Description:
Study Objectives: To investigate whether cognitive behavior therapy was effective for older adults with comorbid insomnia and depression in a community mental health setting, and explore whether an advanced form of cognitive behavior therapy for insomnia produced better outcomes compared to a standard form of cognitive behavior therapy for insomnia. Methods: An 8-week randomized controlled clinical trial was conducted within community mental health services, Victoria, Australia. Seventy-two older adults (56% female, M age 75 ± 7 years) with diagnosed comorbid insomnia and depression participated. Three conditions were tested using a group therapy format: cognitive behavior therapy for insomnia (CBT-I, standard), cognitive behavior therapy for insomnia plus positive mood strategies (CBT-I+, advanced), psychoeducation control group (PCG, control). The primary outcomes were insomnia severity (Insomnia Severity Index) and depression severity (Geriatric Depression Scale). Primary and secondary measures were collected at pre (week 0), post (week 8), and follow-up (week 20). Results: CBT-I and CBT-I+ both generated significantly greater reductions in insomnia and depression severity compared to PCG from pre to post (p < .001), which were maintained at follow-up. Although the differences between outcomes of the two treatment conditions were not statistically significant, the study was not sufficiently powered to detect either superiority of one treatment or equivalence of the two treatment conditions. Conclusion: CBT-I and CBT-I+ were both effective at reducing insomnia and depression severity for older adults. Mental health services that deliver treatment for comorbid insomnia with cognitive behavior therapy may improve recovery outcomes for older adults with depression. Trial Registration: Australian and New Zealand Clinical Trials Registry (ANZCTR); URL: https://www.anzctr.org.au; Trial ID: ACTRN12615000067572; Date Registered: December 12, 2014.
Cognitive behaviour therapy for older adults experiencing insomnia and depression in a community mental health setting: Study protocol for a randomised controlled trial
Development of a model of mental health vulnerability for young men living in rural and regional areas : An investigation of the roles of sense of belonging and employment status
Description:
Recent research indicates that rural Australian adolescents experience a number of barriers to their health, and in particular, their sexual health. Consequently, the present study aimed to examine levels of sexual health knowledge, sexual activity, condom use and attitudes towards condoms in a rural, adolescent population. In addition, the research tested a comprehensive model of condom use. One hundred and thirty six 15 to 19 year old students, 51 males (M age = 16.75, SD =.74 ) and 85 females (M age = 16.73, SD = .85), from schools in five towns of population not more than 6000 residents completed a survey package that included demographic information, a Sexual Health Knowledge Scale, the Condom Attitudes Scale and the Adolescent and Young Adult contraceptive Self-efficacy Scale. Results indicated that overall knowledge levels were low, with males knowing significantly less than females. Sixty-five percent of the participants had engaged in sexual intercourse, with over half of those reporting being inconsistent users or non-users of condoms. Within the context of the model, knowledge, attitudes, self-efficacy and intention to use condoms, all contributed to predicting condom use. Results suggest that rural adolescents require education and assistance to obtain and use condoms in a non-threatening environment.
Description:
Recent research indicates that rural Australian adolescents experience a number of barriers to their health, and in particular, their sexual health. Consequently, the present study aimed to examine levels of sexual health knowledge, sexual activity, condom use and attitudes towards condoms in a rural, adolescent population. In addition, the research tested a comprehensive model of condom use. One hundred and thirty six 15 to 19 year old students, 51 males (M age = 16.75, SD =.74 ) and 85 females (M age = 16.73, SD = .85), from schools in five towns of population not more than 6000 residents completed a survey package that included demographic information, a Sexual Health Knowledge Scale, the Condom Attitudes Scale and the Adolescent and Young Adult contraceptive Self-efficacy Scale. Results indicated that overall knowledge levels were low, with males knowing significantly less than females. Sixty-five percent of the participants had engaged in sexual intercourse, with over half of those reporting being inconsistent users or non-users of condoms. Within the context of the model, knowledge, attitudes, self-efficacy and intention to use condoms, all contributed to predicting condom use. Results suggest that rural adolescents require education and assistance to obtain and use condoms in a non-threatening environment.
Description:
Sense of belonging to the general and broader gay communities has been shown to be beneficial for gay men’s mental health. This research investigated the interrelations between sense of belonging to three forms of gay community (the broader gay community, gay groups, and gay friends), sense of belonging to the general community, and depressive symptoms by examining a path model. A community sample of 177 gay men, aged 18 to 79 years, completed the Sense of Belonging Instrument–Psychological subscale, the Centre for Epidemiological Studies–Depression Scale, and the Sense of Belonging within Gay Communities Scale. The model provided excellent fit to the data in which sense of belonging to the general community mediated the relationships between a sense of belonging to gay groups and with gay friends and depressive symptoms. Results imply that enhancing gay men’s sense of belonging to gay groups and with gay friends is likely to be associated with fewer depressive symptoms, by virtue of their enhanced sense of belonging to the general community.
Description:
Objective: The objective is to investigate the influence of characteristics related to place of residence (self-reliance and stoicism) on men's intentions to use a telephone support service following radical prostatectomy. Methods: A community sample of 447 prostate cancer patients (31% response), recruited via Medicare Australia, completed a survey to assess levels of self-reliance and stoicism, and beliefs about addressing emotional distress through using telephone support services. Results: Results indicated that the model was a partially mediated model. Geographic remoteness was directly related to intention, and indirectly related through stoicism and subjective norms. Conclusion: Men from rural and remote areas in Australia might face particular challenges in seeking support following treatment for prostate cancer. These challenges appear to relate to the influence of stoic attitudes and normative expectations, than to issues of access and availability. Addressing stoic attitudes in the clinical setting, through normalising emotional reactions to cancer diagnosis and treatment, and the act of help-seeking for emotional support, may be beneficial.Sons, Ltd.