartum within Australian pregnancy cohort, the Mercy Pregnancy and Emotional Wellbeing Study (MPEWS). Mother-infant interactions within a standardised observation at six months postpartum were measured by the Emotional Availability (EA) Scales using total scores of the parental scales. In early and late pregnancy and at six months postpartum, mothers rated perceived maternal social support from a partner, family and friends using subscales of the Multidimensional Scale of Perceived Social Support. Depression was measured in early pregnancy and at six months postpartum using the Structured Clinical Interview for the DSM-IV-TR, with repeated measurement of depressive symptoms by the Edinburgh Postnatal Depression Scale (EPDS). Data was analysed using structural equation models. There were significant interactions between depressive symptoms in early pregnancy and perceived maternal support from a partner (B = .18, 95% CI = 03, .31) and separately from family (B = .12, 95% CI = .03, .32) in predicting maternal emotional availability. No such interaction was found for support from friends. While partner and family support moderated the association between early depressive symptoms and emotional availability, there were no direct associations between maternal depressive disorder in early pregnancy and perceived support, and further, maternal depression was not a significant predictor of emotional availability. Future studies should consider extending measurement of the mother-infant relationship beyond the EA Scales, inclusion of a measure of maternal childhood trauma, and replicating our findings. Maternal perception of partner and family support in the postpartum is a predictor of the association between early pregnancy depressive symptoms and maternal emotional availability.
Measuring depression in deaf adults : Adaptation and validation of the Patient Health Questionnaire 9 (PHQ-9) for Auslan users
- Authors: Lake, Shane
- Date: 2018
- Type: Text , Thesis , Masters
- Full Text:
- Description: There is limited research into the prevalence of depression in the deaf population. Results are inconsistent and research has been hampered by the use of measures not specifically designed for individuals who are deaf. Deaf adults, who use Australian sign language (Auslan) to communicate, may not have the spoken and written language skills in English that are required to understand standard psychological measures. The aim of this research was to adapt and validate a measure of depression, the 9 item Patient Health Questionnaire (PHQ-9), for deaf Auslan users. Following established guidelines, an Auslan version of the PHQ-9, that was conceptually equivalent to the original measure, was produced. A community sample of 34 deaf adults, who use Auslan to communicate, and 278 hearing adults, were recruited from the Australian population. Deaf participants completed an Auslan online survey that included the Auslan version of the PHQ-9 and a previously adapted measure, an Auslan version of the Depression Anxiety Stress Scales-21 (DASS-21-Auslan). Hearing participants completed a written English version of the online survey. The Auslan version of the PHQ-9 demonstrated good internal reliability. Concurrent validity was established using the DASS-21-Auslan, with significant correlations found between the two measures. Principal components analysis identified a single factor structure for the Auslan PHQ-9. Differential item functioning was examined using a parametric technique (ordinal logistic regression) and a non-parametric kernel smoothing technique (TestGraf). No evidence of item bias was found. This research has provided promising results for an Auslan version of the PHQ-9 as a culturally appropriate measure for Auslan users. The Auslan PHQ-9 has the potential to provide mental health practitioners and researchers with a more accurate method of assessing and monitoring depression and depressive symptoms in deaf adults who are Auslan users.
- Description: Masters by Research
- Authors: Lake, Shane
- Date: 2018
- Type: Text , Thesis , Masters
- Full Text:
- Description: There is limited research into the prevalence of depression in the deaf population. Results are inconsistent and research has been hampered by the use of measures not specifically designed for individuals who are deaf. Deaf adults, who use Australian sign language (Auslan) to communicate, may not have the spoken and written language skills in English that are required to understand standard psychological measures. The aim of this research was to adapt and validate a measure of depression, the 9 item Patient Health Questionnaire (PHQ-9), for deaf Auslan users. Following established guidelines, an Auslan version of the PHQ-9, that was conceptually equivalent to the original measure, was produced. A community sample of 34 deaf adults, who use Auslan to communicate, and 278 hearing adults, were recruited from the Australian population. Deaf participants completed an Auslan online survey that included the Auslan version of the PHQ-9 and a previously adapted measure, an Auslan version of the Depression Anxiety Stress Scales-21 (DASS-21-Auslan). Hearing participants completed a written English version of the online survey. The Auslan version of the PHQ-9 demonstrated good internal reliability. Concurrent validity was established using the DASS-21-Auslan, with significant correlations found between the two measures. Principal components analysis identified a single factor structure for the Auslan PHQ-9. Differential item functioning was examined using a parametric technique (ordinal logistic regression) and a non-parametric kernel smoothing technique (TestGraf). No evidence of item bias was found. This research has provided promising results for an Auslan version of the PHQ-9 as a culturally appropriate measure for Auslan users. The Auslan PHQ-9 has the potential to provide mental health practitioners and researchers with a more accurate method of assessing and monitoring depression and depressive symptoms in deaf adults who are Auslan users.
- Description: Masters by Research