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A controlled trial of internet-based cognitive-behavioural therapy for panic disorder with face-to-face support from a general practitioner or email support from a psychologist

  • Authors: Pier, Ciaran , Austin, David , Klein, Britt , Mitchell, Joanna , Schattner, Peter , Ciechomski, Lisa , Gilson, Kathryn , Pierce, David , Shandley, Kerrie , Wade, Victoria
  • Date: 2008
  • Type: Text , Journal article
  • Relation: Mental Health in Family Medicine Vol. 5, no. 1 (2008), p. 28-29
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  • Description: Background: Panic disorder (PD) is one of the most common anxiety disorders seen in general practice, but provision of evidence-based cognitive-behavioural treatment (CBT) is rare. Many Australian GPs are now trained to deliver focused psychological strategies, but in practice this is time consuming and costly. Objective: To evaluate the efficacy of an internet-based CBT intervention (Panic Online) for the treatment of PD supported by general practitioner (GP)-delivered therapeutic assistance. Design: Panic Online supported by GP-delivered face-to-face therapy was compared to Panic Online supported by psychologist-delivered email therapy. Methods: Sixty-five people with a primary diagnosis of PD (78% of whom also had agoraphobia) completed 12 weeks of therapy using Panic Online and therapeutic assistance with his/her GP (n = 34) or a clinical psychologist (n = 31). The mean duration of PD for participants allocated to these groups was 59 months and 58 months, respectively. Participants completed a clinical diagnostic interview delivered by a psychologist via telephone and questionnaires to assess panic-related symptoms, before and after treatment. Results: The total attrition rate was 20%, with no group differences in attrition frequency. Both treatments led to significant improvements in panic attack frequency, depression, anxiety, stress, anxiety sensitivity and quality of life. There were no statistically significant differences in the two treatments on any of these measures, or in the frequency of participants with clinically significant PD at post assessment. Conclusions: When provided with accessible online treatment protocols, GPs trained to deliver focused psychological strategies can achieve patient outcomes comparable to efficacious treatments delivered by clinical psychologists. The findings of this research provide a model for how GPs may be assisted to provide evidence-based mental healthcare successfully. © 2008 Radcliffe Publishing.

A fully automated self-help biopsychosocial transdiagnostic digital intervention to reduce anxiety and/or depression and improve emotional regulation and well-being: pre-follow-up single-arm feasibility trial

  • Authors: Klein, Britt , Nguyen, Huy , McLaren, Suzanne , Andrews, Brooke , Shandley, Kerrie
  • Date: 2023
  • Type: Text , Journal article
  • Relation: JMIR Formative Research Vol. 7, no. (2023), p.
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  • Description: Background: Anxiety disorders and depression are prevalent disorders with high comorbidity, leading to greater chronicity and severity of symptoms. Given the accessibility to treatment issues, more evaluation is needed to assess the potential benefits of fully automated self-help transdiagnostic digital interventions. Innovating beyond the current transdiagnostic one-size-fits-all shared mechanistic approach may also lead to further improvements. Objective: The primary objective of this study was to explore the preliminary effectiveness and acceptability of a new fully automated self-help biopsychosocial transdiagnostic digital intervention (Life Flex) aimed at treating anxiety and/or depression, as well as improving emotional regulation; emotional, social, and psychological well-being; optimism; and health-related quality of life. Methods: This was a real-world pre-during-post-follow-up feasibility trial design evaluation of Life Flex. Participants were assessed at the preintervention time point (week 0), during intervention (weeks 3 and 5), at the postintervention time point (week 8), and at 1- and 3-month follow-ups (weeks 12 and 20, respectively). Results: The results provided early support for the Life Flex program in reducing anxiety (Generalized Anxiety Disorder 7), depression (Patient Health Questionnaire 9), psychological distress (Kessler 6), and emotional dysregulation (Difficulties in Emotional Regulation 36) and increasing emotional, social, and psychological well-being (Mental Health Continuum-Short Form); optimism (Revised Life Orientation Test); and health-related quality of life (EQ-5D-3L Utility Index and Health Rating; all false discovery rate [FDR] < .001). Large within-group treatment effect sizes (range |d|=0.82 to 1.33) were found for most variables from pre- to postintervention assessments and at the 1- and 3-month follow-up. The exceptions were medium treatment effect sizes for EQ-5D-3L Utility Index (range Cohen d=

A therapist-assisted cognitive behavior therapy internet intervention for posttraumatic stress disorder: Pre-, post- and 3-month follow-up results from an open trial

  • Authors: Klein, Britt , Mitchell, Joanna , Abbott, Jo-Anne , Shandley, Kerrie , Austin, David , Gilson, Kathryn , Kiropoulos, Litza , Cannard, Gwenda , Redman, Tomi
  • Date: 2010
  • Type: Text , Journal article
  • Relation: Journal of Anxiety Disorders Vol. 24, no. 6 (2010), p. 635-644
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  • Description: This study was an open trial evaluation of a 10-week therapist-assisted cognitive behavior therapy (CBT) internet intervention (PTSD Online) undertaken with people with a primary clinical diagnosis of posttraumatic stress disorder (PTSD) (n= 22) at pre-assessment. Participants were re-assessed at post-assessment and 3-month follow-up. Significant improvements on PTSD severity ratings and related PTSD symptomatology were observed at post-assessment and maintained at 3-month follow-up. At post-assessment, 69.2% of the sample showed clinically significant improvement and 77% of the sample at follow-up assessment. Non-significant, yet improved, change was observed on all other general psychological measures. Overall, treatment satisfaction was good (69%), participant therapeutic alliance ratings were high (87.5%), and the average total therapist time required was 194.5. min. PTSD Online appears to be an efficacious treatment option for people with PTSD that can be provided entirely remotely, with far less therapist time than traditional face-to-face treatment, and without compromising therapeutic alliance. © 2010 Elsevier Ltd.

A therapist-assisted Internet-based CBT intervention for posttraumatic stress disorder : Preliminary results

  • Authors: Klein, Britt , Mitchell, Joanna , Gilson, Kathryn , Shandley, Kerrie , Austin, David , Kiropoulos, Litza , Abbott, Jo-Anne , Cannard, Gwenda
  • Date: 2009
  • Type: Text , Journal article
  • Relation: Cognitive Behaviour Therapy Vol. 38, no. 2 (2009), p. 121-131
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  • Description: Posttraumatic stress disorder (PTSD) is a debilitating mental health condition frequently associated with psychiatric comorbidity and diminished quality of life, and it typically follows a chronic, often lifelong, course. Previous research has shown that trauma-related psychopathology (but not necessarily clinical PTSD) can be effectively treated via the Internet. This study is the first of its kind to report on the online treatment of patients with a Diagnostic and Statistical Manual of Mental Disorders (fourth edition) clinical diagnosis of PTSD with therapist support by e-mail only. Preliminary findings are presented of an open trial involving a 10-week Internet-based therapist-assisted cognitive behavioural treatment for PTSD (PTSD Online). Pre and posttreatment measures of PTSD and related symptomatology were compared for 16 participants with a variety of trauma experiences. Participants showed clinically significant reductions in PTSD severity and symptomatology, moderate tolerance of the program content, and high therapeutic alliance ratings. No significant change was found on measures of more general psychological symptoms. The results suggest that PTSD Online appears to be an effective and accessible clinical treatment for people with a confirmed PTSD diagnosis.

An evaluation of 'Reach Out Central': An online gaming program for supporting the mental health of young people

  • Authors: Shandley, Kerrie , Austin, David , Klein, Britt , Kyrios, Michael
  • Date: 2010
  • Type: Text , Journal article
  • Relation: Health Education Research Vol. 25, no. 4 (2010), p. 563-574
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  • Description: The objective of this study was to conduct an evaluation of Reach Out Central (ROC), an online gaming program designed to support the mental health of people aged 16-25. The evaluation sought to determine the benefit of playing ROC on alcohol use, use of coping strategies, psychological distress, resilience and satisfaction with life. Changes in mental health literacy, mental health stigma and willingness to seek help and program satisfaction were also investigated. A single group (N=266) quasi-experimental repeated measures (pre-, post-program, 2-month follow-up) design was employed. The results demonstrated positive improvements across all outcome measures for females; however, a non-significant worsening effect was observed for males on seeking support, avoidance and resilience. Improvements for both genders were observed on mental health literacy and help-seeking. However, literacy levels and help-seeking were significantly higher, and stigma significantly lower for females. Program satisfaction ratings were high irrespective of gender. Although some inconsistencies between genders were noted, ROC appears to enhance protective factors for the prevention or early intervention of mental health disorders. The results of this study need to be viewed with its limitations in mind, specifically, the use of an open trial methodology and the small number of male participants. © The Author 2009. Published by Oxford University Press. All rights reserved.

Brief report : pregnancy, birth and infant feeding practices : a survey-based Investigation into risk factors for autism spectrum disorder

  • Authors: Whitely, Aleesha , Shandley, Kerrie , Huynh, Minh , Brown, Christine , Austin, David , Bhowmik, Jahar
  • Date: 2022
  • Type: Text , Journal article
  • Relation: Journal of Autism and Developmental Disorders Vol. 52, no. 11 (2022), p. 5072-5078
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  • Description: A succession of interconnected environmental factors is believed to contribute substantially to the development of autism spectrum disorder (ASD). This exploratory study therefore aims to identify potential risk factors for ASD that are associated with pregnancy, birth and infant feeding. Demographic and health-related data on children aged 3–13 years (N = 4306) was collected through an online survey completed by biological mothers. A fitted logistic regression model identified advanced maternal age, prenatal bleeding, pre-eclampsia, perinatal pethidine usage, foetal distress before birth and male sex of child as associated with an increased risk of ASD, whereas longer gestational duration demonstrated a protective effect. These findings highlight potential risk factors and predictor interrelationships which may contribute to overall ASD risk. © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.

Challenging child behaviours positively predict symptoms of posttraumatic stress disorder in parents of children with Autism spectrum disorder and rare diseases

  • Authors: Stewart, Michelle , Schnabel, Alexandra , Hallford, David , McGillivray, Jane , Forbes, David , Foster, Madeline , Shandley, Kerrie , Gardam, Madeleine , Austin, David
  • Date: 2020
  • Type: Text , Journal article
  • Relation: Research in Autism Spectrum Disorders Vol. 69, no. (2020), p.
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  • Description: Background: This study investigated the validity of conceptualising elevated stress in parents of children who exhibit challenging behaviour within the framework of posttraumatic stress disorder (PTSD). It was hypothesised that parents of children with autism spectrum disorder (ASD), and parents of children with a rare disease would endorse greater PTSD symptomatology than parents of typically developing (TD) children, and that challenging child behaviours would positively predict PTSD symptomatology. Method: The Life Events Checklist for DSM-5, Developmental Behaviour Checklist (Parent) and PTSD Checklist for DSM-5 were administered to 395 parents. Results: Significantly more PTSD symptomatology was reported by parents of children with ASD and parents of children with a rare disease than parents of TD children, and challenging child behaviours positively predicted PTSD symptomatology in both groups. Conclusion: A PTSD framework may validly explain elevated stress among some parents of children with ASD and parents of children with a rare disease, and has important implications for support delivered to parents by healthcare providers. © 2019 Elsevier Ltd

Content and functionality of alcohol and other drug websites: Results of an online survey

  • Authors: Klein, Britt , White, Angela , Kavanagh, David , Shandley, Kerrie , Kay-Lambkin, Frances , Proudfoot, Judith , Drennan, Judy , Connor, Jason , Baker, Amanda , Young, Ross
  • Date: 2010
  • Type: Text , Journal article
  • Relation: Journal of Medical Internet Research Vol. 12, no. 5 (2010), p.
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  • Description: Background: There is a growing trend for individuals to seek health information from online sources. Alcohol and other drug (AOD) use is a significant health problem worldwide, but access and use of AOD websites is poorly understood. Objective: To investigate content and functionality preferences for AOD and other health websites. Methods: An anonymous online survey examined general Internet and AOD-specific usage and search behaviors, valued features of AOD and health-related websites (general and interactive website features), indicators of website trustworthiness, valued AOD website tools or functions, and treatment modality preferences. Results: Surveys were obtained from 1214 drug (n = 766) and alcohol website users (n = 448) (mean age 26.2 years, range 16-70). There were no significant differences between alcohol and drug groups on demographic variables, Internet usage, indicators of website trustworthiness, or on preferences for AOD website functionality. A robust website design/navigation, open access, and validated content provision were highly valued by both groups. While attractiveness and pictures or graphics were also valued, high-cost features (videos, animations, games) were minority preferences. Almost half of respondents in both groups were unable to readily access the information they sought. Alcohol website users placed greater importance on several AOD website tools and functions than did those accessing other drug websites: online screening tools (

Development of an online skills training platform for autistics adults : a participatory approach

  • Authors: Van Doorn, George , Klein, Britt , Edwards, Stephen , Shandley, Kerrie , Caine, Joshua
  • Date: 2024
  • Type: Text , Journal article
  • Relation: Research in Autism Spectrum Disorders Vol. 115, no. (2024), p.
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  • Description: Purpose: The voices of adults living on the autism spectrum are being increasingly heard, yet interventions that can be adjusted to their individual needs are urgently required. This paper reports on the first phase of a project that aims to have adults with autism participate meaningfully in co-designing an engaging digital skills development platform incorporating micro-skills training programs and digital tools to enhance wellbeing and social-emotional functioning. Methods: Adults with autism were recruited in Australia to participate in an online survey (N = 17) and/or focus groups or interviews (N = 11) designed to establish preferences for content, presentation, and functionality of the platform. Results: Participants highlighted the importance of integrating communication, social, relationship, employment, and organisational skills with content presented via graphics/diagrams and text. In addition, a consistent finding across both quantitative and qualitative data was the preference for content delivered by peers. Conclusion: There are few evidence-based interventions designed to improve the lives of adults with autism. Key areas of focus were identified, with the importance of personalising the platform to ensure it caters to varying levels of ability and the different preferences of adults with autism also noted. © 2024 The Authors

Exploration of the preliminary effectiveness and acceptability of a self-help digital intervention to support benzodiazepine cessation and improve mental health and wellbeing : a one-group pilot trial

  • Authors: Klein, Britt , Oldenhof, Erin , Nguyen, Huy , Schattner, Peter , Shandley, Kerrie
  • Date: 2023
  • Type: Text , Journal article
  • Relation: Journal of Behavioral and Cognitive Therapy Vol. 33, no. 3 (2023), p. 179-193
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  • Description: Introduction: Benzodiazepines (BDZs) are often inappropriately prescribed to manage anxiety and insomnia for longer-term use, despite guidelines recommending short-term use (i.e., <4 weeks). A range of harms can occur rapidly with regular use, and dependence can make stopping BDZs challenging. Evidence shows that a combination of BDZ tapering and psychological support are effective interventions, yet are not widely accessible. Methods: This was a one-group pilot trial of a 6-week fully automated self-help BDZ digital intervention (‘BDZ digital health’), providing guidance on how to safely taper BDZs as well as psychological support. The trial was undertaken with Australian adults considering a reduction and/or withdrawal from their BDZ (N = 43). Participants were assessed at pre-intervention (Week 0), during intervention (Week 3), post-intervention (Week 6), and at a 3- and 6-month follow-up (Week 18 and 30 respectively). Results: Reductions in BDZ use and self-reported dependency were observed over the course of the intervention. Significant symptom reductions in anxiety, insomnia, depression, psychological distress, and emotional dysregulation, as well as improvements in mental wellbeing and quality of life were observed when looking across all timepoints. However, the specific assessment timepoint changes for depression and psychological distress did not reach significance from the pre- to post-intervention timepoint. The intervention acceptability ratings were in the moderately high to high range. Discussion: The preliminary results of the pilot trial suggest that BDZ digital health is an acceptable and promising self-help digital intervention to assist adults reducing and withdrawing from their BDZs, and to improve their mental health and wellbeing. Trial registration: ACTRN12617000574347 (24/04/2017). © 2023 Association Française de Therapie Comportementale et Cognitive

Internet-based treatment for panic disorder: Does frequency of therapist contact make a difference?

  • Authors: Klein, Britt , Austin, David , Pier, Ciaran , Kiropoulos, Litza , Shandley, Kerrie , Mitchell, Joanna , Gilson, Kathryn , Ciechomski, Lisa
  • Date: 2009
  • Type: Text , Journal article
  • Relation: Cognitive Behaviour Therapy Vol. 38, no. 2 (2009), p. 100-113
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  • Description: Internet-based interventions with therapist support have proven effective for treating a range of mental health conditions. This study examined whether frequency of therapist contact affected treatment outcomes. Fifty-seven people with panic disorder (including 32 with agoraphobia) were randomly allocated to an 8-week Internet-based cognitive behavioural treatment intervention (Panic Online) with either frequent (three e-mails per week) or infrequent (one e-mail per week) support from a psychologist. Posttreatment, intention-to-treat analyses revealed that both treatments were effective at improving panic disorder and agoraphobia severity ratings, panic-related cognitions, negative affect, and psychological and physical quality of life domains, with no differences between conditions. High end-state functioning was achieved by 28.6% of the frequent and infrequent participants, respectively. Therapist alliance, treatment credibility, and satisfaction also did not differ between groups, despite significantly greater therapist time invested in the frequent contact condition. The results provide evidence that the effectiveness of Internet-based mental health interventions may be independent of the frequency of therapist support and may, therefore, be more cost-effective than previously reported. © 2009 Taylor & Francis.

Older adults' preferences for Internet-based services : type and content

  • Authors: Klein, Britt , Shandley, Kerrie , McLaren, Suzanne , Clinnick, Lisa
  • Date: 2023
  • Type: Text , Journal article
  • Relation: Australasian Journal on Ageing Vol. 42, no. 4 (2023), p. 780-785
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  • Description: Objective(s): The aim of this paper was to report on qualitative survey responses provided by older Australian adults regarding their preferences for Internet-based services and content. Methods: Two qualitative questions (‘What type of Internet-based mental health and well-being (1) services, and (2) content would be of most interest to you?’) from a broader survey investigating the mental and physical health of older Australians were thematically analysed for commonly occurring themes. Eighty-nine participants aged 65 years or older (mean age = 71 years, SD = 5.30) responded to at least one qualitative question. Participants were primarily female (60%, n = 53), born in Australia (65%, n = 58), in a relationship (58%, n = 52), living in the community (79%, n = 70) and relatively well educated, with the majority having completed a university degree (38%, n = 34). Results: Themes indicated that participants were most interested in Facebook-style services (n = 17), chat groups (n = 16) and email-based services (n = 4) designed specifically for older adults (n = 14). However, some concerns were raised regarding the trustworthiness of Internet-based services, with the largest proportion of participants (n = 22) noting that they were unlikely to use Internet- or social media-based services. The primary content-related themes were mental fitness (n = 34), grief and loss (n = 20), health information (n = 13), socialisation (n = 11) and physical fitness (n = 10). Conclusions: Participants indicated interest in tailor-made Facebook-style services for older adults that allow them to communicate with their peers and create new social networks and incorporate content relating to strategies for working on mental and physical fitness, information on coping with grief and loss, as well as health information. These findings can be used by organisations to develop Internet-based services and content for older Australian adults. © 2023 The Authors. Australasian Journal on Ageing published by John Wiley & Sons Australia, Ltd on behalf of AJA Inc’.

Pregnancy complications and their association with postpartum depression symptoms : a retrospective study

  • Authors: Swart, Taliah , Shandley, Kerrie , Huynh, Minh , Brown, Christine , Austin, David , Bhowmik, Jahar
  • Date: 2023
  • Type: Text , Journal article
  • Relation: Australian Journal of Psychology Vol. 75, no. 1 (2023), p.
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  • Description: Objective: Postpartum depression affects around 17% of the women worldwide and has considerable implications for maternal and child health. While some risk factors have been identified, the association between pregnancy and delivery complications and postpartum depression is less well understood. This study aims to determine whether specific pregnancy complications are associated with risk of postpartum depression symptoms (PPDS). Method: This study analysed a subset of variables collected as part of a larger study exploring pregnancy circumstances and maternal-foetal health outcomes. Mothers residing in Australia provided information on their biological children aged 3–13 years. Pregnancy complications were analysed using bivariate analyses and binary logistic regression. Results: Mothers (N = 1,926) reported on N = 3,210 pregnancies (mean number of pregnancies = 1.27, SD = 0.97). At the time of childbirth, mothers were on average 30.1 years old (SD = 5.14). Experiencing a pregnancy complication increased the risk of PPDS (X2 = 16.45, df = 1, p < 0.001) However, logistic regression analyses indicated an increased risk of PPDS was associated with the specific pregnancy complications of cytomegalovirus (AOR = 7.06, 95% CI[1.51,32.98]), emergency caesarean (AOR = 1.67, 95% CI[1.31,2.12]), foetal distress before birth (AOR = 1.49, 95% CI[1.16,1.91]), induced labour (AOR = 1.55, 95% CI[1.25,1.91]) and placenta previa (AOR = 2.60, 95% CI[1.44,4.71]). Conclusion: Specific pregnancy complications were associated with PPDS, suggesting that some complications may pose a greater risk for PPDS than others. This study contributes to the growing understanding of peripartum risk factors for postpartum depression, and suggests that early clinical identification of at-risk mothers and early prophylactic and supportive care may be warranted to reduce that risk. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Suicidality among older Australian adults

  • Authors: Klein, Britt , Shandley, Kerrie , McLaren, Suzanne , Clinnick, Lisa , Nguyen, Huy
  • Date: 2023
  • Type: Text , Journal article
  • Relation: Frontiers in Public Health Vol. 10, no. (2023), p.
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  • Description: Background: Vulnerability to suicidality is a concern among older adults, particularly as this proportion of the population is growing. Determining what factors contribute to suicidality will help to create a framework for understanding and assessing suicidal risk among older adults and developing effective treatments. This study examined suicidality among older Australian adults. Methods: This study forms part of a larger study to trial a survey to collect cross-sectional data on the mental and physical health of older Australian adults across time. One hundred and fourteen Australian residents aged 65 years and over completed an anonymous survey online or by returning a paper-and-pencil version of the survey by post. The survey took approximately 25 min to complete and comprised of (1) sociodemographic questions (e.g., age, gender, education), (2) validated questionnaires measuring depression, general anxiety, psychological distress, insomnia, substance dependence, problem gambling, and stress, and (3) mental and physical health and wellbeing items (e.g., religiosity, assistance with daily tasks, and mental health service usage in the last 12-months). The dependent variable, suicidality, was measured by asking participants whether they had ever seriously thought about committing suicide. Results: Associations with suicidality were analyzed using Chi-squares and independent samples t-tests. The results found suicidality to be significantly associated with lower levels of satisfaction with the frequency of seeing and/or communicating with friends, and inadequate levels of community engagement. Conclusion: The results of this survey reinforce the importance of social connectedness as a central and significant protective factor against suicidality among older adults. Copyright © 2023 Klein, Shandley, McLaren, Clinnick and Nguyen.

The first two years of Anxiety Online, an international e-mental health service for the anxiety disorders.

The intergenerational transmission of at-risk/problem gambling : the moderating role of parenting practices

  • Authors: Dowling, Nicki , Shandley, Kerrie , Oldenhof, Erin , Affleck, Julia , Thomas, Shane
  • Date: 2017
  • Type: Text , Journal article
  • Relation: American Journal on Addictions Vol. 26, no. 7 (2017), p. 707-712
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  • Description: Background and Objectives: Although parenting practices are articulated as underlying mechanisms or protective factors in several theoretical models, their role in the intergenerational transmission of gambling problems has received limited research attention. This study therefore examined the degree to which parenting practices (positive parenting, parental involvement, and inconsistent discipline) moderated the intergenerational transmission of paternal and maternal problem gambling. Methods: Students aged 12–18 years (N = 612) recruited from 17 Australian secondary schools completed a survey measuring parental problem gambling, problem gambling severity, and parenting practices. Results: Participants endorsing paternal problem gambling (23.3%) were 4.3 times more likely to be classified as at-risk/problem gamblers than their peers (5.4%). Participants endorsing maternal problem gambling (6.9%) were no more likely than their peers (4.0%) to be classified as at-risk/problem gamblers. Paternal problem gambling was a significant predictor of offspring at-risk/problem gambling after controlling for maternal problem gambling and participant demographic characteristics. The relationship between maternal problem gambling and offspring at-risk/problem gambling was buffered by parental involvement. Discussion and Conclusions: Paternal problem gambling may be important in the development of adolescent at-risk/problem gambling behaviours and higher levels of parental involvement buffers the influence of maternal problem gambling in the development of offspring gambling problems. Further research is therefore required to identify factors that attenuate the seemingly greater risk of transmission associated with paternal gambling problems. Scientific Significance: Parental involvement is a potential candidate for prevention and intervention efforts designed to reduce the intergenerational transmission of gambling problems. (Am J Addict 2017;26:707–712). © 2017 American Academy of Addiction Psychiatry. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Shane Thomas” is provided in this record**

The intergenerational transmission of problem gambling : the mediating role of offspring gambling expectancies and motives

  • Authors: Dowling, Nicki , Oldenhof, Erin , Shandley, Kerrie , Youssef, George , Thomas, Shane
  • Date: 2018
  • Type: Text , Journal article
  • Relation: Addictive Behaviors Vol. 77, no. (2018), p. 16-20
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  • Description: Introduction The risk for developing a gambling problem is greater among offspring who have a problem gambling parent, yet little research has directly examined the mechanisms by which this transmission of problem gambling occurs. For this reason, the present study sought to examine the degree to which children's expectancies and motives relating to gambling explain, at least in part, the intergenerational transmission of problem gambling. Methods Participants (N = 524; 56.5% male) were recruited from educational institutions, and retrospectively reported on parental problem gambling. Problem gambling was measured using the Problem Gambling Severity Index and a range of positive and negative expectancies and gambling motives were explored as potential mediators of the relationship between parent-and-participant problem gambling. Results The relationship between parent-and-participant problem gambling was significant, and remained so after controlling for sociodemographic factors and administration method. Significant mediators of this relationship included self-enhancement expectancies (feeling in control), money expectancies (financial gain), over-involvement (preoccupation with gambling) and emotional impact expectancies (guilt, shame, and loss), as well as enhancement motives (gambling to increase positive feelings) and coping motives (gambling to reduce or avoid negative emotions). All mediators remained significant when entered into the same model. Conclusions The findings highlight that gambling expectancies and motives present unique pathways to the development of problem gambling in the offspring of problem gambling parents, and suggest that gambling cognitions may be potential candidates for targeted interventions for the offspring of problem gamblers. © 2017 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 “Shane Thomas” is provided in this record**

The intergenerational transmission of problem gambling : the mediating role of parental psychopathology

  • Authors: Dowling, Nicki , Shandley, Kerrie , Oldenhof, Erin , Youssef, George , Thomas, Shane
  • Date: 2016
  • Type: Text , Journal article
  • Relation: Addictive Behaviors Vol. 59, no. (2016), p. 12-17
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  • Description: The present study investigated the intergenerational transmission of problem gambling and the potential mediating role of parental psychopathology (problem drinking, drug use problems, and mental health issues). The study comprised 3953 participants (1938 males, 2015 females) recruited from a large-scale Australian community telephone survey of adults retrospectively reporting on parental problem gambling and psychopathology during their childhood. Overall, 4.0% [95%CI 3.0, 5.0] (n = 157) of participants reported paternal problem gambling and 1.7% [95%CI 1.0, 2.0] (n = 68) reported maternal problem gambling. Compared to their peers, participants reporting paternal problem gambling were 5.1 times more likely to be moderate risk gamblers and 10.7 times more likely to be problem gamblers. Participants reporting maternal problem gambling were 1.7 times more likely to be moderate risk gamblers and 10.6 times more likely to be problem gamblers. The results revealed that the relationships between paternal-and-participant and maternal-and-participant problem gambling were significant, but that only the relationship between paternal-and-participant problem gambling remained statistically significant after controlling for maternal problem gambling and sociodemographic factors. Paternal problem drinking and maternal drug use problems partially mediated the relationship between paternal-and-participant problem gambling, and fully mediated the relationship between maternal-and-participant problem gambling. In contrast, parental mental health issues failed to significantly mediate the transmission of gambling problems by either parent. When parental problem gambling was the mediator, there was full mediation of the effect between parental psychopathology and offspring problem gambling for fathers but not mothers. Overall, the study highlights the vulnerability of children from problem gambling households and suggests that it would be of value to target prevention and intervention efforts towards this cohort. © 2016 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 “Shane Thomas” is provided in this record**

The players’ perspective of Reach Out Central: A therapeutic interactive online game

  • Authors: Shandley, Kerrie , Klein, Britt , Austin, David
  • Date: 2008
  • Type: Text , Journal article
  • Relation: Sensoria - A journal of Mind, Brain and Culture. Vol. 4, no. 2 (2008), p.51-55
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  • Description: Therapeutic online games are potentially a valuable way of improving the mental health of young people. The purpose of this paper is to discuss the qualitative component of a formal evaluation conducted on Reach Out Central (ROC), an online game for 16-25 year olds which aims to improve mental health. Participants completing a post-program survey from the evaluation (n=154) were required to respond to two open-ended questions; what they liked most, and least, about ROC. Responses indicate that online games can be a successful way of educating, as well as attracting and engaging, young people. Suggestions are made regarding issues future developers should take into consideration when developing programs of a similar nature..

Therapist-Assisted, Internet-Based Treatment for Panic Disorder: Can General Practitioners achieve comparable patient outcomes to Psychologists?

  • Authors: Shandley, Kerrie , Austin, David , Klein, Britt , Pier, Ciaran , Schattner, Peter , Pierce, David , Wade, Victoria
  • Date: 2008
  • Type: Text , Journal article
  • Relation: Journal of Medical Internet Research Vol. 10, no. 2 (2008), p. 1-15
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  • Description: Background: Mental illness is an escalating concern worldwide. The management of disorders such as anxiety and depression largely falls to family doctors or general practitioners (GPs). However, GPs are often too time constrained and may lack the necessary training to adequately manage the needs of such patients. Evidence-based Internet interventions represent a potentially valuable resource to reduce the burden of care and the cost of managing mental health disorders within primary care settings and, at the same time, improve patient outcomes. Objective: The present study sought to extend the efficacy of a therapist-assisted Internet treatment program for panic disorder, Panic Online, by determining whether comparable outcomes could be achieved and maintained when Panic Online was supported by either GPs or psychologists. Methods: Via a natural groups design, 96 people with a primary diagnosis of panic disorder (with or without agoraphobia) completed the Panic Online program over 12 weeks with the therapeutic assistance of their GP (n = 53), who had received specialist training in cognitive behavioral therapy, or a clinical psychologist (n = 43). Participants completed a clinical diagnostic telephone interview, conducted by a psychologist, and a set of online questionnaires to assess panic-related symptoms at three time periods (pretreatment, posttreatment, and 6 month follow-up). Results: Both treatments led to clinically significant improvements on measures of panic and panic-related symptomatology from pretreatment to posttreatment. Both groups were shown to significantly improve over time. Improvements for both groups were maintained at follow-up; however, the groups did differ significantly on two quality of life domains: physical (F1,82 = 9.13, P = .00) and environmental (F1,82 = 4.41, P = .04). The attrition rate was significantly higher among those being treated by their GP (χ 2 1 = 4.40, P = .02, N = 96). Conclusions: This study provides evidence that Internet-based interventions are an effective adjunct to existing mental health care systems. Consequently, this may facilitate and enhance the delivery of evidence-based mental health treatments to increasingly large segments of the population via primary care systems and through suitably trained health professionals.
  • Description: Background: Mental illness is an escalating concern worldwide. The management of disorders such as anxiety and depression largely falls to family doctors or general practitioners (GPs). However, GPs are often too time constrained and may lack the necessary training to adequately manage the needs of such patients. Evidence-based Internet interventions represent a potentially valuable resource to reduce the burden of care and the cost of managing mental health disorders within primary care settings and, at the same time, improve patient outcomes. Objective: The present study sought to extend the efficacy of a therapist-assisted Internet treatment program for panic disorder, Panic Online, by determining whether comparable outcomes could be achieved and maintained when Panic Online was supported by either GPs or psychologists. Methods: Via a natural groups design, 96 people with a primary diagnosis of panic disorder (with or without agoraphobia) completed the Panic Online program over 12 weeks with the therapeutic assistance of their GP (n = 53), who had received specialist training in cognitive behavioral therapy, or a clinical psychologist (n = 43). Participants completed a clinical diagnostic telephone interview, conducted by a psychologist, and a set of online questionnaires to assess panic-related symptoms at three time periods (pretreatment, posttreatment, and 6 month follow-up). Results: Both treatments led to clinically significant improvements on measures of panic and panic-related symptomatology from pretreatment to posttreatment. Both groups were shown to significantly improve over time. Improvements for both groups were maintained at follow-up; however, the groups did differ significantly on two quality of life domains: physical (F1,82 = 9.13, P = .00) and environmental (F1,82 = 4.41, P = .04). The attrition rate was significantly higher among those being treated by their GP (